Source: http://adventuredoc.net/2013/01/02/new-tuberculosis-drug-and-a-tb-refresher/
Saturday, January 12, 2013
Baltimore Eye Surgeon Discusses Revival in Popularity of PRK Surgery
LASIK Surgeon in Baltimore on the Revival of PRK Surgery
According to a recent study by the American Academy of Ophthalmology, 800,000 refractive surgical procedures were performed in 2010. A similar study reports that among people age 40 and older, more than 3.6 million are visually impaired (defined as 20/40 or worse vision in the better eye even with eyeglasses). Dr. Jay C. Grochmal, a vision correction and LASIK surgeon in Baltimore, says that one of the contributing factors to such a high number of refractive surgical procedures is the resurgence in popularity of photorefractive keratectomy, or PRK. Dr. Grochmal discusses the benefits of a PRK procedure and reasons for its increasing demand.
The American Academy of Ophthalmology (AAO) shows in its latest report that eye doctors performed 800,000 refractive surgical procedures in 2010. The AAO also indicates that more than 3.6 million people age 40 and older are visually impaired, or have 20/40 or worse vision in the better eye even with eyeglasses. At his Baltimore LASIK surgery and eye care practice, Dr. Jay C. Grochmal says many of his patients are choosing PRK surgery as an alternative to LASIK to correct their poor vision. He also says the procedure is rapidly growing in popularity again as patients are beginning to see the benefits it can offer for those who are not candidates for LASIK.
While LASIK surgery accrues more popular attention because of its well-known success and prevalence, Dr. Grochmal says PRK is extremely successful and can oftentimes be the best option for patients who meet certain criteria. Unlike LASIK, where a flap is created to perform the surgery, the surgeon removes the epithelial layer of the cornea and then reshapes the cornea using an excimer laser. Because the procedure does not involve flap creation on the eye, he says patients with thin corneas can often achieve the most effective results through a PRK procedure. Dr. Grochmal says the procedure can also work effectively for patients seeking enhancement of a previous LASIK procedure.
Dr. Grochmal says PRK can also be used for treatment of epithelial distrophy, or issues with the epithelium of the cornea. He adds that PRK’s other benefits include removal of scars on the cornea, strengthening the cornea through cross-linking, and reduced formation of scar tissue. “PRK uses the same laser as LASIK and is adaptable for ‘advanced’ procedures, such as CustomVue, in order to obtain the best visual results. For those with thin or borderline thickness corneas, as well as higher myopic refractive errors, PRK can be performed with the confidence of assuring the patient’s long-term corneal stability.”
While some patients may only qualify for either LASIK or PRK based on an assessment of their individual eye, Dr. Grochmal says both procedures have proven effective and successful. He also recommends consulting with a highly trained and experienced eye surgeon before undergoing any procedure. “Every patient is unique and requires individualized care. A surgeon experienced in PRK and LASIK can help guide the patient in the better treatment for him or her with the goal of preserving corneal health.”
About Jay C. Grochmal, MD
Dr. Jay Grochmal received his medical degree from the University of Maryland and completed a rotating medical and surgical internship at the U.S. Public Health Hospital in Baltimore, Maryland. He completed his residency at the Greater Baltimore Medical Center’s Department of Ophthalmology, achieving the rank of Chief Resident. He is a member of the American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgeons and the Maryland Society of Eye Physicians.
Located at 405 Frederick Rd., Suite 102 in Baltimore, MD, Dr. Grochmal’s practice can be reached at (410) 697-4090 and online at the website grochmaleye.com or facebook.com/pages/Grochmal-Eye-Center/144885478861116.
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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.
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/
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Treatment for Failed Back Surgery Syndrome Video
When pain persists after back surgery, the true cause of the patient's pain needs to be re-evaluated. It may be the case that the surgery was performed to address an issue that was not the true pain generator. It may also be damage from the surgical procedure itself that is causing pain. In a spinal fusion surgery, the mechanical changes to the spine may cause new pain to develop. All these things are considered to evaluate the cause of the post-surgical pain.
Video presented by Zinovy Meyler, MD
[TOC]Video Transcript
Failed back surgery syndrome is a term that is used to describe pain that starts or persists after spine surgery. The important thing to remember is that spine, in itself, serves a certain purpose; it solves a number of problems, but, as with any other tool, it has its own limitations. So, sequelae of the surgery can cause pain, but also at the same time, surgery cannot address all the pain generators. So in looking at it like this, we can actually turn our attention away from the aspect of the surgery and now refocus on the patient and look at the pain generators in that patient in the context of their life and in the context of their overall function. By looking at it like that, we can actually start treating the pain generators and really get to the source of the majority of the pain that's generated after the surgery.
