Mood Disorders Treatment Today

2011-04-29 / Mental Health / 0 Comments

Demi Lovato Reflects on Time at Timberline Knolls

Tucked away in a secluded woodland area off New Avenue, Timberline Knolls Residential Treatment Facility enjoys a relatively quiet existence, often going completely unnoticed by local residents.

Last November, however, a number of Internet sites reported that the Lemont facility was playing host to a high-profile patient—18-year-old Disney star Demi Lovato.

At the time, Lovato’s representatives said she had left a tour with the Jonas Brothers to receive treatment for “emotional and physical issues she has dealt with for some time.”

Recently, Lovato opened up about her experiences in interviews with People magazine and ABC’s 20/20, admitting she had received treatment at Timberline Knolls for cutting, bulimia and anorexia.

She also learned she was suffering from bipolar disorder, she said.

“I had no idea that I was even bipolar until I went into treatment,” she told Robin Roberts during the 20/20 interview that aired Friday.

From Oct. 30 to Jan. 27, Lovato received intense in-patient treatment at Timberline Knolls, which specializes in the treatment of eating disorders, substance abuse and addiction, and mood disorders in women.

“I worked harder in those three months than I ever did in my life,” Lovato told People. “I basically went through hours of therapy every day. … It was a battle, but I stuck it out.”

Since completing treatment, Lovato continues to work with a therapist nutritionist and sponsor in Los Angeles, People reports. She recently announced she was leaving her Disney Channel show, Sonny With a Chance, to focus on music and her recovery.

“I’ve never been more peaceful or happy in my life,” Lovato said. “What’s important is to help others get to this place.”
Timberline Knolls

Timberline Knolls is a 43-acre facility located in Lemont. It was founded in 2005 by a team of psychiatrists, psychologists and clinicians as an in-patient treatment center for women dealing with trauma, eating disorders and drug addiction.

“Our residents — adult women and adolescent girls — come to us when they need immediate, life-saving and life-changing help,” according to the center’s website. “Our vision is to help residents achieve lifelong recovery by bringing together clinical treatment with spiritual and emotional growth.”

In February, Timberline Knolls observed National Eating Disorders Awareness Week by hosting a number of special programs and guest speakers to “educate the public on eating disorders and body image issues while reducing the stigma surrounding eating disorders and improving access to treatment.”

New guidelines for assessing tic disorders

Clinical guidelines from the European Society for the Study of Tourette Syndrome have emphasised the importance of comorbid psychiatric disorders in assessing patients with Tourette’s and other tic disorders.

“Tic disorders represent a range of tics and co-existing symptoms with a varied and heterogeneous presentation,” the guidelines state.
“In most situations, a standard interview with a few additional questionnaires and rating scales are sufficient to guide diagnosis and treatment.

However, psychiatric comorbidity occurs in more than three-quarters of cases that are referred for specialised care.”

Attention deficit hyperactivity disorder is the most common comorbidity — occurring in up to 60 per cent of childhood and adult cases — followed by obsessive compulsive disorders, anger control problems, sleep disorders, learning disorders, mood disorders, anxiety disorders, and conduct and oppositional-defiant disorders.

Self-report scales can help to provide general information on psychopathology. The Child Behaviour Checklist can be completed by parents, and self-report questionnaires can be completed by adolescents. A range of tic-specific instruments are available, including the Yale Global Tic Severity Scale and the Shapiro Tourette Syndrome Severity Scale.

“The features that distinguish tics from other movement disorders — with the exception of akathisia [restless legs syndrome] and psychogenic movement disorders — are 1) the ability to suppress them for a while, and 2) the patient’s experience of tics as a (partly) voluntary movement to relieve an inner tension or premonitory focal sensory sensation.”

Neuropsychological assessment can be useful because of the high prevalence of learning disorders in children with tics. It can define the problems arising from the underlying disorder, and those resulting from the disruption caused to education.

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Diabetes Treatment News

2011-04-28 / Diabetes / 0 Comments

MU researchers pioneer animal diabetes treatment

Studies show the incidence of diabetes in dogs has increased 200 percent over the past 30 years. Now, University of Missouri veterinarians have changed the way veterinarians treat diabetes in animals by adapting a device used to monitor glucose in humans.

