Monday, December 31, 2012

UK has its pediatric heart program under review; chief is on leave, and patients are being referred to other hospitals

Kentucky Children's Hospital at the University of Kentucky is reviewing its cardio-thoracic surgery program and referring surgical patients to other hospitals, "but the reasons why are unclear," Brenna Angel reported Dec. 21 for WUKY-FM, the university-owned station.

Angel did identify "the surgeon at the center of the review," Dr. Mark Plunkett, left, who is on a leave of absence but "remains on staff at UK with a $700,000 annual salary," as chief of cardio-thoracic surgery. "UK denied an open-records request for the date of his most recent surgery and his patient mortality rate," citing privacy rules in the federal Health Insurance Portability and Accountability Act. It was unclear how release of such statistics, without any personally identifying information, would compromise privacy. Plunkett and officials of the medical center refused to be interviewed.

"It's been pretty hush-hush," Tabitha Rainey of Lexington, the mother of a Plunkett patient, told Angel, who reported: "Plunkett and his assistant Dr. Deborah Kozik operated on Waylon seven days after he was born. Tabitha was later told that Dr. Plunkett was taking a leave of absence." Rainey told Angel, "Months went past and they lost another patient, who was a dear friend of mine, and it was pretty heavy in the unit at the time. Then soon after I guess they decided to stop doing the surgeries and review the entire program."

Angle was able to get some records from UK and reported they showed that "The number of children Dr. Plunkett operated on this year is down around 43 percent from two years ago." UK Trustee Dr. Charles Sachatello, a surgeon who sits on the Board of Trustees' health-care committee, told Angel, "I was not aware of that, and that was never announced at the Board of Trustees meeting." Sachatello told Angel that UK should merge its pediatric heart program with the one at the University of Louisville because of the high operational costs of such programs. (Read more)

7 Signs You’re Exercising Too Much

When it comes to healthy habits, too much of a good thing can backfire, and that applies to exercise as well. While most people suffer from lack of exercise, once you get going, it can be addictive and some people do end up exercising too much — either by exercising too intensely, and/or too frequently.
However, a really important part of creating optimal fitness is recovery. An equation to keep in mind is that as intensity increases, frequency can be diminished.
For example, as a weak beginner, you can do high intensity exercise three times a week and not put much stress on your system. But once your strength and endurance improves, each exercise session is placing an increasingly greater amount of stress on your body (as long as you keep pushing yourself to the max).
At that point, it’s actually wise to reduce the frequency of your sessions to give your body enough time to recover in between. In fact, you need to allow your body to fully recuperate in between sessions in order for the exercise to remain productive.

Seven Signs You May Be Overdoing it

The featured article by personal trainer Jennipher Walters addresses signs of overtraining that are commonly overlooked or misdiagnosed. The following seven symptoms may signal that you need to cut back a bit and allow your body to recover between sessions:
Exercise leaves you exhausted instead of energized.
You get sick easily (or it takes forever to get over a cold)
You have the blues
You're unable to sleep or you can't seem to get enough sleep
You have ''heavy'' legs
You have a short fuse
You're regularly sore for days at a time

The Higher the Intensity, the Greater Your Need for Recovery

If you’re doing high intensity interval exercises, it's NOT recommended to do them more than three times a week. Both Phil Campbell and Dr. Doug McGuff have addressed this in previous interviews. If you don't allow your body to fully recuperate and rebuild, your efforts will not pay off beneficial dividends.... especially if you’re exercising to get healthy and live longer.
One of the keys here, as with any exercise program and lifestyle change, is to carefully listen to your body. I can provide you with guidelines and principles but ultimately the key to your success will be learning how to be sensitive to the feedback your body is providing you and then honoring that feedback.
With exercise you have to pay careful attention to recover if you tend to be someone who pushes yourself hard. If you only work out occasionally, this is a non-issue. But for those who are really committed and disciplined, it is very easy to over train, so please understand that recovery is every bit as important as training and if you work out too much you will not achieve the results you're seeking.

Over or Underestimating Yourself Could Nullify Your Efforts

As described in the featured article, many make the mistake of pushing themselves too hard. Others don’t push themselves hard enough. In order to maximize your workout efforts, it is important to strive for that 'Goldilocks' Zone' where you're pushing hard enough to challenge your body at your current level of fitness, while allowing your body to recuperate in between.
Needless to say, this ratio will change over time, and that's the point — many people forget they need to continuously up the ante as their fitness improves. Similarly, you need to look for signs of pushing yourself too hard when the addictive qualities of exercise start to kick in.
This is especially important as it applies to high intensity exercises. As mentioned earlier, doing high intensity interval training more than three times a week can backfire and become counterproductive. This is because when you work your fast-twitch fibers, it takes about 48 hours for that fiber to heal and fully recover. This is twice the recovery time needed for long and slow exercise, which only work your slow-twitch fiber. These can typically heal in just one day.
Earlier this year, I realized I was feeling unusually fatigued between sessions, as I was doing three Peak Fitness sessions per week. I ended up first reducing the intensity of my exercise by about five percent (instead of getting my heart rate to 173 or so, I would only bring it up to about 163).
Later, I switched to doing just two sessions per week instead of three. It’s important to not get too attached to any one particular program, but to continuously keep adapting your regimen as you go along. Most recently I reduced my Peak 8 session to a Peak 6 session, but I increased the intensity back up so now I get my heart rate from 170 to 174. But I only do them once a week unless I am unable to do my strength training, then I increase to twice a week.
So have fun, play with it, and be very careful to listen to your body both post exercise and in the interval between exercising. If you are feeling great and have plenty of energy, that is likely a good sign you are not over exercising. But you know your body better than most and if you know this is a risk for you, then implement the cautions I advise. However if you know you will never push yourself that hard then you need to ignore the caution principle until you have pushed yourself hard enough to know you have overtrained.
So, how do you know if you’re sufficiently recovered from your exercise? One tip gleaned from Dr. Doug McGuff is that you know you’re recovered when you have that restless energy and feel like you have to engage in some type of physical activity. You will just want to work out.

Strive for Balance

While high intensity interval exercises accomplish greater benefits in a fraction of the time compared to slow, endurance-type exercises like jogging, I do not recommend limiting yourself to Peak Exercises alone. Ideally, to truly optimize your health, you'll want to strive for a varied and well-rounded fitness program that incorporates other types of exercise as well. Without variety, your body will quickly adapt.
I recommend incorporating the following types of exercises to create a well-rounded fitness program suitable to your current level of fitness:
Interval (Anaerobic) Training: This is when you alternate short bursts of high-intensity exercise with gentle recovery periods. To perform it correctly, you'll want to raise your heart rate to your anaerobic threshold, and to do that, you have to give it your all for those 20 to 30 second intervals. (As a general guideline, you can calculate your anaerobic threshold by subtracting your age from 220.) For a demonstration, please see the following video.
Strength Training: Rounding out your exercise program with a 1-set strength training routine will ensure that you're really optimizing the possible health benefits of a regular exercise program. You can also "up" the intensity by slowing it down. For more information about using super slow weight training as a form of high intensity interval exercise, please see my interview with Dr. Doug McGuff.
Core Exercises: Your body has 29 core muscles located mostly in your back, abdomen and pelvis. This group of muscles provides the foundation for movement throughout your entire body, and strengthening them can help protect and support your back, make your spine and body less prone to injury and help you gain greater balance and stability.
You need enough repetitions to exhaust your muscles. The weight should be heavy enough that this can be done in fewer than 12 repetitions, yet light enough to do a minimum of four repetitions. It is also important NOT to exercise the same muscle groups every day. They need at least two days of rest to recover, repair and rebuild. Exercise programs like Pilates and yoga are also great for strengthening your core muscles, as are specific exercises you can learn from a personal trainer.
Stretching: My favorite type of stretching is active isolated stretches developed by Aaron Mattes. With Active Isolated Stretching or AIS, you hold each stretch for only two seconds, which works with your body's natural physiological makeup to improve circulation and increase the elasticity of muscle joints. This technique also allows your body to help repair itself and prepare for daily activity. You can also use devices like the Power Plate to help you stretch.

