Awake Sedation for Brain Surgery May Shorten Hospital Stay

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Tue Jan 13, 2015 12:34 pm

Saying no to cancer treatment

Over the past 17 years, I have lived a good life. It has always just been me and my mom and all of our pets. My mom raised me well, to be a strong, competent and independent woman. She taught me right from wrong and always led me in the right direction, standing by my side through every decision I made. I wouldn't have my strength, determination and motivation if it weren't for my mom. She played the role of a mom and a dad, and she did a damn good job!

Words cannot describe what my life has become over the last few months. "Horrifying" seems like an understatement. What I have been going through is traumatizing. Never did it cross my mind that one day I would be diagnosed with cancer. In September, after a stressful summer of blood work, examinations and biopsies, I was diagnosed with Hodgkin's lymphoma.

My mom and I wanted to make sure my diagnosis was correct, so we agreed to seek a second opinion. We wanted to be 100 percent sure I had cancer. Apparently, going for the second opinion and questioning doctors was considered "wasting time" and "not necessary." My mom was reported to the Connecticut Department of Children and Families for medical neglect because we weren't meeting the doctors' time standard.

In no way is my mom neglectful. She has always put me before herself. I am offended by anyone who believes otherwise. My mom has been identified as "hostile," "neglectful" and "unsupportive," three untrue words that break my heart.

In October, DCF and nearly the entire Windsor Locks Police Department arrived when I was home alone and surrounded my house, banging on doors and windows. I hid in my closet, crying on the phone with Mom and my friends, until Mom came home. I sat in my closet for at least an hour while Mom, DCF and the police argued downstairs. I was scared.

I had to leave with DCF. They had me medically evaluated and placed in a foster home until a court date. I was devastated. I needed to be with my mom.

Taking me away from my mom in no way is in my best interest. There are children who need DCF, but I am not one of them.

In November, I was allowed to return home to my mom with the promise to start chemotherapy immediately. Although I didn't have any intention of proceeding with the chemotherapy once I returned home, I endured two days of it. Two days was enough; mentally and emotionally, I could not go through with chemotherapy. I felt backed up against the wall. I had no right to choose what I wanted. I was told I had a voice and was being heard, but it didn't feel like it. I took things into my own hands — I was fed up with DCF — and ran away. I was willing to leave everything I loved — my mom, my friends, my job, my cat, Simba, and, most important, my life that I absolutely loved — to get away from being forced into something that I didn't want.

I packed all my stuff after Mom fell asleep, left my house and met up with people who were willing to take me in and help me. I had no intention of returning to or staying in Connecticut. The people I stayed with were loving and understanding and took such good care of me.

I began to see myself on the news and people from all over were trying to contact me. Some people thought I was dead, and I heard my mom was going to be put in jail, because it was assumed she knew where I was or that she was hiding me somewhere. She didn't — I never even told her that I was leaving — and I couldn't, because I knew she would try to stop me. After about a week, I returned home, because I didn't want people to think I was dead, and I would never forgive myself if my mom went to jail for something I did.

DCF immediately brought me to the hospital to be evaluated. I was OK, and they let me go home. I thought it was over. I was wrong.

In December, a decision was made to hospitalize me. I didn't know what was going to happen, but I did know I wasn't going down without a fight.

I was admitted to the same room I'm in now, with someone sitting by my door 24/7. I could walk down the hallway as long as security was with me, but otherwise I couldn't leave my room. I felt trapped.

After a week, they decided to force chemotherapy on me. I should have had the right to say no, but I didn't have that right. I was strapped to a bed by my wrists and ankles and sedated. I woke up in the recovery room with a port surgically placed in my chest. I was outraged and felt completely violated. My phone was taken away, the hospital phone was removed from my room and even the scissors I used for art were taken.

I have been locked in this hospital for a month, missing time from work, not being able to pay my bills. I couldn't celebrate Christmas and New Year's with my friends and family. I miss my cat and I miss fresh air. Having visitors is complicated, seeing my mom is limited, and I've not been able to see all of the people I'd like to. My friends are a major support; I need them. Finally, I was given an iPad. I can message my friends on Facebook, but it is nowhere near like calling a friend at night when I can't sleep or hearing someone's voice to cheer me up.

This experience has been a continuous nightmare. I want the right to make my medical decisions. It's disgusting that I'm fighting for a right that I and anyone in my situation should already have. This is my life and my body, not DCF's and not the state's. I am a human — I should be able to decide if I do or don't want chemotherapy. Whether I live 17 years or 100 years should not be anyone's choice but mine.

How long is a person actually supposed to live, and why? Who determines that? I care about the quality of my life, not just the quantity. ... story.html

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Thu Jan 15, 2015 1:27 pm

Health Minister Sussan Ley backs away from plan to cut Medicare rebate

The government has capitulated and scrapped its plans to next week cut the Medicare rebate by $20 for short visits to the doctor after a fierce backlash by doctors and non-government Senators, who vowed to veto the measure.

In her first act as the new Health Minister, Sussan Ley broke her holidays to announce on Thursday that the cuts - quietly introduced by her predecessor Peter Dutton late last year - are now "off the table".

Ms Ley said she was still committed to introducing price signals into Medicare including the revised $5 GP co-payment due to start July 1 but pledged to "pause, listen and consult".

"This is very much my stamp, I believe, on the portfolio – that of consulting, engaging and listening," she told reporters in Melbourne.

"I've heard, I've listening and I'm deciding to take this action now," she said.

Ms Ley said she planned to work together with the Senate and sector to make the health sector more sustainable and said she would welcome crossbencher's ideas.

The backdown comes just 24 hours after Prime Minister Tony Abbott had strongly defended the measure as an "economic reform" that would lead to better patient care by busting the so-called practice of "six minute medicine" where short appointments are scheduled to maximise the number of taxpayer subsidies received.

Australian Medical Association President Brian Owler said the government's announcement was a "welcome surprise".

"I think common sense has prevailed and the minister and PM have ended the uncertainty about these changes and now are going toembark on the process of consultation that the AMA has requested all along they do," he said.

In recent days supporters and critics of the Prime Minister had urged Mr Abbott to delay next Monday's cuts to the Medicare rebate for short visits to the doctor after the Senate vowed to veto the measure.

Professor Owler released a copy of a scathing letter he wrote to Mr Abbott last week in which he asked the government to "urgently make a new regulation" to repeal the cuts, which are due to come into effect on January 19 and sought an "early meeting" with the Prime Minister.

"Your government has imposed this significantly detrimental measure on general practice without consultation, with only five weeks' notice and during a period when they are operating with minimum staff," Mr Owler wrote on January 8.

"You have left it to general practitioners to explain your "savings" measure to the Australian people.

"This is hardly congruent with a government that is 'totally committed to rebuilding general practice' and that is 'cutting red tape'," he said.

Professor Owler said the "level of anger and disbelief" among doctors at what Labor is calling a "sneaky backdoor" attack on Medicare is "unprecedented".