Dogs are susceptible to type 1, insulin-dependent diabetes. Affected animals are unable to utilize sugar in their bloodstream because their bodies do not produce enough insulin, a hormone that helps cells turn sugar into energy. Veterinarians treat animals with this type of diabetes similarly to the way humans are treated, with insulin injections and a low-carbohydrate diet.

Amy DeClue, assistant professor of veterinary internal medicine, and Charles Wiedmeyer, assistant professor of veterinary clinical pathology, have been studying the use of a “continuous glucose monitor” (CGM) on animals since 2003. A CGM is a small flexible device that is inserted about an inch into the skin, to constantly monitor glucose concentrations.

“Continuous glucose monitoring is much more effective and accurate than previous glucose monitoring techniques and has revolutionized how veterinarians manage diabetes in dogs,” said DeClue. “The CGM gives us a complete view of what is happening in the animal in their natural setting. For example, it can show us if a pet’s blood glucose changes when an owner gives treats, when the animal exercises or in response to insulin therapy.”

CGMs have become more commonly used in dogs with diabetes that are not responding well to conventional treatment. The monitor provides detailed data for glucose concentrations throughout the course of three days in a dog’s usual environment, so veterinarians can make better treatment decisions. Previously, veterinarians would have created an insulin regimen based on a glucose curve by taking blood from the animal in the veterinary hospital every two hours over the course of a single day. The glucose curve was often inaccurate due to increased stress from the animals being in an unnatural environment.

Dogs show clinical signs of diabetes similar to humans. Clinical signs include increased urination, thirst, hunger and weight loss. Typically, no direct cause is found for diabetes in dogs, but genetic disposition and obesity are thought to play a role in causing diabetes, according to DeClue. Just like people, dogs suffering with diabetes must be medically managed or complications can arise.

“Typically, dogs that are treated properly for diabetes go on to live a long, full life,” said Wiedmeyer.

“Actually, dogs with diabetes are similar to young children with diabetes but somewhat easier to manage. Dogs will eat what their owners give them at the same time each day and they won’t ask for a cupcake at a friend’s birthday party. With tools like the continuous glucose monitor to assist with disease management, the outlook is very good for a dog with diabetes.”

In the future Wiedmeyer projects that the device will become smaller and less invasive. In addition, he hopes device manufacturers develop a device that would monitor blood sugar levels remotely.

DeClue and Wiedmeyer’s most recent article on methods for monitoring and treating diabetes in dogs was published in the journal, Clinic in Laboratory Medicine.

Hospital to pioneer new diabetes treatment

Doctors from Hackensack University Medical Center hope to find a cure for diabetes as they embark on a partnership with one of the world’s leading researchers for the disease.

The hospital will be the first to try a procedure on humans with diabetes that is currently being tested on monkeys in Florida — a collaborative effort with Dr. Camillo Ricordi, a pioneer in the field and the scientific director and chief academy officer of the University of Miami Diabetes Research Institute.

“Dr. Ricordi wants to find a cure for diabetes, and he doesn’t care how many people are involved in the process or share in the credit,” said Dr. Michael Shapiro, Hackensack’s chief of organ transplantation and leader of the diabetes partnership. “This collaboration will do great things for diabetes research.”

Diabetes occurs when the body cannot produce or properly use insulin, a hormone that helps the body metabolize glucose into energy and control blood sugar levels.

With Type 1 diabetes, sometimes called juvenile diabetes and the most serious form of the disease, the body’s immune system destroys the cells from the pancreas that make insulin, called islets. People with Type 2 diabetes make insulin, but their body doesn’t utilize it correctly and production of it typically declines as they age. More than 25 million Americans have diabetes, and about 3 million of those suffer with Type 1.

Health care experts expect the number of diabetics to increase dramatically, as obesity can trigger Type 2 diabetes and Americans continue to get heavier.

Living for years with unregulated blood sugar levels can cause a myriad of symptoms, some as severe as blindness, poor circulation that leads to limb amputation, and kidney failure.

Typical treatment for diabetic patients includes insulin pumps, injections and oral medications. Transplanting islets from deceased donors is sometimes effective, but it frequently triggers other complications because the islets need to be implanted in the liver. The number of organ donors also falls way short of the number of diabetics who would benefit from a transplant.

In this latest study with monkeys, Ricordi loads islets on a disc and then implants them in the abdomen, rather than in the liver.

