Source: http://www.createhealthclinics.org/blog/natural-cycle-ivf/severe-endometriosis/
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Friday, November 30, 2012
Severe endometriosis – successful Natural IVF
Abigail was a 36 year old when she came to us, she had severe endometriosis and she was not able to undergo ovarian stimulation because she suffered from extreme pelvic pain with ovulation and ovarian stimulation could make her endometriosis worse. Her husband’s sperm was normal. She had damaged tubes and needed IVF to help [...]
Experts Weigh in on Preventing and Addressing Obesity
As National Childhood Obesity Awareness Month comes to a close, it’s clear that childhood obesity is an issue supported by communities, parents, schools and community programs around the nation.
Recently, the East Bay Community Foundation partnered with Kaiser Permanente to present the Weight of the Nation—a national public health campaign targeting obesity—at the Council on Foundations’ annual community foundations conference in New Orleans. The East Bay Community Foundation is an important partner in the work to combat obesity in our local communities, and the organization demonstrates how community foundations nationwide can lead collaborative efforts in fighting obesity. In this interview, Nicole Taylor, president and CEO of the East Bay Community Foundation, explains the challenges in Northern California that the East Bay Community Foundation and Kaiser Permanente are working to address.
Although Colorado takes pride in being the leanest state in the nation, the rate of overweight and obesity among children in Colorado is on the rise. In addition, the rate of childhood poverty is rising faster in Colorado than everywhere else in the nation. Children living in poverty are faced with a number of barriers putting them at greater risk for becoming overweight or obese including less access to nutritious foods like whole grains, fruits, and vegetables.
Over the last few years, The Denver Foundation and Kaiser Permanente have both supported a nonprofit aimed at addressing hunger in Colorado. Hunger Free Colorado, formerly known as the Colorado Coalition to End Hunger, is the state’s leading advocate to end hunger. It aims to do this by increasing participation in federal nutrition programs, food stamps, and school breakfast and lunch programs.
In this interview, Barbara Berv, vice president of philanthropic services at The Denver Foundation, speaks about their partnership with Kaiser Permanente and Hunger Free Colorado and the goal of eliminating hunger in Colorado.
The City of New Orleans has been taking bold steps to address obesity and fitness on a local level—most especially for the city’s children. In this recent interview, Dr. Karen DeSalvo, City of New Orleans health commissioner, discusses the Fit NOLA Partnership, which aims to improve fitness levels and combat childhood obesity in New Orleans through a number of innovative, data-driven program and policies. DeSalvo’s vision is that through Fit Nola, New Orleans will become one of the top ten fittest cities in the United States by 2018.
Source: http://centerfortotalhealth.org/2012/experts-weigh-in-on-preventing-and-addressing-obesity/
Simplifying LASIK Basics – Part 1: Starting Points
As we’ve mentioned here before, LASIK has become a household word to anyone relying on glasses or contact lenses for everyday things. There’s no shortage of info out there, and much of it can be confusing, or written like an owner’s manual. At Eye Consultants of Texas, we cover the bases in educating our Dallas/Fort Worth LASIK patients, and try to do this as simply as possible. With that in mind, this is the first in a series of blogs we’ll be posting to highlight the basics of LASIK, in hopes of putting LASIK medical-speak more into simple-speak.
First Things First. LASIK is a simple, painless procedure that can be performed quicker and safer than ever before, mostly thanks to technological advancements. LASIK is also surgery on your eyes, so you owe it to yourself to understand the benefits, risks, and everything else about it. And to choose a skilled doctor who’s on your side.
How Long Has LASIK Been Around? A question to this that often follows is, “how many LASIK procedures have been performed?” To answer this objectively, we’ll go to a reputable source. According to the American Academy of Ophthalmology (AAO), LASIK was first FDA-approved in 1998. Since then, the AAO estimates that nearly 10 million procedures have been performed in the U.S. (an average of 700,000 each year). Worldwide, this number is double by some estimates you might find.
Why Would Someone Get LASIK? People who have LASIK performed are usually those that have to rely on glasses or contact lenses for everyday activities. Sometimes they opt for LASIK so they can see better and look better, or simply because they’re tired of having to wear glasses all the time. Sometimes LASIK may be the best solution if corrective eyewear is no longer doing the trick. Whatever the reason, it’s important that your vision health and overall health checks out, that you’re fully informed, and that you’re over 18 years of age. In other words, you have to be a candidate for LASIK to have it done. If for any reason you’re not, there are other options your doctor can tell you about.
Look for more in our next Simplifying LASIK Basics blog coming soon. Meanwhile, if you’d like to know more about LASIK at Eye Consultants of Texas, please call our office in Grapevine at 877-516-4364, conveniently located to Dallas/Fort Worth.
This blog is a general overview of LASIK surgery for general informational purposes only, and in no way intended as actual medical advice. Always seek a medical or eye care professional for advisement based on your individual health and eye care needs.
So, What Is Presbyopia?
Common signs of presbyopia include:
- Blurry vision when focusing on close-up objects
- Trouble reading small print, especially in low light
- Holding objects far away from the face to see them better
- Headaches
So, why does presbyopia happen? The lens of the eye is responsible for keeping objects in focus. The unique flexibility of the lens allows us to focus on distant objects as well as close-up objects. Presbyopia occurs when this soft lens begins to harden, reducing its flexibility and hindering the eye’s ability to focus on nearby objects.
Thankfully, there are many things we can do about it. Read on to find out a few ways we treat presbyopia today.
Presbyopia Treatments
For some patients, eyeglasses or contact lenses may be enough to combat their presbyopia symptoms. In more serious cases, or for those wishing to avoid corrective lenses, modern ophthalmology offers a few solutions.
