JOAN JACOBSON, Author at Park Record https://www.parkrecord.com Park City and Summit County News Sat, 30 Jun 2007 06:24:52 +0000 en-US hourly 1 https://www.parkrecord.com/wp-content/uploads/2024/03/cropped-park-record-favicon-32x32.png JOAN JACOBSON, Author at Park Record https://www.parkrecord.com 32 32 235613583 Here’s to Your Health https://www.parkrecord.com/2007/06/30/heres-to-your-health-10/ Sat, 30 Jun 2007 06:24:52 +0000 http://dev.parkrecord.com/news/heres-to-your-health-10/ On April 24, 2006, a clinical trial using one of the newest drugs, Alzhemed was found to reduce dementia in four out of nine patients who were involved in the trial. The drug works to reducing the abnormal amyloid/ plaque clumps and bundles of neurofibrillary tangles in the blood vessels in the brain. Alzheimer's, as you recall, is a progressive neurodegenerative disease that results in the development of amyloid plaque and tangles that form in the brain. Age appears to be a factor as is a genetic predisposition to the disease. Three genes for the disease have already been identified that can cause early onset of the disease. Symptoms of the disease include memory loss, language deterioration, impaired ability to mentally manipulate visual information, poor judgment, confusion, restlessness and mood swings.

Unfortunately, the number of people with the disease doubles every five years after age 65 (National Institute on Neurological Disorders and Stroke). There are 5.1 million individuals in the United States who have the disease. The longer a person lives, the greater the risk. One in eight over 65 has it, and half of those over 85 are afflicted with the disease. The estimates by the year 2025 are that over 22 million individuals worldwide will be afflicted.

Paul Aisen, MD, professor of neurology and medicine at Georgetown University Medical Center and principal investigator in the United States of the ongoing Phase III clinical trial tranmiprosate (Alzhemed), says that "Developing successful treatment to slow the progression of this disease, which today remains an unmet medical need, would be a major advance in the fields of neurology and age-related illnesses." Since Phase II of the trial using Alzhemed; the drug continues to show clinically significant benefits on cognitive and global performance measures. Stabilization of the disease was noted in four out of nine mildly affected patients, after three yeas of treatment. For the first time, the laboratory results, presented by Dr. Aisen, are reported on the actual mechanism and action of Alzhemed. In the disease process, beta-amyloid collects between the nerve cells, disrupting brain function and that triggers an immune response that destroys the cells. Beta-amyloid in the form of plaque and tangles are found in the damaged brain cells. The result of this disrupts brain function and triggers an immune response that destroys brain cells. The cause is still unknown. In the clinical trials so far, the drug appears to have a protective effect on brain cells and seems to prevent formation of plaque in the cells.

Phase III of the trial involves 1,052 patients with mild to moderate Alzheimer's disease (AD), at more than 70 clinical sites throughout the United States and Canada. The trial ended in January of this year.There are also ongoing trials in Europe with about 900 mild to moderate AD patients.

There are more than four dozen other drugs now in human clinical trials. One of the most promising is Flurizan, from Myriad Genetics. Researchers should complete testing in the next 18 months. Experts say that these drug trials are the results of over 20 years of scientific work on Alzheimer's. The director of the AD center at University of California at San Diego, Douglas Gailasko,M.D., concurs that "We are now at a point where we understand enough about the molecules and mechanism of the disease to target new therapies very, very precisely."

Sometime this month (closing in on Alzheimer's/AARP Bulletin, June 2007), scientists are expected to present the final test results for the newest generation of drugs designed to attack the underlying cause of the disease. Sam Gandy, chair of the National Medical and Scientific Advisory Council of the Alzheimer's Association and director of the Farber Institute for Neurosciences in Philadelphia, says, "Within three years, it is all but certain that we'll have disease-modifying drugs that fundamentally change the nature of Alzheimer's."

Finally, there is hope. With this exciting news, there may be many more aging men and women who will be living longer and healthier, and without Alzheimer's Disease. Scientists continue to unwind the mystery of who may become victims so that the disease could be arrested in its early stages before damage occurs. For information on clinical trials in your area, call 1-800-438-4380, the government's AD Education and Referral Center, or online, www.nia.nih.gov/Alzheimers .

The post Here’s to Your Health appeared first on Park Record.

]]> On April 24, 2006, a clinical trial using one of the newest drugs, Alzhemed was found to reduce dementia in four out of nine patients who were involved in the trial. The drug works to reducing the abnormal amyloid/ plaque clumps and bundles of neurofibrillary tangles in the blood vessels in the brain. Alzheimer’s, as you recall, is a progressive neurodegenerative disease that results in the development of amyloid plaque and tangles that form in the brain. Age appears to be a factor as is a genetic predisposition to the disease. Three genes for the disease have already been identified that can cause early onset of the disease. Symptoms of the disease include memory loss, language deterioration, impaired ability to mentally manipulate visual information, poor judgment, confusion, restlessness and mood swings.

Unfortunately, the number of people with the disease doubles every five years after age 65 (National Institute on Neurological Disorders and Stroke). There are 5.1 million individuals in the United States who have the disease. The longer a person lives, the greater the risk. One in eight over 65 has it, and half of those over 85 are afflicted with the disease. The estimates by the year 2025 are that over 22 million individuals worldwide will be afflicted.

Paul Aisen, MD, professor of neurology and medicine at Georgetown University Medical Center and principal investigator in the United States of the ongoing Phase III clinical trial tranmiprosate (Alzhemed), says that "Developing successful treatment to slow the progression of this disease, which today remains an unmet medical need, would be a major advance in the fields of neurology and age-related illnesses." Since Phase II of the trial using Alzhemed; the drug continues to show clinically significant benefits on cognitive and global performance measures. Stabilization of the disease was noted in four out of nine mildly affected patients, after three yeas of treatment. For the first time, the laboratory results, presented by Dr. Aisen, are reported on the actual mechanism and action of Alzhemed. In the disease process, beta-amyloid collects between the nerve cells, disrupting brain function and that triggers an immune response that destroys the cells. Beta-amyloid in the form of plaque and tangles are found in the damaged brain cells. The result of this disrupts brain function and triggers an immune response that destroys brain cells. The cause is still unknown. In the clinical trials so far, the drug appears to have a protective effect on brain cells and seems to prevent formation of plaque in the cells.

Phase III of the trial involves 1,052 patients with mild to moderate Alzheimer’s disease (AD), at more than 70 clinical sites throughout the United States and Canada. The trial ended in January of this year.There are also ongoing trials in Europe with about 900 mild to moderate AD patients.

There are more than four dozen other drugs now in human clinical trials. One of the most promising is Flurizan, from Myriad Genetics. Researchers should complete testing in the next 18 months. Experts say that these drug trials are the results of over 20 years of scientific work on Alzheimer’s. The director of the AD center at University of California at San Diego, Douglas Gailasko,M.D., concurs that "We are now at a point where we understand enough about the molecules and mechanism of the disease to target new therapies very, very precisely."

Sometime this month (closing in on Alzheimer’s/AARP Bulletin, June 2007), scientists are expected to present the final test results for the newest generation of drugs designed to attack the underlying cause of the disease. Sam Gandy, chair of the National Medical and Scientific Advisory Council of the Alzheimer’s Association and director of the Farber Institute for Neurosciences in Philadelphia, says, "Within three years, it is all but certain that we’ll have disease-modifying drugs that fundamentally change the nature of Alzheimer’s."

Finally, there is hope. With this exciting news, there may be many more aging men and women who will be living longer and healthier, and without Alzheimer’s Disease. Scientists continue to unwind the mystery of who may become victims so that the disease could be arrested in its early stages before damage occurs. For information on clinical trials in your area, call 1-800-438-4380, the government’s AD Education and Referral Center, or online, www.nia.nih.gov/Alzheimers .

The post Here’s to Your Health appeared first on Park Record.

]]> 10380 Here’s to Your Health https://www.parkrecord.com/2007/06/02/heres-to-your-health-9/ Sat, 02 Jun 2007 13:00:00 +0000 http://dev.parkrecord.com/news/heres-to-your-health-9/ At the new Orthopedic Hospital at the University of Utah, Dr. Charles Saltzman, professor and chairman of the Department of Orthopedics, spoke about the history of feet and their love affair with high heels through the centuries. The doctor attended Brown University and the University of North Carolina School of Medicine. He did a foot and ankle fellowship at the Mayo Clinic in Scottsdale, Ariz. He is also the principal investigator on two major NIH studies. He is the current secretary for the American Orthopaedic Foot and Ankle Society, and has served the society as program chair and research council chairman.

Saltzman began with the history of shoes and the individuals in history who wore them. You will be surprised to learn that men wore high heels for centuries, including 2000 BC to 400 BC, and later in the Medieval and Renaissance periods. During those centuries women wore flat shoes of fabric and leather while the men dressed in high heels. In the Battle of Sempach in 1396, when the Swiss defeated Duke Leopold III, depictions of the battle showed the warriors wearing high heels. Could this have been the reason for the defeat? In later battles, the combatants removed their high heels. During the 1530s, Catherine d' Medici, wore a high-heel shoe that was called a "chopine." A chopine is a type of women's platform shoe that was popular in the 15th and 16th centuries. Chopines were originally used as a clog or over shoe to protect the shoes and dress from mud and street soil. They soon became an article of fashion and were made increasingly taller; some extant examples are over 20 inches (50 cm) high. Preserved chopines are typically made of wood, or sometimes metal (Wikipedia). All of the aristocracy followed the trend and copied Catherine's style.

Saltzman showed pictures of the chopine and later the recent Japanese fad of wearing high-heel edboots the can be from six to 12 inches high.

During the days of the British aristocracy under Kings Charles, James and William (1740-1775), paintings from that era reflect their high-heeled shoes (three- to five-inches high). It is of note that the lowly individuals in the kingdom could not afford high heels. They were lucky to own any shoes at all.

For 5,000 years, the Chinese bound young women's feet so they would be "beautiful" because of their small feet. They wore small (four-inch long) shoes and they couldn't walk. But this made them eligible for families to arrange a marriage-match to a wealthy man. As a result, their feet became terribly deformed and unhealthy. Of course, poor women mostly went barefoot.

In contemporary times, Salvatore Ferragamo came from Italy to the United States, and brought shoes that he designed for the female Hollywood Stars. The glamorous stars wore the shoes and American women copied them. During the past few years the stiletto heel is back in all of the fashion magazines and women are buying them by the gross.

Currently, more women than men require foot surgeries. Some of the disorders that Saltzman says are predominant surgeries in his practice are on: hammer toes, neuromas, bunions (these surgeries are only successful 80 percent of the time) and corns. He also treats knee pain, sprains, disfiguration of the ankle, and even back pain. These conditions are associated with women wearing shoes that are too tight and too high in the heels. Wide high heels are no better than narrow stiletto heels either.

The doctor showed some "disgusting" slides of how our feet can become disfigured by wearing these types of shoes mentioned above. The shoes can press on the ball of the foot causing nerve damage and pain. Arthritis is also common especially when women wear high heels. He thinks flat shoes are best, but finds it difficult to convince women that this is good for them.

Of note, he says that one should never shop for shoes before noon because our feet become wider and longer as the day goes on. This will help to get the proper fit. All shoes may vary in size slightly because all manufacturers may not be consistent in sizing. It is important to try them on for comfort, not for size. Because of this, he recommends not buying from a catalogue. His mantra is flat shoes are best. Even flip-flops are better for you than high heels. It was interesting to hear that Saltzman knew Taryn Rose when she was a student of podiatry. You may have heard of her now very popular and expensive shoe firm.

He says that podiatrists may not be able to deal with complications regarding the feet because theirs is a separate pathway to study than orthopedic surgeons. Orthopedic medical studies are more rigorous, have residency training requirements (three to four years), require board certification, have training in treating diabetes and cardiology, and in performing surgery on removing diseased bones from the foot when necessary. This specialty has high standards and selects only the best and the brightest in the field.

