Cardiologist: Kentucky needs better way to get heart attack patients to dedicated catheterization centers in time

Because cardiovascular disease kills more Kentuckians than anything else, and because what mostly kills them is a heart attack, and because if you can get help within 90 minutes of that heart attack your chances improve dramatically, this state needs a vastly improved way to get heart attack patients to the right hospital in a short amount of time. So explains Dr. William Dillon, an interventional cardiologist in Louisville, who writes an guest column in the In The Prime health blog of The Courier-Journal. He punctuates his point with a graph, right, that shows that Kentucky now ranks 49th of 50 states in acute myocardial infarction (AMI) deaths. AMI is doctor-speak for heart attacks. (American Heart Association graph)

Dillon's medically reasoned plea is for a more systematic regional network -- like one that have saved lives in North Carolina -- is "to transfer AMI patients to dedicated (heart catheterization lab) centers throughout the state." But Dillon also knows that many Kentuckians are not listening to their bodies as closely as they might. He writes that "another source of delay in AMI treatment is that, on average, patients wait more than 90 minutes before seeking medical attention. Furthermore, 50 percent of AMI patients drive to a hospital or clinic without calling EMS. Every year, a significant number of these patients needlessly die en route to the hospital." He adds then that health education -- in this case, early notification of needing EMS help -- is an important component in saving Kentuckians' lives. (Read more)

Because cardiovascular disease kills more Kentuckians than anything else, and because what mostly kills them is a heart attack, and because if you can get help within 90 minutes of that heart attack your chances improve dramatically, this state needs a vastly improved way to get heart attack patients to the right hospital in a short amount of time. So explains Dr. William Dillon, an interventional cardiologist in Louisville, who writes an guest column in the In The Prime health blog of The Courier-Journal. He punctuates his point with a graph, right, that shows that Kentucky now ranks 49th of 50 states in acute myocardial infarction (AMI) deaths. AMI is doctor-speak for heart attacks. (American Heart Association graph)

Dillon's medically reasoned plea is for a more systematic regional network -- like one that have saved lives in North Carolina -- is "to transfer AMI patients to dedicated (heart catheterization lab) centers throughout the state." But Dillon also knows that many Kentuckians are not listening to their bodies as closely as they might. He writes that "another source of delay in AMI treatment is that, on average, patients wait more than 90 minutes before seeking medical attention. Furthermore, 50 percent of AMI patients drive to a hospital or clinic without calling EMS. Every year, a significant number of these patients needlessly die en route to the hospital." He adds then that health education -- in this case, early notification of needing EMS help -- is an important component in saving Kentuckians' lives. (Read more)

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Franklin County health department lays off 5; blames Medicaid managed health claim denials for budget shortfalls

The Franklin County Health Department has laid off five employees effective today, four of those are part-time workers. The layoffs are being made in the midst of a $1.7 million drop in revenue from last year. The staff reductions should save the agency $120,000 annually, health department director Paula Alexander told The State Journal. The news comes only two weeks after the Madison County Health Department announced it has been forced to lay off seven workers because of budget shortfalls. Those cuts affected home-health workers in Madison, Estill and Powell counties.

In both instances, department directors have explained that they had expected to receive reimbursements from Kentucky's three Medicaid managed care organizations. A massive increase in those denied claims were reasons both directors gave for their sudden inability to meet budget goals. Earlier in the year, the Fayette County Health Department lost 25 employees. Faced with similar Medicaid payment issues, several Kentucky counties have tried to cut costs by cutting to a four-day workweek.

The Franklin County Health Department has laid off five employees effective today, four of those are part-time workers. The layoffs are being made in the midst of a $1.7 million drop in revenue from last year. The staff reductions should save the agency $120,000 annually, health department director Paula Alexander told The State Journal. The news comes only two weeks after the Madison County Health Department announced it has been forced to lay off seven workers because of budget shortfalls. Those cuts affected home-health workers in Madison, Estill and Powell counties.

In both instances, department directors have explained that they had expected to receive reimbursements from Kentucky's three Medicaid managed care organizations. A massive increase in those denied claims were reasons both directors gave for their sudden inability to meet budget goals. Earlier in the year, the Fayette County Health Department lost 25 employees. Faced with similar Medicaid payment issues, several Kentucky counties have tried to cut costs by cutting to a four-day workweek.

