Tuesday, August 18, 2009

News Clipping Archives

 

 

Maryland / Regional

 

Md. plan for swine flu vaccine depends on manufacturers (Daily Record)

SeniorCare drug program extended to 2012 (Baltimore Business Journal)

Hospital picks up eight national awards (Frederick News-Post)

MedImmune to test swine flu vaccine (Baltimore Business Journal)

Pr. George's Ban on Pit Bulls Resists Tenacious Opposition (Washington Post)

Queen Anne's ER center to grow (Annapolis Capital)

 

National / International

 

Mental Stress Training Is Planned for U.S. Soldiers (New York Times)

Snoring is more than loud, it's a sign of a health risk (Baltimore Sun)

The Claim: Stress Can Make Allergies Worse (New York Times)

Battling inflammation through food (Baltimore Sun)

Calling Mr. Yuk (Baltimore Sun)

Cheaper Birth Control Returns (Baltimore Sun)

Ore Pharmaceuticals cuts losses, still needs buyer (Baltimore Business Journal)

Cocaine turning up on more dollar bills (Baltimore Sun)

Cooperatives Being Pushed as an Alternative to a Government Plan (Washington Post)

FDA puts hold on Geron spinal injury product (Baltimore Business Journal)

Chinese mayor apologizes for lead poisoning (Hagerstown Herald-Mail)

 

Opinion

 

Medicare offers lessons for national health care reform (Baltimore Sun Commentary)

A soup kitchen seeks to expand in Fells Point (Baltimore Sun Commentary)

Flaws in health care proposal (Carroll County Times Commentary)

Let’s work together to save the Governor’s Wellmobile (Cumberland Times News Letter to the Editor)

Universal health care is more humanitarian (Salisbury Daily Times Letter to the Editor)

 

 

Maryland / Regional

 

Md. plan for swine flu vaccine depends on manufacturers

 

Associated Press

Daily Record

Tuesday, August 18, 2009

 

Millions of Marylanders would be immunized against swine flu for free or for a nominal fee under a plan being developed by state health officials, whose goal is to provide the vaccine to every resident who wants it.

 

The vaccination plan is unprecedented in scope but depends on a robust supply of the vaccine, which is expected to be ready by mid-October at the earliest.

 

When it becomes available, Maryland will begin distributing the vaccine to doctors, pharmacists, local health departments and other partners.

 

The first shots will be given to those deemed most vulnerable by the Centers for Disease Control and Prevention — pregnant women, health care workers, children and people under 65 with chronic health problems, said Frances Phillips, Maryland's deputy secretary for public health.

 

Those priority groups account for more than 2.5 million of the state's 5.6 million residents, Phillips said.

 

"That's to be followed up very quickly thereafter with vaccinating the remaining 3 million Marylanders," Phillips said. "It's a massive, unprecedented vaccination campaign."

 

Some people who receive shots will likely have to pay an administration fee of between $10 and $20, but no one will be denied a shot because they are unable to pay, Phillips said.

 

Vaccination against swine flu remains voluntary, as does vaccination against seasonal influenza.

 

State officials and other experts said it's too early to guess how many people will get shots this year because the severity of the virus and the amount of available vaccine are difficult to predict.

 

The state does not keep track of how many people receive flu shots each year because the vaccines are typically administered privately, officials said.

 

Nationwide, about 34 percent of U.S. residents were vaccinated against seasonal flu during the 2008-09 season, according to the CDC, despite its recommendations that 83 percent of the population be immunized.

 

"There's going to be a lot of unknowns about that vaccine in terms of the uptake," said Dr. John Bartlett, a professor at the Johns Hopkins School of Medicine. "If it turns out to be a serious flu with some deaths, I think people are going to want to get it and really bite and scratch to have it available."

 

Under that scenario, Bartlett is doubtful that the available domestic supply of the vaccine will allow Maryland to fulfill its goal of making it available to everyone.

 

Bartlett also noted that the flu season will be well under way before anyone becomes immunized. Vaccination against swine flu is likely to require two doses, three weeks apart, with immunity taking effect three weeks after the second dose, he said.

 

"The vaccine is going to be late," Bartlett said. "They can't make it any faster."

 Another open question: how the state will pay for all those flu shots. The Department of Health and Mental Hygiene has received nearly $7 million in federal grants for swine flu preparation and will get more once it begins implementing its plans.

 

"The public sector can't do this alone. We can't vaccinate all Marylanders perhaps two times. We're relying on partners," Phillips said, including private insurance and Medicare. "We're hopeful we get the resources we need."

 

Part of the state's plan is to make the vaccine available at schools, preferably in the form of a nasal spray, Phillips said. But it's unclear whether there will be enough doses of nasal-spray vaccine to immunize Maryland's 1 million school-age children.

 

The state is also trying to project what would happen if hospitals became inundated with swine flu patients. It is common during flu season for patients to be sent to hospitals other than the ones closest to their homes, but if swine flu hits hard, some patients may be hospitalized much farther away, Phillips said.

 

To prevent emergency rooms from being overrun, the state is planning a communication and education campaign about how to treat mild flu symptoms. Information will be available on Web sites, and the state may also set up call centers, Phillips said.

 

The World Health Organization has estimated that up to 2 billion people could be sickened during the swine flu pandemic, which is already known to be responsible for more than 1,400 deaths, including six in Maryland.

 

Copyright 2009 Daily Record.

 

 

 

 

SeniorCare drug program extended to 2012

 

The Business Journal of Milwaukee

Baltimore Business Journal

Tuesday, August 18, 2009

 

After reviewing the merits of the program, President Barack Obama and U.S. Health and Human Services Secretary Kathleen Sebelius have officially granted Wisconsin Gov. Jim Doyle's request to extend the state’s prescription drug program for seniors into 2012.

 

The program, SeniorCare, was scheduled to end Dec. 31.

 

“SeniorCare not only gives our seniors the medications they need at a reasonable price, but it also saves Wisconsin taxpayers millions of dollars," Doyle said in a press release Tuesday. "During this tough economic time, our state continues to ensure that seniors have access to this cost-effective program."

 

SeniorCare was created in 2002 and has a $30 annual enrollment fee, an income-based deductible and copayments of $5 for generic drugs or $15 for brand drugs. Unlike the Medicare Part D prescription drug program, SeniorCare also does not have a strict enrollment period or enrollment penalty, nor do members have a gap in coverage.

 

The annual federal cost per enrollee for SeniorCare is $588 and is significantly lower than the average Part D beneficiary cost of $1,690.

 

This difference alone accounts for an annual savings to taxpayers and the federal government of more than $90 million dollars, according to the state Department of Health Services.

 

The state of Wisconsin also is able to leverage additional savings because it can use its bargaining power to negotiate the lowest prices for prescription drugs, while Congress made it illegal for the federal government to bargain for lower prices.

 

Copyright 2009 Baltimore Business Journal.

 

 

 

 

Hospital picks up eight national awards

 

By Patti S. Borda

Frederick News-Post

Tuesday, August 18, 2009

 

Frederick Memorial Healthcare System earned eight national awards for quality care and a reward of $141,340.

 

The hospital has been part of a Centers for Medicare and Medicaid Services, Premier healthcare alliance pay-for-performance project that rewards hospitals for delivering high quality care in five clinical areas.

 

Based on fourth-year results from CMS’ Hospital Quality Incentive Demonstration project, Frederick Memorial received a total of eight awards for Top Improvement and Attainment in the clinical areas of heart attack, heart failure, pneumonia and hip and knee replacement.

 

Sharon Powell, director of the hospital’s Performance Improvement Department, has overseen the hospital’s award-winning efforts.

 

“We’re all excited. ... It’s like icing on the cake,” Powell said.

 

The project evaluates the efficiency of healthcare. Powell said her department has formed teams of doctors, nurses, respiratory therapists and other representative medical staff members to look at hospital standards and practices. Powell’s teams have been to look for ways to be more efficient, all with a goal to improving patient care.

 

“It’s all about the patients,” Powell said.

 

For more on this story, check out Wednesday's edition of The Frederick News-Post.

 

Copyright 1997-09 Randall Family, LLC. All rights reserved.

 

 

 

 

MedImmune to test swine flu vaccine

 

By Vandana Sinha

Baltimore Business Journal

Tuesday, August 18, 2009

 

MedImmune has begun enrolling volunteers around the country for its first clinical trials to test its swine flu vaccine candidate.

 

The company, a subsidiary of London-based AstraZeneca PLC (NYSE: AZN), is running two trials simultaneously, one on children aged 3 to 17 and another on adults from 18 to 49 years of age, signing up 300 healthy individuals for each trial. MedImmune said it hopes to start getting some preliminary data within the month, and as early as two weeks.

 

"If everything works well, we are expected to have our first doses ready by the end of October," said MedImmune spokeswoman Perla Copernik.