So what we need to look at is the physiologic changes after the surgery. Those are:
- Depending on the surgery, the mechanics of the spine will change. Now, if it's fusion surgery, then what happens is that two segments, for instance, that are being fused are no longer moving on their own. They are now moving in unison, which in effect creates a single segment. Because that single segment is no longer taking up the work of two segments, separately, it is now functioning as a single segment, which means - and this is for simplicity sake - we can say five segments doing 100% of work and that's 20% per segment, now we eliminate two or three segments, per se, and now 33% falls on each segment. Now you can imagine that with additional force going through that segment, there's going to be motion, more wear-and-tear, and more potential pain caused by that segment. And that's usually referred to as "adjacent segment disease." And that’s one of the post-surgical effects.
- Another effect is the actual tissue damage that can happen after surgery. So, myofascial pains can happen after a separation of tissue. When that tissue comes back together, the connective tissue may cause fibrosis - and that can trap nerves - or in itself become tight and painful. That can be treated in a separate way.
- Going back into the increased motion at separate segments, we have to remember that the motion actually happens across facet joints. Those joints are hinge-like joints - they are small joints - and those joints are just like any other joint in our body, which means it can get inflamed just like any other joint and that usually happens through overuse. Treating those joints usually resolves the pain that is associated with those joints and in that way, we can restore the function that was lost through the inflammation and alleviate the pain.
- There are many other pain generators that need to be looked at and can certainly be treated with appropriate diagnosis and treatment.
Treatment of pain persisting after surgery should be approached in a systematic way. Diagnosing each pain generator and eliminating the pain generators can serve to restore function and eliminate pain and in order to do that, we can employ a number of different tools that are available to us. And those include a wide array of the tools. Now it can be manipulations, it could be physical therapy, at times injections, or at times if we need to things like spinal cord stimulation or implantable pumps that can supply a steady state of medication can be used to control the pain. By using all the tools that are available to us, we can really improve the patient's quality of life by doing two very important things: decreasing the pain and restoring function. That way, they can reintegrate back into life and not be limited by pain or by mobility.
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Source: http://www.spine-health.com/video/treatment-failed-back-surgery-syndrome-video
Mayo Clinic offers newly approved treatment for GERD
C. Daniel Smith, M.D. , chair of the Department of Surgery at Mayo Clinic in Florida, discusses minimally invasive surgical options for patients with gastroesophageal reflux disease (GERD). A novel device, a ring of tiny magnetic titanium beads that acts to keep stomach acid from leaking into the esophagus, is now offered at Mayo Clinic in Florida. Read more about the LINX Reflux Management System in the April 11, 2012, edition of MedCity News.
Mayo Clinic in Florida is one of the first health care institutions in the U.S. to offer a newly approved device to treat GERD. Mayo Clinic in Florida helped test the device in patients. The U.S. Food and Drug Administration (FDA) approved the device and treatment procedure on March 22, 2012, for patients with GERD who continue to have chronic reflux symptoms despite taking medication. Mayo Clinic in Florida was one of 14 centers nationally that participated in a clinical trial that led to the FDA’s approval of the device.
About GERD
In patients with gastroesophageal reflux disease, liquid or food in the stomach flow back up into the esophagus due to the inability of a ring of muscle between the lower esophagus and the top of the stomach to close properly. If drugs aimed at neutralizing the acid in the stomach fails to prevent GERD, an operation designed to correct the mechanical defect is considered. Nearly 2 million patients of those patients could benefit from this treatment, which is much less complex than current surgical options, says Dr. Smith.
The results of the clinical study that led to approval of the device have not yet been published. “The data presented to the FDA, however, revealed striking results when compared to other GERD treatments that have been investigated over the past 20 years,” says Dr. Smith. “The system offers effective control of GERD with limited side effects and thus far an excellent safety record.”
The implanted device is a ring of tiny magnetic titanium beads that is wrapped around the junction between the stomach and esophagus, serving as a mechanical augmentation of the lower esophageal sphincter (the ring of muscle). The magnetic attraction between the beads is strong enough to keep the sphincter closed to refluxing acid, but weak enough so that food can pass through it into the stomach. The device can be implanted using minimally invasive surgery methods.
“I expect this device to be a game changer for the treatment of GERD in select patients who have failed management with drugs,” says Dr. Smith.
Kenneth R. DeVault, M.D. , chair of the Department of Internal Medicine at Mayo Clinic in Florida, also participated in the studies. “I have many patients who are searching for something more than medication for their reflux, but have been hesitant to undergo a traditional reflux surgery,” he says. “I think this procedure may well be a very attractive option for that group.”
Drs. Smith and DeVault were consultants to the company that developed the device and participated in the research study. Mayo Clinic licensed related technology to the company in exchange for equity.
For more information
View the Torax Medical, Inc. presentation at the January 2012 Gastroenterology and Urology Medical Devices Panel Meeting and read the FDA Executive Summary Memorandum.
Clinical trials at Mayo Clinic
Gastroesophageal reflux disease (GERD)
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Understanding LASIK | Your Top 5 Questions Answered
Here is our list of the Top 5 Patient Questions About LASIK:
- What is LASIK in a nutshell? The goal of a LASIK procedure is simple: to improve vision and reduce a patient’s dependence on corrective lenses. The procedure uses special light energy to reshape the cornea, effectively combating the affects of nearsightedness, farsightedness and astigmatism.