“The challenge is we’re dealing with an autoimmune disease so we have to replace or get cells to regenerate that were destroyed,” Ricordi told dozens of HUMC executives, physicians and health care workers this week. “And the key is to do this without a lifelong regimen of autoimmune rejection drugs.”

Based on the success with the primates, Shapiro is hoping to have four patients undergo the procedure in early 2012, though recruitment hasn’t begun. The ideal patients will be those who aren’t responding to other treatments.

Physicians attending the announcement highlighted Ricordi’s expertise and advances in treatment of the disease.

His creation, the Ricordi Chamber, is so well-known in the field that it was mentioned in a recent episode of the medical drama “Grey’s Anatomy.” Critical for a transplant, it is able to efficiently separate islets from the pancreas.

But successfully transplanting the islets will only be part one of the cure. Researchers need to figure out how to create islets in the lab so there will be enough to treat all diabetic patients who need them. Another research team is working on that endeavor in the Miami institute.

Still, the partnership has hospital executives determined and diabetic patients hopeful.

“I’m absolutely sure we’ll find a cure,” said Robert Garrett, president and chief executive of HUMC.

Stephanie Stone, who was diagnosed with diabetes at 10 and is now 18, attended the announcement with her Franklin Lakes, N.J., family.

“I’m optimistic for the future,” Stephanie said. “If this isn’t a cure, it sounds like it’s a better treatment before a cure is found.”

CeQur Develops Diabetes Compliance Device

An important drawback of current diabetes treatment regimens is patient compliance, particularly for insulin injections that are painful and must also be timely administered. CeQur has developed an innovative technological platform to address this concern, actualizing a minimally invasive wearable drug patch infuser that provides relatively painless, continuous subcutaneous delivery of insulin in basal doses, as well on-demand doses at the push of a button. The company’s minimally invasive subcutaneous route of drug administration precludes the use of the existing injection-based insulin regimens that are burdensome to patients due to their painful nature, which can significantly lower patient compliance. The company has shown through clinical trials that its technology accurately delivers insulin while improving patient comfort and compliance, and is currently waiting health board approvals.

Jim Peterson, CeQur President and CEO contends that insulin delivery devices and technologies are coming and will be a major help for people with Type II diabetes, a major help for them in overcoming the barriers to taking insulin properly and consequently living longer and healthier lives. “People have always known that there are four times as many Type II diabetics taking insulin as Type 1, and 80 percent of all insulin in the world is consumed by Type II diabetics,” he said in an interview for Mass Device last year. “However, the Type II diabetic population has been very under-served as far as technologies helping them with that struggle. It’s estimated that the market is easily a $2 billion marketplace for this new generation of products.”

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Wellness News

2011-04-27 / Health News / 0 Comments

Companies Seek Outside Help On Health Costs

Healthcare costs can be expensive for a company both in money as well as time off for an employee with an extended illness. That’s why some employers have brought in wellness programs to help employees discover and treat unknown health issues, and learn how to live healthier.

Amanda Greene, a certified health education specialist with Valley Preferred in Allentown, said the cost of health insurance is driving interest in wellness programs.

“Increase in the level of commitment in activity has quadrupled in the last three to four years,” Greene said.

One employee with a heart attack and hospital stay for surgery could incur a hospital bill for as much as $250,000, Greene said.

This expense could affect a company’s insurance premiums, while possibly requiring a replacement during the employee’s medical leave. Even before a traumatic illness strikes, health issues can affect an employee’s productivity, she said.

Through health and wellness programs, “we will never know how many heart attacks we would have prevented,” Greene said, “but we can improve employee health.”

At an American Heart Association event last month, Martin Till, president of the Express-Times in Easton, said that when his company implemented a wellness program, healthcare costs dropped in four years.

The program wasn’t popular at first, but three months after its implementation employees came to him and thanked him for it. They told him it “saved their lives.” Their program included information about quitting use of tobacco products and losing weight.

“Now we have much healthier employees and a happier employer,” he said.

Till said that 80 percent of healthcare costs are related to health problems like diabetes, asthma, coronary artery disease, cardiac pulmonary edema, also known as congestive heart failure, and high blood pressure – some of which are preventable.