 

Already, the company has said that it expects to produce significantly more H1N1 vaccine doses than were ordered in two back-to-back Health and Human Services Department contracts totaling $151 million for MedImmune, one of five companies nationwide helping supply vaccines for the disease. Copernik said the company was asked to manufacture 12.8 million doses, but it actually expects to produce 200 million doses by next March.

 

Though, its challenge remains a delivery method for the vaccine technology, which works similarly to MedImmune's seasonal FluMist intranasal spray. The company said it only has enough sprayers to fill 40 million doses worth of the H1N1 vaccine, causing it to request Food and Drug Administration and HHS officials to get the greenlight to use a dropper system in the sprayer's place.

 

"We're still in negotiations about that," Copernik said.

 

Copyright 2009 Baltimore Business Journal.

 

 

 

 

Pr. George's Ban on Pit Bulls Resists Tenacious Opposition

 

By Jonathan Mummolo

Washington Post

Monday, August 17, 2009

 

Opponents of a long-standing pit bull ban in Prince George's County might have an easier time breaking the notorious grip of the dogs themselves than getting the prohibition repealed.

 

Time and again-- despite the recommendations of experts and the outcry of animal rights advocates-- efforts to lift the ban have failed.

 

But none of that stopped Laurel Mayor Craig A. Moe from giving it a go.

 

Last month, Moe wrote to County Executive Jack B. Johnson (D) asking that a task force be formed to take another look at the law. In his letter, Moe said that Laurel has seen an increase in pit bulls and that "all such dogs observed have been calm in demeanor and completely under their owners' control."

 

Then came a jarring reminder of why many officials view revisiting the ban as a non-starter.

 

Last Monday, a 20-year-old man was found dead in a Leesburg house from a headline-grabbing attack by two pit bulls. On Thursday, John Erzen, a spokesman for Johnson, said the executive is "not interested in repealing the ban, nor is he interested in establishing a task force" to review it.

 

Members of the County Council said they did not think Moe's proposal would gain traction, and the county's chief of animal control declined to weigh in on the policy.

 

Even without the Leesburg attack, Moe's request was likely doomed because of the way pit bull politics work in Prince George's: Oppose the ban, and risk appearing soft on public safety and the dogfighting rings and drug dealers often associated with the dogs; support it, and incur the wrath of vocal animal rights groups and dog owners who view the policy as cruel.

 

"No one wants to spend time or political capital dealing with" the pit bull issue, said Del. Justin D. Ross (D-Prince George's). "In light of dealing with poverty and budget issues and drug addiction and youth crime, the fact that we would spend even one moment talking about this issue is insane."

 

The county law, passed by the council in 1996, outlawed pit bulls but included a clause allowing owners to register those acquired before February 1997. Owners caught with unregistered pit bulls face up to six months in jail and a $1,000 fine. Pit bulls seized by the county are euthanized or transferred to an out-of-county government shelter, although there is an appeals process for owners to try to get their dogs back, said Rodney C. Taylor, associate director of the county's Animal Management Group.

 

Prince George's ban is among the strictest pit bull policies in the nation. The District has no ban and allows shelters to offer pit bulls for adoption after being evaluated for temperament. Fairfax, Arlington, Montgomery and Prince William counties have policies similar to the District's. Loudoun County does not offer the animals for adoption but allows them to be transferred to other shelters or rescue groups if they pass an evaluation.

 

In Prince George's, the pit bull ban was examined early in the decade by a task force that in 2003 recommended lifting the breed-specific language and replacing it with "equal requirements, restrictions and sanctions on all dogs that exhibit dangerous behavior." Proposals in 2004 and 2005 to lift the ban were unsuccessful, and some observers said the political climate has not changed since then.

 

"We already had a task force, and the task force recommended revisions . . . and the majority of the council didn't want to make any changes at that time," said council member Thomas E. Dernoga (D-Laurel). "I don't know that a new task force is going to bring us anything."

 

Moe said that the idea that the pit bull population has grown in Laurel is purely anecdotal and that any influx probably stems from dog owners moving there over the years without checking local laws beforehand. He said that there are strong feelings on both sides but that he doesn't think it is necessary to shy away from the issue because it's controversial.

 

"I guess some are concerned about bringing it up," Moe said. "I think that's our job."

 

In another sign of the issue's politically sensitive nature, Taylor, who sat on the task force and has opposed the ban in the past, declined to give an opinion on it this time around. He deferred to the county executive instead.

 

"I can't comment on that," Taylor said when asked whether he still supports the changes to the law proposed in the task force report. "I've got to leave that one alone."

 

Taylor said pit bulls are not the only type of dog that can be dangerous, although they can do more damage than other breeds.

 

"Any breed of dog can be dangerous if it's either mistreated, trained to be dangerous or just totally unsocialized," Taylor said. But if a pit bull decides to turn on a human, "the damage they can do is unbelievable."

 

Taylor said that during the first five to seven years of the ban, animal control officials would encounter an average of 1,200 pit bulls a year but that in recent years that figure has dropped by about half. According to county statistics, 36 pit bull bites, out of 619 total dog bites, were recorded in 2008, down from 95 pit bull bites, out of a total of 853, in 1996.

 

To animal rights advocates, the ban is ill-conceived, if not outright cruel.

 

"Breed bans are ineffective and expensive," said Adam Goldfarb, director of the Humane Society of the United States' Pets At Risk program. "They target the wrong end of the leash."

 

As evidence, Goldfarb cited the Prince George's task force report, which stated that although the ban "may arguably be deemed 'effective' in that the number of pit bulls in the county has been reduced," the policy is "inefficient, costly, difficult to enforce, subjective and questionable in its results."

 

The report also alluded to interest groups that helped shape the ban, noting that the proposal originally outlawed Rottweilers, too-- language that was deleted because of "a successful lobbying campaign."

 

Staff researcher Meg Smith contributed to this report.

 

Copyright 2009 Washington Post.

 

 

 

 

Queen Anne's ER center to grow

Site plan also shows 2 office buildings

 

By Shantee Woodards

Annapolis Capital

Tuesday, August 18, 2009

 

A freestanding emergency room for Kent Island is only one of three buildings planned for the site that will be used to address the area's growing medical needs, plans revealed yesterday.

Courtesy image The plans for the Queen Anne's Emergency Center also include two three-story medical office buildings, which would be off Nesbit Road in the same complex. The buildings — which would house physician offices, along with diagnostic, lab and other services — will be planned after the emergency center opens in late 2010.

 

The upcoming Queen Anne's Emergency Center just off Nesbit Road in Grasonville will treat patients with less serious injuries, as well as the uninsured. The development also is slated to include two three-story medical buildings that would house offices for physicians, imaging and lab space and other services.

 

But detailed planning for the other buildings will not begin until the emergency center is open in 2010, officials said.

 

The county is one of two in the state without a hospital and in recent years has worked to fill the gap for its residents. Last year, Anne Arundel Medical Center opened an urgent-care facility there with extended hours. Still, there remains a great-enough need for additional services, officials said.

 

"Right now, we have a real shortage of health care, that's why we were so (pleased) when Anne Arundel brought the medical building," said County Commissioner Gene Ransom, D-Grasonville. "But we have a real shortage and anything that will have more physicians will be wonderful for the county."

 

State, county and medical officials came to the Nesbit Road property for the groundbreaking ceremony yesterday. University of Maryland Medical System is constructing the building and Shore Health System, which is affiliated with UMMS, will staff it. The $12-million facility will be about 16,000 square feet and will have 11 treatment rooms.

 

Gov. Martin O'Malley, who attended the ceremony, said he was pleased the community could find common ground on this project.

 

"Some things we can't do as individuals, that's why God gave us each other," O'Malley told the crowd. "These are some of the things we could only do together. There is no better day for this and it is right now."

 

Currently, ambulances have to take patients to AAMC or hospitals in Easton or Chestertown for emergencies. It can take up to two hours, especially when dealing with Bay Bridge traffic, to get paramedics back on the road for the next call, officials said. This new center will give a turnaround of 10 to 15 minutes.

 

UMMS officials announced their plans to create an emergency center in Queen Anne's County in 2007. Currently, there are two such facilities in the state- one at the Bowie Health Campus in Bowie and at the Shady Grove Adventist Emergency Center in Germantown.

 

But the Queen Anne's County facility will be the first one in the state to target a rural area.

 

Sen. E.J. Pipkin, R-Eastern Shore, sponsored a bill that made it easier for UMMS to build the facility, and the bill passed. Under terms of the agreement, UMMS will operate the property as an emergency center for at least three years. If that is unsuccessful, the property would revert to the county.

 

The new center is not a hospital, so it will not take overnight patients. It will take patients identified as priority 3 or 4, which are minor injuries. And as an emergency facility, it will not be able to deny service to the uninsured.