Less Really is More, When it Comes to High-Intensity Exercise

One of the major benefits of high intensity exercises is that it allows your body to produce human growth hormone (HGH), commonly referred to as “the fitness hormone.” However, as explained by Dr. McGuff in a previous interview, once you're fit, you really don't need frequent spurts of growth hormone production.
At that point, recovery actually takes precedence as being more important, and your recovery period could be anywhere from three to seven days. In fact, he strongly recommends NOT exercising too frequently once you are in fit condition, and here's why:
"[Y]our adrenal gland… sits right above your kidneys, and it's arranged in layers. On the outermost layers, you have mineral corticoids that control your sodium and your electrolyte levels. In the middle layer, you have your corticosteroids that control sugar and generate stress hormones. And in the innermost layer is where you generate growth hormones and the sex steroids, or that's involved in the axis, in the feedback loop that generates that.
The old saying in medical school to memorize the three layers is "salt, sugar, sex" – the deeper you go, the better it gets. But you got to remember, your adrenal gland is an integrated organ. Those three layers are not perfectly divided. If through high-intensity exercise you're trying to hammer that adrenal gland three times per week, but now you're much stronger and your body hasn't fully recovered from your Monday session and you come back and hit it again on Wednesday… you're going to tap down into that deeper level.
Instead of growth hormones spurt, you're going to get in a cortisol spurt. You're going to completely undermine what it is that you're after."

About Dr Kevin Lau

Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.

When it comes to healthy habits, too much of a good thing can backfire, and that applies to exercise as well. While most people suffer from lack of exercise, once you get going, it can be addictive and some people do end up exercising too much — either by exercising too intensely, and/or too frequently.
However, a really important part of creating optimal fitness is recovery. An equation to keep in mind is that as intensity increases, frequency can be diminished.
For example, as a weak beginner, you can do high intensity exercise three times a week and not put much stress on your system. But once your strength and endurance improves, each exercise session is placing an increasingly greater amount of stress on your body (as long as you keep pushing yourself to the max).
At that point, it’s actually wise to reduce the frequency of your sessions to give your body enough time to recover in between. In fact, you need to allow your body to fully recuperate in between sessions in order for the exercise to remain productive.

Seven Signs You May Be Overdoing it

The featured article by personal trainer Jennipher Walters addresses signs of overtraining that are commonly overlooked or misdiagnosed. The following seven symptoms may signal that you need to cut back a bit and allow your body to recover between sessions:
Exercise leaves you exhausted instead of energized.
You get sick easily (or it takes forever to get over a cold)
You have the blues
You're unable to sleep or you can't seem to get enough sleep
You have ''heavy'' legs
You have a short fuse
You're regularly sore for days at a time

The Higher the Intensity, the Greater Your Need for Recovery

If you’re doing high intensity interval exercises, it's NOT recommended to do them more than three times a week. Both Phil Campbell and Dr. Doug McGuff have addressed this in previous interviews. If you don't allow your body to fully recuperate and rebuild, your efforts will not pay off beneficial dividends.... especially if you’re exercising to get healthy and live longer.
One of the keys here, as with any exercise program and lifestyle change, is to carefully listen to your body. I can provide you with guidelines and principles but ultimately the key to your success will be learning how to be sensitive to the feedback your body is providing you and then honoring that feedback.
With exercise you have to pay careful attention to recover if you tend to be someone who pushes yourself hard. If you only work out occasionally, this is a non-issue. But for those who are really committed and disciplined, it is very easy to over train, so please understand that recovery is every bit as important as training and if you work out too much you will not achieve the results you're seeking.

Over or Underestimating Yourself Could Nullify Your Efforts

As described in the featured article, many make the mistake of pushing themselves too hard. Others don’t push themselves hard enough. In order to maximize your workout efforts, it is important to strive for that 'Goldilocks' Zone' where you're pushing hard enough to challenge your body at your current level of fitness, while allowing your body to recuperate in between.
Needless to say, this ratio will change over time, and that's the point — many people forget they need to continuously up the ante as their fitness improves. Similarly, you need to look for signs of pushing yourself too hard when the addictive qualities of exercise start to kick in.
This is especially important as it applies to high intensity exercises. As mentioned earlier, doing high intensity interval training more than three times a week can backfire and become counterproductive. This is because when you work your fast-twitch fibers, it takes about 48 hours for that fiber to heal and fully recover. This is twice the recovery time needed for long and slow exercise, which only work your slow-twitch fiber. These can typically heal in just one day.
Earlier this year, I realized I was feeling unusually fatigued between sessions, as I was doing three Peak Fitness sessions per week. I ended up first reducing the intensity of my exercise by about five percent (instead of getting my heart rate to 173 or so, I would only bring it up to about 163).
Later, I switched to doing just two sessions per week instead of three. It’s important to not get too attached to any one particular program, but to continuously keep adapting your regimen as you go along. Most recently I reduced my Peak 8 session to a Peak 6 session, but I increased the intensity back up so now I get my heart rate from 170 to 174. But I only do them once a week unless I am unable to do my strength training, then I increase to twice a week.
So have fun, play with it, and be very careful to listen to your body both post exercise and in the interval between exercising. If you are feeling great and have plenty of energy, that is likely a good sign you are not over exercising. But you know your body better than most and if you know this is a risk for you, then implement the cautions I advise. However if you know you will never push yourself that hard then you need to ignore the caution principle until you have pushed yourself hard enough to know you have overtrained.
So, how do you know if you’re sufficiently recovered from your exercise? One tip gleaned from Dr. Doug McGuff is that you know you’re recovered when you have that restless energy and feel like you have to engage in some type of physical activity. You will just want to work out.

Strive for Balance

While high intensity interval exercises accomplish greater benefits in a fraction of the time compared to slow, endurance-type exercises like jogging, I do not recommend limiting yourself to Peak Exercises alone. Ideally, to truly optimize your health, you'll want to strive for a varied and well-rounded fitness program that incorporates other types of exercise as well. Without variety, your body will quickly adapt.
I recommend incorporating the following types of exercises to create a well-rounded fitness program suitable to your current level of fitness:
Interval (Anaerobic) Training: This is when you alternate short bursts of high-intensity exercise with gentle recovery periods. To perform it correctly, you'll want to raise your heart rate to your anaerobic threshold, and to do that, you have to give it your all for those 20 to 30 second intervals. (As a general guideline, you can calculate your anaerobic threshold by subtracting your age from 220.) For a demonstration, please see the following video.
Strength Training: Rounding out your exercise program with a 1-set strength training routine will ensure that you're really optimizing the possible health benefits of a regular exercise program. You can also "up" the intensity by slowing it down. For more information about using super slow weight training as a form of high intensity interval exercise, please see my interview with Dr. Doug McGuff.
Core Exercises: Your body has 29 core muscles located mostly in your back, abdomen and pelvis. This group of muscles provides the foundation for movement throughout your entire body, and strengthening them can help protect and support your back, make your spine and body less prone to injury and help you gain greater balance and stability.
You need enough repetitions to exhaust your muscles. The weight should be heavy enough that this can be done in fewer than 12 repetitions, yet light enough to do a minimum of four repetitions. It is also important NOT to exercise the same muscle groups every day. They need at least two days of rest to recover, repair and rebuild. Exercise programs like Pilates and yoga are also great for strengthening your core muscles, as are specific exercises you can learn from a personal trainer.
Stretching: My favorite type of stretching is active isolated stretches developed by Aaron Mattes. With Active Isolated Stretching or AIS, you hold each stretch for only two seconds, which works with your body's natural physiological makeup to improve circulation and increase the elasticity of muscle joints. This technique also allows your body to help repair itself and prepare for daily activity. You can also use devices like the Power Plate to help you stretch.

Less Really is More, When it Comes to High-Intensity Exercise

One of the major benefits of high intensity exercises is that it allows your body to produce human growth hormone (HGH), commonly referred to as “the fitness hormone.” However, as explained by Dr. McGuff in a previous interview, once you're fit, you really don't need frequent spurts of growth hormone production.
At that point, recovery actually takes precedence as being more important, and your recovery period could be anywhere from three to seven days. In fact, he strongly recommends NOT exercising too frequently once you are in fit condition, and here's why:
"[Y]our adrenal gland… sits right above your kidneys, and it's arranged in layers. On the outermost layers, you have mineral corticoids that control your sodium and your electrolyte levels. In the middle layer, you have your corticosteroids that control sugar and generate stress hormones. And in the innermost layer is where you generate growth hormones and the sex steroids, or that's involved in the axis, in the feedback loop that generates that.
The old saying in medical school to memorize the three layers is "salt, sugar, sex" – the deeper you go, the better it gets. But you got to remember, your adrenal gland is an integrated organ. Those three layers are not perfectly divided. If through high-intensity exercise you're trying to hammer that adrenal gland three times per week, but now you're much stronger and your body hasn't fully recovered from your Monday session and you come back and hit it again on Wednesday… you're going to tap down into that deeper level.
Instead of growth hormones spurt, you're going to get in a cortisol spurt. You're going to completely undermine what it is that you're after."