As finale to this part of the discussion, the doctor showed a slide of his daughter with six of her friends all dressed in high heels and pretty dresses. He says he has no control over the latest teenage fad. But he worries about the disfigurement that will eventually occur in terms of bunions, calluses, and the possibility of required foot surgeries.

The discussion about flat feet revealed that they could keep you out of the army. After World War II and during the Vietnam War, flat feet were ignored. In the Israeli Army, flat-footed men had fewer fractures than those who were not. Saltzman also notes that flat-footed football players are statistically better players.

In the question-and-answer session following his talk, Saltzman said that infants don't need shoes -- barefoot is good. Having well-fitting running and walking shoes is important. He says we should go to a sports store where clerks are trained in fitting a person and know which shoes are best for various activities.

So there you have it. High heels are bad, having well-fitted, flat shoes are best. But, like Dr. Saltzman's daughter and her friends, most women will wear high heels at some time in their lives, and the orthopedic specialists will be there to repair the injuries.

The post Here’s to Your Health appeared first on Park Record.

]]> At the new Orthopedic Hospital at the University of Utah, Dr. Charles Saltzman, professor and chairman of the Department of Orthopedics, spoke about the history of feet and their love affair with high heels through the centuries. The doctor attended Brown University and the University of North Carolina School of Medicine. He did a foot and ankle fellowship at the Mayo Clinic in Scottsdale, Ariz. He is also the principal investigator on two major NIH studies. He is the current secretary for the American Orthopaedic Foot and Ankle Society, and has served the society as program chair and research council chairman.

Saltzman began with the history of shoes and the individuals in history who wore them. You will be surprised to learn that men wore high heels for centuries, including 2000 BC to 400 BC, and later in the Medieval and Renaissance periods. During those centuries women wore flat shoes of fabric and leather while the men dressed in high heels. In the Battle of Sempach in 1396, when the Swiss defeated Duke Leopold III, depictions of the battle showed the warriors wearing high heels. Could this have been the reason for the defeat? In later battles, the combatants removed their high heels. During the 1530s, Catherine d’ Medici, wore a high-heel shoe that was called a "chopine." A chopine is a type of women’s platform shoe that was popular in the 15th and 16th centuries. Chopines were originally used as a clog or over shoe to protect the shoes and dress from mud and street soil. They soon became an article of fashion and were made increasingly taller; some extant examples are over 20 inches (50 cm) high. Preserved chopines are typically made of wood, or sometimes metal (Wikipedia). All of the aristocracy followed the trend and copied Catherine’s style.

Saltzman showed pictures of the chopine and later the recent Japanese fad of wearing high-heel edboots the can be from six to 12 inches high.

During the days of the British aristocracy under Kings Charles, James and William (1740-1775), paintings from that era reflect their high-heeled shoes (three- to five-inches high). It is of note that the lowly individuals in the kingdom could not afford high heels. They were lucky to own any shoes at all.

For 5,000 years, the Chinese bound young women’s feet so they would be "beautiful" because of their small feet. They wore small (four-inch long) shoes and they couldn’t walk. But this made them eligible for families to arrange a marriage-match to a wealthy man. As a result, their feet became terribly deformed and unhealthy. Of course, poor women mostly went barefoot.

In contemporary times, Salvatore Ferragamo came from Italy to the United States, and brought shoes that he designed for the female Hollywood Stars. The glamorous stars wore the shoes and American women copied them. During the past few years the stiletto heel is back in all of the fashion magazines and women are buying them by the gross.

Currently, more women than men require foot surgeries. Some of the disorders that Saltzman says are predominant surgeries in his practice are on: hammer toes, neuromas, bunions (these surgeries are only successful 80 percent of the time) and corns. He also treats knee pain, sprains, disfiguration of the ankle, and even back pain. These conditions are associated with women wearing shoes that are too tight and too high in the heels. Wide high heels are no better than narrow stiletto heels either.

The doctor showed some "disgusting" slides of how our feet can become disfigured by wearing these types of shoes mentioned above. The shoes can press on the ball of the foot causing nerve damage and pain. Arthritis is also common especially when women wear high heels. He thinks flat shoes are best, but finds it difficult to convince women that this is good for them.

Of note, he says that one should never shop for shoes before noon because our feet become wider and longer as the day goes on. This will help to get the proper fit. All shoes may vary in size slightly because all manufacturers may not be consistent in sizing. It is important to try them on for comfort, not for size. Because of this, he recommends not buying from a catalogue. His mantra is flat shoes are best. Even flip-flops are better for you than high heels. It was interesting to hear that Saltzman knew Taryn Rose when she was a student of podiatry. You may have heard of her now very popular and expensive shoe firm.

He says that podiatrists may not be able to deal with complications regarding the feet because theirs is a separate pathway to study than orthopedic surgeons. Orthopedic medical studies are more rigorous, have residency training requirements (three to four years), require board certification, have training in treating diabetes and cardiology, and in performing surgery on removing diseased bones from the foot when necessary. This specialty has high standards and selects only the best and the brightest in the field.

As finale to this part of the discussion, the doctor showed a slide of his daughter with six of her friends all dressed in high heels and pretty dresses. He says he has no control over the latest teenage fad. But he worries about the disfigurement that will eventually occur in terms of bunions, calluses, and the possibility of required foot surgeries.

The discussion about flat feet revealed that they could keep you out of the army. After World War II and during the Vietnam War, flat feet were ignored. In the Israeli Army, flat-footed men had fewer fractures than those who were not. Saltzman also notes that flat-footed football players are statistically better players.

In the question-and-answer session following his talk, Saltzman said that infants don’t need shoes — barefoot is good. Having well-fitting running and walking shoes is important. He says we should go to a sports store where clerks are trained in fitting a person and know which shoes are best for various activities.

So there you have it. High heels are bad, having well-fitted, flat shoes are best. But, like Dr. Saltzman’s daughter and her friends, most women will wear high heels at some time in their lives, and the orthopedic specialists will be there to repair the injuries.

The post Here’s to Your Health appeared first on Park Record.

]]> 10096 Here’s to Your Health https://www.parkrecord.com/2007/05/12/heres-to-your-health-8/ Sat, 12 May 2007 13:00:00 +0000 http://dev.parkrecord.com/news/heres-to-your-health-8/ Although we are not related, I wish that we were. Dr. Jay Jacobson is an extraordinary individual. He is Professor of Internal Medicine and Infectious Diseases and Chief of the Division of Medical Ethics at LDS Hospital, and the University of Utah School of Medicine. He received his medical degree and residency training in internal medicine at the University of Florida. He did special training in epidemiology and infectious diseases at the Centers for Disease Control and the University of Utah, where he joined the medical faculty in 1978 in the Division of Infectious Diseases.

In 1988, he became involved in the emerging discipline of medical ethics. To this end, he studied at the University of Chicago Center for Clinical Medical Ethics. Returning to Utah, he established a new Division of Medical Ethics with colleagues from the University of Utah College of Law, College of Humanities and the School of Medicine. Later, he served on the American Medical Association's Council on Ethical and Judicial Affairs, American Medical Association's Council on Ethical and Judicial Affairs, the American College of Physician's Council on Ethical and Judicial Affairs and the American College of Physician's Ethics and Human Rights Committee. He is known in the community for participating in local hospitals' ethics committees and chairing the School of Medicine Institutional Review Board.

For four years, this extraordinary man directed a Robert Wood Johnson Foundation project to improve End-of-Life Care and, in 2004, he was awarded the Isaac Hays and John Bell Award for Leadership in Medical Ethics. In 2006, Dr. Jacobson received one of the highest honors possible in the profession when his medical students nominated him for the American Association of Medical Colleges Humanism in Medicine Award.

Dr. Jacobson holds forth in the newly built Health Sciences building, which houses classrooms and laboratories for the medical, nursing, pharmacy and allied health sciences. The teaching is under the auspices of the Division of Medical Ethics, Medical Humanities, Department of Internal Medicine and Medical Humanities. The classrooms in the new building are all wired for students to take notes and to respond to their professors on their computers during class. This allows the students to interact with the professors in a non-threatening environment to questions that may be sensitive. The result is the teaching, not only compassionate, but also competent. Sometimes in medicine there is no time for compassion, but we must value both. Compassion can be taught as part of competence in medical education and all of the health sciences as well.

The doctor contends that disease of any kind influences the individual. We in the medical community need to know about that impact so that we can provide respectful and humane care. In addition, it is important to engage all care providers, patients and families to resolve their ethical conflicts in care. Each party may have differences, and we must communicate with them to understand all of the facts. It is then the explanation and methods of care can proceed in an ethical manner. Sometimes we may find that reasoning can be enhanced with literature, film drama, and art. All of the team must be informed regarding ethical issues so that the medical staff can be prepared to communicate compassionately, and with empathy. Medical students and other health care providers must be educated to learn "detached concern" because we are so close to the problem. We must not "internalize" because we would lose our ability to treat the patients because of our internal angst. This isn't general knowledge and is important so that physicians and others can better understand the problems objectively, and imagine the other side of the problem with objectivity. Becoming emotionally attached will lessen the need for objective decisions by the health care providers. Furthermore, we must be prepared for anger in patients and their families when decisions must be made for the patient's good. By having an objective perspective, caregivers will be able to get past rejection when a patient refuses care.

Moral reasoning is also explored. The Ten Commandments tell us not to lie. Discourse with the students is promoted and theories of ethics are discussed. Jacobson says that it is important to help the student to gain insight into the doctor/patient relationship. It is important to learn social history, cultural experiences to understand how people react. For example, when mistakes are made disclosure is essential. Feelings of inadequacy are present when mistakes are made, and one must "read between the lines. Hope is life extension while death is considered a failure." Our society is diverse and we must be able to understand and empathize with different cultures. Social workers may also be brought in to explain diversity and how to deal with the immigrant population, for instance.

Jacobson spoke of the use of literature, poetry and film to assist students in understanding their patients and their needs. He mentioned one film, "A Beautiful Mind," that gives us a great example of schizophrenia and its treatment. Books such as "On Doctoring," by Richard Reynolds and "How Doctors Think," by Jerry Groutman are also suggested.

Internal medicine residents, nurses and other hospital personnel are also encouraged to participate in these discussions. Colleagues in the rest of the medical community and hospital personnel are also invited to the ethics lectures at the University of Utah.

Other discussions relating to medical ethics are related to events that are timely, such as a family's right to refuse medical treatment. An advance directive in a patient's will, and right to privacy laws are also included in the discussions that are held amongst the students and the community at large.

Assisted suicide is another issue discussed. It is legalized in the Netherlands. Oregon is the only state in the United States where suicide is permitted, however it requires a sustained wish for over two weeks. Following the two weeks, a physician is allowed to prescribe oral medications that will assist in the termination of life. The "wish" is also reviewed by other physicians who review the medical records. It is interesting that minorities are under-represented. Psychiatric, suicidal and depressed individuals are often those who might choose to end their lives. Those with chronic and painful diseases may also choose to end their lives. A patient must make his or her own decision. Even so, the practice in Oregon is not that prevalent with only a fraction of the state's patient population choosing assisted suicide. In the Netherlands the large percentage of those who engage in the practice are the elderly and mentally demented if the families choose. This is not the case in Oregon.

Jacobson explains a recent Roberts Wood Johnson Grant for research specifically for the ethical approach to end-of-life care. Living wills are being studied to provide a humane end to a terminally and persistent vegetative state. No heroic measures are allowed and only medications for pain are included in the advanced directives being studied.

It is of interest to note that when the emergency medical technicians and their ambulances are called, a will is irrelevant. Their charter requires medical attention. Sometimes it might be better to let the patient die peacefully at home if the condition is known to be terminal.

On the other hand, "Durable Power of Attorney" says what, who, and when a patient does not need to be treated if in the last stages of life. The family member who is delegated to have the power makes the decision.