Destination Thailand to showcase best of Thailand’s festivals, produce, healthcare and wellness at Dubai Mall

The Royal Thai Consulate-General, together with the Tourism Authority of Thailand (TAT), Thai Airways International, the Thai Trade Center and Thai Business Council in Dubai, is set to hold a promotional event titled “Destination Thailand 2011″ from May 5-7, 2011 at the Star Atrium, Dubai Mall, as part of a series of events to celebrate the auspicious occasion of His Majesty the King of Thailand’s 84th birthday anniversary, and to directly promote Thailand’s festivals, tourism attractions, medical and wellness services, produce and hospitality service sectors to residents of Dubai.

The three day event is based on the theme of “Wonderful Thailand in 2011″ and will feature various information booths, cultural performances, quizzes, competitions, prizes and demonstrations that will highlight the major annual festivals held in Thailand including the festive “Songkran” or Thai New Year celebrations which are held in April, as well as the romantic “Loi Krathong” or Floating Lanterns festival which is held annually in November. Additionally, various informational booths and stands will provide visitors with information regarding Thailand’s tourism attractions, hopsitality services, medical and wellness services, spas and a Fly Thai Airways travel corner.

Says Mr. Pramoth Supyen, Director of the Tourism Authority of Thailand, Dubai and Middle East Office, “We are extremely happy to be associated with this special initiative headed by the Royal Thai Consulate General Dubai. In the iconic Dubai Mall we have a wonderful opportunity to directly introduce the very best that Thailand as a travel destination has to offer and encourage all to come join us for 3 days of everything fun, friendly and Thai!”

Throughout the event various cultural performances such as traditional Thai dancing performances and demonstrations on Thai fruit carving Traditional Thai massage techiques will be conducted. Additionally, informational sessions by some of Thailand’s leading hospitals will be conducted with each sessions followed by quizzes and exciting giveaways.

The “Destination Thailand 2011″ promotional event will be officially opened by His Excellency Mr. Somchai Charanasomboon, Thai Ambassador, Royal Thai Embassy of Abu Dhabi, United Arab Emirates at 6pm on Thursday 5th May, 2011 and will remain open until the end of Saturday 7th.

Natural remedies for spring allergies

For many people who suffer from allergies in the spring, the tried and true methods they have been using for years are certainly tried, but not necessarily true. Most allergy sufferers get little relief from antihistamines and decongestants and, in fact, these medications can sometimes do more harm than good.

An allergic reaction such as a runny nose or watery eyes represents an attempt by the body to rid itself of the hostile allergen, such as pollen, oak, birch or grass. An antihistamine will dry the body so that there are fewer symptoms. The problem is that without the runny nose or watery eyes, the allergens are delayed in leaving the body and the body takes longer to fully cleanse. And many antihistamines make people drowsy, which is seldom a good thing.

A homeopathic remedy can help the body respond more appropriately and stabilize itself without irritations like the drowsiness or dry eyes that can become painful when wearing contact lenses. But before delving too deeply into possible solutions, much good can result from determining and then minimizing the exposure to the allergen. This can be done by considering the home environment.

Before eliminating anything else, it is important to remember that open windows will compound the effects of allergy. Sufferers should not sleep with open windows. The same pollen residue that finds its way onto window sills and dressers is also on pillows and sheets and inhaled all night long as a person sleeps.

An air purifier with HEPA filter, by contrast, can add clean, fresh air to a room and that can be beneficial. An air conditioner works in the same way. It is just very important in either case to make sure that filters are cleaned or replaced regularly.

Mold is an allergen that poses a great risk to overall health. Make sure your house is free of mold. Damp basements are a common source of mold.

The real key with allergies is to help the body to respond in the right way. Like any other illness, for the body to respond effectively, it must be properly nourished and rest is vitally important. Heavily processed foods with lots of white flour or white sugar should be minimized. Stress and strain on the body must be reduced wherever possible and a good night’s sleep is essential to good health and to winning the battle with the allergens.

Avoid contact with allergens as much as you can. If you are allergic to grass you might want to hire a high school student in the area to cut it for you. Yard work should be put off when the pollen count is at its worst.

Quercetin is a substance found in foods such as the skin of red apples, in red onions and in black tea. It has many healthful effects. It can suppress the release of histamines from mast cells and as such is a natural solution to the problem of allergies.