About Dr Kevin Lau

Evaluating natriuretic peptides in hyperthyroid cats

Menaut P, Connolly DJ, Volk A, et al. Circulating natriuretic peptide concentrations in hyperthyroid cats. J Small Anim Pract. 2012; 53: 673-8.

Natriuretic peptides (NPs) are neurohormones stored in heart muscle cells (atrial cardiomyocytes) and released in response to atrial stretch. They possess potent natriuretic and vasorelaxant properties. They have been shown to be chronically up-regulated in cats with underlying heart disease and have thus been used as a biomarker to detect occult heart disease and differentiate cardiac from non-cardiac dyspnea in emergency situations. In particular, the non-biologically active N-terminal fragment from atrial natriuretic peptide, (NT-proANP), and from brain natriuretic peptide, NT-proBNP, have commonly been studied due to their stability in plasma.

Hyperthyroidism is the most common endocrine disease of cats. In humans with hyperthyroidism, a number of studies have shown NP concentrations to be elevated. Therefore, since NP measurement is increasingly being used to assess feline cardiac disease, determining the influence of elevated thyroid function on NP concentrations is essential.

In this study, 61 hyperthyroid cats were assessed before and after treatment for hyperthyroidism. Treatment included using methimazole or methimazole and subsequent surgical thyroidectomy. Cats with overt heart failure or systemic hypertension were excluded from the study due to previous reports showing these conditions to be associated with an increase in NT-proBNP. Assessment included full physical examination, systolic blood pressure (SBP), plasma biochemistries, total thyroid level (TT4), packed cell volume (PCV), and urinalysis, as well as measurement of NT-proBNP and NT-proANP concentrations. The length of time between pre- and post-treatment evaluation was 35 days and the length of time that the cats were on treatment before post-treatment sample was 28 days. Total T4, heart rate, SBP, and PCV all decreased and body weight and creatinine concentrations increased once euthyroidism was established. In addition, NT-proBNP significantly declined, but no change in NT-proANP concentrations was noted. In conclusion, hyperthyroidism has a modest but significant effect on elevating NT-proBNP with little effect on NT-proANP. Therefore, thyroid status should be taken into account when interpreting NT-proBNP results. [GO]

See also: Singletary GE, Rush JE, Fox PR, Stepien RL and Oyama MA. Effect of NT-pro-BNP assay on accuracy and confidence of general practitioners in diagnosing heart failure or respiratory disease in cats with respiratory signs. J Vet Intern Med. 2012; 26: 542-6.

Related blog articles:
Biochemical testing for feline heart disease (March 2009)
Cardiac biomarkers in feline heart disease (July 2011)

More on cat health:
Winn Feline Foundation Library
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Five amazing ways probiotics can protect you this flu season

(NaturalNews) Right on time; flu season is once again upon us, and no doubt you're already getting bombarded with calls to get your "flu shot" so you can be "protected" from this year's strain of influenza.

Well, you can do that if you choose, or you can take a more proactive approach to warding off the bugs and viruses this year by employing probiotics to help defend you.

What are probiotics? Simply put, it is the good bacteria that resides in your gut and battles infection caused by viruses, yeast, fungi and parasites. And it, like bad bacteria, is killed off with antibiotics, often leaving you more vulnerable for the next bug that comes along.

The issue is this: Antibiotics are over-prescribed these days. One of the most recent studies, from the University of Pennsylvania School of Medicine, found that doctors frequently misuse antibiotics when treating patients who have been hospitalized for respiratory tract infections. The study, published in the journal Infection Control and Hospital Epidemiology, found that doctors at a pair of Pennsylvania hospitals were using antibiotics to treat patients with viral infections, which don't respond to such medications.

By comparison, according to a separate study in China, children aged three to five years old that were treated with two types of probiotics had a 63 percent lower rate of fever, a 54 percent reduction in cough, and a 44 percent decline in runny nose. Also, antibiotic use was reduced by a whopping 80 percent in children on the probiotics who had symptoms for about half the time of those on a placebo - 3.4 days compared to 6.5 days with the latter group.

The results led authors to conclude that consuming probiotics on a daily basis significantly reduced the incidence and length of respiratory infection symptoms in young children.

Probiotics are found in supplements and food (and not just yogurt, although that's a good place to start).

Here are five ways probiotics can help protect you and yours this flu season:

-- Digestive health. We have more than 1,000 different types of bacteria that live in our digestive tracts. In fact, bacteria in our bodies outnumber human cells ten to one. Yet when we take an antibiotic, they kill the healthy intestinal flora that helps us digest, in addition to the sickness-causing bacteria. "As a result, doctors commonly prescribe taking probiotics to 'repopulate' the digestive tract with healthful bacteria," the Huffington Post reported. But probiotics can also help with other digestive issues, such as irritable bowel syndrome

-- Urinary tract health. According to research, probiotics - especially lactobacilli - have been successful in treating recurrent urinary tract infections (UTI) in women. "...[I]f you could replace the Lactobacillus in women with recurrent urinary tract infections, you might normalize the vagina and prevent infections," says researcher Dr. Thomas M. Hooton, a professor of clinical medicine at the University of Miami Miller School of Medicine. "So there is as push to develop non-antibiotic methods to prevent and treat infections."

-- Keep those allergies at bay. Hay fever? Cats? Dust? Mold? Research suggests that probiotics could help prevent or reduce the severity of allergies. A team of Finnish researchers at the University of Helsinki found that "exposing pregnant mothers and infants to probiotic bacteria could help stimulate the growth of the immune system and potentially play a role in preventing allergies," ABC News reported in 2008.

-- Improving women's health. Probiotics have found L. acidophilius may help reduce the incidence and severity of bacterial vaginosis and yeast infections, when taken as a vaginal suppository (rather than consumed in foods).

-- Improve your immune response. One of the main functions of healthful bacteria is to stimulate your immune response. "By eating probiotic-rich foods and maintaining good intestinal flora, a person can also help to maintain a healthy immune system," HuffPo reported, citing small-study research.

Probiotics can also help you maintain a healthier weight.

Sources:

http://www.greenmedinfo.com

http://www.huffingtonpost.com

http://health.usnews.com

http://abcnews.go.com

Learn more: http://www.naturalnews.com/038441_probiotics_flu_season_immune_system.html#ixzz2Fwg8nLfs

About Dr Kevin Lau

Generic OxyContin and Opana, headed for market soon, could make fight against pain-pill abuse tougher, McConnell says

With generic versions of the two most commonly-abused painkillers, Opana and OxyContin, coming on the market next year, police, hospitals and health clinics in Kentucky have voiced concern that "these generic crushable drugs lack the tamper-resistant gel coating of the brand-name drugs," says a news release from U.S. Sen. Mitch McConnell.

"Without this technology, addicts crush the pills in order to achieve an immediate heroin-like high from sniffing or injecting the painkillers," the release says. "If these generics come to market without the tamper-resistant coating, much of the work that law enforcement and health care providers have done to stem the tide of pain pill abuse in Kentucky will be lost."

McConnell's news release said he has asked the Food and Drug Administration to keep the crushable drugs off the market "until a workable solution can be found." McConnell, the Senate Republican leader, met Wednesday with the Department for Health and Human Services’ acting general counsel, Bill Schultz, to discuss the issue. (Read more)

Group of 550 doctors in Central Ky. leaving Medicaid's Coventry

A Lexington-area network of doctors says it will no longer contract with Coventry Cares, a Medicaid managed-care company, after Coventry said "it would begin to pay less than the established Medicaid rate in reimbursements — as much as 10 percent less for care from specialists," Cheryl Truman reports for the Lexington Herald-Leader.