Here are two of the most common ways we treat presbyopia today:
- CK Surgery: CK Surgery for Presbyopia, also known as Conductive Keratoplasty, is a non-invasive, non-laser treatment. Instead of a scalpel, a CK procedure uses radio-frequency energy to reshape the cornea and change the way the eye focuses light.
- Presbyopic IOL: A Presbyopic IOL is a replacement lens aimed at total vision correction. These IOLs, such as the ReSTOR® Multifocal Lens, are implanted through a safe procedure similar to that of a cataract patient. Furthermore, presbyopic IOLs have the added benefit of preventing cataracts from developing in the future, as the natural lens is completely replaced.
Ophthalmologist in Winchester
To learn more about presbyopia treatment or to schedule an appointment at our Winchester Ophthalmology Offices, we encourage you to contact us today. We can be reached at (540) 722-6200 and look forward to meeting you soon.
Source: http://www.seeclear.com/blog/presbyopia/so-what-is-presbyopia
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Mayo Clinic study confirms stents are safe for patients allergic to metal
Mayo Clinic researchers have found that cardiac patients who have skin allergies to metals commonly found in jewelry, such as nickel, are at no higher risk for complications if they receive a stent containing these metal components.
Mayo Clinic cardiologist Rajiv Gulati, M.D., Ph.D., and colleagues studied a total of 29 patients with a history of skin allergies to stent metal components who subsequently underwent coronary stent implantation. The research team compared clinical outcomes with a matched control group of 250 non- metal allergic patients who received similar stents. In addition to following the study patients’ outcomes in the long term, the team reviewed blood to look for signs of allergic reactions.
The study was recently published in Circulation: Cardiovascular Interventions.
Authors: Santiago Romero-Brufau, Patricia J.M. Best, M.D., David R. Holmes Jr, M.D., Verghese Mathew, M.D., Mark D.P. Davis, M.D., Gurpreet S. Sandhu, M.D., Ph.D., Ryan J. Lennon, M.S., Charanjit S. Rihal, M.D., M.B.A. and Rajiv Gulati, M.D., Ph.D.
Top 5 Myths of Glaucoma
Now that you have a basic understanding of glaucoma, let’s clear up a few of the most common myths surrounding this serious condition.
Here are the top 5 myths of glaucoma:
1. Myth: Glaucoma is rare.
Fact: On the contrary, it has been estimated that over 2 million Americans are suffering from glaucoma. Even more disturbing is the fact that glaucoma remains a leading cause of blindness in the US.
2. Myth: Only patients with a family history can develop glaucoma.
Fact: Although certain factors like age and heredity can increase your chances of developing glaucoma, the condition can affect anyone, anywhere and at any age.
3. Myth: Glaucoma cannot be treated.
Fact: While there is currently no cure, there are a host of Glaucoma Treatments aimed at minimizing the risk of permanent vision loss. These treatments include medications, eye drops and surgery.
4. Myth: Only patients with glaucoma symptoms should get checked out.
Fact: The majority of glaucoma patients do not experience any symptoms before the optic nerve actually becomes damaged. For this reason, regular glaucoma screenings are vitally important.
5. Myth: Glaucoma screenings are painful.
Fact: Glaucoma screenings test different things—visual field, pressure in the eye, etc. Each of these tests are not only quick, but non-painful.
Get Checked! Schedule a Glaucoma Screening Today
To schedule a glaucoma screening or to learn about any of the ophthalmology services we offer, we encourage you to contact us today. Our offices are located in Winchester, serving Virginia, West Virginia and Maryland. Book your appointment at (540) 722-6200. We look forward to seeing you.
Source: http://www.seeclear.com/blog/glaucoma/top-5-myths-of-glaucoma
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Dr. Bruce Alpert, DC , Flushing, NY, 11355
Website Address:
Phone:
(718) 463-0006
Fax:
718-460-2936
Source: http://www.spine-health.com/doctor/chiropractor/bruce-alpert-flushing-ny
Thursday, November 29, 2012
Is LASIK Right for Me?
Not sure where to look? To get you started, here are a few questions to ask yourself:
- Are you in good health? Good candidates for LASIK are healthy and free of autoimmune disorders such as Lupus, HIV and muscular sclerosis.
- Do you have any eye conditions? Certain eye conditions are not compatible with laser eye surgery. Often, these include cataracts, chronic corneal infections or keratoconus.
- Are you the right age? In the US, LASIK is FDA approved for patients over the age of 18. On the other hand, if you’re worried you’re too old for a LASIK procedure, consider this: Reporting on a recent study on LASIK in older patients, WebMD explains that, “Patients in their 60s were just as likely to have good [LASIK] outcomes as those in their 40s and 50s.”
- Is your dependence on glasses or contacts holding you back? For many patients, reducing their dependence on glasses and contact lenses is a major reason they’re exploring LASIK in the first place. A lot of folks find glasses and contacts to be uncomfortable, inconvenient and unattractive. And, while it can’t guarantee that you’ll never need to put on a pair of glasses again, LASIK will very often reduce a patient’s dependence on them.
- Are you ready to learn more? Finally, a good LASIK candidate is an informed LASIK candidate. Be sure to understand the potential risks and benefits of the procedure, maintain realistic expectations, and most importantly, schedule a consultation with a qualified LASIK surgeon.
Schedule a LASIK Consultation Today
To learn more about laser eye surgery, don’t hesitate to contact us today. Together, we can find the best treatment options for you. Our offices are located in Winchester, serving Virginia, West Virginia and Maryland. Book your appointment at (540) 722-6200.
