Thursday, April 2, 2009

News Clipping Archives

 

Maryland / Regional

Flu appears to be ebbing in Md. (Baltimore Sun)

Cigarette Tax Climbs Over a Dollar (NBC25 NEWS)

Celebrate public health week with April 4 fair (Hagerstown Herald-Mail)

Addiction clinic advises foreign peers (Prince George’s County Gazette)

City Hall garden plots to be planted in veggies (Baltimore Sun)

Resident wants apology after identifying pesticides (Cumberland Times-News)

E. coli found in Va town's water system (USA Today)

Many uninsured adults struggle to find dental care (USA Today)

Nanjemoy Clinic Gets Funding Reprieve (Washington Post)

Woman Charged For Keeping 2 Wild Foxes In Her Home (Baltimore Sun)

EEOC files suit against Rossville medical practice (Baltimore Sun)

More patients, less money hampering clinic (Hagerstown Herald-Mail)

 

National / International

Doctors Are Opting Out of Medicare (Washington Times)

Study Finds Many on Medicare Return to Hospital (New York Times)

FDA Official Says Production Error Probably Contaminated Pistachios (Washington Post)

Massive chemo dose targets cancerous liver (Washington Post)

9 patients made nearly 2,700 ER visits in Texas (Associated Press)

Cereal box typo leads to phone sex line (Hagerstown Herald-Mail)

 

Opinion

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Maryland / Regional

 

Flu appears to be ebbing in Md.

Vaccines called 'better match' to this season's viral strains

 

By Frank D. Roylance

Baltimore Sun

Thursday, April 2, 2009

 

The 2008-2009 influenza season is not quite over, but Maryland health officials say it appears to have peaked and the number of new cases is on the wane.

 

"We expect lower levels of flu throughout the rest of the month of April, but it should finally be over by the beginning of May," said Rene Najera, an epidemiologist with the state Department of Health and Mental Hygiene.

 

This flu season has been milder than last year's, Najera said, and he credits the design of this year's vaccine.

 

"The vaccine strains were a better match" for the viruses actually circulating for most of this season, he said. "Last year, they were a complete mismatch."

 

Flu-related illness has killed three Maryland children this season. The state does not require that flu-related adult deaths be reported.

 

Baltimore-area hospitals reported that 172 adults and 194 children had been admitted for flu-related illness through mid-March, far fewer than were admitted last season.

 

This year's flu outbreaks began in Southern Maryland and spread to metropolitan Baltimore. From there, the illness moved to the Eastern Shore and finally to Western Maryland.

 

As good as this year's vaccine protection was, there are changes in the works for next season, according to the U.S. Centers for Disease Control and Prevention.

 

As the flu season has waned, B-type viruses have come to dominate, though the A-viruses had been more common for most of the winter. By the middle of March, the B-type became the majority - 52 percent of all new cases, the CDC reported. This year's vaccine had little or no impact on most of those B-viruses.

 

For next year's vaccine formulation, the World Health Organization and the U.S. Food and Drug Administration have agreed to once again include the protection against two A-viruses in this year's vaccine - two varieties of A Brisbane.

 

But the antigen for the B-viruses will be changed, from the B/Yamagata virus to the B/Victoria that came to dominate this season and showed only limited sensitivity - or none - to this year's vaccine.

 

Nationally, through mid-March, seasonal flu has killed at least 35 children, 53 fewer than during the full season last year.

 

But "we are not out of the woods yet," Najera said.

 

Copyright 2009 Baltimore Sun.

 

Cigarette Tax Climbs Over a Dollar

 

NBC25 NEWS

Thursday, April 2, 2009

 

NBC25 NEWS - The largest tax increase on tobacco products went into effect Wednesday, raising the federal tax on a pack of cigarettes from $0.39 to $1.01.

 

According to the Deputy Secretary for Health Care Financing, the money will be used to operate CHIP, the Children's Health Insurance Program.

 

In Maryland, it will continue to provide coverage to the 110,000 kids who currently use it.

 

The money will also provide coverage to legally admitted immigrant children and pregnant women during their first five years in the country.

 

Copyright 2009 NBC25 NEWS.

 

Celebrate public health week with April 4 fair

 

By Earl Stoner

Hagerstown Herald-Mail

Thursday, April 2, 2009

 

Public Health Week is April 6-12 and the theme for 2009 is "Building the Foundation for a Healthy America."

 

What is public health and why celebrate Public Health Week? Although most people are familiar with medical care through their experiences at a hospital or doctor's office, public health is largely invisible to the average person.

 

To celebrate Public Health Week, the Washington County Health Department will sponsor a health fair on Saturday, April 4 from 10 a.m. to 2 p.m. at 1302 Pennsylvania Ave. (between North High and Western Maryland Center).

 

Locally, public health is of special interest because Washington County has a remarkable history of making many contributions to public health.

 

Public health is the health of the community. While medical care focuses on making a sick person well, public health focuses on improving the health of the community at large.

 

How can that be done? By providing clean drinking water, basic sanitation, clean air, safe food preparation, and vaccinations. More than 80 percent of the 30 years in life expectancy Americans have gained since 1900 is due to these basic steps.

 

In the 20th century, the primary challenge confronting public health was control of infectious diseases. In 1900, the three leading causes of death were pneumonia, TB and intestinal infections. Due to great advances in the last century, infectious diseases are no longer the leading causes of death, although some, such as HIV, remain a potent threat.

 

Today, chronic diseases have replaced infectious diseases as the leading causes of death. The top three today are heart disease, cancer and stroke.

 

Moreover, about 40 percent of early deaths are attributed to smoking, obesity, inactivity, violence, alcohol, drugs and motor vehicle injuries. Even if every American had access to excellent medical care, only a small fraction of early deaths could be prevented.

 

Inadequate health care accounts for only 10 percent of early deaths, even though enormous resources are committed to health care. Behaviors contribute more to health than genetic predisposition, socioeconomic status or environmental factors.

 

The challenge is to reduce behaviorally-associated diseases and early deaths. For the first time in history, the keys to a healthy life and community are within our control as never before.

 

Decisions regarding smoking, drinking excessively, using illicit drugs, driving recklessly, wearing a seat belt or engaging in violence determine to a large extent not only individual health, but the community's health. Our youth are now more likely to die as a result of violence, drug use, or motor vehicle accidents than of infectious diseases.

 

Washington County's considerable contributions to public health began with the establishment of the Coffman Research Center.

 

Made possible by the contribution of philanthropists Andrew and Gladys Coffman, the center stood on the site of the current Health Department's main building on Pennsylvania Avenue. Our county's contributions were the result of county residents participating in research projects by the National Institutes of Health and Johns Hopkins University.

 

In fact, Washington County has produced more research findings that have advanced public health than virtually any other community in the country.

 

Perhaps the most enduring legacy is the Hagerstown Health Study that occurred in the 1920's. This study documented for the first time ever the extent of illness in a community. Previously, no one knew how common illnesses were. It was just assumed that "everyone got the flu" or "injuries just happen." The local study was the forerunner of today's National Health Interview Survey, which publishes important data on health insurance coverage, risk factors for disease and health status, all used to establish public health programs and priorities.

 

Other examples include the finding that being overweight in childhood is associated with high blood pressure and reduced life expectancy in adulthood. A dental index now used nationwide to record decayed or missing teeth was developed from Washington County school children.