Mr Abbott has called on the opposition and the crossbenchers to come up with alternative savings measures to pay off the debt and deficit instead of obstructing the government's attempts to repair the budget.

Federal Labor has sought to place the issue at the heart of the Queensland state election campaign with Opposition Leader Bill Shorten and his Health Spokeswoman Catherine King campaigning on the issue in Brisbane on Thursday.

Mr Shorten, the Greens, Palmer United and crossbenchers Jacqui Lambie, Ricky Muir and Nick Xenophon all vowed to block the measure in the Senate, leaving a potential $1.3 billion shortfall in the budget bottom line.

"The reaction in the community is widespread and unanimous," Mr Shorten told reporters in Annerley.

"GPs, nurses and clinicians, parents and patients all of one voice are saying to the Abbott government, do not add extra charges and taxes to go and see the doctor," he said.

Queensland Premier Campbell Newman said he had told his federal counterparts he did not support the cuts to the Medicare rebate because it could drive patients to state-funded hospital emergency departments.

"We have expressed concerns about this driving people to emergency departments so we don't support it," Mr Newman said.

Terry Barnes, a former advisor to Mr Abbott when he was the Health Minister, and a key proponent of changes to Medicare rebates, said after the announcement that while he didn't like the "concession to the scare campaign," Ms Ley could "start with a clean sheet".

Mr Barnes had earlier called for delays to the Medicare changes to give the Coalition more time to explain the changes and negotiate with the crossbenchers.

"I don't think the government should capitulate to an AMA-led scare campaign on what is sound policy" he told Fairfax Media.

"They should defer the start to 1 March to allow for a vote to be taken in the Senate and give the government time to explain that the changes won't be the end of civilization as we know it," he said. ... 2qp0n.html

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Sat Jan 17, 2015 1:13 pm

Vitamin D 'aids the immune system to fight colorectal cancer'

Researchers from the Dana-Farber Cancer Institute have shown in a new study that vitamin D can help the body fight against colorectal cancer by boosting the immune system.

The study, published in Gut, contributes to a growing body of research by identifying an association between vitamin D and how the immune system responds to cancer cells among a large human population sample for the first time.

Colorectal cancer is the third most common cancer and fourth leading cause of cancer death worldwide, according to background information in the study. In the US, it is the second leading cause of cancer death. The Centers for Disease Control and Prevention (CDC) report that 51,783 people died from the disease in 2011.

Previous research has indicated that vitamin D could have a preventive effect against colorectal cancer. The vitamin is obtained through exposure to sunlight as well as certain foods and supplements.

The role of vitamin D within the body is to assist the immune system and contribute to calcium absorption and the growth and repair of bones. Some studies have also associated vitamin D with reducing the risk of multiple sclerosis, asthma symptoms and heart attacks.

"People with high levels of vitamin D in their bloodstream have a lower overall risk of developing colorectal cancer," says senior author Dr. Shuji Ogino. "Laboratory research suggests that vitamin D boosts immune system function by activating T cells that recognize and attack cancer cells."

Immune system support and cancer risk
"In this study, we wanted to determine if these two phenomena are related," explains Dr. Ogino. "Does vitamin D's role in the immune system account for the lower rates of colorectal cancer in people with high circulating levels of the vitamin?"

For the study, the researchers assessed data from 170,000 participants of two long-term research projects - the Nurses' Health Study and the Health Professional Follow-up Study.

The team hypothesized that if the two phenomena were related, colorectal tumors developing in participants with high levels of vitamin D would likely be more resistant to the cells of the immune system than those developing in participants with lower levels of the vitamin.

From the data pool, the researchers selected 942 participants - 318 with colorectal cancer and 624 who were cancer free. Each participant had had a blood sample taken in the 1990s, at a time before any of the participants had developed cancer. These samples were then tested for a substance produced in the liver from vitamin D.

Participants with high amounts of the substance - 25-hydroxyvitamin D (25(OH)D) - were found by the researchers to be less likely to develop colorectal tumors permeated with large numbers of immune system cells, suggesting that their hypothesis was correct.

Findings 'vindicate basic laboratory discoveries'
"This is the first study to show evidence of the effect of vitamin D on anti-cancer immune function in actual patients, and vindicates basic laboratory discoveries that vitamin D can interact with the immune system to raise the body's defenses against cancer," states Dr. Ogino.

Unmeasured variables may have impacted on the study's findings, acknowledge the authors. They write that the findings need to be replicated in other research, "given the uniqueness of the current study."

Further evidence for vitamin D's cancer-fighting qualities is provided in additional research from scientists at the Dana-Farber Cancer Institute. A team, led by medical oncologist Dr. Kimmie Ng, observed that patients with metastatic colorectal cancer and high levels of vitamin D prior to treatment survived longer than patients with lower levels of the vitamin in their bloodstream.

"This is the largest study that has been undertaken of metastatic colorectal cancer patients and vitamin D," says Dr. Ng. "It's further supportive of the potential benefits of maintaining sufficient levels of vitamin D in improving patient survival times."

"In the future," concludes Ogino, "we may be able to predict how increasing an individual's vitamin D intake and immune function can reduce his or her risk of colorectal cancer."

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Mon Jan 19, 2015 11:38 am

Former doctor MPs speak out over ‘affront’ to GPs on rebate cut plans

ANGER is swelling within Liberal ranks over the failed push to cut GP rebates, with MPs condemning the move and urging caution on the introduction of a co-­payment amid damaging reports of a cabinet-level split.

Tony Abbott’s office yesterday sought to smooth over reports that the Prime Minister had defied the advice of Joe Hockey and the Health Minister by insisting on the controversial $20 rebate cut, before dumping the proposal last week in an embarrassing backflip.

‘The package of measures announced in December to strengthen Medicare and help make it sustainable, ensuring Australians will continue to have acces­s to affordable, world-class healthcare, was unanimously supported,” said a spokeswoman for Mr Abbott.

Bill Shorten seized on the expenditure review committee leak to say the “dysfunction and division” of last year had continued and warned that the healthcare needs of Australians were being ignored.

“It is not good enough to find out that Treasurer Hockey is fighting with Prime Minister Abbott but the healthcare of Australians is being ignored,” the Opposition Leader said.

“Australians want to see Medicare improved, not attacked.”

South Australian Liberal MP and former general practitioner Andrew Southcott told The Australian yesterday GPs were “affronted” by changes announced in December, including the GP rebate cut and incentive for GPs to charge $5 more for consultations.

He said he had been fielding feedback from contacts in the sector, saying it had been “pretty universally panned”.

“The GPs and primary care sectors were affronted by the way they had been singled out in that change,” he said. “Before the election, we talked a lot about the importance of prim­ary care and our desire to rebuild primary care.

“What’s been confusing a lot of supporters, especially those who support us in the health sector, is how we’ve got bogged down on what really is not a top-order issue. I think the co-payment was sort of asking too much.