A recently enacted Utah law is deemed to be better than a living will. This law allows each individual to instruct his loved ones on his or her wishes at the end of life. This discussion is between spouses, or close relative. There are no conditions, and you or a loved one can express his or her desires on a specified form. Then the family will be able to proceed based on the deceased wishes. It appears that the more you talk about the issues, the better it will be for the family left behind. They will not have to feel guilty because they might go against other family members,' or those of the diseased.

This discussion on medical ethics affects all of us at one time in our lives or another. It makes for safer patient care because we can be assured that the issue of ethical care is being addressed. Most important, it helps all of us when we meet with serious medical conditions. It will enlighten us to make the right choices by making us feel that we have done all that was possible.

The post Here’s to Your Health appeared first on Park Record.

]]> Although we are not related, I wish that we were. Dr. Jay Jacobson is an extraordinary individual. He is Professor of Internal Medicine and Infectious Diseases and Chief of the Division of Medical Ethics at LDS Hospital, and the University of Utah School of Medicine. He received his medical degree and residency training in internal medicine at the University of Florida. He did special training in epidemiology and infectious diseases at the Centers for Disease Control and the University of Utah, where he joined the medical faculty in 1978 in the Division of Infectious Diseases.

In 1988, he became involved in the emerging discipline of medical ethics. To this end, he studied at the University of Chicago Center for Clinical Medical Ethics. Returning to Utah, he established a new Division of Medical Ethics with colleagues from the University of Utah College of Law, College of Humanities and the School of Medicine. Later, he served on the American Medical Association’s Council on Ethical and Judicial Affairs, American Medical Association’s Council on Ethical and Judicial Affairs, the American College of Physician’s Council on Ethical and Judicial Affairs and the American College of Physician’s Ethics and Human Rights Committee. He is known in the community for participating in local hospitals’ ethics committees and chairing the School of Medicine Institutional Review Board.

For four years, this extraordinary man directed a Robert Wood Johnson Foundation project to improve End-of-Life Care and, in 2004, he was awarded the Isaac Hays and John Bell Award for Leadership in Medical Ethics. In 2006, Dr. Jacobson received one of the highest honors possible in the profession when his medical students nominated him for the American Association of Medical Colleges Humanism in Medicine Award.

Dr. Jacobson holds forth in the newly built Health Sciences building, which houses classrooms and laboratories for the medical, nursing, pharmacy and allied health sciences. The teaching is under the auspices of the Division of Medical Ethics, Medical Humanities, Department of Internal Medicine and Medical Humanities. The classrooms in the new building are all wired for students to take notes and to respond to their professors on their computers during class. This allows the students to interact with the professors in a non-threatening environment to questions that may be sensitive. The result is the teaching, not only compassionate, but also competent. Sometimes in medicine there is no time for compassion, but we must value both. Compassion can be taught as part of competence in medical education and all of the health sciences as well.

The doctor contends that disease of any kind influences the individual. We in the medical community need to know about that impact so that we can provide respectful and humane care. In addition, it is important to engage all care providers, patients and families to resolve their ethical conflicts in care. Each party may have differences, and we must communicate with them to understand all of the facts. It is then the explanation and methods of care can proceed in an ethical manner. Sometimes we may find that reasoning can be enhanced with literature, film drama, and art. All of the team must be informed regarding ethical issues so that the medical staff can be prepared to communicate compassionately, and with empathy. Medical students and other health care providers must be educated to learn "detached concern" because we are so close to the problem. We must not "internalize" because we would lose our ability to treat the patients because of our internal angst. This isn’t general knowledge and is important so that physicians and others can better understand the problems objectively, and imagine the other side of the problem with objectivity. Becoming emotionally attached will lessen the need for objective decisions by the health care providers. Furthermore, we must be prepared for anger in patients and their families when decisions must be made for the patient’s good. By having an objective perspective, caregivers will be able to get past rejection when a patient refuses care.

Moral reasoning is also explored. The Ten Commandments tell us not to lie. Discourse with the students is promoted and theories of ethics are discussed. Jacobson says that it is important to help the student to gain insight into the doctor/patient relationship. It is important to learn social history, cultural experiences to understand how people react. For example, when mistakes are made disclosure is essential. Feelings of inadequacy are present when mistakes are made, and one must "read between the lines. Hope is life extension while death is considered a failure." Our society is diverse and we must be able to understand and empathize with different cultures. Social workers may also be brought in to explain diversity and how to deal with the immigrant population, for instance.

Jacobson spoke of the use of literature, poetry and film to assist students in understanding their patients and their needs. He mentioned one film, "A Beautiful Mind," that gives us a great example of schizophrenia and its treatment. Books such as "On Doctoring," by Richard Reynolds and "How Doctors Think," by Jerry Groutman are also suggested.

Internal medicine residents, nurses and other hospital personnel are also encouraged to participate in these discussions. Colleagues in the rest of the medical community and hospital personnel are also invited to the ethics lectures at the University of Utah.

Other discussions relating to medical ethics are related to events that are timely, such as a family’s right to refuse medical treatment. An advance directive in a patient’s will, and right to privacy laws are also included in the discussions that are held amongst the students and the community at large.

Assisted suicide is another issue discussed. It is legalized in the Netherlands. Oregon is the only state in the United States where suicide is permitted, however it requires a sustained wish for over two weeks. Following the two weeks, a physician is allowed to prescribe oral medications that will assist in the termination of life. The "wish" is also reviewed by other physicians who review the medical records. It is interesting that minorities are under-represented. Psychiatric, suicidal and depressed individuals are often those who might choose to end their lives. Those with chronic and painful diseases may also choose to end their lives. A patient must make his or her own decision. Even so, the practice in Oregon is not that prevalent with only a fraction of the state’s patient population choosing assisted suicide. In the Netherlands the large percentage of those who engage in the practice are the elderly and mentally demented if the families choose. This is not the case in Oregon.

Jacobson explains a recent Roberts Wood Johnson Grant for research specifically for the ethical approach to end-of-life care. Living wills are being studied to provide a humane end to a terminally and persistent vegetative state. No heroic measures are allowed and only medications for pain are included in the advanced directives being studied.

It is of interest to note that when the emergency medical technicians and their ambulances are called, a will is irrelevant. Their charter requires medical attention. Sometimes it might be better to let the patient die peacefully at home if the condition is known to be terminal.

On the other hand, "Durable Power of Attorney" says what, who, and when a patient does not need to be treated if in the last stages of life. The family member who is delegated to have the power makes the decision.

A recently enacted Utah law is deemed to be better than a living will. This law allows each individual to instruct his loved ones on his or her wishes at the end of life. This discussion is between spouses, or close relative. There are no conditions, and you or a loved one can express his or her desires on a specified form. Then the family will be able to proceed based on the deceased wishes. It appears that the more you talk about the issues, the better it will be for the family left behind. They will not have to feel guilty because they might go against other family members,’ or those of the diseased.

This discussion on medical ethics affects all of us at one time in our lives or another. It makes for safer patient care because we can be assured that the issue of ethical care is being addressed. Most important, it helps all of us when we meet with serious medical conditions. It will enlighten us to make the right choices by making us feel that we have done all that was possible.

The post Here’s to Your Health appeared first on Park Record.

]]> 9893 Here’s to Your Health https://www.parkrecord.com/2007/04/25/heres-to-your-health-7/ Wed, 25 Apr 2007 13:00:00 +0000 http://dev.parkrecord.com/news/heres-to-your-health-7/ Genital human papilloma virus (HPV) is the most common sexually transmitted infection in the United States. An estimated 6.2 million persons are newly infected every year. This report comes from the Advisory Committee on Immunization Practices at the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, based in Atlanta, Ga. The committee suggests that all females, aged nine to 26, be vaccinated against the genital HPV infection. Some states have made it mandatory for young girls as well as older young women to receive the vaccine to prevent infection by HPV.

The majority of the HPV infections cause no clinical symptoms initially because they are self-limited. But, persistent genital HPV infection can cause cervical cancer in women, and other types of genital cancers and genital warts in both men and women. Besides cervical cancer, HPV infection is also associated with other "anogenital" cancers of the vulva, vagina, penis and anus. These HPV-induced cancers are less common than cervical cancer. It is also found that some research studies support finding an HPV-caused subset of cancers both in the oral cavity and pharynx.

In June 2006, the HPV vaccine, Gardasil, was manufactured by Merck. It was licensed for use among females, aged nine to 26, to prevent HPV-related cervical cancer, and its precursors, vaginal and vulva cancers and genital warts. There are ongoing studies for use of the vaccine for HPV infections in males.

In the US, cervical cancer prevention and control programs have reduced the number of cervical cancer cases and death through cervical cytology screening, which can detect precancerous lesions. The HPV vaccine will not eliminate the need for cervical cancer screening in the U.S. because not all types of cervical cancers are included in the HPV vaccine.

HPV infection is primarily transmitted by genital contact, usually through sexual intercourse. It appears that the more sexual partners a woman or girl is exposed to, the higher the rates of HPV infection. Unfortunately, a partner's sexual behaviors and multiple partners increase the risk of HPV infection for girls and women as well.

Because HPV is transmitted by sexual activity, understanding the epidemiology of HPV requires data on sexual behaviors. The 2002 National Survey of Family Growth (www.cdc.gov/nchs/nsfg) indicates that 20 percent of females in the U.S. were sexually active by age 15. The percentage increased to 40 percent by age 16 and to 70 percent by age 18. Among sexually active females aged 15-19 and those aged 20-24, the median number of lifetime male sex partners was 1.4 and 2.8 respectively. In addition, the 2005 Youth Behaviors Survey indicated that 3.7 percent of female students had been sexually active before age 13. Further it is reported that 5.7 percent of ninth grade and 20.2 percent of 12th grade females had four or more sex partners. Another study of college-age women revealed that the probability of the incidence of HPV was 38 percent by 24 months after first sexual intercourse.

HPV is not the cause of all cervical cancers. Approximately three-fourths of all cervical cancers in the U.S. are found to be squamous cell cancers. The remaining are HPV induced. Furthermore, reporting of HPV does not exist in the United States. Information on the prevalence and incidence is generally from clinic-based populations such as family planning and sexually transmitted disease among university health clinic patients. Detecting HPV infection is not a simple task; it requires identification through DNA testing approved by the U.S. Food and Drug Administration. The HC2 HPV DNA test uses liquid nucleic acid in serologic format.

The National Women's Health Network (NWHN: March/April 2007) reports in a column by Adriane Fugh-Berman, M.D., that 10 percent of women with HPV stay infected. It is these women with persistent infections who are at the highest risk for HPV to progress to cervical cancer.

Cervical cancer rates in the U.S. have decreased because of the widespread use of Papanicolaou testing that can detect precancerous lesions before they develop into cancer. However, during 2007 an estimated 11,100 new cases were diagnosed and it is estimated that from this, 3,700 will die from cervical cancer. Fugh-Berman notes that the need for Pap smears is still necessary because there are other organisms that cause cervical cancer other than those caused by the HPV virus.

Worldwide, the rate of cervical cancer accounts for the second most common cancer cause of death in women, accounting for 288,000 cervical cancer deaths annually according to Fugh-Berman. The development of the cervical cancer vaccine, to protect against the HPV virus, is a public health breakthrough with the potential to save many lives worldwide.

It is important to note that the vaccine, Gardasil, only works well if it is administered before a woman, or girl, is exposed to HPV. The politics of immunization are interesting. Although some states have made it mandatory for all girls, nine years and over, to be vaccinated, the outcry and opposition from other states has been significant. Many do not want the vaccination to be mandatory. As a result, Merck has curtailed its efforts to lobby state legislatures to require the vaccination of all school girls, according to Fugh-Berman. In spite of this, bills are being introduced or drafted by legislatures in 20 states. However, the public backlash against this mandatory vaccination has been severe. There should be an outcry, she says, but not because of vaccine safety. It is safe and well tested, but it should not be orchestrated by a corporation. Rather, Fugh Berman says that public health policy that prevents the possibility of cervical cancer should be the main reason for the vaccine. The policy should be presented by health care professionals not those who will turn a profit. In addition, she says that there should be public education about the use of condoms and cervical cancer screening, and cervical vaccines.