 

Interestingly, a bereavement study found an increased rate of death among surviving spouses, particularly widowers. Other advances are under way today, thanks to the participation of the Washington County community.

 

The Health Department also has a role in public health. Its primary purpose is to promote the health of the community. Some services are well known, such as provision of flu shots and restaurant inspections.

 

Others are less known, such as the review of building permits to ensure adequate water and sanitation, and to check for possible lead or asbestos hazards. Additional services include communicable disease investigations, addictions and mental health treatment and the provision of school health services, among many others.

 

We celebrate Public Health Week because of the historic contributions and future possibilities of Washington County. See you on April 4.

 

Earl Stoner is health officer of Washington County.

 

Copyright 2009 Hagerstown Herald-Mail.

 

Addiction clinic advises foreign peers

Afghani, Kenyan delegates study best practices at Upper Marlboro center

 

By Greg Holzheimer

Prince George’s County Gazette

Thursday, April 2, 2009

 

The patients are different, and so are their addictions. But when a dozen addiction treatment specialists came to a clinic in Upper Marlboro on March 23, they realized Afghanistan, Kenya and the United States have one thing in common — many of their addicted mothers don't get the care they need.

 

The five-day visit to Mellwood House, a center run by the nonprofit Second Genesis, was sponsored by the U.S. Department of State and the International Narcotics and Law Enforcement Bureau with the goal of giving the foreign specialists pointers on caring for addicted women and their children.

 

"We want to see how [Mellwood House] runs," said Jennifer Kimani, director of the National Campaign Against Drug Abuse Authority in Kenya. "The scenario in Kenya is that women do not get treatment."

 

Mellwood client Denise B., who is receiving treatment for alcohol and crack addictions, said she understands the challenges the Kenyan and Afghan delegates are facing. Her family has stood by her even though she has stolen money from them, but many addicted women find themselves alone, she said.

 

Denise — Second Genesis staff asked that her last name not be used — said she hopes the visit will improve treatment in Afghanistan and Kenya. But the tour has done almost as much for the American patients, she said.

 

"We all really have the same problems," she said. "[The visit] makes me realize why I'm here. I'm here for help, but maybe I can help somebody else."

 

Dr. Toorpaikay Zazai, who works at a clinic in Kabul, Afghanistan, and was one of the doctors who visited Mellwood House, said social stigmas prevent many women from seeking treatment.

 

"Some women are not coming to our center because they [are] ashamed," Zazai said. "[Their husbands] are ashamed."

 

Many mothers do not get treatment because their husbands died in wars with Russia and the United States, leaving no one else to look after their children. Women take opium for pain management, often during pregnancy, and some give it to their children to make them easier to manage.

 

The United Nations estimates that in Afghanistan there were 120,000 women and 60,000 children addicted to drugs in 2005.

 

"Some family coming with five, seven children, coming with drug addiction," Zazai said.

 

Zazai said she likes the fact that staff at Second Genesis holds daily meetings and she is impressed by the nonprofit's child care program and support groups. She wants to bring similar programs to her clinic in Kabul, she said.

 

Mellwood House lets children live with addicted parents when they come in for treatment, which usually lasts for six or nine months. Second Genesis staff members say they try to treat addiction in the context of women's families.

 

The foreign delegates sat in on group therapy sessions, saw how mothers are encouraged to interact with their children and watched clients receive job training. Second Genesis also gave them books outlining proper clinical procedures and pointers on administration and fundraising.

 

Kimani, one of the two Kenyan delegates, said the tour has given her a better understanding of how to ask for donations from the Kenyan government and private foundations. Kenya does not provide public funding for addiction treatment, she said.

 

Kimani also hopes the visit will strengthen her hand when she returns to Kenya. If she can convince the government that Second Genesis' program is successful, she might get enough funding to start a small clinic as a pilot program, she said.

 

"This strengthens our case," she said. "We have treatment centers [in Kenya]. But you have to pay—and pay handsomely."

 

Copyright © 2009 Post-Newsweek Media, Inc./Gazette.Net.

 

City Hall garden plots to be planted in veggies

Crops will help to feed the poor at Our Daily Bread

 

By Susan Reimer

Baltimore Sun

Thursday, April 2, 2009

 

Baltimore, which sometimes carries a poor-cousin chip on its shoulder when it comes to the nation's capital, is about to trump the city to the south.

 

Mayor Sheila Dixon is planning to turn the formal gardens in front of City Hall into vegetable gardens covering about 2,000 square feet. Michelle Obama's White House vegetable garden measures only 1,100 square feet.

 

"This was being planned before the White House," said Dixon, firmly. "We are not copying!"

 

The city will be planting decorative urns, about 70 window boxes and several formal raised beds with spring and summer vegetable crops that will benefit Our Daily Bread, which feeds 700 to 800 people a day and often finds itself, even in summer, relying on canned vegetables.

 

"We have a cook who is thrilled," said Kerrie Burch DeLuca, director of communications for the soup kitchen.

 

When asked how many recipes she had for Swiss chard, a favorite element in the design for the City Hall gardens, she laughed. "We will find some," she said. "Nothing will go begging. This is our happy day."

 

City Hall's move reflects the growing interest in vegetable gardens this year as consumers try to deal with a tough economy and concerns about health and food safety.

 

"This news about Baltimore is wonderful news," said Roger Doiron, founder and director of Kitchen Gardeners International, a Maine-based nonprofit that advocates for locally grown food and has campaigned for high-profile vegetable gardens. "It will inspire people to rethink the role cities can play in feeding themselves."

 

Doiron credits the Obama garden with creating a "domino effect" in the United States. "This is why we pushed so hard for so long," he said. "We knew [a White House vegetable garden] would have this inspirational potential."

 

This week, California first lady Maria Shriver announced plans for a vegetable garden at the Statehouse in Sacramento. Citizens in Flint, Mich., are planting a 2-acre vegetable garden in the middle of town. A garden is planned around the Kingston, N.Y., town hall, Doiron said, and the first family of Georgia is discussing an official garden. Maryland's first lady, Katie O'Malley, is planning a vegetable garden for Government House in Annapolis, too, despite the abundance of shade trees.

 

Planting for the Baltimore vegetable garden is expected to begin Saturday. The plantings will extend from the porches of City Hall across War Memorial Plaza to Gay Street.

 

"We have an opportunity to do something right here in front of City Hall," the mayor said. "We have a chance to lead by example and to inspire residents, to show that in an urban environment you can still maintain healthy eating."

 

The City Hall vegetable gardens will be more than bountiful - producing a very conservative estimate of $3,000 worth of everything from kale to corn.

 

They will be beautiful, too, said Angela Treadwell-Palmer, a landscape designer who planned the garden.

 

She at first envisioned a couple of small demonstration gardens: "I was thinking we could just show how pretty vegetables could be." But Bill Vondrasek, head of horticulture for the Department of Parks and Recreation, loved the idea and told her to run with it.

 

"The mayor set the tone with her cleaner, greener, safer, healthier Baltimore," said Vondrasek. "When you have her support, you start thinking about what you can do."

 

Although the scope of the city's vegetable garden might seem ambitious, he said, "The areas that will have vegetables are the same areas that the horticultural staff plants with annuals every year."

 

This year, the city will have extra help from the master gardeners who volunteer at the Cylburn Arboretum in Northwest Baltimore. Because of construction of a new visitors center this year, there is no vegetable garden. So they have some free time on their hands.