We have a homeopathic remedy in our store called Allergy New England Mix. This is an oral spray that is specifically formulated to treat the allergens found in New England. Other off-the shelf treatments may be less effective because they are not specific to what is found in our environment. We have customers who begin using the product before the allergy symptoms begin and they generally find the symptoms to be much more manageable when they do occur.

Other homeopathic medications that have been used successfully by allergy sufferers include Natural Creations nasal spray, which can be used to safely reduce congestion. Histaminum are homeopathic pellets that can be placed under the tongue that also reduce symptoms. Another product that relieves symptoms and provides comfort is a special preparation just for people with mold allergies, called Allergy Atlantic Mold Mix. Lastly, consuming local or raw honey can help combat allergies.

The key in fighting allergies is to help the body work its magic, not hinder it by suppressing natural responses. A runny nose may be an inconvenience, but it is also proof your body is working, as if it were saying “attack, attack!” The trick is to minimize the impact these symptoms have on your daily living and to be as comfortable as possible.

Hotze Health & Wellness Center Addresses a Common, Often Misdiagnosed, Problem

As National Stress Awareness Month draws to a close, Hotze Health & Wellness Center (HHWC) emphasizes the importance of properly diagnosing and treating a common, but often misdiagnosed problem: adrenal fatigue.

“When mainstream physicians label patients with chronic fatigue syndrome they are simply reiterating the symptoms back to the patient”

Adrenal fatigue occurs when the adrenal glands do not produce adequate amounts of the body’s stress hormone, cortisol. Symptoms include: chronic fatigue, dizziness, recurrent infections, depression, dry skin and difficulty recovering from stress.

Adrenal fatigue is usually diagnosed as chronic fatigue syndrome (CFS), which is only diagnosing the symptom rather than the underlying cause.

“When mainstream physicians label patients with chronic fatigue syndrome they are simply reiterating the symptoms back to the patient,” said Steven F. Hotze, M.D., founder and CEO of HHWC. “If your doctor diagnoses you with chronic fatigue syndrome you should ask what is causing it.”

Most individuals are exposed to an onslaught of stressors – noise, pollution, traffic, injuries, illness, and emotional conflicts – that wear on an individual’s adrenal glands. The adrenals are simply unable to meet the demands resulting in a feeling of stress and chronic fatigue. Additionally, individuals suffering from adrenal fatigue oftentimes experience chronic and recurrent infections.

HHWC physicians recommend that those with CFS, which is just another name for adrenal fatigue, should supplement with bioidentical cortisol to replenish and support their adrenal glands in order to properly address the issue.

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Pain Management News

2011-04-26 / Pain Management / 0 Comments

PAINWeek Prepares for New Education Requirements for Prescribers of Opioid Analgesics

The 2011 PAINWeek National Conference for Frontline Clinicians offers significant educational value as the FDA announces the elements of a Risk Evaluation and Mitigation Strategy (REMS) that will require all manufacturers of long-acting and extended-release opioids to develop information for the use of, and ensure training is provided to, prescribers of these medications.

(PRWEB) April 25, 2011

Recent developments in the legal and regulatory arenas pertaining to management of prescription pain medications offer new evidence of the timeliness and relevance of PAINWeek as essential education for frontline practitioners. On April 19, the White House Office of National Drug Control Policy announced that it would seek legislation setting new education requirements for those who prescribe long-acting narcotics. Concurrently, the FDA announced the elements of a Risk Evaluation and Mitigation Strategy (REMS) that will require all manufacturers of long-acting and extended-release opioids to develop information for the use of, and ensure training is provided to, prescribers of these medications.

While the exact nature and dimensions of these initiatives are still in development, PAINWeek attendees will have the opportunity to enhance their understanding of this emerging issue at multiple points in the conference program. Curriculum tracks in Pharmacology, Pain and Chemical Dependency, and Medical/Legal Aspects of Pain Management will offer the latest perspectives. The National Association of Drug Diversion Investigators (NADDI) will return with a full-day program examining the balance between enforcement and pain management as applied to narcotic medications.

PAINWeek, the National Conference on Pain for Frontline Practitioners, managed by Aventine Co., will convene for its fifth year, September 7-10 in Las Vegas. With over 100 hours of continuing medical education activities available, PAINWeek is the largest and best-attended pain management conference in the country.