Source: http://www.seeclear.com/blog/lasik/is-lasik-right-for-me
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Welcome to Our Blog
Hello and welcome to the blog for Grochmal Eye Center! We’ve created this resource to assist our patients who are considering vision correction. Our goal is to provide you with information about the latest technology and procedures in vision care. Our blog will also serve as a forum for patients to learn about their surgical options from our Baltimore, Maryland Ophthalmologist, Dr. Jay C. Grochmal.
Source: http://www.grochmaleye.com/uncategorized/hello-world/
Medicare And Medicaid Overpayment Suit Upheld
Whistleblowers, Lucas Matheny (“Matheny”) and Deborah Loveland (“Loveland”), brought an action against Medco Health Solutions (“Medco”) claiming that Medco and its subsidiaries failed to report and refund to the federal government $69 million in Medicare and Medicaid overpayments. The plaintiffs, former employees of Medco, used the authority of the False Claims Act to bring their lawsuit. The False Claims Act allows private individuals to sue an entity on their own and the government’s behalf. In doing so, the individuals receive compensation for being a “whistleblower”, which is usually between 15% and 25% of the funds recovered, including reasonable expenses, attorney fees and costs.
Matheny and Loveland knew of the overpayments to Medco, but were told that because of insufficient manpower to process the necessary forms, the overpayments would not be refunded to the government. Matheny and Loveland claimed the overpayments were transferred to fictitious patient accounts and perfect records with a zero percent error rate were created using a specific computer program. In addition, Medco filed a false certificate of compliance with the government, knowingly concealing millions of dollars in overpayments.
When the lawsuit was first heard by the court, it was dismissed, due to the court noting that the plaintiffs’ complaint had been amended three times and failed to state a claim. However, on appeal, the court concluded that Matheny and Loveland had sufficiently alleged the existence of a false record. Additionally, the court held that the defendants (Medco) knew the records were false and were to be used to avoid a financial obligation to the government.
The Matheny v. Medco Health Solutions matter is a prime example for healthcare providers to be careful with potential overpayments and how to handle those overpayments should they occur.
Source: http://www.pagingdrblog.com/2012/07/09/medicare-and-medicaid-overpayment-suit-upheld/
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Medicare Star Quality Ratings Released
The Centers for Medicare & Medicaid Services recently announced that of 563 Medicare Advantage plans rated nationwide, only 11 Medicare health plans with prescription drug benefit earned 5 stars for 2013 — the highest overall rating for quality and service.
Each year through the Medicare Star Quality Ratings system, CMS rates Medicare health plans (both parts C and D) on a scale of 1 to 5 stars, with 5 stars representing the highest quality. The overall scores are based on more than 50 care and service quality measures across five categories, including staying healthy, managing chronic conditions, member satisfaction, customer service and pharmacy services.
In addition to receiving high-quality care and service, 5-star excellence means that Medicare beneficiaries may enroll in a 5-star plan from Dec. 8, 2012, to Nov. 30, 2013, without having to wait until the next annual enrollment period.
Leading the nation with six of the 11 Medicare health plans earning 5 stars was Kaiser Permanente. The Kaiser Permanente 5-star Medicare plans are those operating in California, the Northwest, Hawaii, Colorado, Ohio and the Mid-Atlantic States. Kaiser Permanente’s Georgia region is the top-rated plan in its area with 4.5 stars.
Medicare beneficiaries can learn more about the Medicare Star Quality Ratings by visiting kp.org/medicarestars or medicare.gov, or by calling 1-800-MEDICARE (1-800-633-4227).
Source: http://centerfortotalhealth.org/2012/medicare-star-quality-ratings-released/
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Baltimore Laser Eye Surgeon Discusses the Future of Advanced Cataract Surgery
Cataract Surgeon in Baltimore Discusses the Future of Advanced Procedures
Baltimore, MD — According to the latest statistics from the American Academy of Ophthalmology (AAO), cataracts affect nearly 22 million Americans age 40 and older. However, Dr. Jay C. Grochmal, a LASIK and cataract surgeon in Baltimore, says with the recent advancements in cataract surgery, patients do not have to let blurring vision hinder their daily life. Dr. Grochmal discusses the latest innovations in refractive-cataract surgery and how they can benefit patients looking to improve their vision.
At his Baltimore cataract surgery practice, Dr. Grochmal says the aging baby boomer population has brought an influx of patients needing vision correction for cataracts and other age-related conditions. Cataracts develop as people get older and are exhibited in a clouding and opaqueness of the natural lens inside one’s eye, causing vision to blur. The AAO report also shows that by age 80, more than half of all Americans will have visually significant cataracts. Dr. Grochmal says while cataracts can be a bothersome medical issue, the good news is that advancements in ophthalmology and surgical techniques have made clear vision an affordable and effective option through cataract surgery.
With procedures such as laser refractive cataract surgery on the horizon, Dr. Grochmal says treatment is now ultimately safer than ever before and more successful in helping patients achieve improved vision with less dependence on glasses. He says other innovations have helped create smaller incisions for lens extraction and replacement during cataract surgery, and through technology such as the Zeiss IOL Master, doctors can better measure the power of the intraocular lenses and offer more accurate visual results. “With the safety of cataract surgery improving, patients no longer have to wait for their vision to drastically deteriorate before undergoing cataract surgery. Also, the quality of newer IOL’s are allowing excellent vision after surgery,” says Dr. Grochmal.