The Physicians' Network is a group of 550 independent physicians, headed by Dr. Ralph Alvarado of Winchester. He said the cuts will mean that some doctors will be paying to treat Medicaid patients.

d more here: http://www.kentucky.com/2012/12/20/2450679/central-kentucky-doctors-cut-ties.html#storylink=cpy

Coventry issued a statement saying, "This decision would not take effect until March 7, and we do not expect any network access issues for our members. That said, Coventry would like our members to continue enjoying access to this group of providers. We remain committed to continuing negotiations . . . " (Read more)

d more here: http://www.kentucky.com/2012/12/20/2450679/central-kentucky-doctors-cut-ties.html#storylink=cpy

Deaths from drug overdoses in Kentucky hit new high in 2010; more than half involved prescription drugs

Deaths from drug overdoses in Kentucky jumped to a new high in 2010, and "rose a staggering 296 percent from 2000 to 2010," Bill Estep of the Lexington Herald-Leader reports. "A tidal wave of prescription-drug abuse drove the steep increase," with just over half of the deaths involving prescription drugs, according to a study by researchers at the University of Kentucky.

As usual, the problem is worst in Appalachian Kentucky, as illustrated by this Herald-Leader map:

"The increase in deaths might have been even greater because information was not available for Kentucky residents treated in neighboring states, and because some death certificates might not have listed an overdose as the cause of a person's death when in fact it was," Estep reports. "The report did not measure the impact of changes Kentucky lawmakers made this year aimed at confronting the prescription-drug problem, though it will provide a way to help measure the impact of the law."

Read more here: http://www.kentucky.com/2012/12/20/2451315/drug-overdose-deaths-up-296-percent.html#storylink=cpy

Importance of Magnesium is Far Greater than Previously Imagined

By Dr. Mercola

You don't hear much about magnesium, yet an estimated 80 percent of Americans are deficient in this important mineral and the health consequences of deficiency are significant. One reason could be because magnesium, like vitamin D, serves so many functions it's hard to corral.
As reported by GreenMedInfo¹, researchers have now detected 3,751 magnesium binding sites on human proteins, indicating that its role in human health and disease may have been vastly underestimated.
Magnesium is also found in more than 300 different enzymes in your body, which are responsible for:
Creation of ATP (adenosine triphospate), the energy molecules of your body Proper formation of bones and teeth Relaxation of blood vessels
Action of your heart muscle Promotion of proper bowel function Regulation of blood sugar levels

The Health Benefits of Magnesium have Been Vastly Underestimated

A number of studies have previously shown magnesium can benefit your blood pressure and help prevent sudden cardiac arrest, heart attack, and stroke. For example, one meta-analysis published earlier this year in the American Journal of Clinical Nutrition² looked at a total of seven studies collectively covering more than 240,000 participants. The results showed that dietary magnesium intake is inversely associated with risk of ischemic stroke.
But its role in human health appears to be far more complex than previously thought, and—like vitamin D—its benefits may be more far-reaching than we've imagined. GreenMedInfo.com's database project has indexed over 100 health benefits of magnesium so far, including therapeutic benefits for:
Fibromyalgia Atrial fibrillation Type 2 diabetes Premenstrual syndrome
Cardiovascular disease Migraine Aging Mortality

According to the featured report³:
"The proteome, or entire set of proteins expressed by the human genome, contains well over 100,000 distinct protein structures, despite the fact that there are believed to be only 20,300 protein-coding genes in the human genome. The discovery of the "magneseome," as its being called, adds additional complexity to the picture, indicating that the presence or absence of adequate levels of this basic mineral may epigenetically alter the expression and behavior of the proteins in our body, thereby altering the course of both health and disease."
Magnesium also plays a role in your body's detoxification processes and therefore is important for helping to prevent damage from environmental chemicals, heavy metals and other toxins. Even glutathione, your body's most powerful antioxidant that has even been called "the master antioxidant," requires magnesium for its synthesis.

Signs You May Not be Getting Enough Magnesium

There's no lab test that will give you a truly accurate reading of the magnesium status in your tissues. Only one percent of magnesium in your body is distributed in your blood, making a simple sample of magnesium from a blood test highly inaccurate. Other tests that your doctor can use to evaluate your magnesium status include a 24-hour urine test, or a sublingual epithelial test. Still, these can only give you an estimation of your levels, and doctors typically need to evaluate them in conjunction with the symptoms you exhibit. An ongoing magnesium deficiency can lead to more serious symptoms, including:
Numbness and tingling Muscle contractions and cramps Seizures
Personality changes Abnormal heart rhythms Coronary spasms

With that in mind, some early signs of magnesium deficiency to keep an eye out for include:
Loss of appetite
Headache
Nausea and vomiting
Fatigue and weakness

One of the Best Ways to Optimize Your Magnesium Levels

If you suspect you are low in magnesium one of the best ways to consume this mineral is through organically bound magnesium, found in whole foods. As explained in the featured article:
"Chlorophyll, which enables plants to capture solar energy and convert it into metabolic energy, has a magnesium atom at its center. Without magnesium, in fact, plants could not utilize the sun's light energy. "
In many ways chlorophyll is the plant's version of our hemoglobin as they share a similar structure but have magnesium plugged in the middle rather than iron. Green leafy vegetables like spinach and Swiss chard are excellent sources of magnesium, as are some beans, nuts and seeds, like almonds, pumpkin seeds, sunflower seeds and sesame seeds. Avocados are also a good source. Juicing your vegetables is an excellent option to ensure you're getting enough of them in your diet.
In order to ensure you're getting enough, you first need to be sure you're eating a varied, whole-food diet like the one described in my nutrition plan. But there are other factors too, that can make you more prone to magnesium deficiency, including the ailments listed below. If any of these conditions apply to you, you may want to take extra precautions to make sure you're getting a sufficient amount of magnesium in your diet, or, if needed, from a magnesium supplement, in order to avoid magnesium deficiency.
An unhealthy digestive system, which impairs your body's ability to absorb magnesium (Crohn's disease, leaky gut, etc.) Alcoholism -- up to 60 percent of alcoholics have low blood levels of magnesium⁴
Unhealthy kidneys, which contribute to excessive loss of magnesium in urine Age -- older adults are more likely to be magnesium deficient because absorption decreases with age and the elderly are more likely to take medications that can interfere with absorption
Diabetes, especially if it's poorly controlled, leading increased magnesium loss in urine Certain medications -- diuretics, antibiotics and medications used to treat cancer can all result in magnesium deficiency

Foods with the Highest Amounts of Magnesium

Most people can keep their levels in the healthy range without resorting to supplements, simply by eating a varied diet, including plenty of dark-green leafy vegetables. One important point to mention though is that the levels of magnesium in your food are dependent on the levels of magnesium in the soil where they're grown. Organic foods may have more magnesium, as most fertilizer used on conventional farms relies heavily on nitrogen, phosphorous, and potassium instead of magnesium.
The featured article lists more than 20 specific foods that are exceptionally high in magnesium, including the following (for the full list, please see the original report⁵). All portions are listed equate to 100 grams, or just over three ounces:
Seaweed, agar, dried (770 mg) Spices, basil, dried (422 mg)
Spice, coriander leaf, dried (694 mg) Flaxseed (392 mg)
Dried pumpkin seeds (535 mg) Almond butter (303 mg)
Cocoa, dry powder, unsweetened (499 mg) Whey, sweet, dried (176 mg)

Different Types of Magnesium Supplements

If for whatever reason you decide you need a supplement, be aware that there are a wide variety of magnesium supplements on the market, courtesy of the fact that magnesium must be bound to another substance. There's simply no such thing as a 100% magnesium supplement. The substance used in any given supplement combination can affect the absorption and bioavailability of the magnesium, and may provide slightly different, or targeted, health benefits:
Magnesium glycinate is a chelated form of magnesium that tends to provide the highest levels of absorption and bioavailability and is typically considered ideal for those who are trying to correct a deficiency Magnesium oxide is a non-chelated type of magnesium, bound to an organic acid or a fatty acid. Contains 60 percent magnesium, and has stool softening properties
Magnesium chloride / Magnesium lactate contain only 12 percent magnesium, but has better absorption than others, such as magnesium oxide, which contains five times more magnesium Magnesium sulfate / Magnesium hydroxide (milk of magnesia) are typically used as a laxative. Be aware that it's easy to overdose on these, so ONLY take as directed
Magnesium carbonate, which has antacid properties, contains 45 percent magnesium Magnesium taurate contains a combination of magnesium and taurine, an amino acid. Together, they tend to provide a calming effect on your body and mind
Magnesium citrate is magnesium with citric acid, which has laxative properties Magnesium threonate is a newer, emerging type of magnesium supplement that appears promising, primarily due to its superior ability to penetrate the mitochondrial membrane, and may be the best magnesium supplement on the market