“I consult pretty widely in the sector … I’ve never seen a reaction like that and, even for our supporters, they were just a bit baffled.”

He said GPs had been singled out as opposed to specialist colleagues who drew higher incomes.

Queensland MP and former ophthalmologist Andrew Laming was not as critical but agreed that the government had focused too much on changes at a GP level.

He said it was possible to apply a co-payment to higher-fee-charg­ing medical specialists so long as there were protections in place for those who suffered from chronic conditions such as diabetes. “GPs are at liberty to move large numbers of their ill patients on to chronic disease management plans. They haven’t done that so far,” Mr Laming said. “What’s new here is that this protection should extend to specialist visits. Those who are just visiting specialists occasionally should contribute a small co-payment.

“If you don’t have a chronic disease plan, you should be making a small contribution for a specialist visit the same way as you would a general practice visit.”

Australian Medical Association president Brian Owler was sceptical of extending a co-payment to specialists, but was open to consultations with government, saying such a process “could have avoided all of these issues’’. ... 7188945276

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Wed Jan 21, 2015 8:48 am

Cancer surge strains hospitals

Hospitals are being warned to brace for thousands more cancer patients in WA because more people are being diagnosed through screening or living longer with the disease.

Perth researchers say the number of people diagnosed with cancer and still alive has more than doubled in less than two decades.

Breast and prostate cancers in particular are placing a major strain on health services, a trend linked to the ageing population, more cancer screening and people surviving longer with cancer but needing continuing care.

Writing in a health journal, experts from Cancer Council WA and Curtin University warn the new figures "paint a bleak picture of steadily increasing prevalence and cancer burden on hospital services" which easily outpace population growth.

So-called complete prevalence rates - or the cumulative number of people alive who had been diagnosed with cancer - surged 250 per cent between 1992 and 2011, while the population increased only 40 per cent.

The number of hospital bed days occupied by cancer patients increased 80 per cent over that time. Almost half of the cancer increase in men was attributed to prostate cancer, while 44 per cent of the increase in women was fuelled by breast cancer.

Cancer Council WA director of education and research Terry Slevin said though almost 12,000 new cases of cancer were diagnosed in 2012, there were 87,159 people living in WA who had at some time had cancer.

"This data tells us that more people are getting cancer and that suggests more work is needed on prevention," Mr Slevin said.

"It also means more people are surviving longer with cancer and that has implications for the healthcare system.

"The study found that about a third of patients who had their cancer diagnosis more than 10 years ago were still accessing cancer-related hospital services."

He said the study substantially underestimated the number of people with a past cancer diagnosis because it did not include non-melanoma skin cancers.

The rollout of the national bowel cancer screening program would lead to more people being diagnosed and seeking treatment, adding to the burden on hospitals.

"The bottom line is that we need to ensure that our planning for healthcare services takes into account the growing demand by cancer patients and that includes having enough cancer doctors to provide the necessary care," Mr Slevin said. ... hospitals/

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Fri Jan 23, 2015 8:46 am

Is proton therapy the 'magic bullet' for cancer?

(CNN)Even after decades of battling one of the world's biggest killers, the treatment of cancer is still an inexact science.

Successful methods such as chemotherapy work by killing the cancer cells, but they also destroy healthy tissue.

Health practitioners have been searching for a magic bullet that goes straight to the source of the cancer -- and everything from monoclonal antibodies, which carry cancer drugs direct to cancer cells, to straight surgery to cut out tumors have been used with varying degrees of success.

In Belgium, engineer and nuclear physicist Yves Jongen is pioneering a new therapy that targets cancers with proton radiation; a therapy that offers precision and minimal side effects.

"I started to designing equipment (for) proton therapy of cancer -- that was a radically new idea," Jongen told CNN.

Encased in a two-metre thick concrete bunker that serves as a radiation shield, one of Jongen's cyclotron machines produces proton beams to treat cancer patients.

"In this space we accelerate the protons and we give them a higher and higher velocity until they reach two thirds of the speed of light -- that's 200,000 km per second and this acceleration takes place in the shape of a spiral," he said.

It does a lot less collateral damage to the patient - that's the great thing about proton therapy

"That's needed if you want to be able to penetrate one foot into the body of a patient."

Once the proton beam has been generated, it's piped into a treatment room where patients receive a powerful dose of targeted radiation that kills only those cancerous cells.

"It does a lot less collateral damage to the patient," Jongen said. "That's the great thing about proton therapy."

While proton therapy is a giant step forward, it's not yet the magic bullet that clinicians are looking for. So far, it is not effective against all types of cancer.

"There are a number of cancers which are not localized," he said. "If you look at leukemia, which is cancer of the blood cells, there is nowhere to shoot -- it's all through the body."

The other drawback is that the cyclotron is not cheap.

Each system -- and the bunker needed to house it -- doesn't leave much change from $125 million. Currently there are just 43 operational particle therapy facilities worldwide, with a total of 121 treatment rooms.

As the fame of the process has started to spread, some people have been taking desperate measures to get treatment. One British couple last year even sparked an international manhunt after they removed their son from hospital without doctors' permission to get to a proton center in Prague in the Czech Republic.

Proton treatment is not yet available on Britain's National Health Service.

While the proton therapy market is expected to more than double by 2018, with an estimated 300 proton therapy rooms, Jongen's Brussels-based company IBA is working on a smaller and cheaper model they hope will make proton therapy more accessible.

"It would be much less expensive making it more possible for a hospital to afford it -- a smaller system can already treat a relatively large number of patients per year."

At the moment, fewer than 1% of cancer patients are treated with proton therapy, but Jongen is hopeful that smaller and cheaper machines will be the game changer.

"I have a number of letters from parents of young kids saying if it had not been for this treatment we would have lost our kid," he said.

"That's something I really cherish. When I feel a bit depressed, for whatever reason, I go back to those letters and they are very exciting." ... n-therapy/

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Sun Jan 25, 2015 9:07 am

In Silver Case, Odd Link to a Cancer Caused by Asbestos

In the criminal complaint against Sheldon Silver, he is identified simply as “Doctor-1.”

But Dr. Robert N. Taub, who headed a Columbia University center dedicated to curing a rare form of cancer caused by asbestos, is no ordinary doctor.

With a reputation as a devoted clinician intent on trying out innovative therapies, Dr. Taub is something of a hero in the world of mesothelioma, a devastating cancer that is nearly always fatal. Specializing in abdominal cases, a particularly horrific form of the disease, Dr. Taub, 78, attracted last-chance patients from across the country and the world.

The balding, bow-tied oncologist would then seem to be the unlikeliest of candidates to become caught up in a criminal scheme that may lead to the downfall of Mr. Silver, the longtime speaker of the New York State Assembly and one of the state’s most powerful politicians.

Dr. Taub, however, was obsessive about raising money for mesothelioma research, according to current and former colleagues.