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Study: Smoke-free workplace leads to fewer heart attacks

Mayo Clinic researchers have found a 33 percent drop in heart attack rates in a Minnesota county after public smoking bans were enacted. This, while rates of hypertension, diabetes, high cholesterol and obesity remained the same or even increased after the ban was put in place, reports The New York Times. The conclusion: “I think the bottom line is this should turn the page on the chapter discussing whether or not secondhand smoke is a risk factor for heart attacks,” said Dr. Richard D. Hurt, an author of the study and a professor of medicine at the Mayo Clinic in Rochester, Minn.

The study, published in Archives of Internal Medicine, was conducted in Minnesota's Olmstead County where medical records were examined 18 months before the county's 2002 public ban went into effect and 18 months after it extended the ban to all workplaces in 2007. (Read more)

Mayo Clinic researchers have found a 33 percent drop in heart attack rates in a Minnesota county after public smoking bans were enacted. This, while rates of hypertension, diabetes, high cholesterol and obesity remained the same or even increased after the ban was put in place, reports The New York Times. The conclusion: “I think the bottom line is this should turn the page on the chapter discussing whether or not secondhand smoke is a risk factor for heart attacks,” said Dr. Richard D. Hurt, an author of the study and a professor of medicine at the Mayo Clinic in Rochester, Minn.

The study, published in Archives of Internal Medicine, was conducted in Minnesota's Olmstead County where medical records were examined 18 months before the county's 2002 public ban went into effect and 18 months after it extended the ban to all workplaces in 2007. (Read more)

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Passport Health claims state violated bidding process and will make Medicaid overpayments in Jefferson County as a result

Passport Health Plan has charged that the state of Kentucky has violated its own bidding process and will spend as much as $80 million more than necessary per year under its new Medicaid managed-care contracts for the Jefferson County region. Tom Loftus of The Courier-Journal reports that the formal letter of protest of the bidding process was filed Thursday. It is the company's response to the recent division of the services of Jefferson County's 170,000 Medicaid recipients to four Medicaid managed-care companies that were once served only by Passport. Loftus writes that Passport is questioning how the region's recipients have been reapportioned. The company says it anticipated a 41 percent share of the region's Medicaid business, but was notified Wednesday that it initially will be assigned only 27 percent. The Cabinet for Health and Family Services released a statement explained that all bidders were aware of the conditions of the contract during negotiations. (Read more)

Passport Health Plan has charged that the state of Kentucky has violated its own bidding process and will spend as much as $80 million more than necessary per year under its new Medicaid managed-care contracts for the Jefferson County region. Tom Loftus of The Courier-Journal reports that the formal letter of protest of the bidding process was filed Thursday. It is the company's response to the recent division of the services of Jefferson County's 170,000 Medicaid recipients to four Medicaid managed-care companies that were once served only by Passport. Loftus writes that Passport is questioning how the region's recipients have been reapportioned. The company says it anticipated a 41 percent share of the region's Medicaid business, but was notified Wednesday that it initially will be assigned only 27 percent. The Cabinet for Health and Family Services released a statement explained that all bidders were aware of the conditions of the contract during negotiations. (Read more)

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Baptist Health buys Trover Health in Western Kentucky, making Baptist Kentucky's largest health-care provider by licensed beds

Following the nationwide trend of large hospitals taking over smaller ones in light of health care reform demands in a slow economy, Louisville-based Baptist Health added an eighth hospital to its statewide network this week by acquiring Trover Health System in Western Kentucky. Andy Sears, vice president of planning and system development for Baptist Health,  told Laura Ungar of The Courier-Journal that Trover contributed its total assets to Baptist Health, which took over its liabilities, making the deal worth about $120 million.

Ungar reports the Trover acquisition is especially understandable in the context of the times. "Experts," writes Ungar, "say one big reason for the surge is that larger, wealthier organizations can buy what they need at higher volumes for cheaper prices. Bigger health care organizations also have greater might when negotiating reimbursement rates with insurers." Sears agreed, saying standalone hospitals "don't have the resources to compete."

The deal makes Baptist Health that state's largest health care provider by total licensed bed capacity and by geographical coverage. Trover is located in Madisonville. It will now be called Baptist Health Madisonville. (Read more) 

Following the nationwide trend of large hospitals taking over smaller ones in light of health care reform demands in a slow economy, Louisville-based Baptist Health added an eighth hospital to its statewide network this week by acquiring Trover Health System in Western Kentucky. Andy Sears, vice president of planning and system development for Baptist Health,  told Laura Ungar of The Courier-Journal that Trover contributed its total assets to Baptist Health, which took over its liabilities, making the deal worth about $120 million.