 

"This is a big effort on our part, as you might imagine," said Allan DeGray, a master gardener and volunteer with Cylburn who lives, coincidentally, in Gardenville in the city.

 

The Cylburn volunteers will maintain the beds, rotate crops from spring to summer vegetables and harvest the produce weekly so there is nothing on the ground to attract rodents - one of Dixon's chief concerns. Seeds are being donated by Baltimore's Meyer Seed Co. Water trucks that normally maintain the city's plantings will handle the watering.

 

"San Francisco did something similar last year," said Treadwell-Palmer, whose company, Plants Nouveau, introduces new plants to the market. "When you think about it, this isn't a whole lot more trouble than maintaining the bulbs and the annuals the city plants."

 

Treadwell-Palmer's plans are ambitious and her designs are classic.

 

The enormous urns at the foot of the City Hall steps will be planted with sweet potatoes and black pearl peppers. The 70 window boxes on the balustrade beneath the flags and in front of the bronze doors will be planted with a lime-green Swiss chard and more black pearl peppers.

 

Two of the beds near the parking lot will be demonstration vegetable gardens. "They are the perfect size for rowhouse vegetable gardens, and we'll plant the kinds of things that can produce enough food for a family of four," said Treadwell-Palmer.

 

The Cylburn volunteers hope to be there at lunchtime during the week to answer questions from visitors about growing their own vegetables.

 

In the beds around the flagpoles, gardeners will plant edible ornamentals: red mustard greens, red kale and leeks.

 

There will be rhubarb and cucumbers, acorn squash, cabbage, lettuce, peppers and zinnias for cutting along the fence that overlooks War Memorial Plaza (which will not be planted with vegetables because it is the site for summer festivals).

 

Perhaps the most charming aspect of Treadwell-Palmer's plan is for the four classic potage gardens. The raised planters will be filled with an "X" of herbs, including Italian parsley, sage, lavender and rosemary.

 

The four quadrants that the herbs create will be filled with kohlrabi, beets, celery, radishes, carrots, onions, eggplant and zucchini.

 

The farthest beds, across Gay Street from the War Memorial Building, will have elaborate bamboo trellises for cherry tomatoes, and stripes of red and green lettuce, to be replaced with summer crops of okra, collard greens and sweet corn, and with sweet potatoes tucked underneath.

 

The master gardeners from Cylburn gave Treadwell-Palmer a wish list of vegetables, and she used the design skills she learned at the University of Delaware to create a showpiece for the city.

 

"They had to show me that they could do this in a way that would benefit the city," said Dixon, who gave her blessing after she received assurances that the gardens would be maintained in a way to discourage rodents - and that her beloved tulips would remain.

 

"We will be planting the cool-weather crops in between the tulips," said Vondrasek. "About the time the tulips are done, we will be harvesting the lettuces and putting in the summer crops."

 

Will Dixon, who described herself as a "gardener-in-learning," be out in the plots, rake and pruners in hand? "Possibly," she said.

 

Copyright 2009 Baltimore Sun.

 

Resident wants apology after identifying pesticides

 

By Tess Hill

Cumberland Times-News

Wednesday, April 1, 2009 09

 

CUMBERLAND - A Broadway Street resident is asking for a letter of apology from the city after he identified the city’s use of an unregistered pesticide in September. The city had responded with a letter saying his allegations were false, that the pesticide was registered and he was to cease all allegations.

 

At Tuesday’s City Council meeting, Henry Hepner addressed the mayor and council members once again about the chemical Top to Bottom, also known as Knock Out.

 

“When I got a letter to cease all allegations against the city, I contacted the (Maryland) Department of Agriculture, which in their 241-page report, the city got seven violations,” Hepner said. “I believe with the health issues, I think it’s very important that hospitals, doctors, veterinarians and citizens of Cumberland be notified immediately about the effects of this chemical.”

 

The MDA began its investigation in October after Hepner had filed a complaint. Prior to his complaint, he had called the city three times and also addressed the mayor and council at a public meeting.

 

Dennis Howard, chief of the MDA’s Pesticide Section, found the city rinsed the pesticide containers three times and then poured the remaining solution in the sewer drain, which goes to the wastewater treatment plant. The barrels were then painted and used as trash cans in the city’s shop and various parks. Howard said the proper way to dispose of containers is to make them available for recycling.

 

John Chapman, director of the city’s public works department, said the city bought this product because it was less expensive and had been used previously. City Administrator Jeff Repp noted the first recorded purchase of Top to Bottom was Aug. 27, 2003.

 

On Sept. 23, 2008, the city received a letter from Howard ordering the city to immediately cease use of Top to Bottom until it was registered with the MDA.

 

The product was registered with the Environmental Protection Agency on Sept. 25 and with the MDA State Chemist Section around Oct. 1, at which time the city resumed its use.

 

On Jan. 21, Howard sent the city a notice warning it was in violation of seven sections of the Regulations Pertaining to the Pesticide Applicator’s Law.

 

• Failure to use pesticides in strict accordance with the label.

• Failure to provide adequate employee training.

• Improper disposal of pesticides and their containers.

• Improper storage.

• Failure to immediately notify the department of a pesticide incident.

• Failure to provide each employee with personal protective equipment.

• Failure to maintain complete and accurate records.

 

The pesticide has been used at the Jaycees Recreation Complex, Long Field and other areas at Constitution Park, the medians on Centre Street, City View Terrace, Giarritta Parklet in front of City Hall and many other places throughout the city.

 

The MDA also found Get Back Wasp and Hornet Spray was not registered with the state. The Jan. 21 letter notified the city to cease application of that pesticide until properly registered in Maryland.

 

Both products are distributed by Select Specialty Products in Charlottesville, Va. Chapman said he asked if the products were registered and was told by the salesman that they were.

 

Information from the U.S. Environmental Protection Agency and the Material Safety Data Sheet states potential health effects from Top to Bottom include mild eye and skin irritation, dizziness, nausea, headaches, or loss of consciousness if the vapors or mists are inhaled. It also can be harmful or fatal if ingested. Long-term effects include potential brain and nervous system damage, birth defects or other reproductive harm. It is also toxic to aquatic invertebrates.

 

Mayor Lee Fiedler asked Hepner to leave the information he had with Repp, who would look into the issue before the next meeting. Hepner was willing to leave some of the information but said the city would have to request its own copy of the MDA report.

 

Further discussion will continue at the next city meeting, April 14, at 6:15 p.m. in City Hall.

 

Contact Tess Hill at thill@times-news.com.

 

Copyright © 1999-2008 cnhi, inc.

 

E. coli found in Va town's water system

 

Associated Press

USA Today

Thursday, April 2, 2009

 

BUCHANAN, Va. (AP) — Buchanan residents are under a boil water advisory after tests conducted by the state found E. coli in the town's water system.

 

The Virginia Department of Health issued the advisory Wednesday. Bobby Parker with the Department of Health says water used for drinking or cooking should be boiled. Water used for bathing does not have to be boiled.

 

Mayor Tom Middecamp says the town plans to install a new filtration system to correct the problem.

 

But that project isn't expected to be completed until June 2010.

 

An informational meeting for the public was to be held Thursday evening.

 

Copyright 2009 The Associated Press. All rights reserved.

 

Many uninsured adults struggle to find dental care

 

By Sarah Bruyn Jones

USA Today

Thursday, April 2, 2009

 

ROANOKE, Va. — Before Jessica Creel celebrated her 21st birthday, she went to the dentist.