- Are all LASIK procedures the same? There are several types of LASIK procedures available today – each with their own unique benefits. Our practice is proud to offer what many are considering the gold standard in modern laser vision correction: iLASIK™. Using 3D eye mapping to create a fully-customized treatment plan, iLASIK is completely bladeless and relies on cutting-edge “cool laser” technology to safely reshape the cornea.
- Is LASIK painful? While tolerance can sometimes vary, LASIK is generally regarded as a “relatively painless” procedure. Very often, the only sensation patients report is a slight pressure. Furthermore, we work to ensure patient comfort by administering numbing eye drops before the procedure.
- Are most patients happy with their results? While each patient is different and can expect unique results, LASIK tends to be a highly successful procedure. In fact, “LASIK vision correction has the highest patient satisfaction rate of any elective surgery,” reports The Eye Surgery Education Council, “95.4%, according to a 10-year survey of scientific studies from around the world.”
- How can I find out if LASIK is right for me? In general, LASIK patients tend to be in good health, free of eye conditions such as cataracts, over the age of 21. But, since there are other factors to consider in determining a good candidate for LASIK, we encourage anyone interested to schedule a consultation and find out what laser vision correction can do for them.
Considering LASIK? Learn More Today
To learn more about Laser Eye Surgery, 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/uncategorized/understanding-lasik-your-top-5-questions-answered
Varicella (chicken-pox) vaccination
In many countries of the world chicken-pox vaccine is part of the routine childhood vaccination programme. In the UK a child may have free vaccination only if they are over the age of 12 and have not had the disease. There is no current plan to introduce varicella vaccination for children.
Two doses of the vaccine fully protects against chicken-pox in 99% of cases. The tiny number who do not get full protection will experience fewer spots, milder symptoms and a speedier recovery time.
The vaccine is available at the Globe Travel Health Centre.
Source: Joint Committee on Vaccination ad Immunisation (JCVI)
For further advice, contact the Globe Travel Health Centre on 01603 667323
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Friday, January 11, 2013
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
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Dr. Labor Publishes New Technology Article In National Publication
Cataract & Refractive Surgery Today, a major industry publication, recently asked Phillips Kirk Labor, MD to share his expertise about a revolutionary cataract surgery technology he introduced to Dallas/Fort Worth in 2011. The result was an article Dr. Labor authored, Updating Your Practice With Advanced Technology, with the subtitle, Intraoperative aberrometry is a worthwhile investment for the practice and provides added security for cataract patients. The article appeared nationwide in the October 2012 issue.
A prime example of intraopertive aberrometry he discusses is the ORA System. This is a “wavefront aberrometry device,” the first of its kind to measure cataract surgery results in real time – during the procedure. Previously called ORange, Dr. Labor was the first metro Dallas/Fort Worth eye surgeon to use this technology when it was introduced in 2011. When ORange changed to the further enhanced ORA System, Dr. Labor remained at the forefront as an early adopter of this newer, better technology. Today, he is one of the top ORA surgeons in the world.
“Cataract & Refractive Surgery Today is a trusted, highly regarded publication among leading surgeons all over the world. I was grateful when they contacted me, and didn’t hesitate to do it,” Dr. Labor said. “Although written for our industry, my main goal, however, was to share my experiences and successes related to how this benefits the patient first.”
To learn more about the ORA System, or any our comprehensive eye care services, please call us in Grapevine at 877-516-4364. We’re conveniently located to all of Fort Worth and Dallas.
Source: http://www.eyectexas.com/blog/dr-labor-publishes/
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Win An iPad Mini At Our Believe In LASIK Holiday Event
When: Tuesday, December 18, 2012, 6:30 to 7:30 PM
Where: Eye Consultants of Texas, 2201 Westgate Plaza, Grapevine, TX 76051
It’s that time of year when we want to believe in something magical. LASIK isn’t magic, but it can produce seemingly magical results if you rely on glasses or contact lenses every day. Our Believe in LASIK Holiday Event will answer any questions you might have to help you decide if LASIK is right for you.
Plus, just for attending, you can register to win an iPad Mini to be given away that night.
The 1-hour event will be led by one of our expert doctors, who will explain things in simple terms. There’s no obligation and no purchase necessary. It’s entirely Free and open to anyone 18 years or older. The iPad Mini will be awarded to one lucky winner by random drawing, and you must be present to win.
Our LASIK patients often tell us their improved eyesight is like a gift. This could be the first step to one of the greatest gifts you could give yourself. Call 877-516-4364 to reserve your space at our Believe In LASIK Holiday Event, in the comfort of our beautiful Grapevine office, convenient to Dallas/Fort Worth.
Source: http://www.eyectexas.com/blog/win-an-ipad-mini-at-our-believe-in-lasik-holiday-event/
Interview With Wendy Schauer – Author of The 7 Steps To Amazing Health!
Here is a link to an interview that “foodie”, health advocate, and grass fed beef rancher Lisa Wilcox recently did with author Wendy Schauer.