Thanks to a diverse arsenal of lenses such as toric and multifocal IOL’s, Dr. Grochmal says patients can now enjoy the benefits of custom treatment for their individual eye condition and lifestyle needs. Whether patients wish to enhance their vision up close or far away or find a balance of clarity in both distance and near vision, he says there is a solution for every patient’s desires. Dr. Grochmal says cataract surgery recovery is now also much quicker and requires less trauma to the function of one’s eye. “With such small incisions now possible and the availability of toric IOL’s, post operative astigmatism can be minimized if not completely corrected,” he says.
Regardless of whether patients are looking for cataract surgery or another vision correction procedure such as LASIK in Baltimore, Dr. Grochmal says the advancements in ophthalmology are making significant strides towards helping people attain perfect, lasting eyesight. He adds that he is excited to see the further development of patient comfort and care and hopes patients continue to take advantage of the benefits that procedures like cataract surgery can offer.
About Jay C. Grochmal, MD
Dr. Jay C. Grochmal received his medical degree from the University of Maryland, after which he completed a rotating internship at the U.S. Public Health Hospital in Baltimore. He also completed a residency in the Department of Ophthalmology at the Greater Baltimore Medical Center, where he was Chief Resident. A member of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery, Dr. Grochmal has participated in several medical mission trips to offer his experience and skills in vision correction to patients in Pakistan, Jamaica, and the Bahamas. He is currently on staff with the Greater Baltimore Medical Center and St. Agnes Hospital. He is the medical director at the Snowden River Surgery Center.
Located at 405 Frederick Rd, Suite 102 in Baltimore, MD, Dr. Grochmal’s practice can be reached at (410) 697-4090. He can also be contacted online via the website grochmaleye.com or facebook.com/grochmaleye.
Contact:
Rosemont Media
Aaron Hurst
aaron@rosemontmedia.com
(858) 200-0044
www.rosemontmedia.com
###
A nurse practitioner-directed intervention improves the quality of life of patients with metastatic cancer
Gerardo Colon-Otero, M.D., with the Department of Hematology/Oncology at Mayo Clinic in Florida, discusses results of a randomized pilot study that show that an intervention that explains the benefits of hospice and addresses advanced directives early in the course of treatment leads to measurable improvement in the patient’s emotional and mental quality of life (QoL).
The study was published in the Journal of Palliative Medicine online ahead of print on May 4, 2012.
ABSTRACT
Background
There is a paucity of randomized studies evaluating the value of palliative interventions on a prospective basis in newly diagnosed oncology patients. We sought to prospectively evaluate quality of life (QoL) outcomes in advanced cancer patients who received discussion-based palliative care interventions from an advanced registered nurse practitioner (ARNP) integrated into the oncology team, and compare these outcomes with a control population.
Methods
Patients with metastatic cancer were randomized to standard care or an ARNP-directed intervention that included discussions of the benefits of hospice, discussions on living wills and advanced directives (Five Wishes document) along with an assessment of QoL. Relevant endpoints included change from baseline QoL and improvement in hospice knowledge.
Results
From Nov. 13, 2008, through July 28, 2009, 26 patients were accrued at the Mayo Clinic in Jacksonville, Fla. The study closed early due to published data demonstrating the benefits of early palliative care interventions in the management of metastatic cancer patients. Statistically significant improvements from baseline were noted in emotional and mental QoL assessments in the intervention group that were not seen in the control group. Patients found it useful to have the living will and Five Wishes documents offered as part of the ARNP intervention.
Conclusions
An ARNP-directed intervention that explains the benefits of hospice and addresses advanced directives early in the course of metastatic cancer patients’ treatment is well-received by the patients and their relatives and leads to measurable improvement in the patient’s emotional and mental QoL.
Authors
Gerardo Colon-Otero, M.D., Stephen H. Dyar, Jr., M.D., Mary M. Lesperance, A.R.N.P., Robert P. Shannon, M.D., Jeff A. Sloan, Ph.D.
Clinical trials at Mayo Clinic
Metastatic cancer, to bone
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Baltimore Laser Eye Surgeon Discusses the Future of Advanced Cataract Surgery
Cataract Surgeon in Baltimore Discusses the Future of Advanced Procedures
Baltimore, MD — According to the latest statistics from the American Academy of Ophthalmology (AAO), cataracts affect nearly 22 million Americans age 40 and older. However, Dr. Jay C. Grochmal, a LASIK and cataract surgeon in Baltimore, says with the recent advancements in cataract surgery, patients do not have to let blurring vision hinder their daily life. Dr. Grochmal discusses the latest innovations in refractive-cataract surgery and how they can benefit patients looking to improve their vision.
At his Baltimore cataract surgery practice, Dr. Grochmal says the aging baby boomer population has brought an influx of patients needing vision correction for cataracts and other age-related conditions. Cataracts develop as people get older and are exhibited in a clouding and opaqueness of the natural lens inside one’s eye, causing vision to blur. The AAO report also shows that by age 80, more than half of all Americans will have visually significant cataracts. Dr. Grochmal says while cataracts can be a bothersome medical issue, the good news is that advancements in ophthalmology and surgical techniques have made clear vision an affordable and effective option through cataract surgery.
With procedures such as laser refractive cataract surgery on the horizon, Dr. Grochmal says treatment is now ultimately safer than ever before and more successful in helping patients achieve improved vision with less dependence on glasses. He says other innovations have helped create smaller incisions for lens extraction and replacement during cataract surgery, and through technology such as the Zeiss IOL Master, doctors can better measure the power of the intraocular lenses and offer more accurate visual results. “With the safety of cataract surgery improving, patients no longer have to wait for their vision to drastically deteriorate before undergoing cataract surgery. Also, the quality of newer IOL’s are allowing excellent vision after surgery,” says Dr. Grochmal.