That, it turns out, helped set off the extraordinary chain of events that culminated with Mr. Silver surrendering to federal agents on Thursday and the doctor losing his post on Friday. Prosecutors say Dr. Taub referred his patients to a law firm that employed Mr. Silver, enabling him to garner millions. In exchange, Mr. Silver secretly directed state money to the doctor’s center.

Dr. Robert N. Taub, who colleagues said was relentless in his drive to raise funds for research geared toward curing mesothelioma.

Funding is extremely hard to come by in Dr. Taub’s field. Mesothelioma produces tumors that encase organs in a hardened shell. But relatively few people suffer from the disease — it is diagnosed in about 3,000 people a year — and the number is in decline as the dangers of asbestos have become well known.

That makes the disease a low priority for the government and drug companies. As a result, mesothelioma doctors and personal injury lawyers specializing in asbestos-related litigation have developed over the years what some medical ethical experts describe as an unseemly alliance.

For plaintiffs’ lawyers, mesothelioma patients are a bonanza, worth $1.5 million to $2 million on average per case, according to legal experts; individual cases can yield much more. Attorneys’ hunger for these clients is evident to anyone who has watched late-night cable television and seen the garish ads aimed at those afflicted with the disease.

Mesothelioma doctors can offer a direct path to a big payday for law firms, whose courting of such doctors can be relentless, with dinner invitations, tickets to Yankees games and offers of work as expert witnesses. Some doctors, in turn, have set up research centers and asked lawyers to contribute.

A symbiotic relationship has emerged, with lawyers financing research on the disease for doctors who send along streams of potentially lucrative clients.

In 2002, Dr. Taub created one of the nation’s few mesothelioma research hubs, the Columbia University Mesothelioma Center. He was also active in an organization that raised money for research, sitting on the scientific advisory board of one of the few nonprofits created to help victims, the Mesothelioma Applied Research Foundation. The foundation, which awards research grants, relies heavily on gifts from law firms.

Around the same time in 2002, Mr. Silver, a Manhattan Democrat, joined one of the top personal injury law firms in the country, Weitz & Luxenberg, which says it handles about 500 new mesothelioma and other asbestos-related cancer cases a year. The firm’s roots can be traced to the Brooklyn Navy Yard. Perry Weitz, a founder of the firm, obtained $75 million for three dozen workers sickened after toiling in asbestos-lined boiler rooms there. As is typical in such cases, the firm got about one-third of that sum in the form of contingency fees.

The law practice has supported an opulent lifestyle for the firm’s founders. Mr. Weitz, for instance, owns a seven-bedroom, nine-and-a-half-bathroom home on 509 acres just outside Aspen, Colo.

At first, Mr. Silver drew a salary of just $120,000 a year from the firm, which had hired him because of his prestige in Albany, Mr. Weitz said in an interview on Friday. According to the complaint against Mr. Silver, it was Dr. Taub who first pressed the Assembly speaker about his new employer donating money to mesothelioma research.

The request was in line with the urgency with which Dr. Taub viewed his work, colleagues said.

“I wouldn’t necessarily say desperate, that sounds disparaging,” said Dr. Michael Kluger, a surgeon and member of Dr. Taub’s team. “But going to all means to do what he needs to do, to be able to treat the disease.”

Patients to Plaintiffs

Dr. Taub knew from his work with the patient foundation that Weitz & Luxenberg stood out among top asbestos law firms at the time as having provided little financial support for research.

It is unclear when he and Mr. Silver first met; a mutual acquaintance introduced them, the complaint says. Both grew up in Orthodox Jewish households and graduated from Yeshiva University.

Despite Dr. Taub’s overtures, Mr. Silver told him the firm would not be able to donate. Later, however, Mr. Silver asked Dr. Taub to start referring patients to the firm. The doctor complied, eager to curry favor with the powerful Assembly speaker and to attract money for his research, the complaint says.

The first client came from Dr. Taub in November 2003. And as Weitz & Luxenberg collected payouts on the cases, Mr. Silver’s law firm income swelled. By 2005, hundreds of thousands of dollars in client referral fees were coming into Mr. Silver’s bank account from the Weitz firm.

Mr. Silver inappropriately pocketed about $4 million from two different law firms — Weitz & Luxenberg and a real estate law firm, according to prosecutors. Most of the illicit funds, the complaint indicates, came from the Weitz firm, which paid him more than $5 million in all.

Mr. Weitz said that Mr. Silver, who kept an office in the firm’s headquarters, sent just four or five cases a year to the firm, but each one had the potential to be hugely valuable. “Shelly always would bring in an occasional personal injury case,” said Mr. Weitz, whose firm is not accused of wrongdoing. “When you’re a well-known lawyer in the community, people come to you when they have problems.”

The complaint, however, says Mr. Silver steered more than 100 clients to the firm over 11 years, most of them for asbestos litigation. Prosecutors say he never personally met with any of the asbestos clients, merely passing on names and phone numbers.

Soon after Dr. Taub began referring patients, Mr. Silver told him to write a letter and request state funds for his research. The doctor did so.

In 2005, just as Mr. Silver’s referral income from the Weitz firm began to balloon, records show that he directed a state grant worth $250,000 to Dr. Taub for asbestos research, ostensibly related to the Sept. 11, 2001, terrorist attacks. In October 2006, Dr. Taub wrote to Mr. Silver to request another $250,000 grant. A few months later, the money arrived.

Both times, the plans submitted by Dr. Taub’s center said the money would go toward studying the general treatment of mesothelioma, making only passing reference to those who may have been exposed to asbestos after the attacks on the World Trade Center.

At the time, the grants were hidden from public view, drawn from a pool of money that Mr. Silver awarded at his discretion without having to disclose where it went, the complaint said.

That program ended in 2007, and Mr. Silver stopped directing money to Dr. Taub, the complaint says, even as the doctor continued to press Mr. Silver for more.

Dr. Taub kept referring patients to Mr. Silver, according to the court papers. And Mr. Silver continued to offer him favors.

Help Close to Home

In 2008, the complaint says, the speaker directed $25,000 to a nonprofit whose board of directors included a relative of Dr. Taub’s.

Shalom Task Force, a Jewish organization that promotes healthy marriages, where Dr. Taub’s wife, Susan Taub, is on the board, received $25,000 in state funds that year, records show.

In 2010, court papers say, Dr. Taub began to get financial support from a foundation tied to another law firm and to send patients there. Columbia’s website notes a $3.15 million commitment for mesothelioma research from the foundation of the Simmons Law Firm, an asbestos law firm. In a statement, the firm said it was proud to sponsor research at Columbia and elsewhere.

The Weitz firm noticed that client referrals from Mr. Silver had dried up and asked about it. He assured the firm that they would continue. The complaint says he visited Dr. Taub at Columbia, and asked why the referrals had dwindled. Dr. Taub said he had a new source of financing for his research. Still, he continued to send patients Mr. Silver’s way. His goal was to be able to keep asking the Assembly speaker for help, prosecutors allege.