In the end, the choice is up to you and your family. It is true that there are other mandatory vaccines required for entrance into kindergarten. We as parents are conditioned to these immunizations. The argument for HPV vaccine is still under consideration in Utah and many other states. It makes sense to prevent cancer. But this issue also contains a sexual component. Many parents and others in the community are in denial that our young women, like it or not, are engaged in sexual activities at an earlier age than in previous generations. The decision, as it should be, is up to you.

The post Here’s to Your Health appeared first on Park Record.

]]> Genital human papilloma virus (HPV) is the most common sexually transmitted infection in the United States. An estimated 6.2 million persons are newly infected every year. This report comes from the Advisory Committee on Immunization Practices at the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, based in Atlanta, Ga. The committee suggests that all females, aged nine to 26, be vaccinated against the genital HPV infection. Some states have made it mandatory for young girls as well as older young women to receive the vaccine to prevent infection by HPV.

The majority of the HPV infections cause no clinical symptoms initially because they are self-limited. But, persistent genital HPV infection can cause cervical cancer in women, and other types of genital cancers and genital warts in both men and women. Besides cervical cancer, HPV infection is also associated with other "anogenital" cancers of the vulva, vagina, penis and anus. These HPV-induced cancers are less common than cervical cancer. It is also found that some research studies support finding an HPV-caused subset of cancers both in the oral cavity and pharynx.

In June 2006, the HPV vaccine, Gardasil, was manufactured by Merck. It was licensed for use among females, aged nine to 26, to prevent HPV-related cervical cancer, and its precursors, vaginal and vulva cancers and genital warts. There are ongoing studies for use of the vaccine for HPV infections in males.

In the US, cervical cancer prevention and control programs have reduced the number of cervical cancer cases and death through cervical cytology screening, which can detect precancerous lesions. The HPV vaccine will not eliminate the need for cervical cancer screening in the U.S. because not all types of cervical cancers are included in the HPV vaccine.

HPV infection is primarily transmitted by genital contact, usually through sexual intercourse. It appears that the more sexual partners a woman or girl is exposed to, the higher the rates of HPV infection. Unfortunately, a partner’s sexual behaviors and multiple partners increase the risk of HPV infection for girls and women as well.

Because HPV is transmitted by sexual activity, understanding the epidemiology of HPV requires data on sexual behaviors. The 2002 National Survey of Family Growth (www.cdc.gov/nchs/nsfg) indicates that 20 percent of females in the U.S. were sexually active by age 15. The percentage increased to 40 percent by age 16 and to 70 percent by age 18. Among sexually active females aged 15-19 and those aged 20-24, the median number of lifetime male sex partners was 1.4 and 2.8 respectively. In addition, the 2005 Youth Behaviors Survey indicated that 3.7 percent of female students had been sexually active before age 13. Further it is reported that 5.7 percent of ninth grade and 20.2 percent of 12th grade females had four or more sex partners. Another study of college-age women revealed that the probability of the incidence of HPV was 38 percent by 24 months after first sexual intercourse.

HPV is not the cause of all cervical cancers. Approximately three-fourths of all cervical cancers in the U.S. are found to be squamous cell cancers. The remaining are HPV induced. Furthermore, reporting of HPV does not exist in the United States. Information on the prevalence and incidence is generally from clinic-based populations such as family planning and sexually transmitted disease among university health clinic patients. Detecting HPV infection is not a simple task; it requires identification through DNA testing approved by the U.S. Food and Drug Administration. The HC2 HPV DNA test uses liquid nucleic acid in serologic format.

The National Women’s Health Network (NWHN: March/April 2007) reports in a column by Adriane Fugh-Berman, M.D., that 10 percent of women with HPV stay infected. It is these women with persistent infections who are at the highest risk for HPV to progress to cervical cancer.

Cervical cancer rates in the U.S. have decreased because of the widespread use of Papanicolaou testing that can detect precancerous lesions before they develop into cancer. However, during 2007 an estimated 11,100 new cases were diagnosed and it is estimated that from this, 3,700 will die from cervical cancer. Fugh-Berman notes that the need for Pap smears is still necessary because there are other organisms that cause cervical cancer other than those caused by the HPV virus.

Worldwide, the rate of cervical cancer accounts for the second most common cancer cause of death in women, accounting for 288,000 cervical cancer deaths annually according to Fugh-Berman. The development of the cervical cancer vaccine, to protect against the HPV virus, is a public health breakthrough with the potential to save many lives worldwide.

It is important to note that the vaccine, Gardasil, only works well if it is administered before a woman, or girl, is exposed to HPV. The politics of immunization are interesting. Although some states have made it mandatory for all girls, nine years and over, to be vaccinated, the outcry and opposition from other states has been significant. Many do not want the vaccination to be mandatory. As a result, Merck has curtailed its efforts to lobby state legislatures to require the vaccination of all school girls, according to Fugh-Berman. In spite of this, bills are being introduced or drafted by legislatures in 20 states. However, the public backlash against this mandatory vaccination has been severe. There should be an outcry, she says, but not because of vaccine safety. It is safe and well tested, but it should not be orchestrated by a corporation. Rather, Fugh Berman says that public health policy that prevents the possibility of cervical cancer should be the main reason for the vaccine. The policy should be presented by health care professionals not those who will turn a profit. In addition, she says that there should be public education about the use of condoms and cervical cancer screening, and cervical vaccines.

In the end, the choice is up to you and your family. It is true that there are other mandatory vaccines required for entrance into kindergarten. We as parents are conditioned to these immunizations. The argument for HPV vaccine is still under consideration in Utah and many other states. It makes sense to prevent cancer. But this issue also contains a sexual component. Many parents and others in the community are in denial that our young women, like it or not, are engaged in sexual activities at an earlier age than in previous generations. The decision, as it should be, is up to you.

The post Here’s to Your Health appeared first on Park Record.

]]> 9709 Here’s to Your Health https://www.parkrecord.com/2007/03/07/heres-to-your-health-5/ Wed, 07 Mar 2007 15:00:00 +0000 http://dev.parkrecord.com/news/heres-to-your-health-5/ A most intriguing presentation was give by Dr. J. Michael McIntosh, research professor of biology and research director and professor of the Department of Psychiatry at the University of Utah. When he was a student at the university, he worked as a lab assistant. Now he has students working in his own laboratory. In the course of his work in the laboratory, he and his mentor, university biologist Baldomero Olivera, discovered that cone snail venom had sedative powers.

In December (2005), the Food and Drug Administration (FDA) approved Piralt, a painkiller and sedative, that gets its potency from cone snail venom. In the laboratory, the venom was isolated, tested and finally fabricated to become an effective painkiller that would block the sensors that transmit pain without blocking the motor system that could cause a patient to become paralyzed.

McIntosh says that he has always been interested in basic research and says, "You don't know where you're going until you get there. As with many basic science discoveries, the clinical importance of the discovery wasn't appreciated at the time." He has combined his "bench research" with his medical practice in psychiatry. His research process is to examine and isolate the venom, chemically analyze and, finally, re-produce it in the laboratory.

McIntosh has discovered a previously unrecognized molecule that could serve as a target for new drugs designed to combat chronic nerve pain. He found that the ocean dwelling cone snails use their venom to sting and kill prey such as worms, frogs and fish. These snails hide under rubble and harpoon their prey. The fish become paralyzed when hit with the snail venom. Another species of snails have a cone-like mechanism that is able to suck prey into the cone and anesthetize it so that it can be consumed by the snail. This can transfer to paralyzing of a patient's muscles during surgical procedures. Harvesting of the snails is the work of contracted fishermen who ship the snails, live from the Pacific and Atlantic oceans.

McIntosh estimates that there are between 500 and 700 species equating to tens of thousands of different toxins. Each of these toxins appears to act on the nervous system of the prey. It is fascinating that the toxins produced are tested to separate harmful side effects while preserving the therapeutic effect of the drug.

Parkinson's disease is another area of interest for the doctor. He says that 300,000 individuals contract the disease every year. Of these, 15 percent are between ages 64-74, and 30 percent are between 74 and 80. It is found that dopamine, a normal chemical in the body, diminishes with age. The brain releases dopamine, and researchers find that not enough is produced in people with Parkinson's. The amazing fact is that when these older individuals smoked, they have lower rates of Parkinson's than those who do not. Apparently, the nicotine receptor in the brain works to stimulate dopamine production in these older smokers. So, if the nicotine is stimulating, perhaps the harmful cancer-producing property of nicotine could be manipulated and removed so that natural dopamine could be produced in the brain. McIntosh is investigating how to remove the addictive aspect of nicotine and still preserve the beneficial aspects of nicotine. He says that 400,000 Americans die of lung cancer each year. Incidentally, this is higher that the rate of breast cancer.

McIntosh further explains that one-sixth of the population is afflicted with chronic pain in the form of arthritis, cancer, injured nerves from trauma, shingles, diabetes, and multiple sclerosis. His premise is to produce strong pain medications that are not addictive. The doctor is suggesting that pharmaceutical companies be licensed to develop non-addictive drugs to deal with severe chronic pain. Presently, these pain relieving, opiate drugs become ineffective after about two weeks, not to mention the addictive aspect associated with them. Once these substances are isolated, they can be replicated and synthesized without the addictive properties.

Dr. McIntosh is a true pioneer who struggles for grants to support his work. It is sad that the work of good people, in the quest for pain relief for so many individuals, may be lost because of lack of outside funding. It would be a miracle for those with chronic pain to be able to find relief from their suffering.

Finally, I would like to correct an error in my most recent article in "Here's to Your Health" when I wrote that the annual budget for breastcancer.org was $4 billion. It should read $4 million.

The post Here’s to Your Health appeared first on Park Record.

]]> A most intriguing presentation was give by Dr. J. Michael McIntosh, research professor of biology and research director and professor of the Department of Psychiatry at the University of Utah. When he was a student at the university, he worked as a lab assistant. Now he has students working in his own laboratory. In the course of his work in the laboratory, he and his mentor, university biologist Baldomero Olivera, discovered that cone snail venom had sedative powers.

In December (2005), the Food and Drug Administration (FDA) approved Piralt, a painkiller and sedative, that gets its potency from cone snail venom. In the laboratory, the venom was isolated, tested and finally fabricated to become an effective painkiller that would block the sensors that transmit pain without blocking the motor system that could cause a patient to become paralyzed.

McIntosh says that he has always been interested in basic research and says, "You don’t know where you’re going until you get there. As with many basic science discoveries, the clinical importance of the discovery wasn’t appreciated at the time." He has combined his "bench research" with his medical practice in psychiatry. His research process is to examine and isolate the venom, chemically analyze and, finally, re-produce it in the laboratory.

McIntosh has discovered a previously unrecognized molecule that could serve as a target for new drugs designed to combat chronic nerve pain. He found that the ocean dwelling cone snails use their venom to sting and kill prey such as worms, frogs and fish. These snails hide under rubble and harpoon their prey. The fish become paralyzed when hit with the snail venom. Another species of snails have a cone-like mechanism that is able to suck prey into the cone and anesthetize it so that it can be consumed by the snail. This can transfer to paralyzing of a patient’s muscles during surgical procedures. Harvesting of the snails is the work of contracted fishermen who ship the snails, live from the Pacific and Atlantic oceans.

McIntosh estimates that there are between 500 and 700 species equating to tens of thousands of different toxins. Each of these toxins appears to act on the nervous system of the prey. It is fascinating that the toxins produced are tested to separate harmful side effects while preserving the therapeutic effect of the drug.