Balance Your Magnesium with Calcium, Vitamin K2 and D

One of the major benefits of getting your nutrients from a varied whole food diet is that you're far less likely to end up with too much of one nutrient at the expense of others. Foods in general contain all the cofactors and needed co-nutrients in the proper amounts for optimal health, which takes out the guess work. When you're using supplements, you need to become a bit more savvy about how nutrients influence and synergistically affect each other.
For example, it's important to maintain the proper balance between magnesium, calcium, vitamin K2, and vitamin D. Lack of balance between these nutrients is why calcium supplements have become associated with increased risk of heart attacks and stroke, and why some people experience vitamin D toxicity.
Part of the explanation for these adverse side effects is that vitamin K2 keeps calcium in its appropriate place. If you're K2 deficient, added calcium can cause more problems than it solves, by accumulating in the wrong places. Similarly, if you opt for oral vitamin D, you need to also consume it in your food or take supplemental vitamin K2. Taking mega doses of vitamin D supplements without sufficient amounts of K2 can lead to vitamin D toxicity symptoms, which includes inappropriate calcification.
While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, Dr. Kate Rheaume-Bleue (whom I've interviewed on this topic) suggests that for every 1,000 IU's of vitamin D you take, you may benefit from about 100 micrograms of K2, and perhaps as much as 150-200 micrograms (mcg). The latest vitamin D dosing recommendations, which call for about 8,000 IU's of vitamin D3 per day if you're an adult, means you'd need in the neighborhood of 800 to 1,000 micrograms (0.8 to 1 milligram/mg) of vitamin K2.
Now, getting back to magnesium...
Magnesium may actually be more important than calcium if you are going to consider supplementing. However, maintaining an appropriate calcium-to-magnesium ratio is important regardless. Research on the paleolithic or caveman diet has shown that the ratio of calcium to magnesium in the diet that our bodies evolved to eat is 1-to-1⁶. Americans in general tend to have a higher calcium-to-magnesium ratio in their diet, averaging about 3.5-to-1.
Magnesium will also help keep calcium in your cells so they can do their job better. In many ways it serves as nutritional version of the highly effective class of drugs called calcium channel blockers, used in the treatment of high blood pressure, angina, and abnormal heart rhythms. Magnesium and vitamin K2 also complement each other, as magnesium helps lower blood pressure, which is an important component of heart disease.
So, all in all, anytime you're taking any of the following: magnesium, calcium, vitamin D3 or vitamin K2, you need to take all the others into consideration as well, since these all work synergistically with each other.

About Dr Kevin Lau

By Dr. Mercola

You don't hear much about magnesium, yet an estimated 80 percent of Americans are deficient in this important mineral and the health consequences of deficiency are significant. One reason could be because magnesium, like vitamin D, serves so many functions it's hard to corral.
As reported by GreenMedInfo¹, researchers have now detected 3,751 magnesium binding sites on human proteins, indicating that its role in human health and disease may have been vastly underestimated.
Magnesium is also found in more than 300 different enzymes in your body, which are responsible for:
Creation of ATP (adenosine triphospate), the energy molecules of your body Proper formation of bones and teeth Relaxation of blood vessels
Action of your heart muscle Promotion of proper bowel function Regulation of blood sugar levels

The Health Benefits of Magnesium have Been Vastly Underestimated

A number of studies have previously shown magnesium can benefit your blood pressure and help prevent sudden cardiac arrest, heart attack, and stroke. For example, one meta-analysis published earlier this year in the American Journal of Clinical Nutrition² looked at a total of seven studies collectively covering more than 240,000 participants. The results showed that dietary magnesium intake is inversely associated with risk of ischemic stroke.
But its role in human health appears to be far more complex than previously thought, and—like vitamin D—its benefits may be more far-reaching than we've imagined. GreenMedInfo.com's database project has indexed over 100 health benefits of magnesium so far, including therapeutic benefits for:
Fibromyalgia Atrial fibrillation Type 2 diabetes Premenstrual syndrome
Cardiovascular disease Migraine Aging Mortality

According to the featured report³:
"The proteome, or entire set of proteins expressed by the human genome, contains well over 100,000 distinct protein structures, despite the fact that there are believed to be only 20,300 protein-coding genes in the human genome. The discovery of the "magneseome," as its being called, adds additional complexity to the picture, indicating that the presence or absence of adequate levels of this basic mineral may epigenetically alter the expression and behavior of the proteins in our body, thereby altering the course of both health and disease."
Magnesium also plays a role in your body's detoxification processes and therefore is important for helping to prevent damage from environmental chemicals, heavy metals and other toxins. Even glutathione, your body's most powerful antioxidant that has even been called "the master antioxidant," requires magnesium for its synthesis.

Signs You May Not be Getting Enough Magnesium

There's no lab test that will give you a truly accurate reading of the magnesium status in your tissues. Only one percent of magnesium in your body is distributed in your blood, making a simple sample of magnesium from a blood test highly inaccurate. Other tests that your doctor can use to evaluate your magnesium status include a 24-hour urine test, or a sublingual epithelial test. Still, these can only give you an estimation of your levels, and doctors typically need to evaluate them in conjunction with the symptoms you exhibit. An ongoing magnesium deficiency can lead to more serious symptoms, including:
Numbness and tingling Muscle contractions and cramps Seizures
Personality changes Abnormal heart rhythms Coronary spasms

With that in mind, some early signs of magnesium deficiency to keep an eye out for include:
Loss of appetite
Headache
Nausea and vomiting
Fatigue and weakness

One of the Best Ways to Optimize Your Magnesium Levels

If you suspect you are low in magnesium one of the best ways to consume this mineral is through organically bound magnesium, found in whole foods. As explained in the featured article:
"Chlorophyll, which enables plants to capture solar energy and convert it into metabolic energy, has a magnesium atom at its center. Without magnesium, in fact, plants could not utilize the sun's light energy. "
In many ways chlorophyll is the plant's version of our hemoglobin as they share a similar structure but have magnesium plugged in the middle rather than iron. Green leafy vegetables like spinach and Swiss chard are excellent sources of magnesium, as are some beans, nuts and seeds, like almonds, pumpkin seeds, sunflower seeds and sesame seeds. Avocados are also a good source. Juicing your vegetables is an excellent option to ensure you're getting enough of them in your diet.
In order to ensure you're getting enough, you first need to be sure you're eating a varied, whole-food diet like the one described in my nutrition plan. But there are other factors too, that can make you more prone to magnesium deficiency, including the ailments listed below. If any of these conditions apply to you, you may want to take extra precautions to make sure you're getting a sufficient amount of magnesium in your diet, or, if needed, from a magnesium supplement, in order to avoid magnesium deficiency.
An unhealthy digestive system, which impairs your body's ability to absorb magnesium (Crohn's disease, leaky gut, etc.) Alcoholism -- up to 60 percent of alcoholics have low blood levels of magnesium⁴
Unhealthy kidneys, which contribute to excessive loss of magnesium in urine Age -- older adults are more likely to be magnesium deficient because absorption decreases with age and the elderly are more likely to take medications that can interfere with absorption
Diabetes, especially if it's poorly controlled, leading increased magnesium loss in urine Certain medications -- diuretics, antibiotics and medications used to treat cancer can all result in magnesium deficiency

Foods with the Highest Amounts of Magnesium

Most people can keep their levels in the healthy range without resorting to supplements, simply by eating a varied diet, including plenty of dark-green leafy vegetables. One important point to mention though is that the levels of magnesium in your food are dependent on the levels of magnesium in the soil where they're grown. Organic foods may have more magnesium, as most fertilizer used on conventional farms relies heavily on nitrogen, phosphorous, and potassium instead of magnesium.
The featured article lists more than 20 specific foods that are exceptionally high in magnesium, including the following (for the full list, please see the original report⁵). All portions are listed equate to 100 grams, or just over three ounces:
Seaweed, agar, dried (770 mg) Spices, basil, dried (422 mg)
Spice, coriander leaf, dried (694 mg) Flaxseed (392 mg)
Dried pumpkin seeds (535 mg) Almond butter (303 mg)
Cocoa, dry powder, unsweetened (499 mg) Whey, sweet, dried (176 mg)