In 2011, Mr. Silver sponsored an Assembly resolution honoring Dr. Taub that called him a “remarkable doctor” and a leader in the medical community “who had made significant contributions to the fight against cancer.”

According to the complaint and people briefed on the investigation, Dr. Taub also asked Mr. Silver in 2012 to help his son, Jonathan, find a job. The speaker arranged for an interview at OHEL Children’s Home and Family Services, a social services organization based in Brooklyn that had received millions of dollars in state funds from Mr. Silver.

Dr. Taub had grown increasingly anxious about his son’s career path, according to acquaintances who spoke on the condition of anonymity because they did not want to be associated with a criminal case. Jonathan Taub — who, according to public records, lists his parents’ Upper East Side address as his residence — had long seemed far more interested in playing bass guitar and blogging his right-leaning political views than in finding a permanent job, these acquaintances say. Mr. Taub is now employed by OHEL as an operations assistant, according to his LinkedIn profile.

For his part, Dr. Taub served as an expert witness for the Weitz firm as recently as a 2013 case in federal court in Pennsylvania. Legal records show that his rate for working on the case was $1,750-per-hour, plus $7,500 per day for testimony when overnight travel was required.

According to the complaint, Mr. Silver received his last referral fee payment from the Weitz firm in November.

Dr. Taub, who has received a nonprosecution agreement in exchange for his cooperation in the case, did not respond to calls for comment. His lawyer, Lisa Zornberg, called him “an exceptional doctor who has devoted his life to helping patients.”

On Friday, Columbia announced that it would dissolve his mesothelioma center. ... .html?_r=0

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Wed Jan 28, 2015 11:05 am

Top Australian gynaecologist 'on extended leave' as she's investigated over claims she slapped a nurse in front of a patient

One of Australia’s top gynaecologists is under investigation for allegedly slapping a nurse in front of a patient.

Professor Margaret Davy has ‘strongly denied any wrongdoing’ as it was confirmed by South Australia Health Minister Jack Snelling that the reported incident is being looked into by officials.

Prof Davy has taken almost a year’s holiday from her job as head of surgery at the Royal Adelaide Hospital, in South Australia, as the investigation gets under way, The Advertiser reports.

She told the paper she had no knowledge of the alleged incident, which supposedly happened during a colposcopy procedure when the patient was conscious, and revealed that she has gone on long service leave.

‘I have definitely not resigned as I have 354 days of long service leave so I have a year to think about it,’ Prof Davy told The Advertiser.

The Royal Adelaide Hospital did not deny an investigation is happening when contacted by Daily Mail Australia, but a spokesperson said: ‘We are not making any further comment.’

Daily Mail Australia has also contacted Prof Davy for comment.

Mr Snelling told The Advertiser: ‘I am advised that a formal investigation is under way into this serious allegation.

‘If found to be true I would expect appropriate disciplinary action to be taken.’

Prof Davy, 69, has had a long and successful career in the world of gynaecology.

She graduated from the University of Adelaide and went on to work in Oslo, Norway, for ten years at the Norwegian Radium Hospital where she gained extensive knowledge about gynaecological cancer.

She returned to Australia and worked in Women’s Health for 20 years in remote areas in South Australia and the Northern Territory, a service for which she was awarded the Order of Australia (AM) in 2002. ... tient.html

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Sat Jan 31, 2015 9:13 am

8-year-old girl suggests a possible cure for cancer

For most elementary school students, finding the cure for cancer probably isn’t normal dinner table conversation. But for one British 8-year-old, the topic came up— and led to successful lab results, The Independent reported.

Camilla Lisanti’s parents are both cancer researchers at Manchester University. Over dinner, her father, Michael, asked her how she would cure the disease, and she suggested using antibiotics, “like when I have a sore throat.”

Michael and his wife, Federica Sotgia, tested her theory at the lab and were surprised to find that several cheap and widely used antibiotics destroyed cancerous cells in samples from breast, prostate, lung, ovarian, pancreatic, skin, and brain tumors. Some of the antibiotics worked by preventing cancer cells from making energy-providing mitochondria— which cancer stem cells are prolific in.

Most importantly, these common antibiotics tested did not harm healthy cells. Michael believes they could prove to be an effective and inexpensive treatment.

“I thought it was very naïve to think you could cure cancer with antibiotics, but at the end of the day Camilla was right,” he told the Daily Mail. “She usually is right about things.”

The research is promising but is limited to lab results and needs to be tested on people.

In a comment to The Independent, Dr. Alan Worsley, Cancer Research UK’s senior scientist said that some antibiotics have been known to have anti-cancer effects since the 1960s and are a well-established part of cancer treatment, along with chemotherapies.

“There’s no indication from this work that these particular antibiotics would kill cancer cells in patients, or what sort of side effects there might be,” he told The Independent. ... or-cancer/

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Tue Feb 03, 2015 8:17 am

Spot the snake oil: telling good cancer research from bad

Cancer is big news; we often hear of some kind of cure for some version of the illness. But whether it’s a “natural cure” or a promising molecule on its way to becoming a new medicine, there are ways non-scientists can assess if the research underlying the big claims stacks up.

Here are some tips to help you evaluate whether a cure claim is justifiable (spoiler: the evidence is rarely robust enough).

Cell line testing

As a minimum, any cure claim needs to demonstrate that the new molecule or natural therapy can stop the growth of cancer cells in what you might think of as test-tube experiments. Scientists call these in vitro tests (Latin for “in glass”).

These types of tests are the first in a long line because they’re cheap, easy, don’t require ethics approval and can be completed in one or two days.

The most important thing to look for in the results is whether an approved drug is used for comparison. The new cure needs to stop cancer growth at a dose lower than the comparison drug. And it needs to stop cancer cell growth at doses ten to 100 times lower than the approved drug to be really exciting.

Unfortunately, it’s very easy to get a good result in these kinds of tests and many hundreds of drugs are found to be just as effective as approved drugs. If curing cancer was simply a matter of getting a pass at this point, then we would indeed have cured it ten of thousands of times over.

Much of the evidence cited by non-scientists for natural cure claims are based solely on these in vitro tests. In reality, these experiments are only used as a screening (stop-or-go) test to determine whether the next level of testing is justified.

Animal testing

The next level is animal testing – and by animal, 99% of the time we mean specially bred mice. Animal experiments are known as in vivo tests (Latin for “within the living”).

So what do you look for here? First, beware of tests that use more exotic or less established animal models, such as zebra fish embryos as the correlation of the results in these animals to humans is less certain.

And, again, make sure it has been compared to an approved drug, and that the drug is used in humans to treat the type of cancer the tested animal had. Experiments that use the incorrect drug for the cancer they are testing against will make the “cure” look better.

Look out for how often the animals are given the treatment. Most tests use a single treatment early in the study, but some use a schedule of multiple treatments. There can be valid reasons for using multiple treatments, but more treatments do make it a positive result more likely.