 

Leslie and Sally Hearn moved to Grasonville about four years ago from Severna Park. At the time, they didn't think much about the county's lack of a hospital. All of their physicians and medical information is across the Bay Bridge in Anne Arundel County.

 

Whenever they've needed something, "we've had to drive across the Bay Bridge, but luckily they didn't have traffic," Sally Hearn said. "We heard (about the emergency center) ever since we moved out here, so it's been a long time coming. I put in the back of my mind."

 

"It's long overdue," Leslie Hearn said.

 

Copyright 2009 Annapolis Capital.

 

 

National / International

 

Mental Stress Training Is Planned for U.S. Soldiers

 

By Benedict Carey

New York Times

Tuesday, August 18, 2009

 

PHILADELPHIA — The Army plans to require that all 1.1 million of its soldiers take intensive training in emotional resiliency, military officials say.

 

The training, the first of its kind in the military, is meant to improve performance in combat and head off the mental health problems, including depression, post-traumatic stress disorder and suicide, that plague about one-fifth of troops returning from Afghanistan and Iraq.

 

Active-duty soldiers, reservists and members of the National Guard will receive the training, which will also be available to their family members and to civilian employees.

 

The new program is to be introduced at two bases in October and phased in gradually throughout the service, starting in basic training. It is modeled on techniques that have been tested mainly in middle schools.

 

Usually taught in weekly 90-minute classes, the methods seek to defuse or expose common habits of thinking and flawed beliefs that can lead to anger and frustration — for example, the tendency to assume the worst. (“My wife didn’t answer the phone; she must be with someone else.”)

 

The Army wants to train 1,500 sergeants by next summer to teach the techniques.

 

In an interview, Gen. George W. Casey Jr., the Army’s chief of staff, said the $117 million program was an effort to transform a military culture that has generally considered talk of emotions to be so much hand-holding, a sign of weakness.

 

“I’m still not sure that our culture is ready to accept this,” General Casey said. “That’s what I worry about most.”

 

In an open exchange at an early training session here last week, General Casey asked a group of sergeants what they thought of the new training. Did it seem too touchy-feely?

 

“I believe so, sir,” said one, standing to address the general. He said a formal class would be a hard sell to a young private “who all he wants to do is hang out with his buddies and drink beer.”

 

But others disagreed, saying the program was desperately needed. And in the interview, General Casey said the mental effects of repeated deployments — rising suicide rates in the Army, mild traumatic brain injuries, post-traumatic stress — had convinced commanders “that we need a program that gives soldiers and their families better ways to cope.”

 

The general agreed to the interview after The New York Times learned of the program from Dr. Martin E. P. Seligman, chairman of the University of Pennsylvania Positive Psychology Center, who has been consulting with the Pentagon.

 

In recent studies, psychologists at Penn and elsewhere have found that the techniques can reduce mental distress in some children and teenagers. But outside experts cautioned that the Army program was more an experiment than a proven solution.

 

“It’s important to be clear that there’s no evidence that any program makes soldiers more resilient,” said George A. Bonanno, a psychologist at Columbia University. But he and others said the program could settle one of the most important questions in psychology: whether mental toughness can be taught in the classroom.

 

“These are skills that apply broadly, they’re things people use throughout life, and what we’ve done is adapt them for soldiers,” said Karen Reivich, a psychologist at Penn, who is helping the Army carry out the program.

 

At the training session, given at a hotel near the university, 48 sergeants in full fatigues and boots sat at desks, took notes, play-acted, and wisecracked as psychologists taught them about mental fitness. In one role-playing exercise, Sgt. First Class James Cole of Fort Riley, Kan., and a classmate acted out Sergeant Cole’s thinking in response to an order late in the day to have his exhausted men do one last difficult assignment.

 

“Why is he tasking us again for this job?” the classmate asked. “It’s not fair.”

 

“Well, maybe,” Sergeant Cole responded. “Or maybe he’s hitting us because he knows we’re more reliable.”

 

In another session, Dr. Reivich asked the sergeants to think of situations when such internal debates were useful.

 

One, a veteran of several deployments to Iraq, said he was out at dinner the night before when a customer at a nearby table said he and his friends were being obnoxious.

 

“At one time maybe I would have thrown the guy out the window and gone for the jugular,” the sergeant said. But guided by the new techniques, he fought the temptation and decided to buy the man a beer instead. “The guy came over and apologized,” he said.

 

The training is based in part on the ideas of Dr. Aaron Beck and the late Albert Ellis, who found that mentally disputing unexamined thoughts and assumptions often defuses them. It also draws on recent research suggesting that people can manage stress by thinking in terms of their psychological strengths.

 

“Psychology has given us this whole language of pathology, so that a soldier in tears after seeing someone killed thinks, ‘Something’s wrong with me; I have post-traumatic stress,’ ” or P.T.S.D., Dr. Seligman said. “The idea here is to give people a new vocabulary, to speak in terms of resilience. Most people who experience trauma don’t end up with P.T.S.D.; many experience post-traumatic growth.”

 

Many of the sergeants were at first leery of the techniques. “But I think maybe it becomes like muscle memory — with practice you start to use them automatically,” said Sgt. First Class Darlene Sanders of Fort Jackson, S.C.

 

To track the effects of the program, the Army will require troops at all levels, from new recruits to officers, to regularly fill out a 170-item questionnaire to evaluate their mental health, along with the strength of their social support, among other things.

 

The program is not intended to diagnose mental health problems. The results will be kept private, General Casey said.

 

The Army will track average scores in units to see whether the training has any impact on mental symptoms and performance, said Gen. Rhonda Cornum, the director of Comprehensive Soldier Fitness, who is overseeing the carrying out of the new resilience program. General Cornum said that the Army had contracted with researchers at the University of Michigan to determine whether the training was working, and added that corrections could be made along the way “if the program is not having the intended effect.”

 

This being the Army, the sergeants at the training session last week had questions about logistics. How would teachers be evaluated? How and when would Reserve and Guard units get the training?

 

Perhaps the biggest question — can an organization that has long suppressed talk of emotions now open up? — is unlikely to have an answer until next year at the earliest. But the Army’s leaders are determined to ask.

 

“For years, the military has been saying, ‘Oh, my God, a suicide, what do we do now?’ ” said Col. Darryl Williams, the program’s deputy director. “It was reactive. It’s time to change that.”

 

Copyright 2009 New York Times.

 

 

 

 

Snoring is more than loud, it's a sign of a health risk

Interrupted breathing during sleep, depriving body of oxygen, increases chances for dying

 

By Stephanie Desmon

Baltimore Sun

Tuesday, August 18, 2009

 

Severe nightly episodes of interrupted breathing during sleep- commonly known as sleep apnea- double the risk of death for middle-age men, according to a new study being called the largest ever conducted on the disorder.

 

Even men with moderate sleep apnea- anywhere from 15 to 30 instances of oxygen deprivation per hour- appear to be 45 percent more likely to die from any cause than those who have no nighttime breathing problems.

 

As many as one in four men is believed to suffer from sleep apnea, researchers said, and many with less severe apnea may not even know they have it, even though it can dangerously decrease the oxygen in their bloodstream. Sleep apnea- typically characterized by loud snoring- is believed to be a growing problem, since it is often linked to obesity, which has become an epidemic in the United States. Women also are affected by the disorder, but to a lesser degree.

 

"This is a bad disorder that not only affects your lifestyle in the short term, but your life span in the long term as well," said Dr. David Schulman, director of the sleep laboratory at Emory University Hospital in Atlanta, who was not involved in the study. "People with sleep apnea today are more likely to die tomorrow."

 

The study, led by Johns Hopkins pulmonologist Dr. Naresh M. Punjabi, is being published online today in the Public Library of Science, Medicine. Small studies and anecdotal reports have long hinted at the connection between sleep problems and death, especially from heart disease, but this is the first large research study to make the link.

 

This study, part of the Sleep Heart Health Study, involved 6,441 men and women between the ages of 40 and 70. They have been followed for more than eight years. Some had sleep apnea; some did not. Many identified themselves as snorers- a major symptom of the disorder. More than 1,000 participants died since the study began.

 

Men with apnea were more likely to die regardless of age, gender, race, weight or whether they were a current or former smoker, or had other medical conditions such as high blood pressure, heart disease or diabetes, the study found.

 

Punjabi said the study shows that the majority of deaths aren't the result of the daytime drowsiness that is a hallmark of sleep apnea, the result of night after night of interrupted sleep.

 

Losing oxygen

A major culprit appears to be repeated episodes of apnea and the resulting oxygen deprivation, during which blood oxygen levels drop below 90 percent. If the heart doesn't get enough oxygen, it doesn't pump very well. As few as 11 minutes a night spent essentially holding one's breath- 2 percent of an average night's sleep of seven hours- caused the risk of death to double, Punjabi found.

