UCB's Cimzia Approved for Crohn's Disease

The FDA approved Cimzia® (certolizumab pegol) for treatment of Crohn's disease, a chronic inflammatory disease of the digestive tract on April 22, 2008. Cimzia® is a pegylated anti-tumor necrosis factor (anti-TNF) agent also known as tumor necrosis factor agonists, designed to neutralize inflammatory cytokines.

Cimzia® is effective in reducing signs and symptoms and inducing and maintaining clinical remission in patients with moderately to severely active Crohn’s disease. Patients who have had an inadequate response to conventional therapy (oral mesalamine, oral corticosteroids, and 6-mercaptopurine or azathioprine (6-MP/AZA) may benefit. Symptoms of Crohn's disease are:

• abdominal pain
  
• bleeding
• diarrhea
• extraintestinal manifestations (arthritis, uveitis, iritis, pyoderma gangrenosum, erythema nodosum, or spondylitis)
  
• internal fistulae
• intestinal obstruction
• perianal disease
• megacolon
• weight loss

Crohn's disease is marked by cycles of flare-ups and remissions through out the patient's life. Cimzia® is manufactured by UCB Group in Brussels, Belgium. It is administered by subcutaneous injection every four weeks after initial dosing.

Thank you Hamamatu Minami Hospital Gastroenterology and IBD Clinic for use of image.

Labels: biologics, Cimzia, Crohn's disease, inflammatory bowel disease

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Data Theft from Health Care Facilities - What's Up with That?

May 2006: Laptopgate - a VA employee took his laptop containing personal data on over 26 million veterans, active duty personnel and their spouses, home with him. The laptop was subsequently stolen by 3 teenagers and later recovered by police.
August 2006: 10 computers were stolen from HCA offices, containing the personal information of thousands of patients, providers and employees for Medicare and Medicaid.
October 2006: A laptop containing patient data from 14,000 households was stolen from Allina Hospitals and Clinics in Minneapolis.
February 2007: A laptop containing data on 7800 patients was stolen from Seton Family of Hospitals in Texas. In a separate incident, thieves stole backup tapes from Wellpoint BC/BS containing data for 196,000 customers.
July 2007: A computer containing patient information in a tumor registry database was stolen from Johns Hopkins Hospital. The computer was mysteriously returned through an attorney in September.
September 2007: Two computers containing data on thousands of patients was stolen from McKesson Health Services company office.
February 2008: The NIH lost records on 3,000 people involved in a cardiac MRI study when a laptop computer was stolen. One of the people affected was Rep. Joe Barton (R-TX), founder of the Congressional Privacy Caucus.
March 2008: UCLA employees and doctors are disciplined for breaching the security of a certain celebrity's medical records.
April 2008: Data files of 2.1 million patients of the University of Miami health facilities were stolen from a storage facility.

In all of these incidents, security authorities insist that the data was not compromised, the thieves were after the hardware not the data, the data was encrypted and offer many other "reassurances". The VA has pledged to set new standards for the security of personal data, but data breaches continue to rise. With the push for EMRs, we had better make sure security issues - not just online security - but back to the basics like secure laptops (how hard is that?) - is one of the top priorities.

Thank you cdchanes for use of photo medical history.

Labels: data theft, privacy, security

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Rice Wars - the Poor are Hungry

Rice provides 20% of all the food calories consumed by humans on our planet. It is a staple food for half of the world's population - most of them the poor. We are in a global crisis - a rice shortage while food prices are rising due to increases in fuel prices. The shortage is due to population growth and the conversion of arable land for other uses. Rice production has been outstripped by population growth in some countries like Indonesia for over ten years. Riots and deaths in Cameroon and Haiti are the outcome of this dire situation.

The price of rice increased 50% in two weeks at the beginning of April, 2008. People in Bangladesh, China, India, Thailand and the Philippines are affected. The World Bank has predicted that 33 countries around the world face social unrest due to instability in rice supplies and prices. Even in the US, the big warehouse stores like Costco Wholesale are restricting the amount of imported bulk rice that can be purchased to prevent hoarding. Domestic US rice remains widely available at affordable prices.

You can help. Take time out of your busy day, every day, to click on the the button at The Hunger Site. You click daily, the advertising sponsors pay for food.




















Thank you myto for use of photo Rice.

Labels: food shortages, rice

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27% of Teenagers Are Unhappy

In both UNICEF and BBC reports, teens in industrialized nations report low mood. 7 out of 10 teens report feeling pressure to look good and felt under pressure from school, family and classmates. How do you know when your teen has crossed the threshold from low mood into clinical depression, requiring professional intervention? Look for these signs:

• Change in appetite
• Change in sleep patterns
• Doesn't enjoy anything
• Sad all the time
• Socially withdrawn
• Low energy
• Self-medicating with drugs or alcohol

Depressed teens are at serious risk for suicide. Don't be afraid to ask your teen "Are you thinking about killing yourself?". Keep the lines of communication open. And never give up on them...