Ungar reports the Trover acquisition is especially understandable in the context of the times. "Experts," writes Ungar, "say one big reason for the surge is that larger, wealthier organizations can buy what they need at higher volumes for cheaper prices. Bigger health care organizations also have greater might when negotiating reimbursement rates with insurers." Sears agreed, saying standalone hospitals "don't have the resources to compete."

The deal makes Baptist Health that state's largest health care provider by total licensed bed capacity and by geographical coverage. Trover is located in Madisonville. It will now be called Baptist Health Madisonville. (Read more) 

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Aspartame (NutraSweet) Linked To Leukemia and Lymphomas!

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Aspartame Linked To Leukemia And Lymphoma In New Landmark Human Study

As few as one diet soda daily may increase the risk for leukemia in men and women, and for multiple myeloma and non-Hodgkin lymphoma in men, according to new results from the longest-ever running study on aspartame as a carcinogen in humans. Importantly, this is the most comprehensive, long-term study ever completed on this topic, so it holds more weight than other past studies, which appeared to show no risk. And disturbingly, it may also open the door for further similar findings on other cancers in future studies.

22 Years And Over Two Million Person-Years

A total of 2,278,396 person-years of data derived from 77,218 women and 47,810 men over a 22-year is the most thorough and awesomely sheer amount of data to ever been utilized in a study of aspartame (NutraSweet).  Apart from sheer size, what makes this study superior to other past studies is the thoroughness with which aspartame intake was assessed. Every two years, participants were given a detailed dietary questionnaire, and their diets were reassessed every four years. Previous studies which found no link to cancer only ever assessed participants' aspartame intake at one point in time, which could be a major weakness affecting their accuracy.

One Single Diet Soda A Day Increases Leukemia • Multiple Myeloma • Non-Hodgkin Lymphomas

The combined results of this new study showed that just one 12-fl oz. can (355 ml) of diet soda daily leads to: 

• 42% higher leukemia risk in men and women (pooled analysis) 
• 102% higher multiple myeloma risk. 
• 31% higher non-Hodgkin lymphoma risk

These results were based on multi-variable relative risk models, all in comparison to participants who drank no diet soda. It is unknown why only men drinking higher amounts of diet soda showed increased risk for multiple myeloma and non-Hodgkin lymphoma. Note that diet soda is the largest dietary source of aspartame (by far) in the U.S. Every year, Americans consume about 5,250 tons of aspartame in total, of which about 86 percent (4,500 tons) is found in diet sodas.

Confirms Previous Research On Animals

This new study shows the importance of the quality of research. Most of the past studies showing no link between aspartame and cancer have been criticized for being too short in duration and too inaccurate in assessing long-term aspartame intake. This new study solves both of those issues. The fact that it also shows a positive link to cancer should come as no surprise, because a previous best-in-class research study done on animals (900 rats over their entire natural lifetimes) showed strikingly similar results back in 2006: aspartame significantly increased the risk for lymphomas and leukemia in both males and females. More worrying is the follow on mega-study, which started aspartame exposure of the rats at the fetal stage. Increased lymphoma and leukemia risks were confirmed, and this time the female rats also showed significantly increased breast (mammary) cancer rates. This raises a critical question: will future; high-quality studies uncover links to the other cancers in which aspartame has been implicated (brain, breast, prostate, etc.)?

There is now more reason than ever to completely avoid aspartame in our daily diet. The devastation it inflicts on our immune systems should make it a no-brainer! For those who are tempted to go back to sugary sodas as a "healthy" alternative, this study had a surprise finding: men consuming one or more sugar-sweetened sodas daily saw a 66 percent increase in non-Hodgkin lymphoma (even worse than for diet soda).

 The take away from this study....Sodas Kill People!