 

"We all know that breathing's very important to our health, but because we're asleep and there's no pain, the difficulty in breathing while we sleep is not something [doctors] observe ... in a routine office visit," said Michael Twery, director of the National Institutes of Health's National Center on Sleep Disorders Research. "It's one of those hidden conditions."

 

Sleep apnea occurs when the upper airway is intermittently narrowed during sleep, causing breathing to be difficult or completely blocked.

 

The health risks appear to accumulate over many years. "It's a chronic exposure," he said. "One night's exposure in itself is not a health risk. ... It happens hundreds of times a night and it goes on for decades."

 

Along with so many men, about one in 10 women are believed to have sleep apnea. There were too few women in the study to draw any conclusions about apnea and death, but Twery said women also appear to be at risk. He said more needs to be known about women and apnea. There are questions, for example, about snoring during pregnancy and whether it affects the health of the mother and the developing fetus.

 

"It's underdiagnosed," Punjabi said. "Many physicians are unaware of this disorder. ... Patients have to know what they're suffering from."

 

Own snoring wakes him up

 

Jim Cappuccino, a 49-year-old retired police officer who develops and sells medical equipment, has been snoring for more than a decade. Loudly. The Baltimore resident- who at 5 feet 10 weighs 256 pounds- recently learned he has sleep apnea, though he wasn't all that surprised. His own snoring often woke him up.

 

"Some nights I felt I was actually not asleep," he said. "You wake up and you're as bone-tired as when you went to bed."

 

Of his six siblings, four are doctors, who have long pushed him to take better care of himself and to get control over his roller-coaster weight. "It's time I face facts," Cappuccino said. "I'd like to see my [college junior] daughter graduate from college and law school."

 

Now, as part of a different Hopkins study, he is using a Continuous Positive Airway Pressure (CPAP) machine, a mask worn at night that pushes air through the airway passage at a pressure high enough to keep it open during sleep. After two months, he already feels better.

 

Schulman said the public began to pay attention to the breathing disorder after Hall of Fame football player Reggie White's death five years ago was attributed to undiagnosed sleep apnea. The message started getting out, he said: "If you snore, go see your doctor."

 

Apnea in the air

 

When it makes headlines, the stories about sleep apnea are rarely good. This month, National Transportation Safety Board officials said the reason a plane in 2008 overflew a Hawaii airport was because the pilots fell asleep and the captain suffered from undiagnosed sleep apnea. The NTSB is calling for pilots to be screened for sleep apnea.

 

Schulman said treating apnea- through CPAP machines or by losing weight- might prevent deaths, though more research needs to be done.

 

Sleep apnea is diagnosed through a visit to a sleep clinic, something not everyone is willing or able to do.

 

"When we get people in the clinic, they're usually here because they're sleepy," Schulman said. "Often, folks will take treatments because they like the way it makes them feel."

 

But not everyone with apnea feels poorly. Some with more moderate, but still potentially dangerous, night breathing problems don't know there is anything wrong.

 

"There are some people with apnea who don't feel bad," he said.

 

With that group, when the doctor suggests the bulky CPAP machine, "that's a much harder sell," Schulman said.

 

By the numbers

 

Middle-age people with severe apnea were:

 

46 percent

 

more likely to die of any cause

 

•Middle-age people with moderate apnea were

 

17 percent more likely to die of any cause

 

•About

 

1 in 4 men and

 

1 in 10 women suffer from sleep apnea

 

•Breathing problems for as little as 11 minutes a night cause the risk of death to double

 

Copyright © 2009, The Baltimore Sun.

 

 

 

 

The Claim: Stress Can Make Allergies Worse

 

Really?

 

By Anahad O’Connor

New York Times

Tuesday, August 18, 2009

 

THE FACTS

 

This year’s allergy season has not been an easy one, with pollen counts at record highs in several major cities. But for many sufferers, a less stressful life may ease the allergy burden.

 

In recent years, studies have shown that psychological stress and anxiety- even at slight or moderate levels- can worsen allergy symptoms. Scientists suspect that it has something to do with the way stress affects the immune system, causing elevated levels of compounds that heighten the allergic response and remain unaffected by standard treatments for hay fever, like antihistamines.

 

One of the most recent and striking studies was published this year by scientists at Ohio State University. On two different days the scientists subjected hay fever sufferers to a series of skin prick tests to measure their responses to allergens, including the size of the wheals they developed. On one day the subjects gave speeches to a panel and then had to solve math questions in their heads. On the other day they had less stressful tasks, like reading magazines.

 

“Wheal diameters increased after the stressor,” the scientists wrote, “compared to a slight decrease following the control task.”

 

Even a day after the stressor, the most anxious subjects continued to show severe symptoms, suggesting a lingering response from the anxiety.

 

THE BOTTOM LINE

 

Studies show that psychological stress can heighten and possibly prolong allergic responses.

 

ANAHAD O’CONNOR scitimes@nytimes.com

 

Copyright 2009 New York Times.

 

 

 

 

Battling inflammation through food

Though it's an emerging field, proponents of anti-inflammatory diets point to growing evidence that foods like vegetables and fish can ease an overactive immune system.

 

By Shara Yurkiewicz

Baltimore Sun

Tuesday, August 18, 2009

 

If you want to live longer-- avoid heart disease, Alzheimer's disease and cancer-- then pick and choose your foods with care to quiet down parts of your immune system.

 

That's the principle promoted by the founders and followers of anti-inflammatory diets, designed to reduce chronic inflammation in the body.

 

Dozens of books filled with diets and recipes have flooded the market in the last few years, including popular ones by dermatologist Dr. Nicholas Perricone and Zone Diet creator Barry Sears.

 

Those who frequent message boards that discuss arthritis or acne trade tips on which pro- or anti-inflammatory foods may help or trigger their symptoms-- urging co-sufferers to try cherries for their rheumatoid arthritis or avoid gluten for their psoriasis.

 

But proponents claim the benefits go far beyond that, fighting not just pain from inflamed joints or skin flare-ups but also life-threatening diseases.

 

"If your future currently looks bleak because of high levels of silent inflammation, don't worry, because you can change it within thirty days," Barry Sears promises in his book, "The Anti-Inflammation Zone."

 

There's still a lot of science to be done. And should you try such a diet, you probably shouldn't expect any 30-day miracles. But there may be something to eating in an anti-inflammatory way.

 

"[Chronic inflammation] is an emerging field," says Dr. David Heber, a UCLA professor of medicine and director of the university's Center for Human Nutrition. "It's a new concept for medicine."

 

The point of an anti-inflammation diet is not to lose weight, although it is not uncommon for its followers to shed pounds. The goal: to combat what proponents call "chronic silent inflammation" in the body, the result of an immune system that doesn't know when to shut off.

 

The theory goes that long after the invading bacteria or viruses from some infection are gone, the body's defenses remain active. The activated immune cells and hormones then turn on the body itself, damaging tissues. The process continues indefinitely, occurring at low enough levels that a person doesn't feel pain or realize anything is wrong. Years later, proponents say, the damage contributes to illnesses such as heart disease, neurological disorders like Alzheimer's disease or cancer.

 

In general terms, following an anti-inflammatory diet means increasing intake of foods that have anti-inflammatory and antioxidant properties. (Antioxidants reduce the activity of tissue-damaging free radicals at sites of inflammation.) The diet includes vegetables, whole grains, nuts, oily fish, protein sources, spices such as ginger and turmeric and brightly colored fruits such as blueberries, cherries and pomegranates.

 

Foods that promote inflammation-- saturated fats, trans fats, corn and soybean oil, refined carbohydrates, sugars, red meat and dairy-- are reduced or eliminated.

 

It would seem logical that a diet that could dampen an overactive immune system could help prevent or slow diseases that are caused or exacerbated by inflammation. And evidence is certainly mounting that such diseases include heart disease, cancer and Alzheimer's. (See related story online.)

 

Studies with animals suggest that the diet's followers may be on to something.

 

"If you feed rodents different diets, you can very strongly modulate inflammation," says Dr. Andrew Greenberg, the director of the Obesity and Metabolism Laboratory at the Human Nutrition Research Center on Aging at Tufts University in Boston. "Fish oil, for example, ameliorates inflammation in rodents."

 

Resveratrol, found in grape skin and red wine, has been shown to improve blood vessel function and slow aging in rats.

 

Pomegranate juice decreases atherosclerosis development in mice with high cholesterol. Garlic improves blood vessel functioning in the hearts of rats with high blood pressure.

 

And curcumin (an antioxidant chemical found in turmeric) improves ulcerative colitis, rheumatoid arthritis and pancreatitis in mice and has anti-cancer effects in the animals too.

 

Curcumin has also been shown to ease the symptoms of rheumatoid arthritis in people, reducing joint swelling, morning stiffness and walking time. In India, turmeric is used to promote wound healing and reduce inflammation. But though curcumin's effects are being tested in several clinical trials addressing various diseases, rigorous human results are lacking-- as is the case for most anti-inflammatory foods.