Thank you Mt. Carmel Photostream for use of photo Trouble Teens.

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Take the Stairs - It Might Save Your Life

If you can't find the time for regular exercise, just building extra steps into your day through simple activities like taking the stairs might save your life. Cancer, diabetes, heart problems, arthritis and premature death can all be prevented by increasing activity levels. Enter a new risk factor in these chronic diseases - decreased physical activity.

Researchers found that it only takes 2 weeks of inactivity to start noticing the ill effects. Lack of activity, they found, can actually cause chronic disease. It is actually dangerous to be inactive for a couple of weeks. Abdominal fat increases, blood lipids and sugars get higher, and skeletal and muscle mass decrease.

For the developed world the key to health and longevity is pretty simple - eat less, walk more, sleep better.

Thank you ozczecho for use of picture All Smiles.

Labels: activity, disease prevention, walk

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Osteoporosis: Men are at Risk, Too

Low levels of testosterone and age put millions of men at risk for osteoporosis. Low levels of testosterone can lead to decreased bone mineral density (BMD), putting older men at increased risk for bone fractures.

Testosterone replacement therapy (TRT) has been used to replace muscle mass and improve bone density in men, but is associated with an increased risk of prostate cancer. Healthline offers a comprehensive analysis of the situation from Harvard urologist Abraham Morgentaler, M.D. in the article A Harvard Expert Shares His Thoughts on Testosterone Replacement Therapy.

heHealthline has been nominated for the prestigious Webby Award in the category of Health.
The International Academy of Digital Arts and Sciences will choose Webby Award winners, but the People’s Voice Webby lets you decide. It’s easy:

Simply log on to http://peoplesvoice.webbyawards.com/· Register to vote (or log in if you are a returnee)
· After registration, click on the Web site icon and find the Living section, under which the Health category falls
· Vote for Healthline.

And be sure to pass this pass along to your friends and encourage them to vote as well!

Thank you for your support of Healthline Networks.

Thank you Dr. JimiGlide for use of photo "What is it youngblood?"

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Healthline: Nominated Website for 12th Annual Webby Awards

The 12^th Annual Webby Awards has nominated Healthline for Best Health Website for 2008! For those of you who are unfamiliar with the Webby Awards, they are the “Oscars of the Internet”. This is the second Webby nomination Healthline has received in three years.

This Webby nomination is a tribute to the Healthline team’s hard work creating innovative clinical applications like Symptom Search and Drug Search. Healthline continually works to bring quality content (some exclusive) from top medical publishers such as StayWell, Harvard Health Publications, Natural Standard, including video content from Healthology, to the consumer health information web. Sex tips from Self magazine to in-depth Advance Reading on specific disease topics like Rheumatoid Arthritis (RA) from Elsevier, a publisher whose content is usually only available to clinicians for a fee, can be found free of charge on Healthline.com.

Out of nearly ten thousand entries this year, Healthline was selected over several of our better-known competitors. Healthline is also eligible for the People’s Voice Webby. To win the People’s Voice Webby, we need to secure votes from regular people like you, me, our friends and relatives. If you believe Healthline deserves this prestigious award (and we know you do!), please cast your vote for Healthline at the Webby’s People’s Voice award: http://peoplesvoice.webbyawards.com/. We have until the end of April to get out the vote … so vote early, and vote often! Winners will be announced on May 6, 2008 and honored at The 12th Annual Webby Awards in New York City on June 10^th.

Please pass this great news along to your friends and encourage them to vote as well! Thank you for your continued support of Healthline Networks.

Cowritten by Colby Zintl, Director of Communications, Healthline Networks, Inc.

Labels: Healthline, Webby Award

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Laughter Really Is the Best Medicine

Want to decrease anxiety and stress in your life? Plan positive experiences where you know you are going to laugh. Researchers studying the interaction between the brain, behavior and the immune system have found that just looking forward to a good laugh can trigger the release of beta-endorphins and HCG - hormones that protect health. Looking forward to a good laugh can also reduce stress hormones - cortisol, epinephrine and dopac. When these hormones are chronically high due to stress, the immune system is weakened.

Look for humor all around you and opportunities to laugh - and to make others laugh. If you are feeling stressed, choose comedy shows or movies to watch as entertainment rather than dramas or horror movies that might increase your stress. Be aware of opportunities to help kids, teens and the elderly laugh well and often also. Humor distracts us from negative emotions and connects us to others.