 

"I have to go or I won't be seen at all," the mother of two said before the appointment.

 

Virginia adults on Medicaid don't qualify for dental services, but before a 21st birthday they can still use Medicaid at the dentist.

 

Despite several community efforts to bring dental services to low-income, uninsured adults, living with dental pain has become commonplace for many in southwest Virginia.

 

Creel said she felt lucky to squeeze in a dental appointment before the cutoff, but she was worried what would happen if the dentist found too many things wrong to fix in one sitting.

 

Her fears came true.

 

She had two wisdom teeth pulled and a root canal. Four cavities were also discovered, but there wasn't time to fix them. Without a place to go, Creel said she won't have the cavities filled.

 

"There are plenty of people who go untreated, there is no question about that," said Dr. Richard Joachim, an area dentist and the dental director for Bradley Free Clinic. "I know of heart-wrenching stories of suffering moms who in some cases have gone years with chronic infections. There is plenty of need out there. And how to help out with that is challenging."

 

Bradley is one of the better-known places where adults can receive dental care. But getting into the program is not easy.

 

Between 75 percent and 80 percent of people who call Bradley for dental care are turned away, Joachim said. Many of those people are placed on a waiting list, but are never seen because Bradley cannot meet the demand.

 

Bradley isn't the only program with an extensive waiting list.

 

The Virginia Dental Association runs a donated dental services program for the elderly or those with a disability. That program has a waiting list of more than 700 people, and most patients have to wait a year and half for services, said Barbara Rollins, who helps coordinate the program.

 

With this year's cancellation of a two-day free dental clinic that has served about 1,000 people annually, people such as Creel are expected to have even fewer options for dental care. For two years the Roanoke Mission of Mercy dental clinic has been a spring event at the Roanoke Civic Center, but scheduling conflicts forced organizers to push it back to March 2010.

 

For many adults, Mission of Mercy is the only opportunity they have for dental care. Last year 5,038 dental procedures were performed on 991 people, including the pulling of 2,023 teeth.

 

Still, Mission of Mercy can't even meet the need, as each year hundreds of people are turned away.

 

"Many, many adults in the Roanoke area and all of southwest Virginia have learned to live with the pain, and you can do that up to a certain point," said Tom Adams, the dental grants coordinator for Carilion Clinic. "I've talked to people whose mouths look so terrible you just cannot believe the amount of disease they've been walking around with."

 

Worried that postponing the Mission of Mercy for a year would exacerbate any already serious problems, Joachim said he is working with others to put together an adult clinic within the next few months.

 

The substitute clinic will likely not be open to the public. Instead patients will be identified from Bradley's waiting list and through programs such as Project Access of the Roanoke Valley and Child Health Investment Partnership.

 

The patients will likely be screened at the free clinic and then sent to various volunteer dentist offices for treatment.

 

Details are still being worked out, and Joachim said the number of people helped will depend on how many area dentists can be recruited for the cause.

 

While the need for adult services is clear, the state of dental care access for children is slightly different.

 

"As for the children's (access) problem, we haven't solved it, but it's not as big of a problem any more," Adams said.

 

Adams was among those who helped to open Carilion's Pediatric Dental Clinic in 2001.

 

That said, pediatric dental services aren't always the easiest to access. The Pediatric Dental Clinic currently has just one dentist, causing some patients to have to wait for services, Adams said. Typically, the clinic has three dentists, and Adams said they are recruiting for two more.

 

Additionally, the Roanoke City Health Department is also looking to recruit two dentists for its program that sees patients under 21 years of age. Both of the dentists who had worked for the health department recently left, leaving the program without a dentist, said spokesman Robert Parker.

 

"We fully intend to restore that program," Parker said. "We recognize the need for access is becoming more and more important in an economic environment like this."

 

Copyright 2009 The Associated Press. All rights reserved.

 

Nanjemoy Clinic Gets Funding Reprieve

 

By Megan Greenwell

Washington Post

Thursday, April 2, 2009; SM03

 

The imperiled Nanjemoy health clinic has been awarded a grant under the federal stimulus package that will help keep it open, at least in the short run.

 

The clinic, operated by Greater Baden Medical Services, is one of 1,128 health centers nationwide that has received money through a grant program funded by the economic stimulus package passed by Congress last month.

 

Greater Baden, which runs seven clinics in Prince George's, Charles and St. Mary's counties, will receive $270,000 in federal money, its director said Monday.

 

Nanjemoy Health Service, operated out of the county-owned community center, serves about 750 of Charles County's poorest residents, many of whom have no insurance. It is the only health clinic in the rural southwestern part of the county. For most residents, the next closest one is in La Plata, about 15 miles away.

 

Greater Baden officials had said in February that the Nanjemoy clinic would close in a few months without new sources of funding.

 

"Greater Baden Medical Services has provided critical health care to individuals and families throughout our area for nearly three decades," U.S. House Majority Leader Steny H. Hoyer (D-Southern Maryland) said in a statement. "This grant will enhance the clinic's ability to continue that service and better attend to the health needs of those who might not otherwise get the care they require."

 

But for Nanjemoy residents, the news is not all good. The clinic must still move to a more central spot in Charles to stay financially viable, program director Rachel Smith said.

 

"Part of the grant is that we must make the clinic sustainable, and we can't do that without moving to a more populated area," Smith said. "We plan to retain the jobs at Nanjemoy until we find a more suitable facility."

 

Clinic administrators are exploring the possibility of moving to a vacant space in the county's social services building in La Plata. Although the grant will cover staff salaries for two years, Smith said, the Nanjemoy facility will probably close sooner than that. The clinic has lost about $150,000 a year since it opened in 1995, executive director Sarah Leonhard said.

 

Moving the clinic would deal a serious blow to Nanjemoy residents, including many who have neither cars nor phones. The county's bus service, VanGo, recently scaled back its service to Nanjemoy.

 

"If you move the clinic, most folks won't have the ability to get to the new one, or if they do, they'll take an ambulance, which is much more expensive," said Rick Campbell, a Nanjemoy resident and clinic patient who has pushed to keep the clinic there.

 

"There are so many more underlying issues about poverty and transportation that are hurting the community," he said.

 

Still, the grant is a victory for Greater Baden, which hopes to expand services at its profitable clinics while finding a way to sustain a facility in Charles.

 

"We still have to make a move, but this allows us to retain the jobs," Smith said. "We do plan to keep serving Charles County."

 

Copyright 2009 Washington Post.

 

Woman Charged For Keeping 2 Wild Foxes In Her Home

 

By Suzanne Collins

Baltimore Sun

Thursday, April 2, 2009

 

MONTGOMERY COUNTY, Md. (WJZ) ― A Montgomery County woman who nursed two injured foxes back to health has just been to court on nine criminal counts for housing the wild animals.

 

A Montgomery County woman who nursed two injured foxes back to health has just been to court on nine criminal counts for housing the wild animals.

 

Suzanne Collins reports a judge let the woman off easy, but she still thinks Natural Resources Police went too far.

 

Harriett Crosby loves animals, and she used to work at an animal rehabilitation center.

 

She'd been caring for a fox with an injured leg at her home for more than a year, and recently someone gave her a younger one that needed nursing care.

 

"My plan was to release them. I was going to take them to the country, nice wooded place and set them loose," said Crosby.