 

Large, careful human clinical trials are expensive and few have been designed to test dietary interventions. Small trials on individual supplements have been done, though. And scientists have learned a lot from studying populations-- chronicling the natural habits of people and seeing what diseases they get and which they don't.

 

The drug factor

 

It makes sense that anti-inflammatory methods might help the heart, says Dr. Robert H. Eckel, a past president of the American Heart Assn. and professor of physiology and biophysics at University of Colorado Denver's Health Sciences Center.

 

Statin drugs, for example, are known to cut heart disease risk by reducing cholesterol levels-- among other things, these meds fight inflammation.

 

"We don't know how much of statins' effect are due to their anti-inflammatory effects," Eckel says. But, he adds, a growing number of researchers suspect that this property is important.

 

Fish oil, rich in anti-inflammatory omega-3 fatty acids and derived from oily fish such as tuna, salmon and mackerel-- is already recommended by the American Heart Assn. to help prevent cardiovascular disease. It has been shown to reduce blood triglyceride levels and slightly lower blood pressure, lowering the risk for heart attacks and strokes.

 

There is also reason to believe that anti-inflammatory substances would help to ward off cancers. Non-steroidal anti-inflammatory drugs have been shown to prevent tumors with people with inherited colorectal cancer, for example.

 

And population studies have shown that people who had been taking non-steroidal anti-inflammatory meds for other conditions were less likely to develop Alzheimer's disease.

 

In trials, such drugs have failed to treat already-developed Alzheimer's, but the studies suggest that it might be possible to prevent the disease by reducing inflammation, says Greg Cole, a professor of medicine and neurology at UCLA and associate director of the UCLA Alzheimer's Disease Research Center.

 

But it is not safe to take non-steroidal anti-inflammatory drugs for years because of harmful side effects, such as gastrointestinal bleeding. What about anti-inflammatory foods? Several clinical trials, in the U.S. and abroad, have shown that people with mild memory complaints related to aging (not necessarily Alzheimer's disease) showed significant improvement when given the omega-3 fatty acid docosahexaenoic acid, Cole says.

 

And in an 18-month study released in June sponsored by the National Institutes of Health, treating Alzheimer's disease with docosahexaenoic acid slowed its progression in a subgroup of the study population.

 

There are other trials with positive results for fish oil in early Alzheimer's cases, but they are not large enough to be definitive, Cole says.

 

But, he adds, "the real utility is not to slow the progression of someone who's already demented, but it's to treat before dementia happens. We'd like to turn off or keep down [the inflammation] with something that doesn't cause gastrointestinal bleeding or other side effects."

 

Cole's laboratory is looking at the potential for Alzheimer's prevention by controlling inflammation with omega-3 fatty acids and curcumin. Other food substances-- such as resveratrol in red wine and flavonoids in fruits-- may have anti-inflammatory effects by acting along the same pathway that curcumin does, he says.

 

Cole suspects that people are more likely to take a supplement or two than to radically change their diets. "Nutritionists, they'll tell you to eat right. It is good, sound advice, but you can't always get people to do it," he says. "The question is, can you find an easier supplement approach that doesn't require a restricted diet?"

 

Supplements do have their drawbacks. "Many Alzheimer's researchers were prescribing vitamin E [an antioxidant] to all their patients," says Debra Cherry, a clinical psychologist and the executive vice president of the Alzheimer's Assn. of the California Southland. "But some data came out that people had high bleeds and suffered from cardiovascular problems."

 

Dietary revamp

 

Perhaps a complete diet overhaul-- difficult though that may be-- would be a better strategy. The Mediterranean diet, named for the region in which it originated, has many anti-inflammatory features.

 

It includes fruits, vegetables, nuts, fish, whole grains, alcohol, and healthful fats like olive and canola oil. It has been shown to lower LDL cholesterol and triglyceride levels and reduce the risk of blood clots. Studies have shown that diets high in fish, olive oil and cooked vegetables reduce the symptoms of rheumatoid arthritis. A Mediterranean diet or elements of it seems linked to reduced risk for a number of chronic conditions, including cardiovascular disease, cancer, diabetes and Alzheimer's. (See related story online.)

 

"If people noticed they're slightly overweight, or if blood pressure is starting to creep up, or if blood sugar [increases], and they went on a Mediterranean-type diet, they might be able to decrease inflammation and stop the progression of disease," says Dr. Wadie Najm, a clinical professor of family medicine and geriatrics at UC Irvine who directs an integrated medicine clinic at UCI that focuses on complementary and alternative medicine.

 

Many patients visiting his clinic have chronic inflammatory conditions, including autoimmune diseases such as arthritis and gastrointestinal problems such as Crohn's disease. Patients begin a specialized diet and exercise, and make other lifestyle changes to decrease inflammation.

 

"In three weeks, if [patients] follow the protocol, we see great results in improvement in symptomology and reduction in flare-ups," says Bianca Garilli, a naturopathic doctor at the clinic.

 

Of course, these dietary and other lifestyle changes might help treat pain conditions through the placebo effect-- a belief in a treatment rather than the treatment itself, says Dr. Roger Chao, an associate professor of medicine at Oregon Health and Science University and director of clinical guidelines development for the American Pain Society.

 

"You're giving something for people to focus on and do something good for themselves," Chao says.

 

At the end of the day, there is evidence to suggest that your best bet at curbing inflammation is to eat a healthful diet-- and keep your weight in check-- without specifically thinking about anti-inflammatory foods.

 

"There is no doubt that if you lose weight, inflammation is dramatically improved," Greenberg says. When a person is overweight or obese, body fat breaks down into fatty acids, which circulate in the blood. These fatty acids promote an immune response in the same way that infection does, increasing inflammation.

 

It will take time to tease apart the effects of anti-inflammatory diets and supplements. But Cole thinks the effort is well worth it. "The alternative to these kinds of things aimed at prevention is to pay for treatments," he says. "And we can't always afford them."

 

Copyright © 2009, The Los Angeles Times.

 

 

 

 

Calling Mr. Yuk

 

By Stephanie Desmon

Baltimore Sun

Tuesday, August 18, 2009

 

Twice as many kids are overdosing on what's in the medicine cabinet as what's underneath the sink, according to a new study.

 

http://www.ajpm-online.net/webfiles/images/journals/amepre/AMEPRE_2545.pdf

 

More than 70,000 kids each year in the U.S. are treated in emergency room for unintentional medication overdoses-- 80 percent of them from unsupervised ingestion of drugs. Many are getting sick after they get their hands on commonly available over-the-counter medications. The four most frequent culprits: acetaminophen (Tylenol), cough and cold medicine, antidepressants and non-steroidal anti-inflammatory drugs (Ibuprofen).

 

The rate of hospitalizations for medication overdoses, according to the study in this month's American Journal of Preventive Medicine, was four times that for poisonings from non-pharmaceutical products like cleaning sprays, pesticides and shampoos.

 

"The high frequency of medication usage and the rising number of medications stored in American homes increases the potential for medication overdoses ... especially among children," write the study's authors, who are from the Centers for Disease Control and Prevention.

 

The number of pediatric medication poisonings in the U.S. could be even higher because the data only included those who were taken to the hospital, not those who called poison control centers or went to the pediatrician.

 

The numbers, to me, are pretty shocking, so let me throw in one more: One out of every 180 2-year-olds is treated in an ER for medication overdose. This is despite education campaigns and allegedly child-resistant packaging available on most medication.

 

As I write this, I keep thinking about the leftover vitamins and pain relievers from my recent vacation just sitting out on my dresser while the cleaning products are guarded behind child safety locks or are on shelves so high I can barely reach them.

 

The authors call the whole thing a "substantial public health burden" and think prevention efforts need to be redoubled.

 

Copyright 2009 Baltimore Sun.

 

 

 

 

Cheaper Birth Control Returns

Feds take action on the pill

 

Premium Health News Service

By Deborah Kotz

Baltimore Sun

Tuesday, August 18, 2009

 

Everything that was tied up in the previous presidential administration is quickly coming undone. Congress passed a provision in its massive omnibus spending bill that allows pharmaceutical companies to reinstate discounts on birth control pills and other hormonal contraceptives that they had previously offered to family planning clinics and college campus health clinics.

 

A 2005 federal law, designed to save taxpayers money on Medicaid reimbursements for drugs, financially dissuaded pharmaceutical companies from selling their products to these pharmacies at slashed prices. College women were particularly affected. Many saw their favorite contraceptive brands' cost rise from $5 to $10 a month to $30 to $50 a month. The new provision, allows drug companies to once again offer the discounts, at no cost to taxpayers.