Yours In Health!
G.E. Moon II
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Cholera outbreak in Malaysian Borneo
New cases of cholera continue to reported in the Bintulu district of Borneo. Travellers should avoid buying drinks with ice, uncooked salad dishes and ice-cream, as the water used may not have been boiled to decontaminate it. They should also avoid premises that are not spotlessly clean.
Source: ProMed Newsgroup
For further advice, contact the Globe Travel Health Centre on 01603 667323
Supreme Court Health Care Law Hearings
In November of 2011, the Supreme Court announced that it would hear challenges to President Obama’s health care reform law (Patient Protection and Affordable Care Act of 2010). Those hearings are scheduled for March 26-28 and will address the following issues:
- Are opponents of the new health care law challenging the law too soon? According to the new law, everyone is required to purchase health insurance, with or without government assistance, or be fined (individual mandate). However, it is unclear as to whether the fine to be imposed is considered a tax. If it is a tax, then the Anti-Injunction Act, a federal law, prohibits anyone challenging the health care law until 2014, when violators will be required to pay the “fine” or “tax”.
- Assuming the individual mandate can be challenged now, is the individual mandate constitutional? There is a Commerce Clause in the Constitution, which allows Congress to regulate interstate commerce, but does this clause also allow Congress to require people to purchase health care insurance?
- If the individual mandate is found to be unconstitutional, will the rest of the health care law remain in effect? Sometimes a portion of the law can be struck down, if it is found to be unconstitutional, while the rest of the law continues in force. If the Court finds that the unconstitutional part of the law is so intertwined with the rest of the law, then it comes to an all or nothing at all proposition.
- Is the health care law’s expansion of the Medicaid program constitutional? The argument is state versus federal rights. The new law requires states to change their Medicaid programs, so that all people will be eligible for coverage. If states do not change their laws, they will lose all of their federal funding for the program.
The Supreme Court plans to release recordings of the arguments on its website (http://www.supremecourt.gov/) around 2 p.m. each day for arguments held that morning and around 4 p.m. for arguments held in the afternoon of March 28. After hearing the challenges to the new health care law, the Court is expected to reach its decision in June 2012.
Source: http://www.pagingdrblog.com/2012/03/19/supreme-court-health-care-law-hearings/
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Thursday, January 10, 2013
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
New York State Governor Investigates Out-Of-Network Costs
New York State Governor Andrew Cuomo recently announced the continuation of an investigation into out-of-network medical costs. In 2011, the state received more than 2,000 complaints from consumers who unexpectedly received bills from out-of-network specialists and providers after taking measures to choose in-network providers and receive prior insurer approval. Consumers often are not told in advance which specialists are out-of-network, how much they charge, and how much of their fee will be covered by health insurance. The resulting bills contribute to financial strain on consumers, many of whom are unable to pay the amount charged and some of whom are forced into bankruptcy.
To aid consumers in obtaining information on out-of-network care, costs, and coverage, the New York State Department of Financial Services is calling for more transparency, better consumer protection, and system-wide reform. This follows efforts by the Obama administration to require health insurers to provide such easy-to-understand information to consumers. If you are concerned about the potential impact of reforms and new rules, please feel free to contact us to discuss your options and assist you in making decisions regarding your practice.
Source: http://www.pagingdrblog.com/2012/03/15/new-york-state-governor-investigates-out-of-network-costs/
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Reflections on World AIDS Day with Michael Horberg, MD
World AIDS Day is Dec. 1; this year’s theme is ‘Working Together for an AIDS-Free Generation’
CTH Blog:
You’ve been committed to the fight against AIDS/HIV for three decades. What has this journey been like for you?
Michael Horberg, MD:
Professionally, the journey has been extraordinarily rewarding. It has led to a career in advanced HIV care, research and advocacy, with leadership in the HIV Medicine Association, as well as previously the Gay and Lesbian Medical Association. I know I’m a better doctor because of my work in HIV — the continuing education, learning new research and new medications/treatments daily, and the phenomenal collaborations with my Kaiser Permanente colleagues.
On a personal level, the last three decades have also been quite a journey. In the early 1980s, when the first patients infected by the HIV virus were being treated, I was in my third year of medical school. I knew I was gay, but I wasn’t ready for anyone else to know that. It was the fear of rejection, the fear of being ostracized, even in the medical community, of not being able to attract any patients. Ironically, the onset of the AIDS crisis is what finally helped to liberate me. As patients with HIV symptoms, including some of my close friends, began coming to me in private practice, I realized stepping out of the closet would help them get the care they needed and allow me to be a more powerful advocate for specialized care. Furthermore, being able to help my gay and lesbian brothers and sisters fulfilled my desire to meld technical skill with compassion. Especially early in the crisis when there was a limit for what we could do for patients, really caring, really showing love was critical.
CTH Blog:
What continues to motivate you in the fight against HIV/AIDS?