Different Types of Magnesium Supplements

If for whatever reason you decide you need a supplement, be aware that there are a wide variety of magnesium supplements on the market, courtesy of the fact that magnesium must be bound to another substance. There's simply no such thing as a 100% magnesium supplement. The substance used in any given supplement combination can affect the absorption and bioavailability of the magnesium, and may provide slightly different, or targeted, health benefits:
Magnesium glycinate is a chelated form of magnesium that tends to provide the highest levels of absorption and bioavailability and is typically considered ideal for those who are trying to correct a deficiency Magnesium oxide is a non-chelated type of magnesium, bound to an organic acid or a fatty acid. Contains 60 percent magnesium, and has stool softening properties
Magnesium chloride / Magnesium lactate contain only 12 percent magnesium, but has better absorption than others, such as magnesium oxide, which contains five times more magnesium Magnesium sulfate / Magnesium hydroxide (milk of magnesia) are typically used as a laxative. Be aware that it's easy to overdose on these, so ONLY take as directed
Magnesium carbonate, which has antacid properties, contains 45 percent magnesium Magnesium taurate contains a combination of magnesium and taurine, an amino acid. Together, they tend to provide a calming effect on your body and mind
Magnesium citrate is magnesium with citric acid, which has laxative properties Magnesium threonate is a newer, emerging type of magnesium supplement that appears promising, primarily due to its superior ability to penetrate the mitochondrial membrane, and may be the best magnesium supplement on the market

Balance Your Magnesium with Calcium, Vitamin K2 and D

One of the major benefits of getting your nutrients from a varied whole food diet is that you're far less likely to end up with too much of one nutrient at the expense of others. Foods in general contain all the cofactors and needed co-nutrients in the proper amounts for optimal health, which takes out the guess work. When you're using supplements, you need to become a bit more savvy about how nutrients influence and synergistically affect each other.
For example, it's important to maintain the proper balance between magnesium, calcium, vitamin K2, and vitamin D. Lack of balance between these nutrients is why calcium supplements have become associated with increased risk of heart attacks and stroke, and why some people experience vitamin D toxicity.
Part of the explanation for these adverse side effects is that vitamin K2 keeps calcium in its appropriate place. If you're K2 deficient, added calcium can cause more problems than it solves, by accumulating in the wrong places. Similarly, if you opt for oral vitamin D, you need to also consume it in your food or take supplemental vitamin K2. Taking mega doses of vitamin D supplements without sufficient amounts of K2 can lead to vitamin D toxicity symptoms, which includes inappropriate calcification.
While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, Dr. Kate Rheaume-Bleue (whom I've interviewed on this topic) suggests that for every 1,000 IU's of vitamin D you take, you may benefit from about 100 micrograms of K2, and perhaps as much as 150-200 micrograms (mcg). The latest vitamin D dosing recommendations, which call for about 8,000 IU's of vitamin D3 per day if you're an adult, means you'd need in the neighborhood of 800 to 1,000 micrograms (0.8 to 1 milligram/mg) of vitamin K2.
Now, getting back to magnesium...
Magnesium may actually be more important than calcium if you are going to consider supplementing. However, maintaining an appropriate calcium-to-magnesium ratio is important regardless. Research on the paleolithic or caveman diet has shown that the ratio of calcium to magnesium in the diet that our bodies evolved to eat is 1-to-1⁶. Americans in general tend to have a higher calcium-to-magnesium ratio in their diet, averaging about 3.5-to-1.
Magnesium will also help keep calcium in your cells so they can do their job better. In many ways it serves as nutritional version of the highly effective class of drugs called calcium channel blockers, used in the treatment of high blood pressure, angina, and abnormal heart rhythms. Magnesium and vitamin K2 also complement each other, as magnesium helps lower blood pressure, which is an important component of heart disease.
So, all in all, anytime you're taking any of the following: magnesium, calcium, vitamin D3 or vitamin K2, you need to take all the others into consideration as well, since these all work synergistically with each other.

About Dr Kevin Lau

State Auditor Edelen faults Bluegrass mental-health agency for executive compensation, lax management and board oversight

The Bluegrass Regional Mental Health-Mental Retardation Board, a nonprofit agency that gets two-thirds of its money from taxpayers, "paid more than $2.8 million in executive-benefit contributions since 1997 to the president/CEO and various other employees solely at the discretion of the President/CEO with no scrutiny by board members," state Auditor Adam Edelen said in a press release this morning. "The contributions, which are designed to retain talent within an organization, were largely awarded to a core group of central office administrative staff while health-care employees received either no contributions or less significant amounts."

Edelen's release said the audit, made in response to "news media reports and anonymous concerns," also "found problems with . . . spending without supporting documentation and lax management practices." For example, Bluegrass spent $172,025 on lobbying from January 2011 to September 2012 without adequate documentation, and President/CEO Shannon Ware, right, and a consultant "spent nearly $38,000 on credit cards during an 18-month period without detailed receipts to document the business purposes," the release said. The full report is available here. It confirmed several findings by the Lexington Herald-Leader; for the H-L story on the audit, by John Cheves, go here.

U.S. teens' cigarette use drops to a new low, but use of alcohol goes up a bit and more 12th graders are smoking marijuana

Teenagers' cigarette smoking dropped to a record low this year but alcohol use rose slightly after seven years of decline, according to a survey of 45,000 eighth-, 10th- and 12th- graders for the National Institute of Drug Abuse.

The survey also found that the use of illicit drugs dropped slightly among eighth-graders but rose slightly among 12th-graders. Among them, 36.4 percent reported using marijuana in the past year, up from 34.8 percent in 2010, and the share who saw great risk in smoking marijuana occasionally dropped significantly, to 20.6 percent, from 24.5 percent in 2010.

Among all three age groups, only 10.6 percent said they had smoked cigarettes in the past 30 days, down from 11.7 percent in 2010. The University of Michigan researchers who did the survey said the decline was significant, and may have been driven by a big increase in the federal tobacco tax in 2009.

"A 1-percentage-point decline may not sound like a lot, but it represents about a 9 percent reduction in a single year in the number of teens currently smoking," principal researcher Lloyd Johnston said in a news release. Among eighth-graders, the decline was about 20 percent. For other results of the survey, click here; for a PDF version, here. For the full survey report, go here.

"Teen attitudes toward smoking also continued to become more negative. For example, 80 percent of teens said they preferred to date nonsmokers in 2012," Steve Gorman reports for Reuters. "But anti-tobacco advocates said their battle to stamp out teen smoking was far from over, noting that 17 percent of high school seniors still graduate as smokers." And the figure is higher in many rural areas.

Kentucky ranks at or near the top in youth smoking. In 2010, the last year for which state figures are available, 16 percent of Kentucky children aged 12 to 17 (a slightly younger group than the one above) reported smoking a cigarette in the past month. The national rate for that age group was 10 percent, according to the Centers for Disease Control and Prevention.

Lomustine for treatment of feline lymphoma

Dutelle AL, Bulman-Fleming JC, Lewis CA and Rosenberg MP. Evaluation of lomustine as a rescue agent for cats with resistant lymphoma. J Feline Med Surg. 2012; 14: 694-700.

Treating cases of resistant lymphoma is very challenging for veterinarians. The study reported here evaluated the use of lomustine as a rescue agent for 39 cases of resistant lymphoma in cats. The aims of the study were to evaluate lomustine as a rescue agent in this scenario, to determine prognostic factors for progression-free interval, and to detail toxicities noted in the course of the study. Progression-free interval (PFI) was defined as the time from when a cat was placed on lomustine to subsequent progression of disease necessitating a protocol change or euthanasia. The different parameters evaluated were lymphocyte cell size, number of previous chemotherapy drugs and number of chemotherapy protocols received, time from lymphoma diagnosis to initiation of lomustine therapy, body weight, and anatomic location of lymphoma.