 

"It's a tremendous victory for women's health," Planned Parenthood President Cecile Richards tells me. "It's an indication we have a government now that's really focused on prevention and expanding access to women's health care." During the Bush years, her nonprofit had organized a large petition drive among college students, as well as meetings with congressional leaders, in a futile attempt to change the policy.

 

As a result of the higher prices, some college health clinics, like the one at Bowdoin College in Brunswick, Maine, stopped offering hormonal contraceptives altogether because they couldn't afford to maintain the costly inventory. While most clinics were able to offer cheaper, generic versions of birth control pills, the monthly vaginal insert NuvaRing and the patch (placed on the skin) have no generic equivalents. "The NuvaRing in particular was catching on in popularity among college students because it afforded them privacy and the convenience of not having to take a pill every day," says Mary Hoban of the American College Health Association. But, she points out, the new provision "only removes the barrier that was put in place; it doesn't guarantee that manufacturers will reinstate those nominal price contracts."

 

So will companies offer these bargain rates once again? After all, the economy has tanked since they last offered them. "We're looking into it. It's something we would definitely like to support," says Lisa Ellen, spokesperson for Schering-Plough, manufacturer of NuvaRing. Don't expect, though, to see those contraceptive discounts overnight: Health clinics will need time to renegotiate their contracts with the drug companies and will probably want to first sell off their stock of higher-priced contraceptives before purchasing cheaper supplies, says Hoban. Bottom line: Students may not feel an ease on their pocketbooks until the next academic year.

 

Copyright © 2009, Tribune Media Services.

 

 

 

 

Ore Pharmaceuticals cuts losses, still needs buyer

 

By Vandana Sinha

Baltimore Business Journal

Tuesday, August 18, 2009

 

Ore Pharmaceuticals Inc. cut its second-quarter losses nearly in half despite bringing in only 3 percent of the previous year’s quarterly revenue.

 

The Gaithersburg-based biotech company still warned of potential liquidation next year if its cashbox doesn’t significantly improve.

 

The biotech, which plans to continue testing a drug candidate to treat ulcerative colitis this year, has been struggling with cash, reporting $25,000 in total revenue for the second quarter, down from last year’s $1 million for the same period.

 

Ore reported a second-quarter loss of $2.5 million, or 47 cents per share, down 45 percent from a loss of $4.7 million, or 86 cents per share, for the second quarter last year. Ore shrunk from 71 people at the start of 2008 to seven people by the end of this past June, vacating nearly all of its Gaithersburg space and taking up a lower-cost lease in Cambridge, Mass., where it holds another location.

 

Ore successfully requested it be released from liability from its 11-year lease at 50 West Watkins Mill Road, which the local company allotted to India-based Ocimum Biosolutions Ltd. when it sold the latter its genomics business in 2007. Ocimum still owes Ore $1.5 million from that purchase, due Sept. 15. In the meantime, Ore is negotiating with the state of Maryland, which notified the company earlier this spring that it must repay $710,000 from a previous loan and grant agreement.

 

Ore said it held nearly $4.7 million in cash and equivalents as of June 30-- an amount it said would be enough with the Ocimum repayment to last into next year. But company officials warned of more dire consequences if that cash doesn’t prove sufficient and doors remain closed to more financings.

 

“If the company is not successful in achieving its objectives, it might be necessary to liquidate the company in late 2010,” according to the company.

 

Ore recently hired a new chief financial officer, Benjamin Palleiko, to help pull the company through the rough patch. Palleiko, a former life sciences investment banker who will be based in Ore’s Cambridge, Mass., office, is expected to get a $80,000 raise, more than a third of his current salary, if the company undergoes a business transaction that results in significant positive cash flow.

 

Though, that is not the only change in leadership at Ore, where a revolving door at the top job has led to three CEOs in two years, the latest being another board member, Mark Gabrielson. Ore’s first CEO in that time, Mark Gessler, had been replaced by a board member in 2007, but he’d remained on the board since then until suddenly resigning this year on July 23. A week later, Ore brought in Jim Fordyce, another life sciences venture capitalist and former managing member of private investment firm Fordyce & Gabrielson LLC, to join the board.

 

Ore is also proposing that its shareholders approve a move to create a new holding company, Ore Pharmaceutical Holdings Inc., to take over the company’s assets and allow it to continue to claim future tax benefits on its current losses. Under that plan, which will receive a vote at the shareholder meeting Oct. 20, the company said Ore’s stockholders would exchange each Ore share for an Ore Holdings share with little other change. Ore said it’s protecting tax benefits on $324 million in tax loss carryforwards, while trying to keep in place restrictions on stock transfers that could bump up a party’s ownership to more than 5 percent of the company.

 

 All contents of this site © American City Business Journals Inc. All rights reserved.

 

 

 

 

Cocaine turning up on more dollar bills

Up to 90% of paper money in large cities may contain tiny amounts of drug

 

By Nick Madigan

Baltimore Sun

Tuesday, August 18, 2009

 

Everybody knows that once a bank note has passed through a few hands, it's not the cleanest thing in the world.

 

What you might not know is that, in addition to germs, grime and other visitors, the bills in your wallet probably contain cocaine.

 

Although such traces have been reported in the past, a scientists' group said Monday that cocaine is present in up to 90 percent of the paper money in the United States, particularly in large cities such as Baltimore, Boston and Detroit.

 

The 90 percent figure represents a significant jump from a similar study conducted two years ago. In the earlier survey, 67 percent of U.S. paper money was found to contain traces of cocaine.

 

Scientists attending an American Chemical Society meeting in Washington were told that bank notes from more than 30 cities in five countries- the United States, Canada, Brazil, China and Japan- were tested and showed "alarming" evidence of cocaine, although the amounts found on individual bills were usually tiny, and certainly not enough for a high.

 

Professor Yuegang Zuo of the University of Massachusetts, who led both studies, said the U.S. had the highest levels of cocaine among the countries surveyed. China and Japan had the lowest.

 

Zuo pointed out that the amount of cocaine found on most notes was so small that consumers should not worry about their health or legal jeopardy when handling paper money.

 

In an e-mail message Monday, Zuo said that of the 10 bank notes examined in Baltimore, nine contained cocaine, findings that matched a survey taken in the city in 1996.

 

Across the United States, a total of 234 bank notes were tested for the latest survey, for which denominations were not specified.

 

Washington ranked above the average, with cocaine found on 95 percent of the sampled bank notes. The lowest average cocaine levels appeared in bills collected from Salt Lake City.

 

The researchers studied 27 bank notes from Canada and found that 85 percent were contaminated with cocaine. Of the 10 bills analyzed from Brazil, eight had the drug.

 

Some people in the Baltimore area played down the findings.

 

"I don't think there's that much chance of it being a real problem," said Bryan Taylor, who describes himself as a "house rehabber" from North Baltimore. "I suppose they teach the dogs to be alert to high-enough levels. Otherwise, our airports would be in chaos. There's a horrible thought- airports even worse than they are now."

 

Martha Elliott, another North Baltimore resident, said it was no surprise that bank notes would become contaminated by cocaine.

 

But, she added, "I wonder how difficult it would be to plead your case were you to be fingered- or nosed- by a drug-sniffing dog? I suspect that that would depend a great deal on your age, color and other demographics."

 

In 1994, the 9th U.S. Circuit Court of Appeals in San Francisco said the probative value of positive alerts by drug-sniffing dogs had been weakened by the "contamination of America's paper money supply" with drug residues.

 

Paper money can become tainted with cocaine during drug deals or when users snort the powder through rolled bills. The contamination can spread to other bank notes in wallets or when they are processed through currency-counting machines.

 

Copyright © 2009, The Baltimore Sun.

 

 

 

 

Cooperatives Being Pushed as an Alternative to a Government Plan

 

By David S. Hilzenrath and Alec MacGillis

Washington Post

Tuesday, August 18, 2009

 

As prospects fade for a public, or government-run, option as part of health-care reform, key senators are considering another model to create competition for private insurers: member-owned, nonprofit health cooperatives.

 

Sen. Kent Conrad (D-N.D.), the chief advocate for including cooperatives in reform legislation, has cited examples as disparate as the Land O'Lakes dairy concern, rural electricity cooperatives and Ace Hardware.

 

But so far, cooperatives have been defined in the health-care debate primarily in terms of what they are not: They would not be run by the government.

 

That may make the cooperatives more politically palatable to conservatives, as well as to some Democrats such as Conrad, who fear that the public option may be a bridge too far. But it also presents new challenges: Cooperatives would face potentially greater difficulty getting off the ground and obtaining discounted rates from doctors and hospitals, observers say.

 

"It's very difficult to start up a new insurance company and break into markets where insurers are very established," said Paul B. Ginsburg, president of the Center for Studying Health System Change. "I don't see how they're going to obtain a large enough market share . . . to make a difference."