MH:
It’s been more than three decades since AIDS was first reported and the statistics of the epidemic still continue to haunt me. Every day, more than 150 people in the United States become infected with HIV. That adds up to between 50,000 and 56,000 people a year – just in the United States. And racial and ethnic minorities in gay and bisexual men are disproportionately impacted by this epidemic. About half of the nation’s HIV population is African-American – yet African-Americans have a 15 percent greater chance of dying from HIV than white Americans. This is a disease of disparities.
Until we no longer have an epidemic, I will continue to be motivated.
CTH Blog:
At the International AIDS Conference Washington D.C this summer, of which Kaiser Permanente was a key sponsor, there was a lot of discussion about an AIDS-free generation. Do you think that’s possible?
MH:
Yes, there is great hope. It can be achievable, but it requires resources, increased research, and increased access to quality HIV care for all living with HIV. I am proud to support the concept of an AIDS-free generation and working towards that goal. As a leader in HIV treatment, what we are doing at Kaiser Permanente and the tools and research we can share with the world, it’s entirely possible.
CTH Blog:
How has Kaiser Permanente been a leader in HIV treatment?
MH:
Kaiser Permanente has an outstanding record of successful HIV clinical care outcomes. Our care teams have treated more than 60,000 people and have reduced disparities among its current HIV population of approximately 20,000 people by working to meet or exceed the objectives of the U.S. National HIV/AIDS Strategy. We also have an outstanding record of successful HIV clinical care outcomes. Such as:
- HIV mortality rates that are half the national average
- 94 percent median treatment adherence among KP patients that are regularly in care and on antiretroviral therapy
- No disparities among Kaiser Permanente’s African-American and Latino HIV-positive patients for both mortality and medication rates, compared to a 15 percent higher rate in the U.S. for mortality and medication
- 89 percent of Kaiser Permanente’s HIV-positive patients are in HIV-specific care within 90 days, compared to 50 percent in the U.S. within one year
- 69 percent of Kaiser Permanente’s HIV-positive patients have maximal viral control compared to 19-35 percent nationally
CTH Blog:
And how does this knowledge help other health care providers?
MH:
We started by challenging them. Earlier this year, the organization challenged all health care providers nationwide to follow its lead and improve the health equity for people living with HIV by sharing a toolkit of clinical best practices, tools, mentoring, training and health IT expertise (kp.org/hivchallenge).
We also reach out to our communities through grants. This year, Kaiser Permanente announced several grants for community organizations to continue their work on HIV/AIDS care and prevention.
In May 2012, Kaiser Permanente committed $2 million to award to eight community health organizations focusing on eliminating racial and ethnic disparities in health care and health outcomes, specifically related to HIV disease. The first four recipients will be announced later this year. Furthermore, we’ve also had significant grants in our Northern California, Southern California and Colorado regions. The organizations awarded grants were chosen specifically for having innovative approaches to preventing new HIV infections; identifying HIV positive patients sooner and connecting them with high quality HIV care; and reducing disparities among minority populations — particularly gay, African-American, youth and Latino — disproportionately impacted by HIV disease.
CTH Blog:
And we reach out to students and youth across the country as well, correct?
MH:
Yes! For more than two decades, Kaiser Permanente has been reaching out to millions of youth about HIV prevention through our Educational Theatre Program. In the early 1980s when many organizations were uneasy about talking about sexual behavior and prevention of HIV to adolescents, Kaiser Permanente wasn’t. In 1989, Kaiser Permanente’s Northern California ETP created the live production “Secrets,” aimed at educating young people about the growing epidemic. Since 1989, it’s been shown to 1.5 million youth in Northern California alone. Almost all of our theater programs, which serve communities where Kaiser Permanente is present in eight states and the District of Columbia, have adopted a production dealing with HIV prevention in one way or another. We continuously work with educators, community groups and Kaiser Permanente physicians, to update our productions to meet the needs of our communities.
CTH Blog:
World AIDS Day is just around the corner. What do you hope people reflect on Dec. 1?
MH:
I hope on World AIDS Day people reinvigorate themselves to meeting the challenge of fighting HIV. But I also hope they take the opportunity to show love — for themselves, and for those impacted by HIV. This isn’t the end, but at least we can envision the end realistically now.
Source: http://centerfortotalhealth.org/2012/reflections-on-world-aids-day-with-michael-horberg-md/
Distribution of arterial lesions in Takayasu’s arteritis
Steven R. Ytterberg, M.D., with the Department of Rheumatology at Mayo Clinic in Rochester, Minn., discusses a study that examined similarities and differences between two forms of vasculitis: giant cell arteritis and Takayasu’s arteritis. Findings suggest that TAK and GCA may exist on a spectrum within the same disease. The study was published online on Feb. 10, 2012 in the Annals of the Rheumatic Diseases.
ABSTRACT
Objectives
To compare patterns of arteriographic lesions of the aorta and primary branches in patients with Takayasu’s arteritis (TAK) and giant cell arteritis (GCA).
Methods
Patients were selected from two North American cohorts of TAK and GCA. The frequency of arteriographic lesions was calculated for 15 large arteries. Cluster analysis was used to derive patterns of arterial disease in TAK versus GCA and in patients categorized by age at disease onset.