Thanks to a diverse arsenal of lenses such as toric and multifocal IOL’s, Dr. Grochmal says patients can now enjoy the benefits of custom treatment for their individual eye condition and lifestyle needs. Whether patients wish to enhance their vision up close or far away or find a balance of clarity in both distance and near vision, he says there is a solution for every patient’s desires. Dr. Grochmal says cataract surgery recovery is now also much quicker and requires less trauma to the function of one’s eye. “With such small incisions now possible and the availability of toric IOL’s, post operative astigmatism can be minimized if not completely corrected,” he says.
Regardless of whether patients are looking for cataract surgery or another vision correction procedure such as LASIK in Baltimore, Dr. Grochmal says the advancements in ophthalmology are making significant strides towards helping people attain perfect, lasting eyesight. He adds that he is excited to see the further development of patient comfort and care and hopes patients continue to take advantage of the benefits that procedures like cataract surgery can offer.
About Jay C. Grochmal, MD
Dr. Jay C. Grochmal received his medical degree from the University of Maryland, after which he completed a rotating internship at the U.S. Public Health Hospital in Baltimore. He also completed a residency in the Department of Ophthalmology at the Greater Baltimore Medical Center, where he was Chief Resident. A member of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery, Dr. Grochmal has participated in several medical mission trips to offer his experience and skills in vision correction to patients in Pakistan, Jamaica, and the Bahamas. He is currently on staff with the Greater Baltimore Medical Center and St. Agnes Hospital. He is the medical director at the Snowden River Surgery Center.
Located at 405 Frederick Rd, Suite 102 in Baltimore, MD, Dr. Grochmal’s practice can be reached at (410) 697-4090. He can also be contacted online via the website grochmaleye.com or facebook.com/grochmaleye.
Contact:
Rosemont Media
Aaron Hurst
aaron@rosemontmedia.com
(858) 200-0044
www.rosemontmedia.com
###
Wednesday, November 28, 2012
Simplifying LASIK Basics – What’s Involved
Welcome to the second in our Simplifying LASIK Basics series. In this edition, we’ll highlight what the procedure’s like and types of LASIK in a way that should keep it simple. Hopefully it can help you determine what types of questions to ask your doctor as part of your decision to have LASIK performed.
What’s The Procedure Like? Although there’s more to it than this, here are the basics. Big Picture: Laser technology reshapes your cornea so things look sharper and clearer. Who It’s For: Mainly for anyone who is nearsighted, farsighted or has astigmatism. What Happens: A “flap” is created in the cornea, then the flap is gently lifted and folded back, and the cornea is reshaped using laser pulses to correct focusing problems in the eye. On average, it takes approximately 5 minutes, and may take slightly longer if your vision problems are more severe.
Types Of LASIK. Essentially, there are three basic types of LASIK, each designed to do what LASIK is supposed to do – help you see better, possibly better than you ever have with less dependency on glasses or contact lenses. You may have seen types of LASIK referred to this way: Conventional LASIK, Wavefront-Optimized LASIK, and Wavefront-Guided LASIK (also called Custom LASIK).
Which Type Of LASIK Is Best? Different doctors may use different types for different reasons. At Eye Consultants of Texas, we use a system based on Custom LASIK. It brings together two highly advanced technologies for a procedure branded “iLASIK.” Dr. Labor selected this after careful evaluation, mainly because it has proven to be more efficient and successful than other LASIK technologies he has used. But also, because of what it was designed to do – give the surgeon more control in customizing the procedure to each patient’s eye to get the best results. While the technology itself is extremely important, it’s even more important that your doctor has the skill and expertise to use it! Having been the first in the U.S., Texas, or locally to perform new procedures, Dr. Labor does his homework, and trains extensively on new technologies and advancements before ever putting them to use.
Until our next Simplifying LASIK Basics blog, if you’d like to know more about LASIK at Eye Consultants of Texas, please call our office in Grapevine at 877-516-4364. We’re conveniently located to Dallas/Fort Worth.
This blog is a broad overview of LASIK surgery for general informational purposes only. In no way is it intended as actual medical advice. Always seek a medical or eye care professional for advisement based on your individual health and specific eye care needs.
New e-edition newsletter delivers Cancer Center research information quarterly
Forefront is a complimentary magazine from the Mayo Clinic Cancer Center, a National Cancer Institute-designated cancer center located in Arizona, Florida and Minnesota. The Cancer Center specializes in translational research and the effort to discover better ways to prevent, detect and treat cancer. It serves diverse patient populations across a broad geographic area and collaborates across the full spectrum of cancer research, from basic biology to treatment.
Email edition available
Forefront articles highlight Mayo Clinic’s cancer research and its translation into clinical advances. Forefront is published in print and online annually, but beginning in summer 2012 a complimentary quarterly email edition will also be available. Subscribers to the email version receive:
- A personal message from Robert B. Diasio, M.D., Cancer Center director
- Updates about research conducted by Cancer Center scientists and physicians
- A regular column that features and discusses Cancer Center statistics
- Stories about patients whose lives were impacted by Cancer Center research
- Administrative updates on the Cancer Center’s ongoing efforts to ensure that the needs of the patient come first
Subscribe to Forefront today
Receive complimentary, quarterly emailed news and information from the Mayo Clinic Cancer Center.
Clinical trials at Mayo Clinic
Cancer
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Federal Government Questions Legality Of Certain ASC-Service Provider Arrangements
Recently, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued an advisory opinion regarding two types of Proposed Arrangements between an anesthesia provider (AP) and physician-owned ambulatory surgery centers (ASCs). This came as a result of a request for an opinion from an AP who, because of competitive market pressures, was considering one of two new business relationship models. Under the AP’s current professional arrangement, the ap offers exclusive anesthesia services to ASCs, employs personnel to meet the anesthesia needs of the ASCs, and independently bills patients and third party payors, including Medicare, for professional fees. The ASCs bill the same parties for professional services plus a facility fee for materials and ancillary staff.