 

Karen Davis, president of the Commonwealth Fund, a foundation focused on health care and social policy research, said co-ops may not enroll enough people to negotiate favorable rates with health-care providers.

 

Dennis G. Smith, a senior fellow at the Heritage Foundation, a conservative policy research group, said he cannot yet tell whether co-ops would amount to government-run health plans by another name.

 

There are at least two major health-care organizations that could serve as models for Congress: HealthPartners in Minnesota and Group Health Cooperative, based in Seattle. They employ physicians and own health-care facilities, giving them greater power to control the delivery of care.

 

A major question Congress would have to decide is whether the new cooperatives would be integrated medical systems, like HealthPartners and Group Health. Or, would they simply negotiate reimbursement contracts with health-care providers, as conventional insurers do?

 

According to Conrad's Web site, co-ops would contract with providers and act as insurers. That could make them more like mutual life insurance companies, which are owned by their policyholders and are therefore somewhat insulated from the pressures and temptations of Wall Street.

 

Like the proposed public option, state or regional co-ops would be among the choices offered through a new regulated marketplace, in which eligible individuals could more easily comparison-shop for insurance.

 

However, co-ops would lack perhaps the main advantage of the public option: reimbursement rates for doctors and hospitals set by federal law, like those paid by Medicare, the program for older Americans. Federally determined reimbursement rates were central to the cost-saving promise of a government-run health plan and a potentially powerful competitive advantage. They were also a lightning rod for intense opposition from health-care providers and private insurers, who denounced the public option as a threat to their financial survival.

 

Co-ops would lack the ability to piggyback onto existing government institutions, like the ones that help administer Medicare.

 

President Obama championed a government-run health plan as a way to generate competition for private insurers and keep them honest, but the administration over the weekend signaled that it is willing to accept reform legislation without a public option.

 

As nonprofit enterprises, cooperatives would not have to worry about generating returns for shareholders. They could use that freedom to reduce members' premiums or put more money into improving care. HealthPartners aims for a 2 percent profit margin, said Mary Brainerd, the group's chief executive.

 

Being owned by members could make them more accountable to consumers, Brainerd said. Although HealthPartners is not owned by members, policyholders elect its board, and candidates for board seats have run campaign ads on local cable television, Brainerd said.

 

"It's not a magic answer, but I think it has a lot of the incentives that you would want to see that are pro-consumer," she said.

 

How the co-ops would spring to life is an open question. As start-ups, they could have a hard time competing with insurers that already dominate local markets. It is possible that existing health care organizations could try to convert themselves into co-ops.

 

There is a danger that co-ops could someday try to turn themselves into something else. Many non-profit health-care institutions, including CareFirst in the Washington area, have tried to convert themselves into for-profit corporations listed on the stock markets. CareFirst's attempt foundered amid criticism that it would generate huge financial windfalls for the company's executives and convert years of tax advantages into private gain.

 

Most Blue Cross and Blue Shield plans have a history as consumer cooperatives in the sense that they were nonprofit and owned by their members, said Mark V. Pauly, professor of health-care management at the University of Pennsylvania's Wharton School.

 

"The history here is that they did bargain aggressively with hospitals because they often had (and still have) the largest market share of any private insurer. But there is little evidence that they held down spending growth, and a lot of evidence that they were captured by their professional management and not really controlled by consumers or by the public," Pauly said by e-mail.

 

Conrad envisions the co-ops receiving seed money from the government.

 

"The hard reality is, the reason I was asked to see if I could come up with [an alternative] is that the public option does not have enough support in the Senate to pass," Conrad said in a recent interview. "It's an alternative that would accomplish much of what's appealing [in the public option] and not have the fierce opposition of virtually every Republican and some Democrats."

 

It remains to be seen whether the co-op alternative would win any support for the legislation in Congress.

 

Sen. John D. Rockefeller IV (D-W.Va.), a leading proponent of the public option, isn't sold on Conrad's substitute.

 

"The co-op approach is very weak," he said in a recent interview.

 

Apparently, the proposed health co-ops would differ from another form of co-operative, the real estate version. Unlike, say, Manhattan's exclusive co-ops, whose boards decide who can move into the building, health co-ops would have to admit anyone willing to pay the premium, according to Conrad's Web site.

 

Copyright 2009 Washington Post.

 

 

 

 

FDA puts hold on Geron spinal injury product

 

San Francisco Business Times

Baltimore Business Journal

Tuesday, August 18, 2009

 

The Food and Drug Administration put a hold on Geron Corp.’s Investigational New Drug application for a spinal cord injury product.

 

The hold on Menlo Park-based Geron’s (NASDAQ: GERN) GRNOPC1, a cell therapy for neurologically complete, subacute spinal cord injury, gives the FDA time to review new nonclinical animal study data submitted by the company.

 

A clinical hold is an order that the FDA issues to a sponsor to delay a proposed trial or to suspend an ongoing trial.

 

Since filing the IND, Geron studied dose escalation of its spinal cord injury product and has been investigating application of the product to other neurodegenerative diseases.

 

No patients have yet been treated in this study.

 

Copyright 2009 Baltimore Business Journal.

 

 

 

 

Chinese mayor apologizes for lead poisoning

 

Associated Press

By David Wivell

Hagerstown Herald-Mail

Tuesday, August 18, 2009

 

CHANGQING, China (AP)-- A mayor apologized to residents of two Chinese villages where more than 600 children were sickened by lead poisoning, saying a nearby smelter targeted by angry protests would not reopen until it meets health standards, state media said Tuesday.

 

Authorities have promised to relocate hundreds of families within two years, the official Xinhua News Agency said, but residents were not reassured.

 

"If they relocate us to these nearby places, who can guarantee that our babies will be safe?" said farmer Deng Xiaoyan, a resident of Sunjianantou, one of the affected villages. She said a recent test showed her 3-year-old daughter had high levels of lead.

 

Environmental problems have escalated as China's economy booms, sometimes prompting violent protests. Counting on lax enforcement of regulations, some companies find it easier and cheaper to dump poisons into rivers and the ground rather than dispose of them safely.

 

At least 615 of 731 children in two villages near the Dongling Lead and Zinc Smelting Co. plant in Shaanxi province's Changqing town have tested positive for lead poisoning. Some had lead levels 10 times the level China considers safe.

 

Lead poisoning can damage the nervous and reproductive systems and cause high blood pressure, anemia and memory loss. It is especially harmful to young children, pregnant women and fetuses, and that damage is usually irreversible, according to the World Health Organization.

 

The mayor of Baoji city, which oversees Changqing, arrived at the plant Monday as hundreds of villagers were protesting, tearing down fences and blocking traffic outside the factory, Xinhua reported. Dai Zhengshe apologized and said the plant will not be allowed to open again until it meets health standards, the report said.

 

Villagers had been enraged by the plant's defiance of the Aug. 6 order to suspend operations, Xinhua said. Fighting between angry parents and scores of police broke out Sunday, and trucks delivering coal to the plant were stoned.

 

The mayor said the plant halted production only on Monday because of safety reasons. "We had to make sure the gas in the pipeline was exhausted before the plant was finally shut down," Dai said in the Xinhua report.

 

A man surnamed Ma who lives in Madaokou- the other of the badly affected villages, about 500 yards (meters) from the factory- said residents believed at least two villagers were taken from their homes by police Monday night. He said the Baoji city government sent officials to his village Tuesday to try to pacify residents.

 

"They wanted to persuade us not to cause trouble, but they didn't provide any solution to our problems," Ma said by telephone.

 

Associated Press journalists saw no sign of workers at the factory Tuesday, while about 50 police officers guarded the compound. Another 50 sat in police buses. The windows of the factory's reception area and security office were shattered.

 

A few hundred children were being tested Tuesday for lead poisoning in a third village, Luobosi.

 

Dr. Pascal Haefliger, a health and environment expert with the World Health Organization in Geneva, said lead stays in the body for years after exposure and continues to affect brain development and the nervous system in growing children.

 

"Medical treatment exists, but will not be successful in removing all the lead from the body," he said.

 

Xinhua said authorities have promised to relocate hundreds of families within two years, with the building of new homes about 3 miles (5 kilometers) from the plant starting last week.

 

Deng, the farmer, cradled her daughter and said she thought those houses would still be too close.

"There is lead in the air, the air is polluted, everything is polluted," she said.

 

Associated Press writer Gillian Wong and researcher Xi Yue contributed to this report from Beijing.

 

© 2009 The Associated Press. All rights reserved.

 

 

 

Opinion

 

Medicare offers lessons for national health care reform

 

By Dr. John R. Burton

Baltimore Sun Commentary

Tuesday, August 18, 2009

 

Our national experience with the Medicare program can provide guidance to the choices our legislators must make regarding health care reform. If one favors more or less government in health care, positive and negative lessons emerge from the nearly 50-year Medicare experience of providing universal health care coverage for all those age 65 and older.