Using latent class analysis, computer derived classification models based upon patterns of arterial disease were compared with traditional classification.
Results
Arteriographic lesions were identified in 145 patients with TAK and 62 patients with GCA. Cluster analysis demonstrated that arterial involvement was contiguous in the aorta and usually symmetric in paired branch vessels for TAK and GCA. There was significantly more left carotid (p=0.03) and mesenteric (p=0.02) artery disease in TAK and more left and right axillary (p<0.01) artery disease in GCA. Subclavian disease clustered asymmetrically in TAK and in patients ≤55 years at disease onset and clustered symmetrically in GCA and patients >55 years at disease onset.
Computer-derived classification models distinguished TAK from GCA in two subgroups, defining 26 percent and 18 percent of the study sample; however, 56 percent of patients were classified into a subgroup that did not strongly differentiate between TAK and GCA.
Conclusions
Strong similarities and subtle differences in the distribution of arterial disease were observed between TAK and GCA. These findings suggest that TAK and GCA may exist on a spectrum within the same disease.
Authors
Peter C. Grayson, Kathleen Maksimowicz-McKinnon,Tiffany M. Clark, Gunnar Tomasson, David Cuthbertson, Simon Carette, Nader A .Khalidi, Carol A. Langford, Paul A. Monach, Philip Seo, Kenneth J. Warrington, M.D., Steven R. Ytterberg, M.D., Gary S. Hoffman, and Peter A. Merkel, for the Vasculitis Clinical Research Consortium
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Baltimore Eye Surgeon Discusses Revival in Popularity of PRK Surgery
LASIK Surgeon in Baltimore on the Revival of PRK Surgery
According to a recent study by the American Academy of Ophthalmology, 800,000 refractive surgical procedures were performed in 2010. A similar study reports that among people age 40 and older, more than 3.6 million are visually impaired (defined as 20/40 or worse vision in the better eye even with eyeglasses). Dr. Jay C. Grochmal, a vision correction and LASIK surgeon in Baltimore, says that one of the contributing factors to such a high number of refractive surgical procedures is the resurgence in popularity of photorefractive keratectomy, or PRK. Dr. Grochmal discusses the benefits of a PRK procedure and reasons for its increasing demand.
The American Academy of Ophthalmology (AAO) shows in its latest report that eye doctors performed 800,000 refractive surgical procedures in 2010. The AAO also indicates that more than 3.6 million people age 40 and older are visually impaired, or have 20/40 or worse vision in the better eye even with eyeglasses. At his Baltimore LASIK surgery and eye care practice, Dr. Jay C. Grochmal says many of his patients are choosing PRK surgery as an alternative to LASIK to correct their poor vision. He also says the procedure is rapidly growing in popularity again as patients are beginning to see the benefits it can offer for those who are not candidates for LASIK.
While LASIK surgery accrues more popular attention because of its well-known success and prevalence, Dr. Grochmal says PRK is extremely successful and can oftentimes be the best option for patients who meet certain criteria. Unlike LASIK, where a flap is created to perform the surgery, the surgeon removes the epithelial layer of the cornea and then reshapes the cornea using an excimer laser. Because the procedure does not involve flap creation on the eye, he says patients with thin corneas can often achieve the most effective results through a PRK procedure. Dr. Grochmal says the procedure can also work effectively for patients seeking enhancement of a previous LASIK procedure.
Dr. Grochmal says PRK can also be used for treatment of epithelial distrophy, or issues with the epithelium of the cornea. He adds that PRK’s other benefits include removal of scars on the cornea, strengthening the cornea through cross-linking, and reduced formation of scar tissue. “PRK uses the same laser as LASIK and is adaptable for ‘advanced’ procedures, such as CustomVue, in order to obtain the best visual results. For those with thin or borderline thickness corneas, as well as higher myopic refractive errors, PRK can be performed with the confidence of assuring the patient’s long-term corneal stability.”
While some patients may only qualify for either LASIK or PRK based on an assessment of their individual eye, Dr. Grochmal says both procedures have proven effective and successful. He also recommends consulting with a highly trained and experienced eye surgeon before undergoing any procedure. “Every patient is unique and requires individualized care. A surgeon experienced in PRK and LASIK can help guide the patient in the better treatment for him or her with the goal of preserving corneal health.”
About Jay C. Grochmal, MD
Dr. Jay Grochmal received his medical degree from the University of Maryland and completed a rotating medical and surgical internship at the U.S. Public Health Hospital in Baltimore, Maryland. He completed his residency at the Greater Baltimore Medical Center’s Department of Ophthalmology, achieving the rank of Chief Resident. He is a member of the American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgeons and the Maryland Society of Eye Physicians.
Located at 405 Frederick Rd., Suite 102 in Baltimore, MD, Dr. Grochmal’s practice can be reached at (410) 697-4090 and online at the website grochmaleye.com or facebook.com/pages/Grochmal-Eye-Center/144885478861116.