 

But a Natural Resources officer came in December. She was given a citation and told she had 45 days to get rid of the wild animals.

 

Crosby and her friend say they were surprised when more officers returned just three days later to confiscate the foxes.

 

"I was here, and I insisted that they honor what they said three days earlier, and they said 'No, we're taking the animals, and we're going to kill them,'" said Brett Kimberlin, Crosby's friend.

 

"I was just shocked. I was panicked. It was like somebody saying we're going to kill your child," said Crosby.

 

A spokesperson for DNR says Crosby didn't have an animal rehabilitation permit, and the first officer later learned, unlike fallow deer, foxes are on a list of animals at risk for rabies and a public health danger.

 

"The fox, or raccoon, or skunk, or bear must be seized immediately if they're found to be in captivity," said Captain Robert Davis, DNR.

 

Crosby says she quickly took the foxes in their cages, put them in her Prius to try to drive them to the woods and release them. She says police blocked her car and pulled her out of the driver's seat.

 

"They just manhandled her, grabbed the cages, put her on the ground, basically assaulted her," said Kimberlin.

 

"I don't really know what happened. I wasn't there and can't really speak intelligently to that," said Davis.

 

But it was Crosby who was charged with assault and with all nine criminal charges related to keeping wild animals.

 

"Why do they criminalize taking care of animals while they allow people to get a permit or trap, hunt, shoot and kill," said Crosby.

 

Late last week, a judge let Crosby plead guilty to a very minor charge. All the rest were dropped. She paid a $10 fine.

 

The Humane Society of the United States says it tried to intercede so the foxes weren't euthanized, but it does not condone keeping wild animals in captivity without a permit.

 

(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)

 

EEOC files suit against Rossville medical practice

 

By Mary Gail Hare

Baltimore Sun

Thursday, April 1, 2009

 

The U.S. Equal Employment Opportunity Commission said Wednesday that it has filed a lawsuit against a Baltimore County medical practice for firing an employee who attempted to return to work after breast cancer surgery.

 

The suit, filed in the U.S. District Court for Maryland, alleges that Medical Health Group Inc. of the 9100 block of Philadelphia Road in Rossville violated the Americans with Disabilities Act by discriminating against Barbara Metzger, a 58-year-old referral clerk, who had worked at the company for nearly 25 years.

 

"The ADA was enacted to enable people with disabilities to work," Maria Luisa Morocco, EEOC senior trial attorney, said Wednesday.

 

Metzger, a Baltimore resident, was diagnosed with breast cancer in January 2007 and was fired on May 31, 2007, about one week before her approved five-month medical leave ended, according to the suit. Shortly before she was fired, Metzger had informed her employer that she planned to work while undergoing her remaining chemotherapy and radiation therapy.

 

"Ms. Metzger was ready, able and medically clear to work," Morocco said. "Her employer made an incorrect assumption about her ability to work that was not based on medical fact. This is surprising given this was a medical practice."

 

Deb Wolcott, practice manager for the company, said Wednesday that she had no knowledge of the lawsuit and had no comment.

 

The EEOC said it was unsuccessful in its attempts to reach a voluntary settlement before filing the suit.

 

"We bring lawsuits like this to provide appropriate protection for working women who are battling or who have battled breast cancer," EEOC Acting Regional Attorney Debra M. Lawrence said in a news release Wednesday. "It is hard to understand how a medical practice could blatantly disregard its statutory obligation and summarily fire a qualified employee who had devoted 25 years of service to her employer."

 

Copyright 2009 Baltimore Sun.

 

More patients, less money hampering clinic

 

By Andrew Schotz

Hagerstown Herald-Mail

Thursday, April 2, 2009

 

HAGERSTOWN - Without more money, the Community Free Clinic in Hagerstown might stop seeing new patients, its executive director said Wednesday.

 

A year ago, the clinic at 249 Mill St. accepted about 10 new patients a week. Now, that number is 40, clinic executive director Robin Roberson said.

 

The effects of a faltering economy have hit the clinic and the community, Roberson said. More patients need free medical care, but it’s been tougher for the clinic to raise more money, she said.

 

The clinic is holding an open house April 2 for the public, particularly donors, to learn about its services.

 

Roberson said patient visits spiked around August or September of last year, after a few local employers had large layoffs and other established businesses eliminated health-insurance coverage for employees.

 

The clinic’s 2008-09 operating budget was about $680,000, she said. Money comes from grants, fundraisers, local government, charities and private donations.

 

Revenue from contributions is about 50 percent below budget for January and February, Roberson said.

 

Some businesses have ended their corporate sponsorships, and certain grants no longer are available.

 

The federally funded Tri-State Community Health Center has had a “significant increase” in patients needing medical help in Cumberland, Md., and McConnellsburg, Pa., administrator Sheila DeShong said.

 

The center operates clinics and charges sliding-scale fees in Cumberland, McConnellsburg and Hancock, where the increase has been more manageable, she said.

 

In an e-mail, DeShong said the number of patients there steadily increased about 3 percent per month from November 2008 to February 2009.

 

“Fortunately, some of the employers that have closed or reduced their work force have continued health care benefits for their employees for a period of time,” she wrote. “I think we have yet to see some of the impact.”

 

A few Community Free Clinic patients talked Wednesday about the value of the service.

 

Brandi Nelson, 24, of Hagerstown said her health insurance as a server at Buffalo Wild Wings doesn’t cover her diabetes, a pre-existing condition.

 

She said her blood-sugar level skyrocketed one day and she was very sick, so she visited the clinic. Two years later, she gets insulin, syringes and blood tests there. The clinic has twice replaced her glucose meter.

 

Nelson said she donates when she can. Every now and then, she takes chicken wings there to show her appreciation.

 

Last year, Winfred Winston of Hagerstown lost his job when General Electric closed its Maugansville distribution center. That was the end of his health insurance.

 

Winston, 50, said he needs medicine for diabetes and to control his blood pressure. He goes to the clinic a few times a month and contributes when he can.

 

“If I got change, I put it in the box,” he said.

 

He said the area needs more of what the clinic provides.

 

“You need somebody when you’re down and out,” he said.

 

Dora Webb of Hagerstown said epilepsy prevents her from having a steady job and affording medicine. She was a paralegal at a law firm and has worked as a waitress.

 

Through the clinic, she said, she gets medicine to control seizures and depression.

 

Webb, 51, said she also got medicine to ease the sharp pain of a tumor that was later removed.

 

“We’re very fortunate to have a clinic like that ...,” she said. “I wish I had money because I’d give the clinic lots of it.”

 

If You Go

What: Open house

When: Thursday, 5:30 to 7:30 p.m.

Where: Community Free Clinic, 249 Mill St., Hagerstown

 

Hagerstown Herald-Mail.

 

National / International

 

Doctors Are Opting Out of Medicare

 

By Julie Connelly

Washington Times

Thursday, April 2, 2009

 

EARLY this year, Barbara Plumb, a freelance editor and writer in New York who is on Medicare, received a disturbing letter. Her gynecologist informed her that she was opting out of Medicare. When Ms. Plumb asked her primary-care doctor to recommend another gynecologist who took Medicare, the doctor responded that she didn’t know any - and that if Ms. Plumb found one she liked, could she call and tell her the name?

 

Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors - often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists - are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle.

 

When shopping for a doctor, ask if he or she is enrolled with Medicare. If the answer is no, that doctor has opted out of the system. Those who are enrolled fall into two categories, participating and nonparticipating. The latter receive a lower reimbursement from Medicare, and the patient has to pick up more of the bill.