The results demonstrated that the significant prognostic factors for PFI were cell size, number of previous chemotherapeutic drugs, number of previous chemotherapeutic protocols, and anatomic location. Cats with large cell lymphoma were 9.8 times more likely to have disease progression. Twenty-one cats (54%) received more than 1 dose of lomustine. Cats that had received 3 to 4 prior protocols were 3.6 times more likely to have disease progression than cats receiving 1 or 2 prior protocols. And cats with non-GI lymphoma were 4.7 times more likely to have progression of disease as ones with GI lymphoma. The most commonly noted toxicities in this study were vomiting, diarrhea, thrombocytopenia, leukopenia, and elevated ALT. It was noted that strict monitoring of the CBC while cats are on this drug is very important. [VT]

See also: Musser ML, Quinn HT and Chretin JD. Low apparent risk of CCNU (lomustine)-associated clinical hepatotoxicity in cats. J Feline Med Surg. 2012; 14: 871-5.

Related blog articles:
Pulmonary fibrosis in a cat receiving lomustine (July 2008)
Treatment for mast cell tumors in cats (April 2008)

More on cat health:
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Dutelle AL, Bulman-Fleming JC, Lewis CA and Rosenberg MP. Evaluation of lomustine as a rescue agent for cats with resistant lymphoma. J Feline Med Surg. 2012; 14: 694-700.

Feds tell states it's all or nothing on Medicaid expansion; Washington Post map shows Ky. is only state 'leaning' toward it

By Al Cross
Kentucky Health News

When the Supreme Court upheld federal health reform but said states could opt out of the expansion of Medicaid to people with incomes above the poverty line, to be funded with generous federal subsidies, one of the first questions was whether a state had to go all the way: to 133 percent of poverty (138 percent with an official fudge factor). Now the Obama administration has answered "no." And that could make the decision tougher for Kentucky, which is the only state The Washington Post listed this month as leaning toward expansion.

The Post's Sarah Kliff wrote, "The administration’s reasoning goes like this: The federal government was giving states a really, really good deal on the Medicaid expansion. It was footing the entire bill for the newly eligible enrollees for three years," 2014 through 2016, rather than the 72 percent it pays Kentucky for current enrollees. The subsidy for the new eligibles would drop to 95 percent in 2017, 94 percent in 2018, 93 percent in 2019; and 90 percent in 2020.

White House aides told Kliff that in passing the bill, Congress (which is to say the Democrats in Congress) "gave states that really high funding in the service of a very specific goal: Ensuring all Americans have access to insurance options." But "If a state decided to cover, say, everyone up to the federal poverty line, they would be working with a smaller, more manageable population," Kliff explains. "Those living above the poverty line, meanwhile, wouldn’t be left in the lurch. The Affordable Care Act allows them to receive very generous subsidies in the private insurance market."

However, Medicaid Administrator Cindy Mann told Kliff that if states could fall short of the 133 percent level, they wouldn’t be within the spirit of the law. Kliff paraphrases Mann: "They wouldn’t offer all their residents a way to purchase affordable coverage, and if they’re not going to do that, the White House says they don’t deserve the extra funding."

Gov. Steve Beshear said again today that Kentucky should expand Medicaid "if we can afford it" because so many people in the state have no health insurance and are in poor health, and improving their health would be good for the state's economy.

Kentucky now makes Medicaid available to people with household incomes below 70 percent of the poverty line, which varies by household size. The Urban Institute has estimated that expanding the program to 133 percent of poverty would cost the state about 5 percent more than it would otherwise spend through 2022. That would be $1.3 billion extra in 2017-22, and some Republicans in the legislature have said the state can't afford it. The state expects to spend $1.5 billion on Medicaid in the 2013-14 fiscal year.

While the Post lists Kentucky as the only state "leaning yes" to expansion, it seems likely to be joined by several others. "States have stayed mum on whether they will participate in the expansion, seeing first if they could get a better deal — the partial expansion," Kliff writes. "The federal government took a while to show its cards; it wanted to see if states would sign up for the full expansion, without giving them a scaled-back option." Only 17 states have said yes, and as many are undecided, the Post reports.

In setting a firm rule, the White House may think states "will decide the 100 percent match is too good to pass up and that the federal money will pull everyone in," Kliff writes. "Or, it could indicate the Obama administration is okay with not all states participating with the Medicaid expansion on day one. Again, this wouldn’t be unprecedented: Only six states initially signed up for Medicaid when it launched in 1965."

States should realize that expanding Medicaid is a long-term investment in the health of their people that will pay off in the long run, Dr. Wayne Myers, who once ran Kentucky's rural-health office and was the first director of the federal Office of Rural Health Policy, writes in the Daily Yonder. He says that if a state doesn't expand Medicaid, many of its people will remain or become uninsured.

"Medicaid is a rural issue because a higher percentage of low-income people live in rural communities, and rural families are less likely to have private health insurance," Myers writes, adding that the program is also "a major economic driver." According to the National Center for Rural Health Works at Oklahoma State University, Medicaid was responsible for 113,000 jobs and a total of $10.5 billion in economic activity in Oklahoma in 2010.

Myers cites studies showing that patients with insurance who are hospitalized after accidents are 40 percent less likely to die than those without insurance, because uninsured patients got less attention from medical staff. Opting out of the expansion "may get a governor a self-inflicted gunshot wound to the foot, some dead hospitals and a bunch of dead citizens who needn't have died," Myers writes.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

When Dr. Jeremy Corbett of Lexington found that "nearly one in five pregnant women enrolled in the Medicaid managed-care program where he works were using narcotics or other harmful drugs," he tackled the problem. As medical director of the Kentucky Spirit Health Plan, "He designed a new program combining high-tech health information with case management to tackle the problem of addicted babies, which is exploding statewide," reports Laura Ungar of The Courier-Journal. (C-J photo by Tim Webb)

Ungar describes how Corbett's program works: "Employees examine patient records for pregnant Kentucky Spirit members. The pharmacy department uses an analytics report, coupled with the Kentucky All Schedule Prescription Electronic Reporting System, or KASPER, to cross-check for drugs that could be dangerous during pregnancy, including narcotics. Department employees also look at the pattern of prescriptions, which could point toward doctor-shopping for pills. . . . Kentucky Spirit sends letters to the prescribing doctor and the obstetrician the woman is seeing, letting them know she is pregnant and has received a prescription for dangerous drugs. Corbett said sometimes the prescribing doctor doesn’t know the woman is pregnant, and the obstetrician doesn’t know she’s taking narcotics. Corbett said they also send letters outlining the dangers of taking certain drugs during pregnancy, and case managers reach out to women at risk of giving birth to addicted babies."

The program started three weeks ago. Corbett said two women have asked to get substance-abuse treatment, for which Kentucky Spirit pays — "even residential treatment, which is not required by Kentucky law — because it saves money in the long run," Ungar reports. "Kentucky has seen its hospitalizations for addicted newborns climb from 29 in 2000 to 730 last year — a 2,400 percent increase that far outpaces the national increase." Corbett told her, “When these babies wind up in the neonatal intensive care unit, it’s a huge loss, emotionally, and it’s also a huge loss of state dollars.” (Read more)

Animals from industrial farms are giving rise to diseases in human beings

Today, a lot of animals are reared all over the world in order to serve the ever increasing human demands of meat and milk. But apart from providing victuals, these animals also serve the human population in another way. Natural News reports that these industrial farm animals are the main origin of increased diseases in humans. Continuous and over-consumption of meats that come fresh from farms may lead to severe diseases in humans. This is why many health conscious people have totally renounced animal flesh from their daily diets.