Parkinson’s disease is another area of interest for the doctor. He says that 300,000 individuals contract the disease every year. Of these, 15 percent are between ages 64-74, and 30 percent are between 74 and 80. It is found that dopamine, a normal chemical in the body, diminishes with age. The brain releases dopamine, and researchers find that not enough is produced in people with Parkinson’s. The amazing fact is that when these older individuals smoked, they have lower rates of Parkinson’s than those who do not. Apparently, the nicotine receptor in the brain works to stimulate dopamine production in these older smokers. So, if the nicotine is stimulating, perhaps the harmful cancer-producing property of nicotine could be manipulated and removed so that natural dopamine could be produced in the brain. McIntosh is investigating how to remove the addictive aspect of nicotine and still preserve the beneficial aspects of nicotine. He says that 400,000 Americans die of lung cancer each year. Incidentally, this is higher that the rate of breast cancer.

McIntosh further explains that one-sixth of the population is afflicted with chronic pain in the form of arthritis, cancer, injured nerves from trauma, shingles, diabetes, and multiple sclerosis. His premise is to produce strong pain medications that are not addictive. The doctor is suggesting that pharmaceutical companies be licensed to develop non-addictive drugs to deal with severe chronic pain. Presently, these pain relieving, opiate drugs become ineffective after about two weeks, not to mention the addictive aspect associated with them. Once these substances are isolated, they can be replicated and synthesized without the addictive properties.

Dr. McIntosh is a true pioneer who struggles for grants to support his work. It is sad that the work of good people, in the quest for pain relief for so many individuals, may be lost because of lack of outside funding. It would be a miracle for those with chronic pain to be able to find relief from their suffering.

Finally, I would like to correct an error in my most recent article in "Here’s to Your Health" when I wrote that the annual budget for breastcancer.org was $4 billion. It should read $4 million.

The post Here’s to Your Health appeared first on Park Record.

]]> 9256 Here’s to Your Health https://www.parkrecord.com/2007/02/24/heres-to-your-health-4/ Sat, 24 Feb 2007 15:00:00 +0000 http://dev.parkrecord.com/news/heres-to-your-health-4/

I had the opportunity a few days ago to hear Dr. Marisa Weiss, founder of breastcancer.org, speak about the work she is doing to spread the word to the world about breast cancer. She is a moving speaker -- dedicated and committed to the cause of telling all of us about the dread disease that affects so many women. In the United States, there are about 150 million women and girls; about 19 million will be diagnosed with breast cancer. In the world of 3 billion women, 400 million women will develop breast cancer over a lifetime.

Breast cancer.org offers 2,500 pages of medically reviewed, all-original content that covers risk reduction, symptoms and diagnosis, treatment, research news, expert conferences, recovery, renewal, and support online. Top-notch medical experts, writers and editors are dedicated to presenting cutting-edge, complex medical information in a compassionate tone and easy-to-understand language. Dr. Weiss began the Web site about five years ago. She began in her own living room with one assistant. Now, she has a staff of 12 and a place outside her home where she works three days a week at the Web site offering easy-to-understand information for the woman who needs to know what an estrogen receptor or arm lymphedema is and how to deal with the diagnosis. She practices medicine on the other two days.

Dr. Weiss explains that the Web site is available 24 hours a day, seven days a week, to provide information to women who want to know the faces and how to prevent and treat breast cancer. The site identifies not smoking and participating in physical fitness activities to maintain good health. She has appeared on the Today Show, CNN, ABC, CBS, and is profiled in People magazine, and a host of other magazines and newspapers around the nation. A $4 billion budget is required to support the non-profit Web site. Last year there were at least 61 million hits on breastcancer.org.

The information provided includes the actual stages of breast cancer, genetic and family connections to the disease, illustrations and pictures of the tumors and surgical intervention results. It is said that "one picture is worth 1,000 words."

Furthermore, the Web site is a safe place for women and their families to visit on their own and to see what breast cancer really is and its implications for you and your loved ones. There are also 24,000 chat rooms with no cost to any of the participants. Because medical jargon is often confusing and complicated, celebrities such as Whoopie Goldberg often narrate some of the information. It is presented so anyone can understand the issues.

Breastcancer.org is also a venue where women can chat with each other about their diagnoses, stages, and what worked for them. Breastcancer.org asks, "What can we do to help?" They will provide services to those who have difficulty understanding English. There are, for example, Spanish speakers who will interpret for them.

I was struck by the fact that the site reaches out to family members as well. Most important are the young girls whose mothers may be afflicted with the disease. These children need to be reassured and told not to be afraid to be a woman, and how to protect themselves from developing the disease themselves and what to do in the event of a diagnosis. Again, this is a safe place; the information is state-of-the-art and invaluable for all women and their families. Dr. Weiss also believes women and their doctors need to connect, and to this end, sensitivity and humanistic training is becoming the norm for medical students. Weiss says, "There's a huge need that exists outside of the hospital walls."

It is indeed an honor to have met such an amazing woman and a true pioneer committed to helping women through an extremely devastating time in their lives. Try to connect with breastcancer.org. It will provide tips on prevention, symptoms, treatment, research, recovery and renewal and support, if necessary.

The post Here’s to Your Health appeared first on Park Record.

]]>

I had the opportunity a few days ago to hear Dr. Marisa Weiss, founder of breastcancer.org, speak about the work she is doing to spread the word to the world about breast cancer. She is a moving speaker — dedicated and committed to the cause of telling all of us about the dread disease that affects so many women. In the United States, there are about 150 million women and girls; about 19 million will be diagnosed with breast cancer. In the world of 3 billion women, 400 million women will develop breast cancer over a lifetime.

Breast cancer.org offers 2,500 pages of medically reviewed, all-original content that covers risk reduction, symptoms and diagnosis, treatment, research news, expert conferences, recovery, renewal, and support online. Top-notch medical experts, writers and editors are dedicated to presenting cutting-edge, complex medical information in a compassionate tone and easy-to-understand language. Dr. Weiss began the Web site about five years ago. She began in her own living room with one assistant. Now, she has a staff of 12 and a place outside her home where she works three days a week at the Web site offering easy-to-understand information for the woman who needs to know what an estrogen receptor or arm lymphedema is and how to deal with the diagnosis. She practices medicine on the other two days.

Dr. Weiss explains that the Web site is available 24 hours a day, seven days a week, to provide information to women who want to know the faces and how to prevent and treat breast cancer. The site identifies not smoking and participating in physical fitness activities to maintain good health. She has appeared on the Today Show, CNN, ABC, CBS, and is profiled in People magazine, and a host of other magazines and newspapers around the nation. A $4 billion budget is required to support the non-profit Web site. Last year there were at least 61 million hits on breastcancer.org.

The information provided includes the actual stages of breast cancer, genetic and family connections to the disease, illustrations and pictures of the tumors and surgical intervention results. It is said that "one picture is worth 1,000 words."

Furthermore, the Web site is a safe place for women and their families to visit on their own and to see what breast cancer really is and its implications for you and your loved ones. There are also 24,000 chat rooms with no cost to any of the participants. Because medical jargon is often confusing and complicated, celebrities such as Whoopie Goldberg often narrate some of the information. It is presented so anyone can understand the issues.

Breastcancer.org is also a venue where women can chat with each other about their diagnoses, stages, and what worked for them. Breastcancer.org asks, "What can we do to help?" They will provide services to those who have difficulty understanding English. There are, for example, Spanish speakers who will interpret for them.

I was struck by the fact that the site reaches out to family members as well. Most important are the young girls whose mothers may be afflicted with the disease. These children need to be reassured and told not to be afraid to be a woman, and how to protect themselves from developing the disease themselves and what to do in the event of a diagnosis. Again, this is a safe place; the information is state-of-the-art and invaluable for all women and their families. Dr. Weiss also believes women and their doctors need to connect, and to this end, sensitivity and humanistic training is becoming the norm for medical students. Weiss says, "There’s a huge need that exists outside of the hospital walls."

It is indeed an honor to have met such an amazing woman and a true pioneer committed to helping women through an extremely devastating time in their lives. Try to connect with breastcancer.org. It will provide tips on prevention, symptoms, treatment, research, recovery and renewal and support, if necessary.

The post Here’s to Your Health appeared first on Park Record.

]]> 9154 Here’s to Your Health https://www.parkrecord.com/2007/02/14/heres-to-your-health-3/ Wed, 14 Feb 2007 15:00:00 +0000 http://dev.parkrecord.com/news/heres-to-your-health-3/ I know that many of you who saw the film "Away From Her" were affected as I was by Julie Christie's performance in which she began to lose her memory and actually wandered away from her home one night. Her frantic husband drove around the town and finally found her. She ultimately decided to check herself into a home specializing in Alzheimer's disease. Fiona (her name in the film) did not want to burden her loving husband of 45 years. The transition was heartbreaking, not too many dry eyes in the theater. When it was over, the solemn theatergoers filed out and I overheard one man say, "That was my mother," another woman said "So sad, it could be me in the future." It's the kind of film that lingers on in our memories.

In December 2006, US News and World Report published an article "Alzheimer's Today." The big news in the story was that it appears that younger people in their 50s are being diagnosed with early-onset Alzheimer's. It is reported that as many as 640,000 Americans under 65 are suffering from dementia caused by the disease. This is reported by Dr. Ronald Peterson, a neurologist at the Mayo Clinic. He notes that in the past five years, more and more individuals in their 40s and 50s are showing up and asking for help. "Alzheimer's is not just a disease that hits 80 year olds in nursing homes," says Dallas Anderson, a specialist in the epidemiology of dementia at the National Institute on Aging. The director of the Memory Disorders Clinic at the Banner Alzheimer's Institute in Phoenix, Pierre Tariot, reports that "there's not enough help for younger people with dementia, or older people."

Alzheimer's Disease (AD) is not a normal part of aging. It is a devastating disorder of the brain's nerve cells that impairs memory, thinking and behavior and leads, ultimately, to death. The impact of AD on individuals, families and our health care system makes the disease one of our nation's greatest medical, social and economic challenges. This information is supplied by the Alzheimer's Foundation. It is estimated that 4.5 million Americans have the disease that has more than doubled since 1980. These numbers will continue to grow. By 2050, the numbers could rise as high as 11.3 to 16 million. Finding a treatment that could delay onset by five years could reduce the number with the disease nearly 50 percent over 50 years.

A Gallup poll, commissioned by the AD Foundation, found that one in 10 Americans said that they had a family member with the disease and one in three knew someone who had the disease.

Increasing age is a major risk factor. One in 10 individuals over 65 and nearly half of those over 85 have the disease. As mentioned above, rare, inherited forms of AD can strike individuals as early as their 30s and 40s (Annals of Neurology, 1989).

Longevity of an AD patient can be as short as eight years and as long as 20 or more years. From the time of diagnosis, AD patients generally survive about half as long as an individual without the disease. Just imagine the plight of the families who care for these individuals. Many cannot afford nursing home care. It is truly an emerging national problem.

National direct and indirect annual costs of caring for individuals with Alzheimer's disease are at least $100 billion, according to estimates used by the Alzheimer's Association and the National Institute on Aging. It costs American businesses $61 billion a year. This was reported by the Alzheimer's Association Commission. Of that figure, $24.6 billion covers Alzheimer's health care and $36.5 billion covers costs related to caregivers of individuals with AD, including lost productivity, absenteeism and worker replacement.

Half of all nursing-home residents have AD or a related disorder. Nursing care is $42,000 but can exceed $70,000 annually. The average lifetime cost for a patient with AD is $174,000. Medicare costs for beneficiaries with AD are expected to increase 75 percent, from $91 billion in 2005 to $160 billion in 2010. Medicaid expenditures on residential dementia care will increase 14 percent, from $21 billion in 2005 to $24 billion in 2010. This is the report of the AD Association's Commission Report.

The Alzheimer's Association has awarded $200 million in research grants since 1982, according to the annual audited financial statements. It is estimated that the federal government spent approximately $647 million for AD in fiscal year 2005. Where we go from here is the question. AD is on the rise and we must rise to the occasion and fund the research for this dreaded and devastating disease.