- Under Proposed Arrangement A, the AP would continue to provide exclusive anesthesia services to the ASC and to bill independently. Additionally, the AP would pay a market value “management services” fee to the ASC for each non-Federally funded patient. The ASC would both collect this fee and continue to charge a facility fee to Federal and third party payors.
- Under Proposed Arrangement B, the ASC physician-owners would set up a separate subsidiary to exclusively provide anesthesia services to their patients. The subsidiary then would hire the AP as the exclusive independent anesthesia services contractor, handle all billing with the assistance of the AP and its staff, pay the AP out of fees collected, and retain any profits.
In analyzing the legality of the two arrangements, the OIG considered two questions: 1. Does either arrangement violate the Federal anti-kickback statute, and, 2. Would any safe harbor protection apply?
Under the anti-kickback statute, it is a criminal offense to offer, pay, solicit, or receive any remuneration for referrals reimbursable by a Federal health care program. This statute seeks to ensure that referrals are based on sound medical judgment and not financial or other incentives. Regarding Proposed Arrangement A, although the AP would pay a management services fee only for non-Federal health care program patients, this does not reduce the risk that the fee might be paid by the AP to induce referrals from the ASC of all types of patients. Additionally, the arrangement allows the ASC to be paid twice for the same services, and this could unduly influence the ASC to select the AP as the exclusive provider. The OIG concluded that Proposed Arrangement A could violate the anti-kickback statute. No safe harbor protections apply.
Safe harbor protections for ASCs, employment, and personal services and management contracts were determined to not apply to Proposed Arrangement B. The Subsidiary does not qualify as a Medicare-certified ASC because it would not provide surgical services, only anesthesia services. As such, its income and the profits distributed to the ASC physician-owners would not be protected by any safe harbor provisions. Additionally, the OIG is concerned about exclusive arrangements between those who refer business (the ASC physician-owners), and those who furnish goods or services reimbursed by a Federal health care program (the AP). The AP and the ASC physician-owners both would benefit financially in Proposed Arrangement B, with the AP receiving its negotiated rate and the physician-owners receiving residual profits from the subsidiary after expenses and payment to the AP. The OIG concluded that Proposed Arrangement B would permit the physician-owners to receive compensation in the form of profits from the subsidiary from referring patients to the AP; this payment would be for services that they themselves could not provide. The more than minimal risk of fraud and abuse and the prohibited remuneration both would be in violation of the Federal anti-kickback statute.
Physicians should be aware of this development, as it may affect current and future professional relationships. A health care attorney can offer assistance in interpreting the potential impact of the OIG decision and evaluating the need to restructure business arrangements.
Private Practice Or Hospital Employment?
According to data released by Medscape Medical News, physician employment by hospitals has increased since 2000. This increase is partly due to the protection that working for a large entity affords a physician. Many physicians feel that they can truly focus upon their specialized field by working in a hospital environment, as opposed to opening a private practice.
Working for a hospital relieves the physician of trying to keep up with complex private health care insurance and government regulations, investing in medical equipment and technology, marketing and HR issues. While owning a private practice gives a physician more independence and the physician is not constrained by the hospital’s policies or procedures, the private-practice physician must be concerned with all the business issues, which could be undertaken by a hospital employer.
It seems the current trend is leaning toward more physicians choosing to work for a hospital, with the private-practice physician becoming rare. But, as Uwe Reinhardt, Ph.D., a healthcare economist at Princeton University, told Medscape, “Don’t forget, there are cycles. Some years from now, there will be a whole new trend. Physicians working in hospitals will see what is profitable and what is not, and will jump out and establish practices in the profitable things.”
Meiselman, Denlea, Packman, Carton & Eberz P.C. offers legal advice to physicians on medical issues. If you need legal assistance or guidance on a matter regarding your practice, please call our office.
Source: http://www.pagingdrblog.com/2012/04/12/private-practice-or-hospital-employment/
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Private Practice Or Hospital Employment?
According to data released by Medscape Medical News, physician employment by hospitals has increased since 2000. This increase is partly due to the protection that working for a large entity affords a physician. Many physicians feel that they can truly focus upon their specialized field by working in a hospital environment, as opposed to opening a private practice.
Working for a hospital relieves the physician of trying to keep up with complex private health care insurance and government regulations, investing in medical equipment and technology, marketing and HR issues. While owning a private practice gives a physician more independence and the physician is not constrained by the hospital’s policies or procedures, the private-practice physician must be concerned with all the business issues, which could be undertaken by a hospital employer.
It seems the current trend is leaning toward more physicians choosing to work for a hospital, with the private-practice physician becoming rare. But, as Uwe Reinhardt, Ph.D., a healthcare economist at Princeton University, told Medscape, “Don’t forget, there are cycles. Some years from now, there will be a whole new trend. Physicians working in hospitals will see what is profitable and what is not, and will jump out and establish practices in the profitable things.”
Meiselman, Denlea, Packman, Carton & Eberz P.C. offers legal advice to physicians on medical issues. If you need legal assistance or guidance on a matter regarding your practice, please call our office.