Sources for this article include:
http://www.naturalnews.com/037772_aspartame_leukemia_lymphoma.html
http://www.ncbi.nlm.nih.gov/pubmed/23097267
http://www.ncbi.nlm.nih.gov/pubmed/16507461
http://www.ncbi.nlm.nih.gov/pubmed/17805418

-->

Aspartame Linked To Leukemia And Lymphoma In New Landmark Human Study

As few as one diet soda daily may increase the risk for leukemia in men and women, and for multiple myeloma and non-Hodgkin lymphoma in men, according to new results from the longest-ever running study on aspartame as a carcinogen in humans. Importantly, this is the most comprehensive, long-term study ever completed on this topic, so it holds more weight than other past studies, which appeared to show no risk. And disturbingly, it may also open the door for further similar findings on other cancers in future studies.

22 Years And Over Two Million Person-Years

A total of 2,278,396 person-years of data derived from 77,218 women and 47,810 men over a 22-year is the most thorough and awesomely sheer amount of data to ever been utilized in a study of aspartame (NutraSweet).  Apart from sheer size, what makes this study superior to other past studies is the thoroughness with which aspartame intake was assessed. Every two years, participants were given a detailed dietary questionnaire, and their diets were reassessed every four years. Previous studies which found no link to cancer only ever assessed participants' aspartame intake at one point in time, which could be a major weakness affecting their accuracy.

One Single Diet Soda A Day Increases Leukemia • Multiple Myeloma • Non-Hodgkin Lymphomas

The combined results of this new study showed that just one 12-fl oz. can (355 ml) of diet soda daily leads to: 

• 42% higher leukemia risk in men and women (pooled analysis) 
• 102% higher multiple myeloma risk. 
• 31% higher non-Hodgkin lymphoma risk

These results were based on multi-variable relative risk models, all in comparison to participants who drank no diet soda. It is unknown why only men drinking higher amounts of diet soda showed increased risk for multiple myeloma and non-Hodgkin lymphoma. Note that diet soda is the largest dietary source of aspartame (by far) in the U.S. Every year, Americans consume about 5,250 tons of aspartame in total, of which about 86 percent (4,500 tons) is found in diet sodas.

Confirms Previous Research On Animals

This new study shows the importance of the quality of research. Most of the past studies showing no link between aspartame and cancer have been criticized for being too short in duration and too inaccurate in assessing long-term aspartame intake. This new study solves both of those issues. The fact that it also shows a positive link to cancer should come as no surprise, because a previous best-in-class research study done on animals (900 rats over their entire natural lifetimes) showed strikingly similar results back in 2006: aspartame significantly increased the risk for lymphomas and leukemia in both males and females. More worrying is the follow on mega-study, which started aspartame exposure of the rats at the fetal stage. Increased lymphoma and leukemia risks were confirmed, and this time the female rats also showed significantly increased breast (mammary) cancer rates. This raises a critical question: will future; high-quality studies uncover links to the other cancers in which aspartame has been implicated (brain, breast, prostate, etc.)?

There is now more reason than ever to completely avoid aspartame in our daily diet. The devastation it inflicts on our immune systems should make it a no-brainer! For those who are tempted to go back to sugary sodas as a "healthy" alternative, this study had a surprise finding: men consuming one or more sugar-sweetened sodas daily saw a 66 percent increase in non-Hodgkin lymphoma (even worse than for diet soda).

 The take away from this study....Sodas Kill People!

Sources for this article include:
http://www.naturalnews.com/037772_aspartame_leukemia_lymphoma.html
http://www.ncbi.nlm.nih.gov/pubmed/23097267
http://www.ncbi.nlm.nih.gov/pubmed/16507461
http://www.ncbi.nlm.nih.gov/pubmed/17805418

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Treatment of feline sporotrichosis

Chaves AR, de Campos MP, Barros MB, et al. Treatment abandonment in feline sporotrichosis - study of 147 cases. Zoonoses Public Health. Aug 17, 2012.

Sporotrichosis is a environmental or zoonotic disease caused by the fungus Sporothrix schenckii and is commonly found in soil, wood, and decaying vegetation. The fungus is a dimorphic forming yeast in tissues or culture at 37^oC, but growing as a filamentous mould in the environment at room temperature. Most cases of sporotrichosis are acquired from the environment as a result of contact between broken skin and fungal spores and are most common in persons that work with vegetation such as forestry workers, horticulturists, gardeners and florists. As a consequence, the disease is commonly referred to as “Rose Gardener’s Disease”. Cats can similarly acquire infection from the environment via wound contamination or penetrating foreign bodies. 