Sadly, the 2006 International Conference on Alzheimer's Disease (ICAD) reports NO unequivocal breakthroughs. The July conference in Madrid, Spain did highlight many exciting works in progress, ranging from methods for early and more accurate differential diagnosis of dementia to an impressive array of potential disease-modifying treatments for various stages of pre-clinical and clinical development. They are looking for deposits of amyloid or plaque using the latest brain imaging technology, and an analysis of cerebrospinal fluid to provide early detection of amyloid/plaque development.

There is still a long way to go. The problem is growing and the public needs to be made aware. It is indeed a heartbreaking process.

The post Here’s to Your Health appeared first on Park Record.

]]> I know that many of you who saw the film "Away From Her" were affected as I was by Julie Christie’s performance in which she began to lose her memory and actually wandered away from her home one night. Her frantic husband drove around the town and finally found her. She ultimately decided to check herself into a home specializing in Alzheimer’s disease. Fiona (her name in the film) did not want to burden her loving husband of 45 years. The transition was heartbreaking, not too many dry eyes in the theater. When it was over, the solemn theatergoers filed out and I overheard one man say, "That was my mother," another woman said "So sad, it could be me in the future." It’s the kind of film that lingers on in our memories.

In December 2006, US News and World Report published an article "Alzheimer’s Today." The big news in the story was that it appears that younger people in their 50s are being diagnosed with early-onset Alzheimer’s. It is reported that as many as 640,000 Americans under 65 are suffering from dementia caused by the disease. This is reported by Dr. Ronald Peterson, a neurologist at the Mayo Clinic. He notes that in the past five years, more and more individuals in their 40s and 50s are showing up and asking for help. "Alzheimer’s is not just a disease that hits 80 year olds in nursing homes," says Dallas Anderson, a specialist in the epidemiology of dementia at the National Institute on Aging. The director of the Memory Disorders Clinic at the Banner Alzheimer’s Institute in Phoenix, Pierre Tariot, reports that "there’s not enough help for younger people with dementia, or older people."

Alzheimer’s Disease (AD) is not a normal part of aging. It is a devastating disorder of the brain’s nerve cells that impairs memory, thinking and behavior and leads, ultimately, to death. The impact of AD on individuals, families and our health care system makes the disease one of our nation’s greatest medical, social and economic challenges. This information is supplied by the Alzheimer’s Foundation. It is estimated that 4.5 million Americans have the disease that has more than doubled since 1980. These numbers will continue to grow. By 2050, the numbers could rise as high as 11.3 to 16 million. Finding a treatment that could delay onset by five years could reduce the number with the disease nearly 50 percent over 50 years.

A Gallup poll, commissioned by the AD Foundation, found that one in 10 Americans said that they had a family member with the disease and one in three knew someone who had the disease.

Increasing age is a major risk factor. One in 10 individuals over 65 and nearly half of those over 85 have the disease. As mentioned above, rare, inherited forms of AD can strike individuals as early as their 30s and 40s (Annals of Neurology, 1989).

Longevity of an AD patient can be as short as eight years and as long as 20 or more years. From the time of diagnosis, AD patients generally survive about half as long as an individual without the disease. Just imagine the plight of the families who care for these individuals. Many cannot afford nursing home care. It is truly an emerging national problem.

National direct and indirect annual costs of caring for individuals with Alzheimer’s disease are at least $100 billion, according to estimates used by the Alzheimer’s Association and the National Institute on Aging. It costs American businesses $61 billion a year. This was reported by the Alzheimer’s Association Commission. Of that figure, $24.6 billion covers Alzheimer’s health care and $36.5 billion covers costs related to caregivers of individuals with AD, including lost productivity, absenteeism and worker replacement.

Half of all nursing-home residents have AD or a related disorder. Nursing care is $42,000 but can exceed $70,000 annually. The average lifetime cost for a patient with AD is $174,000. Medicare costs for beneficiaries with AD are expected to increase 75 percent, from $91 billion in 2005 to $160 billion in 2010. Medicaid expenditures on residential dementia care will increase 14 percent, from $21 billion in 2005 to $24 billion in 2010. This is the report of the AD Association’s Commission Report.

The Alzheimer’s Association has awarded $200 million in research grants since 1982, according to the annual audited financial statements. It is estimated that the federal government spent approximately $647 million for AD in fiscal year 2005. Where we go from here is the question. AD is on the rise and we must rise to the occasion and fund the research for this dreaded and devastating disease.

Sadly, the 2006 International Conference on Alzheimer’s Disease (ICAD) reports NO unequivocal breakthroughs. The July conference in Madrid, Spain did highlight many exciting works in progress, ranging from methods for early and more accurate differential diagnosis of dementia to an impressive array of potential disease-modifying treatments for various stages of pre-clinical and clinical development. They are looking for deposits of amyloid or plaque using the latest brain imaging technology, and an analysis of cerebrospinal fluid to provide early detection of amyloid/plaque development.

There is still a long way to go. The problem is growing and the public needs to be made aware. It is indeed a heartbreaking process.

The post Here’s to Your Health appeared first on Park Record.

]]> 9052 Guest Editorial https://www.parkrecord.com/2006/03/11/guest-editorial-53/ Sat, 11 Mar 2006 15:00:00 +0000 http://dev.parkrecord.com/news/guest-editorial-53/ Imagine driving down the road and suddenly your eyes become blurred and start twitching. You blink and try as best you can to continue. Then your facial muscles begin to get numb, weaken and almost freeze. You feel a sudden pain. Maybe there is something really wrong. You are "scared to death." As soon as possible, you head for the nearest emergency room. The doctor examines you and assesses your symptoms. You are told that your symptoms are a classic attack of Bell's Palsy.

Bell's Palsy is defined by the National Institute of Neurological Disorders and Stroke --an Institute of the National Institutes of Health -- as a form of temporary facial paralysis. It may result from damage or trauma to one of the two facial nerves. The facial nerve is also called the seventh cranial nerve. It is a paired structure that travels through a narrow, bony canal (called the Fallopian canal), in the skull beneath the ear, to the muscles on each side of the face. For most of its journey, the nerve is encased in this bony shell.

Each facial nerve directs the muscles on one side of the face, including those that control eye blinking and closing, and facial expressions such as smiling and frowning. In addition, the facial nerve carries nerve impulses to the lacrimal or tear glands, the saliva glands and the muscles of a small bone in the middle of the ear called the stapes. The facial nerve also transmits taste sensations from the tongue.

When Bell's Palsy occurs, the function of the facial nerve is disrupted, causing an interruption in the messages the brain sends to the facial muscles. This interruption results in facial weakness or paralysis.

It was named for Sir Charles Bell, a 19th-century Scottish surgeon who was the first to describe the condition. The disorder, which is not related to stroke, is the most common cause of facial paralysis. Generally, Bell's Palsy affects only one side of the paired facial nerves, and one side of the face; it is rare to have both sides involved.

Naturally, the symptoms become complex because the nerve has so many functions. Damage to the nerve or disruption in its function can lead to many problems. Symptoms may vary from person to person, and range in severity from mild weakness to total paralysis. There can be twitching, weakness or paralysis in one or both sides of the face, drooping of the eyelid and a corner of the mouth, drooling, impairment of taste, and excessive tearing in one eye. Most often, these symptoms begin suddenly, and reach their peak within 48 hours. They can lead to significant facial distortion.

Other symptoms may include pain or discomfort around the jaw and behind the ear, ringing in one or both ears, headache, loss of taste, hypersensitivity to sound on the affected side, impaired speech, dizziness and difficulty eating or drinking.

The mechanism in which Bell's Palsy occurs is that the facial nerve becomes swollen, inflamed or compressed. Then facial weakness or paralysis can be the result. Many scientists believe that a viral infection such as viral meningitis or even the common cold sore virus (herpes simplex) can cause the disorder. They say that when the facial nerve becomes inflamed and swollen it is a reaction to an infection. This causes pressure within the Fallopian canal leading to an infarction to the nerve cells. An infarction can cause death of the nerve cells due to insufficient blood and oxygen to the cells. In mild cases the only damage is to the myelin sheet, or fatty covering that insulates the nerve fibers in the brain.

Bell's Palsy is almost always associated with some kind of influenza, or other flu-like illnesses. Other conditions can be headaches, chronic middle-ear infection, high blood pressure, diabetes, tumors, Lyme disease and trauma such as skull fracture or other facial injury.

Over 40,000 Americans are afflicted with the disease annually. It affects men and women equally and can occur at any age. It is less prevalent before age 15 or over age 60. It disproportionately attacks pregnant women and people who have diabetes or upper respiratory ailments such as flu or a cold. This is another reason to get an annual flu shot.

Making a diagnosis is based on the patient's symptoms. There is no specific laboratory test to confirm diagnosis. The diagnosis is made strictly on the individual's symptoms. There is a test called electromyography (EMG) that can confirm the presence of nerve damage and determine the severity and extent of nerve involvement. An x-ray of the scull can help rule out infection or tumor. Magnetic resonance imaging (MRI) or a computed tomography (CT) scan can eliminate whether there are other causes of pressure on the facial nerve.

There is no known cure or standard of treatment of Bell's Palsy. The most important thing is to eliminate the source of the nerve damage. Each individual reacts differently. Some cases turn out to be mild and do not require treatment because the symptoms can subside within two weeks.

Recent studies have shown that steroids are effective in treating Bell's Palsy. An antiviral drug such as acyclovir may be used in combination with an anti-inflammatory drug such as the steroid prednisone. Analgesics such as aspirin, acetaminophen, or ibuprofen may relieve pain. Patients should consult with their physicians to make sure that none of the above interferes with any other medications a patient is taking.

Extremely important is the treatment of the eye that may become dry because of the inability to blink that leaves the eye exposed to irritation and drying out, especially at night. Artificial tears, or gels, that lubricate the eyes and eye patches are also effective.

Physical therapy to stimulate the facial nerve may help maintain muscle tone is also effective. Likewise, facial exercises to stimulate the muscles to prevent contracture are also important. Moist heat on the face is also helpful. Rarely, cosmetic surgery may be required to restore the damaged facial muscles.

The prognosis for those with Bell's Palsy is generally very good. The extent of the nerve damage determines the recovery. Improvement is gradual, and most individuals get better within two weeks. Sometimes, for those with more severe involvement, it may require several months before a full recovery. It is rare to have a recurrence.

For more information on neurological disorders or research funded by National Institute of Neurological Disorders and Stroke, contact the Institute's Brain Resources Network: Brain, P.O. Box 5801, Bethesda, Md. 20824; call 1-800-352-9424; or visit www.rarediseases.org.

The post Guest Editorial appeared first on Park Record.

]]> Imagine driving down the road and suddenly your eyes become blurred and start twitching. You blink and try as best you can to continue. Then your facial muscles begin to get numb, weaken and almost freeze. You feel a sudden pain. Maybe there is something really wrong. You are "scared to death." As soon as possible, you head for the nearest emergency room. The doctor examines you and assesses your symptoms. You are told that your symptoms are a classic attack of Bell’s Palsy.

Bell’s Palsy is defined by the National Institute of Neurological Disorders and Stroke –an Institute of the National Institutes of Health — as a form of temporary facial paralysis. It may result from damage or trauma to one of the two facial nerves. The facial nerve is also called the seventh cranial nerve. It is a paired structure that travels through a narrow, bony canal (called the Fallopian canal), in the skull beneath the ear, to the muscles on each side of the face. For most of its journey, the nerve is encased in this bony shell.

Each facial nerve directs the muscles on one side of the face, including those that control eye blinking and closing, and facial expressions such as smiling and frowning. In addition, the facial nerve carries nerve impulses to the lacrimal or tear glands, the saliva glands and the muscles of a small bone in the middle of the ear called the stapes. The facial nerve also transmits taste sensations from the tongue.

When Bell’s Palsy occurs, the function of the facial nerve is disrupted, causing an interruption in the messages the brain sends to the facial muscles. This interruption results in facial weakness or paralysis.

It was named for Sir Charles Bell, a 19th-century Scottish surgeon who was the first to describe the condition. The disorder, which is not related to stroke, is the most common cause of facial paralysis. Generally, Bell’s Palsy affects only one side of the paired facial nerves, and one side of the face; it is rare to have both sides involved.