Thank you dana v. photostream for use of beautiful photo Laughter & Joy.

Labels: humor therapy, laugh medicine

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Diogenes Syndrome: Living in Extreme Squalor

Always looking for positive ways to channel my teenager's energy, I signed us up to help with a church-affiliated community rebuilding project. Hmm...Think Grey Gardens minus The Discreet Charm of the Bourgeouis. We were just along for the ride - I didn't know any of the back story, but it didn't take long for the clinician in me to assess the situation.

It was a case of three able bodied adults who disclosed psychiatric diagnoses, living in extreme squalor with a few cats and at least one dog. I've seen it before and it's always terrifying. It has a name. It is called Diogenes Syndrome or Squalor Syndrome or Messy House Syndrome.
Signs?:

• filth
• clutter
• living in isolation
• severe self-neglect
• hoarding behaviors
• compulsive hoarding is a form of obsessive-compulsive disorder (OCD)
• excessive acquisition of objects
• hoarding is different than collecting. Collecting is an organized activity and others can appreciate that which is collected.
  
• inability to discard possessions
  
• interpersonal relationships are mediated by objects
• refusal of help

Depression and dementia are risk factors for squalor syndrome. There appears to be frontal lobe involvement. Diogenes Syndrome is considered a behavioral disorder. It is highly prevalent in people aged 60-90 years who have above average intelligence with successful work histories throughout their adult lives but may have lacked significant relationships despite adequate social networks. It may represent the end stage of a personality disorder, characterized by these traits:

• aloof
• domineering
• suspicious
• aggressive
• obstinate
• lack of insight
• loss of initiative

People with Diogenes Syndrome may have had life long patterns of compulsiveness and paranoia combined with an inability to form relationships that progress into social breakdown. Persistent refusal of help, abandoning social norms and defense mechanisms of denial of need and withdrawal are distressing to family, neighbors, friends or the community who want to help. The continued refusal of help from people who are legally mentally competent presents complex ethical issues for everyone involved.

Public health hazards, fire hazards, personal health hazards are evident to the casual observer in these cases. Prognosis is poor. Management is challenging. The specter of it is chilling. It inspired me to go home and ruthlessly throw or give away bags of unneeded items and scrub everything until gleaming.

Thank you Dean Terry for use of photo, Gun Room.

Labels: Diogenes syndrome, extreme squalor.

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15 Million Americans with Social Anxiety Disorder

The Harvard Medical School is reporting that 15 million Americans have Social Anxiety Disorder that interferes with their ability to lead productive social and romantic lives. People with the disorder have difficulty developing friendships and romantic relationships, because of fears of humiliating themselves or making mistakes. The anxiety results in symptoms of sweating, heart palpitations, blushing, feeling faint and trembling.

Most people with the disorder are embarrassed by it and those who seek diagnosis and treatment find that it helps their ability to form romantic relationships. Treatment includes cognitive behavior therapy, medications (antidepressants) and relaxation technique.

So if you are wondering about people who don't answer or return your phone calls - 60% of people with social anxiety disorder report this behavior. 55% report no close friends. 77% report their problems negatively impact romantic relationships. Encourage others who may be suffering from this subtle problem to seek help.

Thank you bionicteaching for use of photo Lonely girl 14?

Labels: social anxiety disorder, social phobia

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Thank You, Dr. Wes for Grand Rounds 4.29!

Dr. Wes is a blogging cardiologist who seems to be implying my piece on a Public Health Crisis at Endoscopy Center gave him Atrial Fibrillation. Still, he included it his round up of great writing in cyberspace and for that, I thank him. Great reading all around!

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American Idol Gives Back Again: Saving Children 2008

IDOL GIVES BACK, the historic Emmy Award-winning television event and music celebration airs tonight. Wednesday, April 9 (7:30-10:00 PM ET/PT) FOX to raise awareness and funds to benefit six charities. including: the Children's Defense Fund, The Global Fund, Make It Right, Malaria No More, Save The ChildrenU.S. Programs and the Children's Health Fund.

The Children's Defense Fund: seeks to ensure child health coverage, end poverty and promote youth leadership.

The Global Fund: Fights AIDS, tuberculosis and malaria.

Make It Right: Putting people displaced in New Orleans back into green, affordable homes. (very cool project - check it out!)

Malaria No More: Bed nets to prevent malaria.

Save The Children: Sponsor a child who lives in poverty.

Idol Gives Back Foundation is a new not-for-profit organization established by the producers of American Idol and FOX to raise money and awareness for children and families living in poverty and at risk in the U.S. and abroad. Idol Gives Back Foundation is will improve the health conditions of vulnerable children and their families around the globe. Tune in tonight and be part of this global movement to improve the lives of children.