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Baltimore Eye Surgeon Discusses Revival in Popularity of PRK Surgery
LASIK Surgeon in Baltimore on the Revival of PRK Surgery
According to a recent study by the American Academy of Ophthalmology, 800,000 refractive surgical procedures were performed in 2010. A similar study reports that among people age 40 and older, more than 3.6 million are visually impaired (defined as 20/40 or worse vision in the better eye even with eyeglasses). Dr. Jay C. Grochmal, a vision correction and LASIK surgeon in Baltimore, says that one of the contributing factors to such a high number of refractive surgical procedures is the resurgence in popularity of photorefractive keratectomy, or PRK. Dr. Grochmal discusses the benefits of a PRK procedure and reasons for its increasing demand.
The American Academy of Ophthalmology (AAO) shows in its latest report that eye doctors performed 800,000 refractive surgical procedures in 2010. The AAO also indicates that more than 3.6 million people age 40 and older are visually impaired, or have 20/40 or worse vision in the better eye even with eyeglasses. At his Baltimore LASIK surgery and eye care practice, Dr. Jay C. Grochmal says many of his patients are choosing PRK surgery as an alternative to LASIK to correct their poor vision. He also says the procedure is rapidly growing in popularity again as patients are beginning to see the benefits it can offer for those who are not candidates for LASIK.
While LASIK surgery accrues more popular attention because of its well-known success and prevalence, Dr. Grochmal says PRK is extremely successful and can oftentimes be the best option for patients who meet certain criteria. Unlike LASIK, where a flap is created to perform the surgery, the surgeon removes the epithelial layer of the cornea and then reshapes the cornea using an excimer laser. Because the procedure does not involve flap creation on the eye, he says patients with thin corneas can often achieve the most effective results through a PRK procedure. Dr. Grochmal says the procedure can also work effectively for patients seeking enhancement of a previous LASIK procedure.
Dr. Grochmal says PRK can also be used for treatment of epithelial distrophy, or issues with the epithelium of the cornea. He adds that PRK’s other benefits include removal of scars on the cornea, strengthening the cornea through cross-linking, and reduced formation of scar tissue. “PRK uses the same laser as LASIK and is adaptable for ‘advanced’ procedures, such as CustomVue, in order to obtain the best visual results. For those with thin or borderline thickness corneas, as well as higher myopic refractive errors, PRK can be performed with the confidence of assuring the patient’s long-term corneal stability.”
While some patients may only qualify for either LASIK or PRK based on an assessment of their individual eye, Dr. Grochmal says both procedures have proven effective and successful. He also recommends consulting with a highly trained and experienced eye surgeon before undergoing any procedure. “Every patient is unique and requires individualized care. A surgeon experienced in PRK and LASIK can help guide the patient in the better treatment for him or her with the goal of preserving corneal health.”
About Jay C. Grochmal, MD
Dr. Jay Grochmal received his medical degree from the University of Maryland and completed a rotating medical and surgical internship at the U.S. Public Health Hospital in Baltimore, Maryland. He completed his residency at the Greater Baltimore Medical Center’s Department of Ophthalmology, achieving the rank of Chief Resident. He is a member of the American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgeons and the Maryland Society of Eye Physicians.
Located at 405 Frederick Rd., Suite 102 in Baltimore, MD, Dr. Grochmal’s practice can be reached at (410) 697-4090 and online at the website grochmaleye.com or facebook.com/pages/Grochmal-Eye-Center/144885478861116.
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Generic Versus Brand-Name Drugs
Generic drugs account for almost 80 percent of all prescribed medications in the United States and most states allow generic drugs to be dispensed in place of brand-name drugs. This is quite a large number of generic drugs being taken by quite a large number of the nation’s population. The possibility of people who take generic drugs and having reactions to the drugs is also large – unfortunately, this is what is happening across the country. People, who are taking generic drugs, are having severe complications from taking the drugs. Reactions to these generic drugs are very serious, with some consumers developing inflammatory bowel disease, gangrene, and even movement disorders.
What is even more distressing is that the manufacturers of these generic drugs are protected by a U.S. Supreme Court ruling. In a 5-4 decision, the Supreme Court ruled in June 2011 that makers of generic drugs cannot be sued for not including side-effect warnings on their labels, if the warnings are also not on the labels of their brand-name equivalent. This makes it difficult for consumers who may not know they are receiving a generic form of a drug, such as in a hospital, or may be required by their insurance plan to fill a prescription with a generic drug. If they develop a medical issue while taking a generic form of a prescription drug, they basically have no legal remedy.
The Supreme Court ruling is based on the Hatch-Waxman Act of 1984. This law allowed companies to skip the involved process required to approve new drugs, if they could prove that the generic drug was equivalent to its brand-name counterpart. However, Representative Henry A. Waxman, who co-wrote the Act, has stated that “Congress did not intend for consumers’ rights to be categorically eliminated simply because they purchased a generic rather than a brand-name drug.” Mr. Waxman is investigating a change in the ruling.