Naturally, the symptoms become complex because the nerve has so many functions. Damage to the nerve or disruption in its function can lead to many problems. Symptoms may vary from person to person, and range in severity from mild weakness to total paralysis. There can be twitching, weakness or paralysis in one or both sides of the face, drooping of the eyelid and a corner of the mouth, drooling, impairment of taste, and excessive tearing in one eye. Most often, these symptoms begin suddenly, and reach their peak within 48 hours. They can lead to significant facial distortion.

Other symptoms may include pain or discomfort around the jaw and behind the ear, ringing in one or both ears, headache, loss of taste, hypersensitivity to sound on the affected side, impaired speech, dizziness and difficulty eating or drinking.

The mechanism in which Bell’s Palsy occurs is that the facial nerve becomes swollen, inflamed or compressed. Then facial weakness or paralysis can be the result. Many scientists believe that a viral infection such as viral meningitis or even the common cold sore virus (herpes simplex) can cause the disorder. They say that when the facial nerve becomes inflamed and swollen it is a reaction to an infection. This causes pressure within the Fallopian canal leading to an infarction to the nerve cells. An infarction can cause death of the nerve cells due to insufficient blood and oxygen to the cells. In mild cases the only damage is to the myelin sheet, or fatty covering that insulates the nerve fibers in the brain.

Bell’s Palsy is almost always associated with some kind of influenza, or other flu-like illnesses. Other conditions can be headaches, chronic middle-ear infection, high blood pressure, diabetes, tumors, Lyme disease and trauma such as skull fracture or other facial injury.

Over 40,000 Americans are afflicted with the disease annually. It affects men and women equally and can occur at any age. It is less prevalent before age 15 or over age 60. It disproportionately attacks pregnant women and people who have diabetes or upper respiratory ailments such as flu or a cold. This is another reason to get an annual flu shot.

Making a diagnosis is based on the patient’s symptoms. There is no specific laboratory test to confirm diagnosis. The diagnosis is made strictly on the individual’s symptoms. There is a test called electromyography (EMG) that can confirm the presence of nerve damage and determine the severity and extent of nerve involvement. An x-ray of the scull can help rule out infection or tumor. Magnetic resonance imaging (MRI) or a computed tomography (CT) scan can eliminate whether there are other causes of pressure on the facial nerve.

There is no known cure or standard of treatment of Bell’s Palsy. The most important thing is to eliminate the source of the nerve damage. Each individual reacts differently. Some cases turn out to be mild and do not require treatment because the symptoms can subside within two weeks.

Recent studies have shown that steroids are effective in treating Bell’s Palsy. An antiviral drug such as acyclovir may be used in combination with an anti-inflammatory drug such as the steroid prednisone. Analgesics such as aspirin, acetaminophen, or ibuprofen may relieve pain. Patients should consult with their physicians to make sure that none of the above interferes with any other medications a patient is taking.

Extremely important is the treatment of the eye that may become dry because of the inability to blink that leaves the eye exposed to irritation and drying out, especially at night. Artificial tears, or gels, that lubricate the eyes and eye patches are also effective.

Physical therapy to stimulate the facial nerve may help maintain muscle tone is also effective. Likewise, facial exercises to stimulate the muscles to prevent contracture are also important. Moist heat on the face is also helpful. Rarely, cosmetic surgery may be required to restore the damaged facial muscles.

The prognosis for those with Bell’s Palsy is generally very good. The extent of the nerve damage determines the recovery. Improvement is gradual, and most individuals get better within two weeks. Sometimes, for those with more severe involvement, it may require several months before a full recovery. It is rare to have a recurrence.

For more information on neurological disorders or research funded by National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources Network: Brain, P.O. Box 5801, Bethesda, Md. 20824; call 1-800-352-9424; or visit www.rarediseases.org.

The post Guest Editorial appeared first on Park Record.

]]> 4936 Guest Editorial https://www.parkrecord.com/2006/03/01/guest-editorial-50/ Wed, 01 Mar 2006 15:00:00 +0000 http://dev.parkrecord.com/news/guest-editorial-50/ In case the name is not familiar to you, the Susan G. Komen Foundation was founded on a promise made between two sisters --Susan Goodman Komen and Nancy Goodman Brinker. Suzy was diagnosed with breast cancer in 1978, at a time when little was known about the disease and it was rarely discussed in public. Before she died, at the age of 36, Suzy asked her sister to do everything possible to bring an end to breast cancer. Nancy kept her promise by establishing the foundation more than 20 years ago. The Komen Foundation is a global leader in the fight against breast cancer through its support of innovative research and community-based outreach programs. You may have heard of the "Komen Race for the Cure." The foundation is dedicated to eradicate breast cancer by funding research grants and meritorious awards, and supporting education, screening and treatment projects in communities around the world.

The recent Komen Foundation newsletter (fall 2005) reports on three hopeful research projects. The first is a breast fluid test that could aid in early detection, risk and assessment. The test consists of using a small sample of breast nipple fluid to provide relatively quick answers to a number of urgent questions, like "Do I have cancer?" and "Will I get cancer?" The test, called the QM-MSP, or quantitative multiples methylation-specific PCR, is being developed by a team of researchers at the Johns Hopkins Kimmel Cancer Center. The research team is led by the principal investigator, Saraswati Sikumar, Ph.D. and the project is being funded in part by the Susan G. Komen Foundation.

The research can be useful in detecting breast cancer in its very early stages. It may be useful to substantiate other tests obtained by conventional means. These may include needle biopsies. The test may also be useful in assessing DNA and a woman's genetic predisposition to developing breast cancer. Key proteins can be found that help to resist breast cancer as well. Another use of the QM-MSP is that it can monitor whether cancer treatments are working. This is based on the level of methylation found in the sampled cells. It may also reduce the need for breast biopsies, and allow for the treatment of the cancer to begin as early as possible following the test results.

At the University of Wyoming, researchers are exploring whether a simple saliva test can, in one rapid and non-invasive step determine whether a patient has the antigen, HER-2 neu. This is a biomarker for an aggressive form of breast cancer, according to Beverly Sullivan, Ph.D., the principal investigator in this Komen-funded research project. Again, with this research it will be possible for early breast cancer treatment so that more lives can be saved.

The researchers in the Wyoming study are working on the simple saliva test following animal studies that suggest that it is possible to detect a fragment or HER-2 neu in the blood, even before a tumor or any other irregularities are clinically evident. For patients, that could mean detection of breast cancer even before x-ray-mammography, breast self-examination, or clinical breast examination by a trained practitioner might by chance find any breast abnormalities.

Presently, techniques such as the enzyme-linked assay (ELISA) use blood samples to detect HER-2 neu. This technique requires multiple steps and can take hours to produce an answer. The ultimate goal of the Wyoming study group is to develop a saliva test technique that can be easily used in a physicians office and provide instant results.

The HER-2 neu is a protein that sits outside the membrane of breast cancer cells. If the protein is present, some of it is likely to break away from the breast membrane and enter into the blood stream. The fragment is very small and the theory is that it can actually end up in the saliva. Because saliva is so easily obtained, measuring for HER-2 neu fragments is an ideal medium for collecting the cancerous cells. Earliest detection of this particularly aggressive cancer is the goal. Furthermore, the saliva test could enable easy, ongoing measuring of treatment therapies and their effectiveness. Later, it could be useful to detect any recurrence of the cancer. Sullivan says these uses are still under investigation but it seems that the possibilities are very promising.

Finally, in the Komen Foundation newsletter there is a report of a study noted by the National Cancer Institute (NCI). In this study, the use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin and their association to breast cancer risk was the focus of a study released last summer in the Journal of the National Cancer Institute. These drugs are widely used for many conditions including arthritis and reducing fever. Additionally, they are used to decrease the risk of stroke and heart attack.

In the California Teachers Study, researchers looked at the use of NSAIDs, the risk of breast cancer and the hormone status of cancer in 114,460 women, ages 22 to 85.

According to the study results: Regular use of NSAIDs, more than once weekly, did not increase breast cancer risk; long-term daily use of aspirin (five or more years) was associated with a reduction in the risk for estrogen and progesterone receptor positive breast cancer. This is not considered to be a significant finding, however, more than five years of daily use increased risk for breast cancer.

Daily use of ibuprofen long-term (five or more years) was associated with more breast cancer risk that was non-localized (breast cancer that was stage two or higher and had spread to the lymph nodes or had metastasized). Whether these observed associations were the cause of the risk were not clear from the study's findings. It is possible that other factors were in play, and that the use of NSAIDs was only coincidental.

The upside of NSAID use is that in other studies, they inhibited and blocked the COX-2 enzyme that is involved in the inflammatory process. They are actually showing promising results in colon cancer trials. The authors of this study suggest more research is needed. These findings are only a "noted association" of these drugs and breast cancer.

Thankfully, the research is ongoing; it appears that we are on the brink of early detection and prevention of certain cancers. The Susan G. Komen Foundation has been instrumental in moving the research forward. Should you wish more information, the Web site is www.komen.org.

The post Guest Editorial appeared first on Park Record.

]]> In case the name is not familiar to you, the Susan G. Komen Foundation was founded on a promise made between two sisters –Susan Goodman Komen and Nancy Goodman Brinker. Suzy was diagnosed with breast cancer in 1978, at a time when little was known about the disease and it was rarely discussed in public. Before she died, at the age of 36, Suzy asked her sister to do everything possible to bring an end to breast cancer. Nancy kept her promise by establishing the foundation more than 20 years ago. The Komen Foundation is a global leader in the fight against breast cancer through its support of innovative research and community-based outreach programs. You may have heard of the "Komen Race for the Cure." The foundation is dedicated to eradicate breast cancer by funding research grants and meritorious awards, and supporting education, screening and treatment projects in communities around the world.

The recent Komen Foundation newsletter (fall 2005) reports on three hopeful research projects. The first is a breast fluid test that could aid in early detection, risk and assessment. The test consists of using a small sample of breast nipple fluid to provide relatively quick answers to a number of urgent questions, like "Do I have cancer?" and "Will I get cancer?" The test, called the QM-MSP, or quantitative multiples methylation-specific PCR, is being developed by a team of researchers at the Johns Hopkins Kimmel Cancer Center. The research team is led by the principal investigator, Saraswati Sikumar, Ph.D. and the project is being funded in part by the Susan G. Komen Foundation.

The research can be useful in detecting breast cancer in its very early stages. It may be useful to substantiate other tests obtained by conventional means. These may include needle biopsies. The test may also be useful in assessing DNA and a woman’s genetic predisposition to developing breast cancer. Key proteins can be found that help to resist breast cancer as well. Another use of the QM-MSP is that it can monitor whether cancer treatments are working. This is based on the level of methylation found in the sampled cells. It may also reduce the need for breast biopsies, and allow for the treatment of the cancer to begin as early as possible following the test results.

At the University of Wyoming, researchers are exploring whether a simple saliva test can, in one rapid and non-invasive step determine whether a patient has the antigen, HER-2 neu. This is a biomarker for an aggressive form of breast cancer, according to Beverly Sullivan, Ph.D., the principal investigator in this Komen-funded research project. Again, with this research it will be possible for early breast cancer treatment so that more lives can be saved.

The researchers in the Wyoming study are working on the simple saliva test following animal studies that suggest that it is possible to detect a fragment or HER-2 neu in the blood, even before a tumor or any other irregularities are clinically evident. For patients, that could mean detection of breast cancer even before x-ray-mammography, breast self-examination, or clinical breast examination by a trained practitioner might by chance find any breast abnormalities.

Presently, techniques such as the enzyme-linked assay (ELISA) use blood samples to detect HER-2 neu. This technique requires multiple steps and can take hours to produce an answer. The ultimate goal of the Wyoming study group is to develop a saliva test technique that can be easily used in a physicians office and provide instant results.