Source: http://www.pagingdrblog.com/2012/04/12/private-practice-or-hospital-employment/
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MHC Partners with the South Memphis Alliance to provide free HIV & Syphilis Screening!
will provide free HIV & SYPHILIS TESTING
WEDNESDAY, JUNE 27, 2012
10:00 AM – 2:00 PM
360 E. H. Crump Blvd.
FREE REFRESHMENTS, & GIVE A-WAYS WHILE SUPPLIES LAST
Tuesday, November 27, 2012
Safety Of Medical Implants Questionable
Millions of Americans receive medical implants yearly and those who do presume that the implants are safe and will alleviate, or at least help to ease, their specific medical problem. However, according to a May 2012 article in Consumer Reports, “Dangerous Devices”, most implants (artificial joints, defibrillators, surgical mesh) have not been tested for safety and effectiveness. The “testing” is done on the patient who has the medical device implanted. In other words, patients are living with implants that often times give them more pain and suffering than not having had the implant at all. According to the article, the FDA is not testing medical devices and most times all that is needed for the device to be placed on the market is for the manufacturers to “. . . file some paperwork and pay the Food and Drug Administration a user fee of roughly $4,000 to start selling a product that can rack up millions of dollars in revenue. . . .” Frequently, it takes years before the FDA even tests a product or reclassifies it to a high-risk category.
It is crucial for doctors, as well as their patients, to research a medical implant thoroughly before implantation, as the consequences can be debilitating. An orthopedic surgeon, for example, who had an all-metal hip replacement (the same type of device he implanted in his patients) experienced medical issues of increased chromium and cobalt levels in blood, sleep disturbance, constant pain, mood swings and anxiety, hearing loss, tinnitus, and visual problems.
Meiselman, Denlea, Packman, Carton & Eberz P.C. offers legal advice to physicians on medical issues. If you need legal assistance or guidance on a matter regarding your practice, please call our office.
Source: http://www.pagingdrblog.com/2012/05/08/safety-of-medical-implants-questionable/
The 7 Steps To Amazing Health
We are excited to announce that Dr. Wendy Schauer, D.C., the author of, “The 7 Steps To Amazing Health” will be a featured guest today for Jim Edwards from 7 Day eBook and I Gotta Tell You. Jim will be interviewing Wendy on her book and how she came to write it.
As soon as the interview is available we will be sure to post it here.
Yours In Health!
G.E. Moon II
Source: http://www.abundanthealthcenter.com/blog/the-7-steps-to-amazing-health
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Mayo Clinic study finds that cardiac rehab reduces mortality by 45 percent
Randal J. Thomas, M.D., director of Mayo Clinic’s Cardiovascular Health Clinic, and colleagues found that patients who participate in cardiac rehabilitation after having heart interventions such as angioplasty, stents and clot-busting drugs have a 45 percent lower mortality rate.
The research team studied data from more than 2,300 patients between 1994 and 2008, and recently published the results in Circulation.
Only about 40 percent of patients in the study participated in cardiac rehabilitation. These findings are particularly important for interventional cardiologists, Dr. Thomas says, because encouraging patients to pursue cardiac rehab after their procedure can potentially save more lives than previously thought.
Authors: Kashish Goel, M.B.B.S.; Ryan J. Lennon, M.S.; R. Thomas Tilbury, M.D.; Ray W. Squires, PhD; Randal J. Thomas, M.D., M.S.
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A nurse practitioner-directed intervention improves the quality of life of patients with metastatic cancer
Gerardo Colon-Otero, M.D., with the Department of Hematology/Oncology at Mayo Clinic in Florida, discusses results of a randomized pilot study that show that an intervention that explains the benefits of hospice and addresses advanced directives early in the course of treatment leads to measurable improvement in the patient’s emotional and mental quality of life (QoL).
The study was published in the Journal of Palliative Medicine online ahead of print on May 4, 2012.
ABSTRACT
Background
There is a paucity of randomized studies evaluating the value of palliative interventions on a prospective basis in newly diagnosed oncology patients. We sought to prospectively evaluate quality of life (QoL) outcomes in advanced cancer patients who received discussion-based palliative care interventions from an advanced registered nurse practitioner (ARNP) integrated into the oncology team, and compare these outcomes with a control population.
Methods
Patients with metastatic cancer were randomized to standard care or an ARNP-directed intervention that included discussions of the benefits of hospice, discussions on living wills and advanced directives (Five Wishes document) along with an assessment of QoL. Relevant endpoints included change from baseline QoL and improvement in hospice knowledge.
Results
From Nov. 13, 2008, through July 28, 2009, 26 patients were accrued at the Mayo Clinic in Jacksonville, Fla. The study closed early due to published data demonstrating the benefits of early palliative care interventions in the management of metastatic cancer patients. Statistically significant improvements from baseline were noted in emotional and mental QoL assessments in the intervention group that were not seen in the control group. Patients found it useful to have the living will and Five Wishes documents offered as part of the ARNP intervention.
Conclusions
An ARNP-directed intervention that explains the benefits of hospice and addresses advanced directives early in the course of metastatic cancer patients’ treatment is well-received by the patients and their relatives and leads to measurable improvement in the patient’s emotional and mental QoL.
Authors
Gerardo Colon-Otero, M.D., Stephen H. Dyar, Jr., M.D., Mary M. Lesperance, A.R.N.P., Robert P. Shannon, M.D., Jeff A. Sloan, Ph.D.
Clinical trials at Mayo Clinic
Metastatic cancer, to bone
Monday, November 26, 2012
Cost of LASIK versus glasses or contacts
Since the first LASIK technology was FDA-approved, well over a decade ago, LASIK has gone from little known treatment to household name. If you’ve depended on glasses or contacts for most of your life, chances are that you’re familiar with LASIK’s benefits. Our LASIK patients across Dallas/Fort Worth certainly come to us more savvy about this procedure than ever before.