Thank you Gary Moyes/Comic Relief LTD for use of Photo American Idol judge Simon Cowell visits children in Africa.

Labels: american idol, Children's health, Idol Gives Back Foundation, Save the Children

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Wake Up Call for Pediatricians & Parents: Underage Drinking

Kids as young as 10 are now using alcohol as their drug of choice, making them at risk for problem drinking as they develop. Heavy drinking in late adolescence leads to neurological and social problems that continue to plague them the rest of their lives. 11 million kids in the US use alcohol but parents, educators and pediatricians are in a state of denial.

US Surgeon General Michael Levitt reports that by age 15, half of all kids have had a full drink of alcohol, not just a few sips. 18-20 year olds have the highest prevalence of alcohol dependency than any other age group - over 12%. More kids use alcohol than use tobacco or marijuana. 10 % of 9-10 year olds have started drinking. Middle school is the peak time of alcohol initiation.

White kids are the most likely to drink alcohol. Blacks and Asian kids have lower incidence of underage drinking. Surprisingly, the incidence of female drinking is not that much lower than it is for males. Male children indulge in more binge drinking than do females.

Underage drinking contributes to:

• accidental death from injury - the major cause of mortality in this age group
• risky sexual behaviors resulting in STD's and pregnancy
• fetal alcohol syndrome
  
• increased risk of physical and sexual assault
• academic failure
• alteration in brain function
• legal problems
• heavy drinking later in life

As a parent of a middle school student, I can unfortunately bear witness to these reports. Girls have shown up drunk at school dances and been suspended for bringing vodka to school in water bottles. This weekend a group of them had a birthday party. It was supposed to be held at a pizza restaurant, but the location was mysteriously changed at the last minute to the beach. My kid and I were both suspicious but had a plan. I would take her to the beach but if any alcohol or drugs appeared at the party, she had instructions to go across the street to a well-lit business establishment and call me. She was only there for an hour when a friend's uncle brought beer for kids as young as 12. My kid left and waited for me at the designated spot. My daughter and I, despite arguing a lot or maybe because we argue a lot, have great communication. I know she will get through these years safely and make good choices, as long as we stay close and keep talking.

It's the other kids I worry about. It's not the job of the cops to chase the kids off the beach. It's not the job of teachers to monitor what they pack in their lunches. I can't go into details about the parental indifference and apathy I have witnessed. Middle school is a vulnerable age. Kids are big enough to look like adults but immature enough to still need parental guidance and protection. Hold them close and know what's going on with them, even when they battle against you. They need us to be grown-ups and fight for them.

Thank you aiboo for use of photo drinkgirl.

Labels: alcohol use, underage drinking

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Geography Matters: Survival of Children depends on what State they are born in

The Every Child Matters Education Fund has reported startling findings. 13 million US children live in poverty, 8 million kids lack health insurance coverage and 3 million kids are abused and neglected annually. The state a child is born is a determining factor in the health, well-being and even life expectancy of the child.

The highest ranking state for quality of life of children is Vermont. The lowest ranking is Louisiana. Children in the lowest ranking 10 states are 70 times more likely to die before age 1 than kids from the 10 highest ranking states. Children in the bottom 10 states are more likely to end up in jail and teens from the lowest ranking states (Louisiana, Mississippi, New Mexico, Arizona, South Dakota, South Carolina, Nevada, Arkansas, Oklahoma and Texas) are more likely to get pregnant or die than kids living in the 10 highest ranked states (Vermont, Hawaii, Iowa, Massachusetts, Connecticut, Washington, New Hampshire, Rhode Island, Minnesota, Maine).

Vermont, Idaho, Delaware and North Dakota had no fatalities due to child abuse. Texas reported 197. California reported 140 children died due to child abuse. Florida reported 117 child deaths due to child abuse.

Federal spending on children has declined since the 1960's. We are not one nation with justice for all as long as children die from preventable causes. Childrens' health and protecting the vulnerable should be a priority for the next administration

Thank you brassard for use of photo Boxsledding in Baltimore.

Labels: childrens health

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Worried about Superbugs? Drink Green Tea

Out of Egypt comes a study reporting findings that drinking green tea while taking antibiotics increases their efficacy (ability to fight disease) by as much three times. For some reason, drinking green tea while taking antibiotics decreases the drug resistance of bacteria and increases the drugs effectiveness in fighting disease.

Green tea is brewed from the dried leaves of the evergreen shrub Camellia sinensis and has been used by humans for at least 5,000 years. Green tea has strong antioxidants and is thought to help protect against many diseases. It has known anti-microbial properties and is used to prevent halitosis (bad breath).



Thank you, tdstevenson, for use of photo Green Tea.

Labels: green tea, preventive medicine

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