Also look out for in vivo tests where the approved drug is given one way (like an injection) but the new drug is given a different way (swallowed or inhaled). It’s hard to compare them accurately in these circumstances.

Next, look for how well it delays cancer growth compared with the approved drug. Is the difference only small or is the delay quite evident? Have the scientists shown a statistical difference in cancer growth (they’ll mention this somewhere in the research paper) under the two treatment regimes?

Remember, these tests are just another stop-or-go checkpoint to warrant further testing. By themselves, they don’t indicate the new cure will work for humans. And many that do work in these tests go on to have no effectiveness in people.

Clinical trials

Clinical trials are really the point where you can start to pay attention to cure claims. This is when the first testing on humans takes place. But not all clinical trials are created equal.

There are three main levels. Phase I is only for determining side effects and effectiveness is not of primary concern. But it’s not uncommon for one or two patients to have cancers that respond to treatment. A positive result at this stage doesn’t indicate it will work for all patients, so beware of any study that claims a cure based only on phase I tests.

Phase II and phase III trials, where the drug is tested in specific cancer types and compared alongside approved drugs, are the important ones.

The key thing to look for in the results is the overall survival rate (how many patients live for five years after the start of treatment) or the improvement in time-to-disease progression (the amount of time from the start of treatment until the cancer spreads or gets bigger).

Phase II, and more importantly phase III, trials are highly regulated. Any positive results claimed in the findings are reliable and indicative of real potential to make a difference in cancer treatment.

You can find details of cancer clinical trials in Australia here, in the United States here and in the European Union here.

Anecdotes are not evidence

There’s a saying among scientists, “the plural of anecdote is not data”. And you’ve undoubtedly heard one of a hundred stories of how John or Jane Smith down the street was cured when treated with oil-of-something.

Many possible explanations for such “cures” may have nothing to do with their miracle substance. First, there could be a strong placebo effect; just the belief that what they’re using works can sometimes have an effect on someone’s health. But while a placebo may work for one person, we can’t know it will work for the another.

Next, if the Smiths were using the untested “drugs” alongside normal treatment, it could be just the regular treatment that was working.

And, although rare, some cancers can go into spontaneous remission. In these cases, the cancer would have been cured regardless of what John or Jane was taking.

Finally, it’s important to remember when reading about cancer cures from less stringent sources that there can be selection bias. For every miracle cure story you read on a website (like this one) or on social media, there are thousands of stories of where it didn’t work that don’t make the cut. People don’t write about the failures.

So before you get excited about claims of a cancer cure, make sure you do your homework and determine whether the results are reliable, significant and not biased. ... -bad-36344

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Thu Feb 05, 2015 11:32 am

Today is World Cancer Day, Feb. 4

Wednesday is World Cancer Day, and to help raise awareness and help cancer patients here in Austin, Pure Ryde Cycling Studio is sponsoring what it’s calling “20 colors/20 hours.” Indoor cyclists at the West Austin studio will be peddling hard this weekend to raise money. They will be riding in shifts based on the colors of the cancer ribbon that they wear.

They still need volunteers to race. You can stop on by the Studio on West Fifth Street to cheer them on. The race is from 7 p.m. Friday until 3 p.m. Saturday.

The World Health Organization has put together some statistics on the deadly disease.

Key facts

Cancers figure among the leading causes of morbidity and mortality worldwide, with approximately 14 million new cases and 8.2 million cancer related deaths in 2012.
The number of new cases is expected to rise by about 70% over the next 2 decades.
Among men, the 5 most common sites of cancer diagnosed in 2012 were lung, prostate, colorectum, stomach, and liver cancer.
Among women the 5 most common sites diagnosed were breast, colorectum, lung, cervix, and stomach cancer.
Around one third of cancer deaths are due to the 5 leading behavioural and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, alcohol use.
Tobacco use is the most important risk factor for cancer causing around 20% of global cancer deaths and around 70% of global lung cancer deaths.
Cancer causing viral infections such as HBV/HCV and HPV are responsible for up to 20% of cancer deaths in low- and middle-income countries.
More than 60% of world’s total new annual cases occur in Africa, Asia and Central and South America. These regions account for 70% of the world’s cancer deaths.
It is expected that annual cancer cases will rise from 14 million in 2012 to 22 within the next 2 decades.

Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumors and neoplasms. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs, the latter process is referred to as metastasizing. Metastases are the major cause of death from cancer.

The problem

Cancer is a leading cause of death worldwide, accounting for 8.2 million deaths in 2012 (1). The most common causes of cancer death are cancers of:

lung (1.59 million deaths)
liver (745 000 deaths)
stomach (723 000 deaths)
colorectal (694 000 deaths)
breast (521 000 deaths)
oesophageal cancer (400 000 deaths).

What causes cancer?

Cancer arises from one single cell. The transformation from a normal cell into a tumor cell is a multistage process, typically a progression from a precancerous lesion to malignant tumors. These changes are the result of the interaction between a person’s genetic factors and 3 categories of external agents, including:

physical carcinogens, such as ultraviolet and ionizing radiation;
chemical carcinogens, such as asbestos, components of tobacco smoke, aflatoxin (a food contaminant) and arsenic (a drinking water contaminant); and
biological carcinogens, such as infections from certain viruses, bacteria or parasites.

WHO, through its cancer research agency, International Agency for Research on Cancer (IARC), maintains a classification of cancer causing agents.

Ageing is another fundamental factor for the development of cancer. The incidence of cancer rises dramatically with age, most likely due to a build up of risks for specific cancers that increase with age. The overall risk accumulation is combined with the tendency for cellular repair mechanisms to be less effective as a person grows older.

Risk factors for cancers

Tobacco use, alcohol use, unhealthy diet and physical inactivity are the main cancer risk factors worldwide. Some chronic infections are risk factors for cancer and have major relevance in low- and middle-income countries.

Hepatitis B (HBV), hepatitis C virus (HCV) and some types of Human Papilloma Virus (HPV) increase the risk for liver and cervical cancer respectively. Infection with HIV substantially increases the risk of cancer such as cervical cancer.

How can the burden of cancer be reduced?

Knowledge about the causes of cancer, and interventions to prevent and manage the disease is extensive. Cancer can be reduced and controlled by implementing evidence-based strategies for cancer prevention, early detection of cancer and management of patients with cancer. Many cancers have a high chance of cure if detected early and treated adequately.

Modifying and avoiding risk factors

More than 30% of cancer deaths could be prevented by modifying or avoiding key risk factors, including:

tobacco use
being overweight or obese
unhealthy diet with low fruit and vegetable intake
lack of physical activity
alcohol use
sexually transmitted HPV-infection
infection by HBV
ionizing and non-ionizing radiation
urban air pollution
indoor smoke from household use of solid fuels.

