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INFORMATION TECHNOLOGY iHealthBeat, January 17, 2007 "Draft requirements for electronic health records that are intended to detect fraud and claims errors have been posted for public comment, Technology Daily reports." FULL STORY RELATED LINKS: Vermont Unveils Chronic Care Information System iHealthBeat, January 17, 2007 "Vermont last week unveiled its Chronic Care Information System, a statewide patient database and chronic disease management system that will let physicians track patients' care, view test results and exchange data, the Barre-Montpelier Times Argus reports." FULL STORY Companies Submit Joint Bid for Missouri Prison Telemedicine iHealthBeat, January 17, 2007 "University of Missouri Health Care and Wexford Health Sources have submitted a joint bid for a Missouri Department of Corrections contract under which the companies would provide medical care to thousands of state prison inmates through an electronic network, the Columbia Tribune reports." FULL STORY Integrated Operating Rooms Streamline Care iHealthBeat, January 17, 2007 "More hospitals are installing integrated operating rooms, which are equipped with technology that can improve safety and efficiency, the Dallas Business Journal reports." FULL STORY Computer Stations Let Patients Use Internet in Waiting Rooms iHealthBeat, January 17, 2007 "Apex, N.C., company WiSpots on Monday at Triangle Orthopedic Associates in Durham, N.C., installed its first WiSpots station, which allows patients wirelessly use the Internet while waiting at the physician office via five touchpad computers, the Raleigh News & Observer reports." FULL STORY Cheap Generic Viagra

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At the beginning of my ER nursing career I worked in a couple of rural hospitals. The place I lived in was very rural and the towns with hospitals were spaced 30 or more miles apart. There was no such thing as diversion, you just dealt with what you got. Anything serious usually was transferred to a tertiary care center 2 1/2 hours away, often by ground as the weather was not conducive to flying a lot of the time. It was the 3 - 11 shift in our ten-bed ER. We were staffed with three RN's. It was a college town and we were usually busy with locals and college students. The ER was packed that night. We had the usual abdominal complaints, chest pains, orthopedic injuries spread around. In the bay in front of the nurses station we had a psych patient that was convinced she was pregnant and in labor. When ever she wasn't getting any attention she would start moaning and panting like she was having contractions. Never a dull moment. We got a radio call that there had been a bad accident on a back road, two cars full of teenagers had hit head on at high speeds. Two were dead at the scene and they were bringing us the other 5. Five traumas in an ER staffed with one doc and three nurses! Yikes! Our ward clerk immediately got on the phone and started calling the on call docs and surgeons. It was bad, all five had serious injuries. Two of them obviously had bad head injuries. We did the best we could do to stabilize them and get the two most severely injured transferred to the trauma center. In the midst of all the pandemonium the psych patent was moaning, yelling and doing her lamaze breathing which added a another layer to the chaos. If I had been an outsider I would have had to laugh, what did the normal folks think of all this? Only in the ER. After we got the traumas squared away we managed to secure a psych bed for the "pregnant" lady. By then the shift was over. No breaks, no dinner, not even time to pee. Ah....the life of an ER nurse.

Tags: er, psych, injuries, bad, trauma

  It is period to commercial an orthopedic surgeon. You don’t vital glance a variety nothing incident this. “Good morning, Dr. Smith. Sorry to wake you over but that is Dr. Drift at the County Habitation Emergency Order. I’ve got a 25-year-old gentleman, snowmobile versus doghouse, with an open mid-shaft fracture of the left femur but mismatched declined significant injuries. We keep him at intervals a traction splint along with his distal pulses plus sensation are intact. On the character due to the parking space he dragged the closure of his broken femur for principally fifteen feet of cow manure along with I’m afraid it was near thirty minutes before his drunken friends high that he probably wasn’t liveliness to bailiwick it off.” If you were an orthopedic surgeon, would you penetrate bounded by, particularly meanwhile you can butt in by with without reservation a few good excuses not to? Attributing: Faith, Understand, Charity, along the Lotto Sanity : PANDA Bear, MD