Animal right activists have been pointing out the deplorable condition of animal farming for quite some time now. Though, previously, it largely went unheard and unheeded, now the issue is gaining some importance. Pew Commission on industrial Farm Animal Production made it clear in its 2008 report that animal farms are the cradle of germs and bacteria that may give rise to severe diseases in the human body. The commission carried out an extensive research work of one and a half years prior to the publication of the report. The uncontrolled use of antibiotics on the animals is giving rise to antibiotic resistant superbugs that can annihilate a large population from the face of earth.

http://www.naturalnews.com/025716_antibiotic_animals_antibiotics.html

Natural News also reports that the Food and Drug Administration, or FDA, has quietly increased the level of radiation allowed in foods. It is needless to mention that radiated foods can usher serious illness in human beings, but the FDA does not seem to be moved by the gravity of the situation. Keeping all these things in mind, it can be said that the slow poisoning of

U.S.

citizens continues unchecked with big pharmaceuticals and food giants earning millions out of the volatile situations.

http://www.naturalnews.com/038255_radiation_meats_FDA.html#ixzz2EfL9WfIE

http://www.naturalnews.com/025716_antibiotic_animals_antibiotics.html

http://www.naturalnews.com/038255_radiation_meats_FDA.html#ixzz2EfL9WfIE

http://www.naturalnews.com/025716_antibiotic_animals_antibiotics.html

U.S.

citizens continues unchecked with big pharmaceuticals and food giants earning millions out of the volatile situations.

http://www.naturalnews.com/038255_radiation_meats_FDA.html#ixzz2EfL9WfIE

http://www.naturalnews.com/025716_antibiotic_animals_antibiotics.html

http://www.naturalnews.com/038255_radiation_meats_FDA.html#ixzz2EfL9WfIE

http://www.naturalnews.com/025716_antibiotic_animals_antibiotics.html

By Al Cross
Kentucky Health News

Many Kentucky parents don't realize that their children are obese or overweight, or at least aren't willing to acknowledge it. That is the obvious conclusion to draw from the latest results of the Kentucky Parent Survey, released Tuesday by the Foundation for a Healthy Kentucky.

The poll found that only 14 percent of Kentucky parents say their child weighs too much, but the National Survey of Children's Health found that 37 percent of Kentucky children are overweight or obese. Conversely, 76 percent of parents in the poll think their child's weight is about right, but the national survey found that only 58 percent of Kentucky kids have healthy weight.

The Kentucky Parent survey, taken by land-line and cell telephone from July 19 to Aug. 22 by the Center for Survey Research at the University of Virginia, interviewed 1,006 Kentucky parents, step-parents, grandparents, foster parents or other legal guardians of children in Kentucky selected at random. The statistical margin of error for that sample size is plus or minus 3 percentage points.

The poll also found that 56 percent of Kentucky children are watching more than the maximum daily recommended amount of “screen time” – watching television, playing video games or using the Internet – and that 59 percent drink sugar-sweetened beverages every day. Both are major factors in childhood obesity, research has found, and experts recommend no more than two hours of screen time a day and no sugar-sweetened drinks at all.

“Parents can help reduce this risk by encouraging healthy behaviors for their children,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky.“Our children’s habits and behaviors impact their health today and shape their quality of life as they grow. When kids eat poorly and don’t get enough physical activity, it increases their risk for obesity, diabetes, heart disease and other chronic diseases. This poll data helps us understand what parents think about the behaviors that are so critical to health.”

The Kentucky Parent Survey also found that only 56 percent of Kentucky parents said their child got "enough" fruits and vegetables every day during the preceding week, and 66 percent of parents reported their child got "enough" physical activity every day during the preceding week. It also found that elementary and high-school students often get less than the recommended amount of sleep per day (chart).

The survey did not define "enough." The foundation noted that one strategy to reduce childhood obesity in Kentucky is "5-2-1-0," reflecting experts' recommendations that each day, children should eat at least five servings of fruits and vegetables, have no more than two hours of screen time, engage in one hour of physical activity, and drink zero sugar-sweetened beverages. For the foundation's press release, click here.

Oregon may show the way for Kentucky in drug treatment

In facing up to its need for more drug-treatment facilities, Kentucky could learn some lessons from Oregon, Courier-Journal reporter Laura Ungar writes in the third and last part of her package of stories about drug treatment, or lack of it, in our state: "Oregon, like Kentucky, is a largely rural state with about 4 million people — and a substantial prescription-drug abuse problem. But Oregon has acted more quickly and aggressively to tackle treatment." She cites examples:

• Oregon is spending about $51 million annually on substance abuse treatment, $11 million more than six years ago. "Kentucky’s Department of Behavioral Health, Developmental and Intellectual Disabilities spends $29 million a year , and hasn’t increased that amount in more than a decade."

• Medicaid, the federally subsidized health-insurance program for the poor and disabled, covers substance abuse treatment in Oregon, "while Kentucky, with a few exceptions, does not."
• Oregon admits more than twice as many addicts for treatment, and "Oregonians are much more likely to receive intensive treatment: "10 percent of treatment admissions were to long-term, residential facilities, compared with 1.1 percent in Kentucky."
• Kentucky had a much higher rate of deaths from drug overdoses in 2008, the most recent year available — 17.9 per 100,000 compared with 11.7. "Health experts say effective treatment leads to fewer overdoses." (Read more)

Creation of ATP (adenosine triphospate), the energy molecules of your body	Proper formation of bones and teeth	Relaxation of blood vessels
Action of your heart muscle	Promotion of proper bowel function	Regulation of blood sugar levels

Fibromyalgia	Atrial fibrillation	Type 2 diabetes	Premenstrual syndrome
Cardiovascular disease	Migraine	Aging	Mortality

Numbness and tingling	Muscle contractions and cramps	Seizures
Personality changes	Abnormal heart rhythms	Coronary spasms

An unhealthy digestive system, which impairs your body's ability to absorb magnesium (Crohn's disease, leaky gut, etc.)	Alcoholism -- up to 60 percent of alcoholics have low blood levels of magnesium⁴
Unhealthy kidneys, which contribute to excessive loss of magnesium in urine	Age -- older adults are more likely to be magnesium deficient because absorption decreases with age and the elderly are more likely to take medications that can interfere with absorption
Diabetes, especially if it's poorly controlled, leading increased magnesium loss in urine	Certain medications -- diuretics, antibiotics and medications used to treat cancer can all result in magnesium deficiency

Seaweed, agar, dried (770 mg)	Spices, basil, dried (422 mg)
Spice, coriander leaf, dried (694 mg)	Flaxseed (392 mg)
Dried pumpkin seeds (535 mg)	Almond butter (303 mg)
Cocoa, dry powder, unsweetened (499 mg)	Whey, sweet, dried (176 mg)

Magnesium glycinate is a chelated form of magnesium that tends to provide the highest levels of absorption and bioavailability and is typically considered ideal for those who are trying to correct a deficiency	Magnesium oxide is a non-chelated type of magnesium, bound to an organic acid or a fatty acid. Contains 60 percent magnesium, and has stool softening properties
Magnesium chloride / Magnesium lactate contain only 12 percent magnesium, but has better absorption than others, such as magnesium oxide, which contains five times more magnesium	Magnesium sulfate / Magnesium hydroxide (milk of magnesia) are typically used as a laxative. Be aware that it's easy to overdose on these, so ONLY take as directed
Magnesium carbonate, which has antacid properties, contains 45 percent magnesium	Magnesium taurate contains a combination of magnesium and taurine, an amino acid. Together, they tend to provide a calming effect on your body and mind
Magnesium citrate is magnesium with citric acid, which has laxative properties	Magnesium threonate is a newer, emerging type of magnesium supplement that appears promising, primarily due to its superior ability to penetrate the mitochondrial membrane, and may be the best magnesium supplement on the market

Pages

Monday, December 31, 2012

Thursday, December 27, 2012

Seven Signs You May Be Overdoing it

The Higher the Intensity, the Greater Your Need for Recovery

Over or Underestimating Yourself Could Nullify Your Efforts

Strive for Balance

Less Really is More, When it Comes to High-Intensity Exercise

About Dr Kevin Lau

Seven Signs You May Be Overdoing it

The Higher the Intensity, the Greater Your Need for Recovery

Over or Underestimating Yourself Could Nullify Your Efforts

Strive for Balance

Less Really is More, When it Comes to High-Intensity Exercise

About Dr Kevin Lau

Sunday, December 23, 2012

About Dr Kevin Lau

About Dr Kevin Lau

Friday, December 21, 2012

Thursday, December 20, 2012

The Health Benefits of Magnesium have Been Vastly Underestimated

Signs You May Not be Getting Enough Magnesium

One of the Best Ways to Optimize Your Magnesium Levels

Foods with the Highest Amounts of Magnesium

Different Types of Magnesium Supplements

Balance Your Magnesium with Calcium, Vitamin K2 and D

About Dr Kevin Lau

The Health Benefits of Magnesium have Been Vastly Underestimated

Signs You May Not be Getting Enough Magnesium

One of the Best Ways to Optimize Your Magnesium Levels

Foods with the Highest Amounts of Magnesium

Different Types of Magnesium Supplements

Balance Your Magnesium with Calcium, Vitamin K2 and D

About Dr Kevin Lau

Wednesday, December 19, 2012

Tuesday, December 18, 2012