Consumers should protect themselves and do their own research before taking any drug – check with your doctor about generic versus brand-name prescriptions and find out about all the possible risks and side effects.
Source: http://www.pagingdrblog.com/2012/03/22/generic-versus-brand-name-drugs/
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Wednesday, January 9, 2013
Activist Shares her Story to Increase HIV/AIDS Awareness
At birth, Hydeia Broadbent was abandoned at the University Medical Center of Southern Nevada in Las Vegas, where Patricia and Loren Broadbent adopted her as an infant. Although her HIV condition was congenital, she was not diagnosed as HIV-positive with advancement to AIDS until age 3. The prognosis was that she would not live past the age of 5. Now more than 20 years later, Broadbent spends her time spreading the message of HIV/AIDS awareness and prevention by promoting abstinence, safe-sex practices (for people who choose to have sex), and the initiative “Knowing Your HIV/AIDS Status.”
Broadbent was a keynote speaker at Kaiser Permanente’s 2011 National Diversity Conference, speaking to several hundred Kaiser Permanente physicians and employees celebrating and learning about diversity and inclusion. We caught up with Broadbent recently to see what messages she had to share in honor of World AIDS Day.
CTH Blog:
When did you start speaking publicly about HIV/AIDS?
Hydeia Broadbent:
I started speaking out at the age of 6. Back then my focus was talking about compassion for individuals living with HIV/AIDS to make sure they were treated fairly. In the late 1980s a lot of people lost their jobs or they were kicked out of their homes. Some kids couldn’t even go to school, so I really started speaking about compassion and understanding.
Now, my primary goal is to provide a clear understanding of how to avoid at-risk behaviors through self-examination and informed decision-making. With all that we know about the virus, it is clear to me that contracting HIV/AIDS today is a choice and we can’t allow anyone the power to make that choice for us.
CTH Blog:
What has your message been to clinical staff and caregivers?
HB:
Growing up I spent a lot of time in the hospital. For those who work with someone who is infected with HIV/AIDS, you guys are very important to our lives. We spend a lot of time with our doctors and our nurses and our case workers.
I know how important it is for communication between a doctor and patient. Patients want to be informed about the medicines and procedures that they go through. And it also goes back to compassion because a lot of times when people have chronic illnesses they may be facing them alone. Sometimes they don’t have the support of their families or friends. Service with a smile really does go along way.
CTH Blog:
There was a time last year when you were without insurance?
HB:
Yes, and that was very scary. I know how expensive these out-of- pocket costs can be. A lot of people wanted to help me, but I wanted to make sure we help others – it’s not just about Hydeia. I feel like I speak for a lot of people who don’t have a name or a face or a voice, but they are out there, and they deserve the compassion of their fellow brothers and sisters. Everything I go through serves a purpose. I want to inspire people, not to just care about me, but others who are living with HIV/AIDS.
CTH Blog:
At Kaiser Permanente’s 2011 National Diversity Conference, you mentioned you received care at a Kaiser Permanente facility?
HB:
I live in Las Vegas, but once I got sick when I was in Los Angeles and ended up at a Kaiser Permanente facility, so I know the care and the service that Kaiser Permanente provide, and it’s excellent.
CTH Blog:
What are you working on now?
HB:
On Nov. 26, a project I’ve been helping work on, “Forgotten but Not Gone: Kids, HIV & AIDS,” aired on Nickelodeon. The inspiration came to me after seeing a story about a 13-year-old boy in Pennsylvania who had applied to a private boarding school, but was refused because he is HIV-positive. The show is a powerful piece featuring many stories of youth who have been living with HIV, and it addresses stereotypes.
I’ve been doing a lot of work around youth lately, such as public service announcements that they can relate to. A lot of young people don’t like to be lectured to, so you have to make sure it’s more of a discussion and you’re not just preaching. And also when it comes to HIV, you have to install a sense of fear. We have kind of glamorized it because we wanted people with HIV to be accepted, but we forgot to talk about the reality of what this disease is, and it still kills people. There are medications, but not everyone can afford these medications, so we need to make sure we are speaking to the reality that these medications cost a lot of money.
CTH Blog:
World AIDS Day is around the corner. What do you hope people think about on Dec. 1?
HB:
I grew up in a time when there was no hope. I’ve seen countless friends die — my own doctor had passed away. We are definitely in a new time when there are advancements to medications and people aren’t dying at alarming rates from AIDS as they once did. But the fight is far from over. You have to go home and talk to your kids. You have to talk to them about HIV. You have to talk to them about sex. You have to talk to your nieces your nephews. We have come to a place where we are complacent about HIV/AIDS because people are healthier they are living longer and it’s kind of on everyone’s back burner. If you aren’t talking to your kids about these things, someone else probably is.
I’d also like people to stop and think: Do you know your own HIV status?
Below is an excerpt from Broadbent’s keynote at Kaiser Permanente’s 2011 National Diversity Conference.
Source: http://centerfortotalhealth.org/2012/activist-shares-her-story-to-increase-hivaids-awareness/
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