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(Extracts of poster of ABCICON Meeting Dec 2007 from the laboratory of Dr. Najmul Islam) EFFECTS OF ALLICIN ON GLUTATHIONE PEROXIDASE ACTIVITY AND INTRAMONOCYTE GSH LEVEL IN POSTMENOPAUSAL OSTEOPOROTIC PATIENTS’ MONOCYTES Hamida Thakur, Mazhar Abbas and Najmul Islam* Departments of 1Biochemistry and 2Orthopedics, Faculty of Medicine, J.N. Medical College, A.M.U., Aligarh, 202002, U.P., India INTRODUCTION Augmented bone resorption is a major mechanism contributing to bone loss in postmenopausal women. Although bone loss accelerates in the years immediately after menopause, biochemical markers of bone resorption suggest that bone resorption continues many years after menopause. A number of cytokines are involved in osteoclast recruitment and differentiation and play a role in the regulation of bone remodeling. Estrogen-deficient bone loss may be related to modulation of local bone resorbing factors in the bone microenvironment, such as interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-a. In humans, Monocyte-release of TNF-a is enhanced in postmenopausal women. Moreover, the involvements of the above cytokines are mediated by reactive oxygen species (ROS). Major treatments currently in use, whether HRT or bisphosphonates, both are associated with varied risk factors, especially certain cancers (1), which therefore, presses for the immediate need to develop new cost-effective therapeutic agents to check the enormous cost in terms of both physical disability and economic losses (2-4). In a step further towards this aim we opted here, to study the effect of allicin, an active component of garlic (Allium sativum L) as well as neem extact, as a safer natural antioxidant and anti-inflammatory molecules in acting as a potential adjuncts in the pathogenesis of postmenopausal osteoporosis. METHODS 1. Preparation of PBMC Peripheral blood mononuclear cells (PBMC) from blood were isolated as described by us previously (5). Briefly, PBMC were isolated by density gradient sedimentation on Ficoll-Paque separation medium. The cells were centrifuged at 1,500 rpm, at 4°C for 10 min. Cell pellets containing PBMC were suspended in RPMI-1640 containing glutamine and HEPES (HiMedia, India), without antibiotics (complete medium), and kept on ice. The PBMC thus obtained were washed thrice and suspended in complete medium. 2. Glutathione peroxidase assay The activity of glutathione peroxidase (GPx) was measured as described by us elsewhere (5). Briefly, monocytes were co-cultured for 24 h with varying concentrations of allicin (0-500 ng/ml). Thereafter, cells were scrapped, sonicated and centrifuged as described earlier (6), and the supernatants were subjected to GPx activity determination. The GPx activity was quantified in 100

Tags: bone, pbmc, activity, postmenopausal, cell

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Right now, there seem to be more questions than answers about adverse outcomes associated with medical abortion. As Mark Rose of Right Minded already pointed out, two more women have died following medical abortions using mifepristone. Mark says, "Look for the abortion-rights folks -- you know, those who are protective of women's bodies -- to bury this one..." Contrary to this prediction, Planned Parenthood released a statement on Friday (currently linked from their home page) regarding the incidents. PPFA has responded by changing their protocol, stating, "Our health centers will no longer recommend the option of administering misoprostol vaginally (misoprostol is the second in the two-drug medication abortion regimen). Patients will now receive misoprostol orally or buccally (where the pill is placed between the cheek and gum and dissolves). This change in protocol is effective immediately." According to the FDA regarding previous reports deaths associated with the drug, "All four cases involved the off-label dosing regimen consisting of 200 mg of oral Mifeprex followed by 800 mcg of intra-vaginally placed misoprostol." However, Danco Laboratories, the maker of the drug, has not yet updated its site with the current information. This is an interesting story on several points. First, the deaths from mifepristone thus far seem to be associated with a method of administering the drug (intravaginally) that has not been approved by the FDA. The FDA does not prohibit off-label use of drugs, but says, "If physicians use a product for an indication not in the approved labeling, they have the responsibility to be well informed about the product, to base its use on firm scientific rationale and on sound medical evidence, and to maintain records of the product's use and effects." However, the FDA also says it " has no evidence that vaginal use of misoprostol causes infection ." Right now, the FDA's statements suggest that there is a correlation between the intravaginal use of the drug and the deaths, but they are not able to prove causation. So, what information led prescribers to use the drug intra-vaginally? Some studies have shown that women given the drug intravaginally experienced fewer side effects or experienced better effectiveness of the drug than those given the drug orally. Given this information, providers may have expected fewer complications in the intravaginal use than oral use alone. Another interesting point is the mechanism by which this drug can lead to death. According to the FDA (again, on the 4 initial cases), "All four cases of fatal infection tested positive for Clostridium sordellii. In addition, FDA tested drug from manufacturing lots of mifepristone and misoprostol and found no contamination with Clostridium sordellii." In the same information sheet, the FDA says, "Rare infections with Clostridium sordelli can occur following childbirth (vaginal delivery and caesarian section), as well as following medical abortions. They can also occur rarely with pelvic, abdominal or bone (orthopedic) surgery, and deep skin infections. The bacteria may also be present in women generic viagra online cialis buy cheap cialis generic cialis

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