 

Doctors who have opted out of Medicare can charge whatever they want, but they cannot bill Medicare for reimbursement, nor may their patients. Medigap, or supplemental insurance, policies usually do not provide coverage when Medicare doesn’t, so the entire bill is the patient’s responsibility.

 

The solution to this problem is to find doctors who accept Medicare insurance - and to do it well before reaching age 65. But that is not always easy, especially if you are looking for an internist, a primary care doctor who deals with adults. Of the 93 internists affiliated with New York-Presbyterian Hospital, for example, only 37 accept Medicare, according to the hospital’s Web site.

 

Two trends are converging: there is a shortage of internists nationally - the American College of Physicians, the organization for internists, estimates that by 2025 there will be 35,000 to 45,000 fewer than the population needs - and internists are increasingly unwilling to accept new Medicare patients.

 

In a June 2008 report, the Medicare Payment Advisory Commission, an independent federal panel that advises Congress on Medicare, said that 29 percent of the Medicare beneficiaries it surveyed had a problem finding a primary care doctor or specialist to treat them, up from 24 percent the year before. Those looking for a primary care doctor had more difficulty. A 2008 survey by the Texas Medical Association found that while 58 percent of the state’s doctors took new Medicare patients, only 38 percent of primary care doctors did.

 

Currently, about 40 million Americans have Medicare insurance, according to medicare.gov. Coverage is provided to those 65 or older, some younger disabled people and people of all ages with end-stage renal disease.

 

Those approaching Medicare eligibility should talk to their doctors. Even doctors who won’t take new Medicare patients may be willing to allow their existing ones to remain in their care. If they are not, it’s advisable to start looking around. But the search will be easier for people who start early.

 

“If you have just moved into town and are 64,” said Dr. Jeffrey P. Harris, an internist and the president of the American College of Physicians, “it is easier for you to see a doctor than if you had just moved into town and are 65.”

 

Before giving up on a doctor who will not accept Medicare, a patient should ask about signing a private contract that stipulates the patient will be responsible for paying the doctor’s fees and lists exactly what those fees are and what they cover. Some doctors may be willing to negotiate and tailor prices to what patients can afford.

 

For example, a doctor who charges younger patients with employer health coverage $250 for an office visit might be willing to accept $175 from an older patient who pays cash and requires no insurance claims.

 

“I have a lady of 93 who pays me $5 a visit, and for her that’s real money,” said Dr. Steven D. Knope, an internist and private contract doctor in Tucson. “I charge her because then she listens to what I say.”

 

How do you find a doctor who accepts Medicare? The Web site www.medicare.gov provides a list of enrolled doctors. Other sources are state medical societies and local hospitals, most of which have online directories of doctors. But that’s no guarantee they will see new patients.

 

Other options are also available. Roughly 18,000 walk-in, stand-alone urgent care centers in the United States are staffed with doctors who set simple fractures, take X-rays, do minor surgery, diagnose ailments and write prescriptions. By far the majority of these centers take Medicare.

 

Although they were never intended to provide continuing care, “our primary care practice is growing more than anything else,” said Dr. Franz Ritucci, who is medical director of the American Academy of Urgent Care Medicine and practices at America’s Urgent Care in Orlando, Fla., a chain of walk-in centers that also has clinics in Columbus, Ohio.

 

The centers are open 12 to 18 hours a day and patients do not need an appointment, though they may have to wait. Some centers allow appointments to see a specific doctor for follow-up.

 

“If you can hook up with a primary care provider in an urgent care center who is willing” to provide continuing care, said Dr. J. James Rohack, a cardiologist who is president-elect of the American Medical Association, “then yes, it’s an option.”

 

Type “urgent care centers” into a search engine and thousands come up. In June, the Academy of Urgent Care Medicine plans to add a list of centers it has accredited to its Web site, www.aaucm.org.

 

Another, more expensive option is concierge or “boutique” care, which comes in two forms. In the most popular kind, doctors accept Medicare and other insurance, but charge patients an annual retainer of $1,600 to $1,800 to get in the door and receive services not covered by Medicare, like annual physicals. Before signing up and paying the retainer, patients should get a written agreement spelling out which services the doctor will bill Medicare for and which the retainer covers. And always check carefully for double-billing.

 

The other form of concierge medicine - doctors who have opted out of Medicare - is more expensive still. Fees range as high as $15,000 a year and cover office visits, access to the doctor when care is needed, referrals to specialists and thorough annual physicals.

 

Dr. Knope, the author of “Concierge Medicine: A New System to Get the Best Healthcare,” has this kind of practice in Tucson. His patients sign a contract agreeing to pay $6,000 a year for individuals and $10,000 a year for couples. The fee covers office visits, physical exams and phone consultations, and Dr. Knope will meet patients in the emergency room, see them in the hospital and occasionally make house calls.

 

A list of about 500 concierge doctors throughout the country is available on Dr. Knope’s Web site, www.conciergemedicinemd.com.

 

Is the care worth the money? Harold and Margret Thomas, who are in their mid-70s and live in Cincinnati, spend the winter in Tucson. After many phone calls, the couple were unable to find an internist in Tucson who took new Medicare patients, so they signed with Dr. Knope in 1996. Five years ago, when Mrs. Thomas developed a blinding headache, her husband called the doctor at 8 o’clock one night, and he, suspecting an aneurysm, insisted they get to the emergency room immediately.

 

The doctor met them and ordered an M.R.I. and a CT scan. The tests revealed an aneurysm, and Dr. Knope found a surgeon who quickly operated. Medicare paid for the emergency room, the surgery and the hospital stay.

 

“If there were a concierge practice in Cincinnati, I’d be part of it there, too,” Harold Thomas said.

 

Copyright 2009 The New York Times Company.

 

Study Finds Many on Medicare Return to Hospital

 

By Reed Abelson

New York Times

Thursday, April 2, 2009

 

The nation spends billions of dollars a year on patients’ return visits to the hospital — many of which are readmissions that could be prevented with better follow-up care, according to a study published Wednesday in the New England Journal of Medicine.

 

As many as a fifth of all Medicare patients are readmitted within a month of being discharged, according to the study, and a third are rehospitalized within 90 days.

 

Half the patients who returned to the hospital within 30 days of undergoing treatment other than surgery apparently did not see a doctor before they went back.

 

The high rate of hospital readmissions is “one of the fruits of an increasingly fragmented health care system,” said Dr. Stephen F. Jencks, a former Medicare official who is an author of the study, which analyzed Medicare claims information for 2003 and 2004. He estimated that the cost of the unplanned return trips was $17 billion in 2004 alone.

 

Policy analysts say that while high return rates have long been a problem, controlling those costs is increasingly urgent.

 

“Given the current financial situation, this is no longer something we can ignore,” said Dr. Anne-Marie J. Audet, a policy specialist for the nonprofit Commonwealth Fund, a health research foundation that helped pay for the recent study.

 

The Obama administration, as it seeks money to provide health care for more Americans, has already identified hospital readmissions as a source of potential cost-cutting. The president’s budget calls for $26 billion in savings from readmissions over 10 years, which includes lowering payments to hospitals with high numbers of patients who are readmitted.

 

Many elderly patients who leave the hospital with a chronic illness like heart failure or diabetes are left to cope largely on their own. They often do not receive clear instructions on what medications they should be taking, and they frequently have difficulties making doctor appointments to continue their treatment outside the hospital.