Tobacco use is the single most important risk factor for cancer causing about 20% of global cancer deaths and around 70% of global lung cancer deaths. In many low-income countries, up to 20% of cancer deaths are due to infection by HBV and HPV.

Prevention strategies

Increase avoidance of the risk factors listed above.
Vaccinate against human papilloma virus (HPV) and hepatitis B virus (HBV).
Control occupational hazards.
Reduce exposure to non-ionizing radiation by sunlight. (UV)
Reduce exposure to ionizing radiation (occupational or medical diagnostic imaging).

Early detection

Cancer mortality can be reduced if cases are detected and treated early. There are 2 components of early detection efforts:

Early diagnosis

The awareness of early signs and symptoms (for cancer types such as skin, cervical, breast, colorectal and oral) in order to get them diagnosed and treated at early stage. Early diagnosis is particularly relevant when there is no effective screening methods or – as in many low-resource settings– no screening and treatment interventions implemented. In absence of any early detection or screening and treatment intervention, patients are diagnosed at very late stages when curative treatment is no longer an option.


Screening aims to identify individuals with abnormalities suggestive of a specific cancer or pre-cancer and refer them promptly for treatment or when feasible for diagnosis and treatment. Screening programmes are especially effective for frequent cancer types for which cost-effective, affordable, acceptable and accessible screening tests are available to the majority of the population at risk.

Examples of screening methods are:

visual inspection with acetic acid (VIA) for cervical cancer in low-resource settings;
HPV testing for cervical cancer;
PAP cytology test for cervical cancer in middle- and high-income settings;
mammography screening for breast cancer in high-income settings.

A correct cancer diagnosis is essential for adequate and effective treatment because every cancer type requires a specific treatment regimen which encompasses one or more modalities such as surgery, and/or radiotherapy, and/or chemotherapy. The primary goal is to cure cancer or to considerably prolong life. Improving the patient’s quality of life is also an important goal. It can be achieved by supportive or palliative care and psychological support.

Potential for cure among early detectable cancers

Some of the most common cancer types, such as breast cancer, cervical cancer, oral cancer and colorectal cancer have high cure rates when detected early and treated according to best practices.

Potential for cure of some other cancers

Some cancer types, even though disseminated, such as leukaemias and lymphomas in children, and testicular seminoma, have high cure rates if appropriate treatment is provided.

Palliative care

Palliative care is treatment to relieve, rather than cure, symptoms caused by cancer. Palliative care can help people live more comfortably; it is an urgent humanitarian need for people worldwide with cancer and other chronic fatal diseases. It is particularly needed in places with a high proportion of patients in advanced stages where there is little chance of cure.

Relief from physical, psychosocial and spiritual problems can be achieved in over 90% of advanced cancer patients through palliative care.

Palliative care strategies

Effective public health strategies, comprising of community- and home-based care are essential to provide pain relief and palliative care for patients and their families in low-resource settings.

Improved access to oral morphine is mandatory for the treatment of moderate to severe cancer pain, suffered by over 80% of cancer patients in terminal phase. ... day-feb-4/

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Sun Feb 08, 2015 8:58 am

Is it Time To Regulate E-Cigarettes?

E-cigarettes were supposed to be this great thing; this alternative to traditional cigarettes which help to make the habit of smoking a little less toxic. Research shows, however, that they may be just as dangerous.

Representative Gerry Pollet, D-Seattle, explains, “We are facing a burgeoning public health crisis with e-cigarettes and we need to approach it as a public health issue and provide people with an understanding of safety risks.” The University of Washington School of Public Health clinical instructor continue, “We also need to take very quick action to prevent our children from becoming addicted to this new product.”

A new bill attempts to better regulate the stuff. Bill co-sponsor Rep, Reuven Carlyle (D-Seattle), adds, “We don’t tax the product and we don’t regulate the product. We have to modernize our laws and acknowledge there’s been an evolution in how people deliver the active and addictive product of nicotine.”

But the most important issue is how the product appears to be marketed directly to youth. And statistics show that electronic cigarettes appeal to the younger generation because it is mechanical and novel but also because it tastes much better than traditional cigarettes.

North Shore/Cape Ann Tobacco Program director, Joyce Redford, notes “One of the big things is that they’re geared towards youth, especially disposables. The whole thing is geared towards addiction. It’s nicotine and they’re all flavored. There’s like 100 flavors—there are things like strawberry banana, blueberry blizzard, and grape crush.”

Redford goes on to say, “Note the placement with candy and bright colors. In addition, that is below energy drinks, which may imply they can be swallowed. If ingested by swallowing one could be poisoned or go into cardiac arrest. Go into many tobacco retailers and you will see the same type of marketing played out across the region and state.” ... ttes/37790

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Wed Feb 11, 2015 8:28 am

Panel advances $132.5 million for cancer research building

FRANKFORT, Ky. (AP) - The University of Kentucky would use $132.5 million of taxpayer money to build a new cancer research building under a bill that cleared the House budget committee on Tuesday.

Kentucky lawmakers approved the state's $9.6 billion spending plan last year, and it is unusual for lawmakers to vote to amend that plan in a non-budget year. But University of Kentucky President Eli Capilouto said the school has run out of quality space for researchers at its Markey Cancer Center in a state with one of the highest cancer rates in the country.

Some House Democrats voted against the proposal because they objected to the timing. If it passes the House, it would head over to the Republican controlled Senate, where Senate President Robert Stivers has endorsed the bill. ... 24941.html

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Sat Feb 14, 2015 9:08 am

Canadian-led study confirms game-changing approach to stroke care

Canadian and international researchers have shown a new approach to treating some devastating strokes could dramatically lower the toll these brain attacks cause.

The new technique, which involves extracting large clots from the brain arteries they block, should substantially lower the number of deaths caused by stroke and make an enormous difference in post-stroke quality of life, several research teams reported at the American Stroke Association conference in Nashville, Tenn.

"Basically we saw that people who would end up in a nursing home were walking home back into their lives," Dr. Michael Hill, director of the stroke unit at Calgary's Foothills Hospital and senior author of one of the papers, said in an interview. Hill, a neurologist, is also a professor at the University of Calgary.

"So it's a pretty big deal for us in the stroke world."

Hill's study, which reports results of a clinical trial testing the procedure in five countries, was published online Wednesday by the New England Journal of Medicine, which also published an Australian paper investigating the same technique. Both were presented at the Nashville conference, along with a third that found similar results.

All three were stopped early when it became clear that the new procedure was more effective than the treatment it was tested against, the standard of care for strokes caused by clots. The standard treatment is to use a drug, tPA, which breaks up the clot. It must be used as quickly as possible and is not effective if it is not given within 4 1/2 hours of a stroke occurring.

"This is a once-in-a-generation advance in stroke care," the head of one study, Dr. Jeffrey Saver, stroke chief at the University of California, Los Angeles, told The Associated Press.

An independent expert, Dr. Lee Schwamm of Massachusetts General Hospital, called it "a real turning point in the field." For many patients, "this is the difference between returning home and not returning home," although only certain types of patients can be offered it, he said.