The most common form of the disease in cats and humans is a lymphocutaneous form that first appears at the site of inoculation leading to formation of papules. The papules develop into pustules that slowly expand along the draining lymph system, forming swollen cutaneous nodules that may become necrotic, ulcerate, and produce a gray or yellowish pustular exudate. Subclinical infections are possible. Disseminated and pulmonary sporotrichosis are serious, life-threatening diseases, but are much less common.

Sporotrichosis is also an important zoonotic disease and transmission from infected cats to humans is possible due to the high number of infectious organisms found in open draining wounds. Cats can also harbor the fungus in the mouth, nasal cavity, and nail beds facilitating transmission via bites or scratches.

This study describes the epidemiological, clinical, and mycological aspects of feline sporotrichosis in 147 infected cats identified between 1998 and 2005 in Rio de Janeiro, Brazil. A large number of cases of infection in cats, dogs and humans have occurred in this area, representing the first zoonotic epidemic of this mycosis. Treatment of infected cats typically is carried out by oral administration of anti-fungal agents such as itraconazole or ketoconazole. Factors in treatment abandonment included low income of owners, the difficulty in transporting the cats to clinics for follow-up, and the difficulty in administrating oral medications to cats. The most common reason for treatment abandonment was the misperception by owners of lesion healing, often leading to recurrence of the disease. Treatment abandonment may represent an obstacle in control of this disease and possibly contributes to the Rio de Janeiro epidemic. Efforts on adherence to the protocol in the beginning of treatment, but especially after the skin lesions have improved, seems to be an important measure for better compliance and increased cure rates. [GO]

See also: Reis ÉG, Gremião IDF, Kitada AAB, et al. Potassium iodide capsule treatment of feline sporotrichosis. J Feline Med Surg. 2012; 14: 399-404.

More on cat health:
Winn Feline Foundation Library
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Chaves AR, de Campos MP, Barros MB, et al. Treatment abandonment in feline sporotrichosis - study of 147 cases. Zoonoses Public Health. Aug 17, 2012.

Sporotrichosis is a environmental or zoonotic disease caused by the fungus Sporothrix schenckii and is commonly found in soil, wood, and decaying vegetation. The fungus is a dimorphic forming yeast in tissues or culture at 37^oC, but growing as a filamentous mould in the environment at room temperature. Most cases of sporotrichosis are acquired from the environment as a result of contact between broken skin and fungal spores and are most common in persons that work with vegetation such as forestry workers, horticulturists, gardeners and florists. As a consequence, the disease is commonly referred to as “Rose Gardener’s Disease”. Cats can similarly acquire infection from the environment via wound contamination or penetrating foreign bodies. 

The most common form of the disease in cats and humans is a lymphocutaneous form that first appears at the site of inoculation leading to formation of papules. The papules develop into pustules that slowly expand along the draining lymph system, forming swollen cutaneous nodules that may become necrotic, ulcerate, and produce a gray or yellowish pustular exudate. Subclinical infections are possible. Disseminated and pulmonary sporotrichosis are serious, life-threatening diseases, but are much less common.

Sporotrichosis is also an important zoonotic disease and transmission from infected cats to humans is possible due to the high number of infectious organisms found in open draining wounds. Cats can also harbor the fungus in the mouth, nasal cavity, and nail beds facilitating transmission via bites or scratches.

This study describes the epidemiological, clinical, and mycological aspects of feline sporotrichosis in 147 infected cats identified between 1998 and 2005 in Rio de Janeiro, Brazil. A large number of cases of infection in cats, dogs and humans have occurred in this area, representing the first zoonotic epidemic of this mycosis. Treatment of infected cats typically is carried out by oral administration of anti-fungal agents such as itraconazole or ketoconazole. Factors in treatment abandonment included low income of owners, the difficulty in transporting the cats to clinics for follow-up, and the difficulty in administrating oral medications to cats. The most common reason for treatment abandonment was the misperception by owners of lesion healing, often leading to recurrence of the disease. Treatment abandonment may represent an obstacle in control of this disease and possibly contributes to the Rio de Janeiro epidemic. Efforts on adherence to the protocol in the beginning of treatment, but especially after the skin lesions have improved, seems to be an important measure for better compliance and increased cure rates. [GO]

See also: Reis ÉG, Gremião IDF, Kitada AAB, et al. Potassium iodide capsule treatment of feline sporotrichosis. J Feline Med Surg. 2012; 14: 399-404.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

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