 

“When you get out of the hospital, you need to have an active interaction with the health system,” said Dr. Audet of the Commonwealth Fund, which also provided a grant to the nonprofit Institute for Healthcare Improvement to work with states to try to reduce the number of times patients go back to the hospital. “The patient has to be seen.”

 

Some hospitals have already shown they can reduce readmissions by taking seemingly simple steps to make sure patients get necessary follow-up care when they go home or to a nursing facility.

 

At Geisinger Health System, a network in Pennsylvania that has been a leader in improving the quality of hospital care, doctors say they are taking varied approaches to reducing readmissions rates, depending on why the patient was initially hospitalized.

 

With surgery patients, for example, Geisinger has focused on educating people before they come to the hospital about what they are likely to experience and what they should expect when they leave. The effort could reduce readmission rates by as much as 20 percent, said Dr. Ronald A. Paulus, a senior executive at the health system. Geisinger’s early findings, he said, indicate that if patients “are not ready by the time they come in, it’s too late.”

 

Geisinger has also found it effective to alert the patients’ doctor about the hospital visit, including a brief summary of the patient’s discharge plan that is sent the doctor within 72 hours of the patient’s departure. That kind of simple step, Dr. Paulus noted, does not require an overhaul of the current system.

 

Successful measures elsewhere have included working more closely with patients or their caregivers to better manage conditions like diabetes, said Dr. Eric A. Coleman, one of the study’s authors and a policy specialist at the University of Colorado at Denver. Coaching patients to be more diligent about taking their medicine and recognizing when their condition is deteriorating helps people stay out of the hospital, he said.

 

But Dr. Coleman also said doctors needed to take more responsibility for their patients’ continuing care. “Physicians haven’t really been stepping up to the plate and taking on this accountability,” he said, although he said several professional societies were expected this spring to clarify the doctors’ roles.

 

Many policy analysts say that insurers like Medicare must change the way they pay hospitals and doctors — rewarding medical providers that help patients get and stay better. Under the current system, reducing the number of returning patients can work against the financial interests of a hospital needing to fill empty beds. About one in four of the nation’s hospitals derive 25 percent of their admissions from return visits by patients, according to the study.

 

“Reducing admissions in a hospital is quite punitive in today’s environment,” said Dr. Amy E. Boutwell, a policy specialist at the Institute for Healthcare Improvement. The institute is working with states including Massachusetts, Washington and Michigan to determine how to change the payment system to encourage hospitals to work more closely with doctors and others to prevent needless round trips.

 

Copyright 2009 The New York Times Company.

 

FDA Official Says Production Error Probably Contaminated Pistachios

 

By Lyndsey Layton

Washington Post

Wednesday, April 1, 2009; A03

 

A basic error on the production lines of a California processing plant is thought to have contaminated its pistachios with salmonella, a top federal food safety official said yesterday.

 

Setton Pistachio of Terra Bella, the nation's second-largest processor of the nut, ran raw and roasted pistachios through the same machinery on several production lines, said David Acheson, assistant commissioner for food protection at the Food and Drug Administration.

 

Salmonella bacteria can live on raw nuts but are usually killed during the roasting process. Good manufacturing standards call for keeping raw and roasted nuts separate so that bacteria do not spread between the two.

 

It is unclear why Setton Pistachio ran raw and roasted nuts through the same machinery. A company spokeswoman did not respond to queries.

 

The company was apparently aware that it had a salmonella problem because its own tests found the bacteria on roasted nuts, Acheson said. Managers ran the nuts through the roasting process a second time to kill the bacteria before shipping them to customers, an accepted way to "recondition" the product, he said.

 

The FDA learned of the test results in the past week. Setton Pistachio did not report them to any regulatory agency because it is not required to do so under state or federal law. It is unclear what additional steps, if any, the company took to address the presence of salmonella in its plant, Acheson said.

 

Setton recalled more than 2 million pounds of pistachios Monday. But because the company supplies its nuts to about 35 wholesalers and food manufacturers, who repackage the pistachios for retail sale or use them as ingredients in other products, it was not clear which consumer goods are affected. It could take weeks to compile a comprehensive list.

 

That has prompted federal officials to warn consumers to temporarily stop eating all foods containing pistachios. "Our advice is to avoid eating pistachio products; don't throw them out, hold on to them as we learn more about this," Acheson said.

 

Food safety advocates said the government lacks basic modern tools to quickly trace the origin and destination of foods -- information that is crucial when public health is at stake. Several food safety reform bills pending in Congress would create food-tracing systems to better track agricultural products from the farm to the table.

 

"It's important to get the word out as quickly as possible so that people don't eat contaminated food," said Erik Olson, director of food and chemical safety programs at Pew Charitable Trusts. "They've known about this for about a week, and a lot of people have probably eaten these pistachios. Companies can't immediately trace where their food was headed and who eats it. We still won't know for a long time which products are affected. It just highlights the system is broken."

 

No illnesses have been linked to the nuts from Setton. Two people have complained to the FDA that they got sick after eating pistachios, but health officials have not made any definitive connection to the nuts in question, Acheson said. Salmonella can cause diarrhea, fever and cramping. The infection can be fatal for children, the elderly and people with weakened immune systems.

 

The problem with the Setton pistachios was caught through internal tests by Georgia Nut, which buys the nuts from Setton to make the Back to Nature Nantucket Blend trail mix under a contract with Kraft Foods International.

 

Georgia Nut was doing routine testing, said Susan Davidson, a Kraft spokeswoman. The company notified Kraft that it had identified four strains of salmonella in the pistachios. Kraft contacted the FDA on March 24 to say it was voluntarily recalling the trail mix. It later expanded the recall to all Planters products containing pistachios.

 

The FDA, after discussions with Georgia Nut, identified Setton as the processor and began investigating, Acheson said. The California Department of Public Health dispatched a team of investigators and scientists to review the company's records and production practices and collect environmental and product samples for laboratory analysis. Results are pending.

 

Setton Pistachio was inspected by the FDA in 2003 and by the state of California last year; neither inspection turned up significant problems, Acheson said.

 

The FDA, roundly criticized by both parties on Capitol Hill recently during a wave of food-borne illnesses -- including an ongoing salmonella outbreak tied to peanuts that has sickened 690 people, killed nine and led to the largest food recall in U.S. history -- got new leadership Monday. Joshua Sharfstein started work as the deputy administrator and is running the agency. His boss-to-be, Margaret Hamburg, is awaiting congressional confirmation.

 

Sharfstein immediately set an aggressive tone, Acheson said. "The priority is the potential public health risk here," Acheson said. "We're out in front, getting the product off the market."

 

But Caroline Smith DeWaal at the Center for Science in the Public Interest said food safety laws clearly need an overhaul. "It's not really comforting when a regulatory agency has to rely on private companies to find problems," she said.

 

Copyright 2009 Washington Post.

 

Massive chemo dose targets cancerous liver

 

Associated Press

By Lauran Neergaard

Washington Post

Tuesday, March 31, 2009

 

WASHINGTON -- Bill Darker grinned as he headed into the operating room for a dramatic experiment: A super-high dose of chemotherapy dripped directly into his cancer-ridden liver, 10 times more than patients normally can tolerate.

 

Not to fear. Working through small puncture holes, doctors sealed off Darker's liver and washed most of the toxic medication from his blood so it didn't poison the rest of his body.