 

Medicare eliminated the fragmented, episodic and often dehumanizing care that many retired seniors were forced to seek through emergency departments or charitable sources because they no longer had coverage from an employer. I witnessed this phenomenon first hand, and I don't believe anyone who has experienced such care as a patient or a provider would argue that it should be acceptable. The implementation of Medicare increased the demand for primary care from physicians in private practice. With access to comprehensive primary care, overall health care quality went up, and average per-patient costs went down.

 

Patients generally like Medicare and the freedom of choice it provides. Admiration seems to hold even if individuals had private insurance before retirement. It seems to be admired by individuals of nearly all political persuasions. It is a largely government-run program then does seem acceptable to many Americans.

 

Medicare was designed in the 1960s when life expectancy was only around age 68 and acute health care problems dominated. Now, the life expectancy is closer to 80 years and chronic diseases are most prominent. Some argue updating of Medicare has been slow. Yet it has adapted partially to the changes of the past 50 years. Improved coverage for prevention, counseling/education and house calls and, most recently, partial drug coverage show such improvement.

 

But there are problems. Primary care in Medicare has become unattractive to providers in recent years. Increasingly, seniors and especially those with multiple chronic diseases can't find a primary care provider. Experts argue this is because of the increasing complexity of illness, mostly in the very old.

 

Many patients find they must participate in a concierge program or the like or join a practice. Caring for older patients with multiple chronic diseases does take more provider time.

 

Team care is ideal in such situations, yet it is inadequately compensated and, therefore, not widely available. Accordingly, any health care reform must include strategies for recruiting professionals of all disciplines to primary care and sponsor the creation of innovative models of care delivery.

 

Medicare is a successful public/private partnership. In the fee-for-service Medicare program, most individuals have a co-payment or purchase supplemental private insurance in the form of a MediGap policy or they participate in the Medicare drug program.

 

Seniors in the Medicare Advantage program essentially have private insurance that is paid for by Medicare. In the 1980s, most experts predicted the vast majority of seniors would enroll in Medicare Advantage plans. This didn't happen, and many argue that some private insurers didn't recognize that the very old and those with multiple diseases could not be treated as if they were well 50-year-olds. There are stories of private insurance companies or groups subcontracted to them not allowing physicians the time to provide proper care.

 

However, some private insurance companies used this opportunity to create innovative programs to provide care for the chronically ill and disabled. But still proven innovations are not widely available in either the Medicare Advantage or fee-for-service programs. If one finds fault with government programs, there seems to be opportunity to do the same with private companies.

 

The Medicare program has been a godsend to American seniors. I shudder to think of their plight had it not been enacted. Without regard to one's political persuasion, lessons from our Medicare program, both its government and private components, could serve as a guide to doing what we must do: assure that all Americans have some form of adequate health insurance.

 

Dr. John Burton is a professor of medicine and director of the Johns Hopkins Geriatric Education Center and Consortium. His e-mail is jburton@jhmi.edu.

 

Copyright © 2009, The Baltimore Sun.

 

 

 

 

A soup kitchen seeks to expand in Fells Point

 

By Andy Green

Baltimore Sun Commentary

Tuesday, August 18, 2009

 

Here's a preview of an editorial we're working on. Let us know what you think. The best comments will appear alongside it in the print edition.

 

Beans & Bread, a soup kitchen in Upper Fells Point, feeds 300 people a day. That’s not expected to change, even if Beans & Bread wins city approval to build an addition. What would change is that the people who already line up for food would get to queue up inside the building instead of out on the sidewalk. They would have a place to shower and wash their clothes. The expansion also would give Beans & Bread staff offices rather than cubicles, so when they’re trying to help someone find services for, say, AIDS treatment, they can discuss that in private.

 

Some neighbors and area businesses fear an expanded Beans & Bread will draw more homeless people the area. But St. Vincent de Paul of Baltimore, which has operated the soup kitchen at Bank and South Bond streets for the past 17 years, insists that will not happen. The dining room will not grow, it says, and the showers and other services will only be available to people who eat there.

 

Neighbors and businesses who feel the homeless population is growing and dragging the area down are understandably wary. But those 300 people aren’t going away. What’s the downside to getting the line off the sidewalk, helping the homeless clean up and getting them services that could get some off the streets?

 

Copyright 2009 Baltimore Sun.

 

 

 

 

Flaws in health care proposal

 

By Rob Spring

Carroll County Times Commentary

Tuesday, August 18, 2009

 

The heated debate on health care continues. Both sides are slinging talking points and in some cases, fail to address legitimate concerns at all. They also use smoke and mirrors to make you believe what isn’t necessarily true.

 

I’m not an advocate of government health care. The government has never been efficient at anything, nor is it capable of doing more with less. With those facts in mind, let’s review where we currently stand.

 

President Barack Obama has said that if you like your current health care plan you can keep it. This is misdirecting your concern. Sure you can keep your plan, but if you ever lose coverage or need to change it, welcome to government health care.

 

This is how they will phase out private insurance. Pages 16 and 17 of the bill explain this in detail. In addition, by keeping insurance costs artificially low through subsidies with tax dollars, the government can drive private insurance into bankruptcy. Private insurers don’t get tax dollars to cover their shortfalls.

 

The most laughable thing Obama has said is we will pay less. Has the government ever done anything for less? You might actually pay less, but your taxes, combined with premiums or co-pays, will exceed the current total cost of coverage. Even the Congressional Budget Office has said the plan will increase health care costs.

 

If they magically reduce costs, there’s only one way to do that. It’s called reducing quality or quantity. I think it’s hilarious when supporters of this plan tout Medicare as a success story. For those out of the loop, the Congressional Budget Office has stated that Medicare is projected to go bankrupt in 2017.

 

I thought it was comical last week when Obama was at a town hall trying to market his plan. He said that Fed-Ex and UPS are doing just fine and that the post office always has the problems and long lines. Sounds like that public option is a model to be followed. By the way, the post office is looking at a $9 billion shortfall this year and is considering reducing delivery days. Is this sort of like limiting care if money gets tight?

 

Here’s my plan. The government has stated that 47 million people are without health care. When the number is analyzed, we find that a majority of that number are illegal immigrants or people who make enough to purchase insurance, but instead, they purchase an expensive car.

 

Basically, we’re looking at 15 million or so poor who need insurance. They do get health care, they just don’t have insurance. So, for less than 5 percent of our population we’re going to reduce the quality of our health care system. How many lives will that cost? Instead, offer a voucher to the poor so they can purchase their own private insurance. Health insurance problem solved.

 

It’ll never happen because the government wants to control your health care, and you.

 

Rob Spring writes from Westminster. His columns appear every other Monday. E-mail him at backitupwithfacts@yahoo.com

 

Copyright 2009 Carroll County Times.

 

 

 

 

Let’s work together to save the Governor’s Wellmobile

 

Cumberland Times-News Letter to the Editor

Tuesday, August 18, 2009

 

I would like to bring an awareness to the importance of the Governor’s Wellmobile.

 

I realize in these harsh economic times the necessity of budget cuts but cutting out completely the services of the Wellmobile is unacceptable. In my eyes it is a grave mistake.

 

With the high cost of health insurance there are many residents in this area that do not have insurance nor can they go to a hospital or doctor’s office since they don’t have those required funds. The Wellmobile services such individuals and many rely on it just to get their needed medications.

 

I’m making a plea to anyone and everyone to rally to protect and keep the Wellmobile services from discontinuing. Whoever there is out there that may have some influence on the decision making powers, please help to keep this program in operation at some level.

 

I would like to thank in advance all those who react to this plea in any positive manner.

 

Gregory M. Morris

Cresaptown

 

Copyright © 1999-2008 cnhi, inc.

 

 

 

 

Universal health care is more humanitarian

 

Salisbury Daily Times Letter to the Editor

Tuesday, August 18, 2009

 

In the current debate about health care reform, we feel an important perspective is too often lost. For us, it is based not on rhetoric, but on personal experience from living and working here in the United States as well as in countries in relatively poor South America and relatively rich Europe.

 

We feel a universal health care system is many times better for the whole population, primarily because no one is denied and more preventive care is given. While certainly not always perfect, it is far more just and it is this humanitarian perspective we feel too often gets pushed aside in the political back and forth.

 

Yes, we've also known people who've come from other countries to the United States for health care because we have excellent doctors and research hospitals. However, these patients were only able to obtain this level of care because they could pay cash-- hardly an option for most.

 

Change is challenging and it will take a lot of time and effort to make things work well, but we're certainly not inventing anything new. Americans are extremely capable of efficiency and compassion, if so motivated. We urge you to please keep in mind the human toll within the many other seemingly louder factors of costs, business interests and political battle cries.

 

Susan Holt

Carlos Moreno

Salisbury

 

Copyright 2009 Salisbury Daily Times.

 

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