There are the obvious benefits. LASIK is a simple procedure that can add years of improved vision. However, although LASIK is elective (and not covered by insurance), there can be cost benefits as well. On average, LASIK can actually cost less than wearing glasses or contacts over time. Naturally, this can depend on things like how often you have to buy contacts or change your prescription; related doctor visits, and the age you have LASIK performed.
Costs can vary between patients, depending on what is actually required. This is where a thorough eye exam becomes so important. It ensures you’re a LASIK candidate, and helps to pinpoint what needs to be done. More importantly, it takes your vision and overall health into consideration, and allows our doctors to give you the full story.
To get a basic idea of costs versus glasses or contacts, click on the iLASIK Calculator on our LASIK page. To learn more or to set up an appointment, please call our Metro Dallas offices in Grapevine at 877-516-4364.
Source: http://www.eyectexas.com/blog/cost-of-lasik/
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Congressman Steve Cohen Announces MHC to Receive $3.1m in New Funding
COHEN ANNOUNCES $3.1 MILLION IN NEW FEDERAL FUNDS FOR MEMPHIS HEALTH CENTER
MEMPHIS, TN – Congressman Steve Cohen (TN-09) today announced the Memphis Health Center will receive $3,133,617 in new federal funds from the U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) Division of Grants Management Operations so the facility can continue providing health services to the local community.
“The Memphis Health Center is a wonderful organization that provides invaluable health resources throughout Memphis,” said Congressman Cohen. “These new federal funds will help keep the Memphis Health Center going strong so more people throughout the city can receive the health care they need.”
The new federal funds are being awarded under the Health Center Cluster competing continuation grant program. The overall purpose of the health center continuation grant is to provide financial assistance to health centers to support the continued provision of comprehensive primary health care services to an underserved area or population.
The health center continuation grant supports the continued operation of a health center for the provision of required comprehensive primary, preventive, enabling and additional health care services including oral health care, mental health care and substance abuse services as appropriate, either directly on-site or through established arrangements without regard to ability to pay.
Narcotic Drugs for the Treatment of Chronic Pain: A Double Edged Sword
Over the past 10 years, the use of narcotic pain killers to treat chronic pain - in particular chronic low back pain - has risen steeply.
In the past, usage of narcotics was limited to acute situations of severe pain (i.e. trauma or post-surgical pain) because of the potential risk of addiction.
Source: http://www.spine-health.com/blog/narcotic-drugs-treatment-chronic-pain-double-edged-sword
One thousand patients with primary myelofibrosis: The Mayo Clinic experience
Ayalew Tefferi, M.D., with the Department of Hematology at Mayo Clinic in Rochester, Minn., discusses the results of a study of 1,000 patients who have primary myelofibrosis.
Key findings
Researchers found that when patients with myelofibrosis present, their clinical features are not at a steady state and usually progress within the first few months of the diagnosis. It is best to wait a several months before providing a prognostic score.
Many patients with primary myelofibrosis can live a long life (exceeding 15 years) and patients who won’t live that long can be identified.
The most recent version of DIPSS-plus scoring system performed much better than prior versions, helping researchers to determine what proportion of patients with myelofibrosis are suitable for therapies. More than 50 percent of patients require observation alone.
A description of the study is included in the January 2012 issue of Mayo Clinic Proceedings.
ABSTRACT
Objective
To share our decades of experience with primary myelofibrosis and underscore the importance of outcomes research studies in designing clinical trials and interpreting their results.
Patients and methods
One thousand consecutive patients with primary myelofibrosis seen at Mayo Clinic between Nov. 4, 1977, and Sept. 1, 2011, were considered.
The International Prognostic Scoring System (IPSS), dynamic IPSS (DIPSS), and DIPSS-plus were applied for risk stratification. Separate analyses were included for patients seen at time of referral (N=1000), at initial diagnosis (N=340), and within or after 1 year of diagnosis (N=660).
Results
To date, 592 deaths and 68 leukemic transformations have been documented. Parameters at initial diagnosis vs time of referral included:
- Median age (66 vs 65 years)
- Male sex (61% vs 62%)
- Red cell transfusion need (24% vs 38%)
- Hemoglobin level less than 10 g/dL (38% vs 54%)
- Platelet count less than 100 × 109/L (18% vs 26%)
- Leukocyte count more than 25 × 109/L (13% vs 16%)
- Marked splenomegaly (21% vs 31%)
- Constitutional symptoms (29% vs 34%)
- Abnormal karyotype (31% vs 41%)
Mutational frequencies were 61% for JAK2V617F, 8% for MPLW515, and 4% for IDH1/2.
DIPSS-plus risk distributions at time of referral were 10% low, 15% intermediate-1, 37% intermediate-2, and 37% high. The corresponding median survivals were 17.5, 7.8, 3.6, and 1.8 years vs 20.0, 14.3, 5.3, and 1.7 years for patients younger than 60 years of age.
Compared with both DIPSS and IPSS, DIPSS-plus showed better discrimination among risk groups. Five-year leukemic transformation rates were 6% and 21% in low- and high-risk patients, respectively.
Conclusion
The current document should serve as a valuable resource for patients and physicians and provides context for the design and interpretation of clinical trials.
AUTHORS
Ayalew Tefferi, M.D., Terra L. Lasho, M.T., Thitina Jimma, M.D., Christy M. Finke, B.S., Naseema Gangat, MBBS, Rakhee Vaidya, MBBS , Kebede Hussein Begna, M.D., Aref Al-Kali, M.D., Rhett P. Ketterling, M.D., Curtis A. Hanson, M.D., Animesh Pardanani, MBBS, Ph.D.
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