The HER-2 neu is a protein that sits outside the membrane of breast cancer cells. If the protein is present, some of it is likely to break away from the breast membrane and enter into the blood stream. The fragment is very small and the theory is that it can actually end up in the saliva. Because saliva is so easily obtained, measuring for HER-2 neu fragments is an ideal medium for collecting the cancerous cells. Earliest detection of this particularly aggressive cancer is the goal. Furthermore, the saliva test could enable easy, ongoing measuring of treatment therapies and their effectiveness. Later, it could be useful to detect any recurrence of the cancer. Sullivan says these uses are still under investigation but it seems that the possibilities are very promising.

Finally, in the Komen Foundation newsletter there is a report of a study noted by the National Cancer Institute (NCI). In this study, the use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin and their association to breast cancer risk was the focus of a study released last summer in the Journal of the National Cancer Institute. These drugs are widely used for many conditions including arthritis and reducing fever. Additionally, they are used to decrease the risk of stroke and heart attack.

In the California Teachers Study, researchers looked at the use of NSAIDs, the risk of breast cancer and the hormone status of cancer in 114,460 women, ages 22 to 85.

According to the study results: Regular use of NSAIDs, more than once weekly, did not increase breast cancer risk; long-term daily use of aspirin (five or more years) was associated with a reduction in the risk for estrogen and progesterone receptor positive breast cancer. This is not considered to be a significant finding, however, more than five years of daily use increased risk for breast cancer.

Daily use of ibuprofen long-term (five or more years) was associated with more breast cancer risk that was non-localized (breast cancer that was stage two or higher and had spread to the lymph nodes or had metastasized). Whether these observed associations were the cause of the risk were not clear from the study’s findings. It is possible that other factors were in play, and that the use of NSAIDs was only coincidental.

The upside of NSAID use is that in other studies, they inhibited and blocked the COX-2 enzyme that is involved in the inflammatory process. They are actually showing promising results in colon cancer trials. The authors of this study suggest more research is needed. These findings are only a "noted association" of these drugs and breast cancer.

Thankfully, the research is ongoing; it appears that we are on the brink of early detection and prevention of certain cancers. The Susan G. Komen Foundation has been instrumental in moving the research forward. Should you wish more information, the Web site is www.komen.org.

The post Guest Editorial appeared first on Park Record.

]]> 4844 Guest Editorial https://www.parkrecord.com/2006/02/25/guest-editorial-49/ Sat, 25 Feb 2006 15:00:00 +0000 It is really true that laughter is some of the best medicine for staying well and healthy. And, there is even simple scientific evidence. When you laugh endorphins are released, they are the body's natural painkillers, and they suppress epinephrine, the stress hormone.

Twenty-seven years ago, in 1979, Norman Cousins wrote "Anatomy of an Illness" after having a life-changing experience. He was stricken with a crippling and life-threatening collagen disease. Collagen is the fibrous protein in the bones, cartilage, tendons and other connective tissue. Cousins was treated by his physicians who predicted that he didn't have long to live. He decided to take matters into his own hands. He followed a regimen of high doses of vitamin C and positive emotions that included daily doses of belly laughter. This strategy gave him an additional hour pain-free sleep. Eventually he got well using his strategy. He said, "Laughter may or may not activate endorphins or enhance respiration, as some medical researchers contend. What seems clear, however, is that laughter is an antidote to apprehension and panic." Fifteen years later, he had a heart attack. He recovered once again using his laughter strategy, and wrote "The Healing Heart." He died in 1990, following cardiac arrest, at the age of 75. He lived years longer than his doctors had predicted, more than once. He calculated 10 years after his first heart attack, 16 years after his collagen illness, and 26 years after his doctors had diagnosed heart disease.

Cousins was invited by the Dean of Medicine, Sherman Mellinkoff, to join the faculty at the University of California at Los Angeles (UCLA) in 1978. He was designated an adjunct professor of medical humanities. What brought him to UCLA was the quest for proof that a patient's psychological approach to illness could have an effect on biological states. Cousin was particularly interested in the impact of positive emotions and attitudes, such as purpose, determination to live and festivity. He wondered if the brain played an active, conscious role in the healing process. What would the implications of such findings be on the treatment of serious illness? Could a good vehicle for making such discoveries be the emerging field of psychoneuroimmunology? At UCLA, he appointed a task force of high-caliber scientists. Out of these efforts grew the UCLA program that was subsequently named the Cousins Center for Psychoneuroimmunology (UCLA-PNI Cousins Center).

Presently, the center is studying the psychological and behavioral and immune factors associated with environmental factors, allergy, autoimmune disease, inflammatory disease, genetic factors, cancer, infectious diseases, cardiovascular disease and stroke.

The research on laughter continues. In the January 2006, issue of the University of Maryland Magazine an article entitled "Laughter: Good Medicine for the Heart" describes the laughter research work of Michael Miller, M.D. It was shown that laughter has a therapeutic effect on the body specifically, on the endothelium, the protective lining of the blood vessels. Laughter actually caused the lining to expand allowing for increased blood flow to the heart. The study, supported by the National Institutes of Health and the Veterans Affairs Merit Award, involved 20 healthy volunteers. Their blood flow was measured before and after they watched a funny movie or a stress-inducing movie.

Prior to the study, the researchers performed a baseline test to measure how the subjects blood pressure reacted to increased blood flow under normal every-day circumstances. Each subject in the study was invited to watch a 15-minute segment of either a funny or emotionally disturbing movie. The opening battle scene of "Saving Private Ryan" was chosen for its "stress-inducing quality," and "King Pin," a zany comedy about a professional bowler was the laughter-inducing segment, according to Dr. Miller.

Following the viewing of each segment, the researchers measured the subject's blood pressure. A sonogram was also used to measure constriction or dilation inside of the vessels in the arm. The subjects were tested on two separate days; one for the funny segment and the other for the disturbing segment.

The study participants' blood pressure was dramatically affected by both films. In 14 of the 20 volunteers who watched "Saving Private Ryan," the blood vessels constricted and the diameter was decreased by an average of 35 percent. This is remarkable, says Miller, "because even some of those 14 subjects who had a reaction had previously seen the film." The decrease in diameter is called "vasoconstriction" and can be a potentially unhealthy development. "Over time, impairment in the endothelium (that lines the blood vessels) may be associated with a greater tendency to fat and cholesterol build-up in the coronary arteries. This can lead to heart attack," Miller explains. Conversely, after the funny movie, the blood vessel diameter (or vasodilatation) was increased in 19 of the 20 volunteers by an average of 25 percent, according to the researcher.

It was shown by the researchers that a good hearty laugh releases endorphins from the brain, which then produces euphoric feelings and wellness. Miller says, "At the very least, laughter offsets mental stress and the release of chemicals, such as cortisol that lead to a breakdown in nitric oxide, which causes vasoconstriction."

It is suggested that laughter strategies be incorporated into the treatment of heart disease as well as its prevention. The study by Miller was published in Heart in 2005, and received global attention. This is probably because it is something everyone can understand and even practice without a prescription. As Norman Cousin would suggest, I leave you with the adage: "End today and begin tomorrow with laughter."

Park City resident Joan Jacobson, PhD, RN, is an adjunct professor for the University of Utah College of Nursing. She is the author of Midlife Women.

The post Guest Editorial appeared first on Park Record.

]]> It is really true that laughter is some of the best medicine for staying well and healthy. And, there is even simple scientific evidence. When you laugh endorphins are released, they are the body’s natural painkillers, and they suppress epinephrine, the stress hormone.

Twenty-seven years ago, in 1979, Norman Cousins wrote "Anatomy of an Illness" after having a life-changing experience. He was stricken with a crippling and life-threatening collagen disease. Collagen is the fibrous protein in the bones, cartilage, tendons and other connective tissue. Cousins was treated by his physicians who predicted that he didn’t have long to live. He decided to take matters into his own hands. He followed a regimen of high doses of vitamin C and positive emotions that included daily doses of belly laughter. This strategy gave him an additional hour pain-free sleep. Eventually he got well using his strategy. He said, "Laughter may or may not activate endorphins or enhance respiration, as some medical researchers contend. What seems clear, however, is that laughter is an antidote to apprehension and panic." Fifteen years later, he had a heart attack. He recovered once again using his laughter strategy, and wrote "The Healing Heart." He died in 1990, following cardiac arrest, at the age of 75. He lived years longer than his doctors had predicted, more than once. He calculated 10 years after his first heart attack, 16 years after his collagen illness, and 26 years after his doctors had diagnosed heart disease.

Cousins was invited by the Dean of Medicine, Sherman Mellinkoff, to join the faculty at the University of California at Los Angeles (UCLA) in 1978. He was designated an adjunct professor of medical humanities. What brought him to UCLA was the quest for proof that a patient’s psychological approach to illness could have an effect on biological states. Cousin was particularly interested in the impact of positive emotions and attitudes, such as purpose, determination to live and festivity. He wondered if the brain played an active, conscious role in the healing process. What would the implications of such findings be on the treatment of serious illness? Could a good vehicle for making such discoveries be the emerging field of psychoneuroimmunology? At UCLA, he appointed a task force of high-caliber scientists. Out of these efforts grew the UCLA program that was subsequently named the Cousins Center for Psychoneuroimmunology (UCLA-PNI Cousins Center).

Presently, the center is studying the psychological and behavioral and immune factors associated with environmental factors, allergy, autoimmune disease, inflammatory disease, genetic factors, cancer, infectious diseases, cardiovascular disease and stroke.

The research on laughter continues. In the January 2006, issue of the University of Maryland Magazine an article entitled "Laughter: Good Medicine for the Heart" describes the laughter research work of Michael Miller, M.D. It was shown that laughter has a therapeutic effect on the body specifically, on the endothelium, the protective lining of the blood vessels. Laughter actually caused the lining to expand allowing for increased blood flow to the heart. The study, supported by the National Institutes of Health and the Veterans Affairs Merit Award, involved 20 healthy volunteers. Their blood flow was measured before and after they watched a funny movie or a stress-inducing movie.

Prior to the study, the researchers performed a baseline test to measure how the subjects blood pressure reacted to increased blood flow under normal every-day circumstances. Each subject in the study was invited to watch a 15-minute segment of either a funny or emotionally disturbing movie. The opening battle scene of "Saving Private Ryan" was chosen for its "stress-inducing quality," and "King Pin," a zany comedy about a professional bowler was the laughter-inducing segment, according to Dr. Miller.

Following the viewing of each segment, the researchers measured the subject’s blood pressure. A sonogram was also used to measure constriction or dilation inside of the vessels in the arm. The subjects were tested on two separate days; one for the funny segment and the other for the disturbing segment.

The study participants’ blood pressure was dramatically affected by both films. In 14 of the 20 volunteers who watched "Saving Private Ryan," the blood vessels constricted and the diameter was decreased by an average of 35 percent. This is remarkable, says Miller, "because even some of those 14 subjects who had a reaction had previously seen the film." The decrease in diameter is called "vasoconstriction" and can be a potentially unhealthy development. "Over time, impairment in the endothelium (that lines the blood vessels) may be associated with a greater tendency to fat and cholesterol build-up in the coronary arteries. This can lead to heart attack," Miller explains. Conversely, after the funny movie, the blood vessel diameter (or vasodilatation) was increased in 19 of the 20 volunteers by an average of 25 percent, according to the researcher.

It was shown by the researchers that a good hearty laugh releases endorphins from the brain, which then produces euphoric feelings and wellness. Miller says, "At the very least, laughter offsets mental stress and the release of chemicals, such as cortisol that lead to a breakdown in nitric oxide, which causes vasoconstriction."

It is suggested that laughter strategies be incorporated into the treatment of heart disease as well as its prevention. The study by Miller was published in Heart in 2005, and received global attention. This is probably because it is something everyone can understand and even practice without a prescription. As Norman Cousin would suggest, I leave you with the adage: "End today and begin tomorrow with laughter."

Park City resident Joan Jacobson, PhD, RN, is an adjunct professor for the University of Utah College of Nursing. She is the author of Midlife Women.

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