 

It's a rigorous effort to fight a notorious killer, cancer that has spread to the liver from elsewhere in the body and left patients with few options and little time.

 

"I've always wanted to treat this cancer very aggressively since I know the prognosis is very dim," said Darker, 46, who managed to save his eye from ocular melanoma only to have the cancer spread tentacles in his liver. "I just take the gloves off and go for it."

 

Three times, so far, he has flown from his home in Imperial Beach, Calif., to the National Institutes of Health in suburban Washington to repeat the experimental therapy. Before his last round, Darker's liver tumors had shrunk by about a third.

 

Now a study at NIH and 10 other hospitals nationwide aims to show whether that kind of shrinkage makes enough of a difference in the length and quality of recipients' lives, and is safe enough, for Food and Drug Administration approval to treat eye or skin melanoma that spreads to the liver.

 

"It seems like a good weapon," said Dr. Marybeth Hughes of the NIH's National Cancer Institute, as she prepared to treat Darker last week. "If it works effectively it would be very important, because the only other choice patients have is constant chemotherapy."

 

More than 200,000 U.S. patients a year learn that various types of cancer - from the eye, skin, colon, pancreas - have metastasized, or spread, to the liver. Whatever the original tumor type, few survive beyond a year or two.

 

Often, cancer this aggressive hits multiple organs. But up to 40,000 patients a year have a life-threatening metastasis confined just to the liver. They're the target of the new approach, called PHP, for percutaneous hepatic perfusion. While the melanoma research is furthest along, NIH is beginning smaller studies with certain other liver metastases.

 

How do you seal off a liver? With balloons similar to those used in heart surgery, only bigger.

 

Darker lay under general anesthesia as NIH's Dr. Elliott Levy carefully threaded a catheter through an artery in his left leg all the way up to where it branches off into the liver.

 

Then came catheter No. 2, through a vein in the right leg and up to the vena cava, the highway where blood normally flows from the liver into the heart. This tube bore an uninflated balloon at each end and holes in the middle. Guided by sophisticated X-ray images, Levy inflated the balloons at the top and bottom of the liver, blocking blood's normal exit route.

 

The tube's holes capture chemo-saturated blood and reroute it out of the body, to a pump where filters scrub away the drug. Filtered blood re-enters the body through a tube in the neck.

 

It's done with team precision. "Initiating bypass, 10:31," doctors called.

 

Is the seal good? They injected a dye to be sure. No leaks.

 

Then Hughes, the oncologist, was up. "Chemo on, 10:45," she called. For 30 minutes, she dripped a concentrated dose of the drug melphalan through catheter No. 1 into the hepatic artery, saturating the liver. The pump is to run for another half-hour after the drug's done, ultimately removing between 80 percent and 90 percent of the chemo.

 

"The ability to shrink cancers in the livers of patients who failed other therapies is exciting," acknowledged Dr. Neal Meropol, gastrointestinal cancer chief at Fox Chase Cancer Center, who isn't involved with the study. But he said cancer specialists are watching the work very skeptically, because it's such a complex procedure.

 

It's not that much more complicated than existing treatments that infuse chemo without preventing bodywide leakage, and which have widely varying results, said Dr. James Pingpank, a former NIH researcher now at the University of Pittsburgh Medical Center, one study site.

 

Years ago, NIH doctors created an open-surgery version of the treatment that did help but patients could endure it only once. In a partnership with New York-based Delcath Systems Inc., they've made the procedure far less invasive and potentially repeatable - assuming it works - as often needed.

 

But it's not risk-free. Not all the chemo is removed, so patients suffer some fatigue and a weakened immune system for a few days between treatments. The pump causes blood pressure to temporarily plummet, requiring quick doses of drugs to push it back up. Because every patient's anatomy is slightly different, doctors must carefully map blood vessels to be sure ones that lead, for example, to the stomach aren't so close that chemo could leak in.

 

First-stage studies reported few serious side effects, although one patient died during an apparently unrelated operation about two weeks after a PHP.

 

The required operating-room team means if approved, PHP could cost just under $20,000 - hefty, but fairly comparable to some other advanced cancer therapies.

 

Darker called the procedure easier than standard liver treatments, saying he felt good two days later: "It's running like clockwork."

 

EDITOR'S NOTE - Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

 

On the Net:

Study info:http://www.livercancertrials.com

Ocular melanoma info:http://www.ocularmelanoma.org

 

© 2009 The Associated Press.

 

9 patients made nearly 2,700 ER visits in Texas

 

Associated Press

Thursday, April 2, 2009

 

AUSTIN, Texas - Just nine people accounted for nearly 2,700 of the emergency room visits in the Austin area during the past six years at a cost of $3 million to taxpayers and others, according to a report. The patients went to hospital emergency rooms 2,678 times from 2003 through 2008, said the report from the nonprofit Integrated Care Collaboration, a group of health care providers who care for low-income and uninsured patients.

 

"What we're really trying to do is find out who's using our emergency rooms ... and find solutions," said Ann Kitchen, executive director of the group, which presented the report last week to the Travis County Healthcare District board.

 

The average emergency room visit costs $1,000. Hospitals and taxpayers paid the bill through government programs such as Medicare and Medicaid, Kitchen said.

 

Eight of the nine patients have drug abuse problems, seven were diagnosed with mental health issues and three were homeless. Five are women whose average age is 40, and four are men whose average age is 50, the report said, the Austin American-Statesman reported Wednesday.

 

"It's a pretty significant issue," said Dr. Christopher Ziebell, chief of the emergency department at University Medical Center at Brackenridge, which has the busiest ERs in the area.

 

Solutions include referring some frequent users to mental health programs or primary care doctors for future care, Ziebell said.

 

"They have a variety of complaints," he said. With mental illness, "a lot of anxiety manifests as chest pain."

 

Copyright 2009 Associated Press.

 

Cereal box typo leads to phone sex line

 

By Erin Julius

Hagerstown Herald-Mail

Wednesday, April 1, 2009

 

HALFWAY - What does organic cereal have in common with a phone line selling sex?

 

Not much, you'd think.

 

But because of a typo, customers who select boxes of Peace Cereal and decide to call the company's 800-number listed on the side of the package are in for a surprise.

 

Callers are greeted by a recording of a sultry voice asking, "Do you love sex? ... Isn't that why you called?" and later, the caller is warned, "if you're under 18, you must hang up now." Eventually, callers are told what they can do if they have a credit card.

 

Peace Cereal, which is on shelves in local stores, in December 2008 was made aware of a misprint on its cereal boxes and the company immediately ordered new packaging, said Valerie Crowley, a customer service representative.

 

Crowley blamed the misprint on a proofreading error.

 

The cereal is now being shipped from the Eugene, Ore., manufacturing plant in corrected packaging, she said.

 

The all-natural cereal is available in at least one local grocery store. Thirteen varieties of the cereal were on the store's shelves Wednesday. Of those, seven varieties came in boxes bearing the incorrect telephone number.

 

Peace Cereal is a product of Golden Temple of Oregon LLC, according to the box.

 

It was introduced by Golden Temple in 1997 "as a way to support a more loving planet," according to the company's Web site at goldentemple.com. Golden Temple is privately owned by a nonprofit organization and was founded by Yogi Bhajan, according to the Web site.

 

Copyright 2009 Hagerstown Herald Mail.

 

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