Stroke care "needs to be completely changed" to make the treatment more widely available, said Dr. Walter Koroshetz, acting director of the National Institute of Neurological Disorders and Stroke.

The new procedure requires doctors to work swiftly to diagnose the cause of the stroke. Some are caused by bleeding in the brain and cannot be treated this way.

Once the cause is determined to be a clot, the clot-busting drug is administered. But with really large clots — which cause the most damage in survivors — the drug sometimes isn't enough to open the artery and re-establish blood flow to the brain.

With this new technique, doctors made an incision in the patient's groin and snaked a catheter up into the brain, to the site of the clot. They threaded a retrievable stent — a small tube — over the clot, trapping it inside. The stent was then removed.

In the Canadian-led study, people who had their clots removed were nearly 50 per cent less likely to die from their stroke, and survivors had substantially fewer consequences of the brain attack.

Still, this is a technique that cannot be rolled out overnight. Even getting hospitals to use tPA on all patients who would benefit from it has been tough slogging, said Dr. Stephen Phillips, a Halifax-based stroke neurologist who was an investigator in the Canadian-led trial.

The new technique involves more sophisticated imaging and requires the skills of highly trained interventional radiologists, Phillips said. Even at his institution — the Queen Elizabeth II Health Sciences Centre, which took part in the trial — adjustments will need to be made to be able to offer this level of care around the clock.

Talks have been underway to try to find ways to extend this type of care to the rest of Nova Scotia, he said, but "we don't have a clear plan of action yet about how we're going to do it."

"It's not straightforward. There are lots of logistical hurdles."

The Canadian-led study was funded in part by Medtronic, which makes the retrievable stent. ... cachetoken

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Re: Awake Sedation for Brain Surgery May Shorten Hospital St

Post by kenobewan » Tue Feb 17, 2015 3:42 pm

A Cancer Cluster Is Tough to Prove

Last month, thousands of Marines and their families were blocked in federal court from pursuing their claim that the government had given them cancer. The decision, involving people exposed to contaminated drinking water while stationed at Camp Lejeune, a base in North Carolina, didn’t consider the science.

Long before expert witnesses could be called to testify, a United States Court of Appeals let stand its earlier ruling that the lawsuit had come too late. It failed to meet the requirements of a state statute banning claims arising more than 10 years after the final occurrence of a harmful act.

The genetic mutations that cause cancer can take decades to manifest themselves, far longer than the North Carolina statute of repose allowed. But the laws we cobble together often trump those of science. And even when legal obstacles can be overcome, a link between a cancer and environmental pollutants is exceedingly difficult to establish, whether in a laboratory or a court of law.

In past investigations, only two residential cancer clusters in the country have been linked, though only weakly, to environmental toxins. Camp Lejeune has become the third.

The plaintiffs in the lawsuit lived at the base at various times from the 1950s through 1985, a period when the drinking water was polluted with dry-cleaning fluid, organic solvents and benzene — chemicals on the National Toxicology Program’s list of known and probable carcinogens.

Even so, epidemiological studies published last year by the Centers for Disease Control and Prevention found that Camp Lejeune’s rate of cancer mortality was lower than that of the general public — 1,078 cases among the Marines during a 10-year period, when 1,272 would have been expected in a population that size.

That would ordinarily seem to rule out a cancer cluster. Epidemiologists, however, suspected that the numbers might have been distorted by a “healthy soldier” or “healthy veteran” effect. The military and their kin may receive better medical care than most people, making them less likely to die prematurely from cancer. To allow for that possibility, cancer deaths at Camp Lejeune were compared with those at Camp Pendleton in Southern California, where there was no water contamination. It was then that hints of a problem appeared.

Over all, Marines who had served at Lejeune were 10 percent more likely to die from cancer than their counterparts at Pendleton. Deaths from kidney cancer, for example, were 35 percent more likely. Altogether, 16 of 21 types of cancer showed modest increases at Lejeune.

Most of these conditions are rare enough that the absolute number of excess deaths was low — 42 from kidney cancer, for example, when 36 was considered average. For multiple myeloma, the increased risk was razor thin: 17 deaths at Lejeune, when 16 would have been expected. (Similar results were found in a separate study involving the base’s civilians.)

The more unusual a cancer, the harder it is to separate genuine influences from statistical noise. Especially puzzling were some 80 Lejeune veterans who came forward with diagnoses of male breast cancer, some at an unusually early age. The annual incidence of this condition is about 1.4 cases per 100,000 men — about 1 percent of the rate for women.

Hundreds of thousands of men may have been exposed, for various lengths of time, to Camp Lejeune water. Whether that is enough to implicate the pollution is still under consideration.

Investigations of other suspected cancer outbreaks have been even less clear-cut. Over the years, state and federal epidemiologists have looked into hundreds of incidents in which people have reported what they feared were unusually high concentrations of cancer. Only a fraction of these turned out to be genuine anomalies, with cancer rates that were actually higher than demographics would suggest.

Of these outliers, only two were ultimately associated with an environmental agent. The rest of the clusters apparently occurred by chance, like stars forming constellations in the sky.

Among the places that didn’t make the cut were Love Canal, N.Y., which was the original Superfund site, and Hinkley, Calif., the subject of the movie “Erin Brockovich.”

Clusters involving factory workers are more common — the exposures are more intense. But you can scour the records and find only two cases in recent history in which environmental contaminants may have caused a blip in the cancer rate: a small increase in the number of childhood leukemias in Woburn, Mass., featured in the movie “A Civil Action,” and in Toms River, N.J.

In both investigations, a wisp of a pattern emerged when the data was parsed just so. In Woburn, a few extra cases occurred among boys, and in Toms River among girls. Nothing known about the biology of leukemia could explain why the carcinogens in question would have exhibited a preference for gender, leading to doubts that the clusters were real.

Biologists tell us that cancer is caused by an accumulation of genetic mutations — tiny distortions in a cell’s DNA that retool it into a viciously replicating machine. Some of the mutations are inherited, some are inflicted by outside agents, and some are simply copying errors that occur spontaneously as a body’s cells divide.

Pollutants add to the burden. But no matter how carcinogenic they are, the doses most people receive can hardly compare with the thick concentration of chemical waste inhaled, minute after minute, by cigarette smokers into the microscopic depths of their lungs. To get that kind of exposure, you would have to hook a tube to a factory smokestack and breath the fumes for years, or subject yourself to an intravenous drip of toxic sludge.

None of this means that the spillage of manufactured chemicals is not a problem or that polluters should not be fined and jailed. Some epidemiologists suspect that synthetic carcinogens are giving many people cancer, but at levels that their mathematical tools cannot detect.

Judging from the evidence, the former residents of Camp Lejeune may have a stronger argument than the people of Woburn and Toms River did, but only if their lawyers can find a way to get the case back into court. ... .html?_r=0

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