Commenting on the curriculum enhancements, Debra Weiner, Director of PAINWeek Program Development, noted, “ We are clearly on the cusp of new and demanding educational requirements for practitioners in all disciplines in the area of prescription medication understanding and practice. PAINWeek has been addressing this issue for some time, and as a result, our attendees will thus be better equipped to deal with the new reality as it emerges. Our curriculum offers a comprehensive approach to chronic pain management that places medication within the broader spectrum of treatment options available to practitioners and patients.”

Over 1,500 healthcare professionals from diverse medical specialties are expected to attend PAINWeek 2011, to be held at the new Cosmopolitan of Las Vegas on the Vegas strip. In addition to the course curriculum and its multidisciplinary faculty, attendees will be able to experience a comprehensive roster of commercially supported programs and special interest sessions, satellite symposia, scientific assemblies, and exhibitors. More information and the PAINWeek 2011 Schedule-at-a-Glance can be found at

About PAINWeek

In 2007, Aventine Co. launched the PAINWeek National Conference on Pain for Frontline Practitioners, the first of its kind designed for frontline clinicians with an interest in pain management. This year, the PAINWeek National Conference is expected to welcome over 1,500 physicians, nurses, pharmacists, and other healthcare professionals seeking to improve their assessment, diagnosis, and treatment of acute and chronic pain. This has made PAINWeek the largest professional pain conference in the U.S. Building on this expertise in pain management education, Aventine is presenting the PAINWeekEnd™ Regional Conference Series in five US metropolitan areas in 2011. In addition to developing and producing the PAINWeek conference series, Aventine is also the management company for the American Society of Pain Educators (ASPE), a 501(c)(3) organization.

FDA looks to crack down on misuse of opioid painkillers

U.S. health officials unveiled Tuesday a new plan to try to curb misuse of extended-release and long-acting opioid pain killers such as OxyContin, morphine and methadone.

The new Risk Evaluation and Mitigation Strategy (REMS) is part of a larger multi-agency initiative announced Tuesday by the White House to reduce overall prescription drug abuse in the United States.

“This new REMS will provide tools to doctors and other prescribers for appropriate pain management to reduce risks and at the same time preserve access for patients and appropriate management of pain for those suffering from moderate to severe pain,” said Dr. Janet Woodcock, director of the Center for Drug Evaluation and Research at the U.S. Food and Drug Administration, the agency that launched the new program.

For now, the initiative will be limited to extended-release and long-acting products, which, Woodcock said, “have a much greater risk than immediate-release because they contain more medicine.”

She did not rule out the possibility that the approach could be expanded to include immediate-release drugs in the future.

Right now, the action affects 16 companies that make both branded and generic products. The products affected are known under their generic names as hydromorphone, methadone, morphine, oxycodone, oxymorphone, transdermal fentanyl and transdermal buprenorphine.

According to Woodcock, about 23 million prescriptions are dispensed each year for extended-release and long-acting opioids, which represented about 10% of the opioid market in 2009.

But, abuse and misuse is also extensive, with the FDA estimating that 33 million Americans aged 12 and older used such a drug for non-medical purposes in 2007, up from 29 million people in 2002.

Some 50,000 emergency room visits in 2006 were related to opioids, officials said.

“This is a large and growing problem and, despite a number of efforts over the years, it continues to grow,” Woodcock said. “It’s clear we have a huge problem on our hands.”

One of the main components of the new FDA program will be educating doctors and other prescribers on proper ways to prescribe opioids, as well as how to identify appropriate patients for these drugs.

“If a prescriber has a concern that a patient might unintentionally or intentionally misuse the drug, they need to know how to spot these individuals,” Woodcock said.

Doctors will also get materials on how to educate their patients, not only on proper use of opioids but also on proper storage and disposal.

Manufacturers will be required to use one central system to provide these educational materials, Woodcock said. And the FDA will monitor company-generated literature to make sure it isn’t promotional but is effective, she added.

Companies have 120 days to issue a draft REMS and Woodcock hoped matters will be completed by early 2012.

“In the meantime, doctors should be prescribing opioids as they have been doing and we hope they thoroughly discuss risks and benefits with their patients,” Woodcock said. “People taking opioids should continue to take them as directed and, if they have concerns, should consult a health-care professional.”

Florida Pain Clinic Society: PILL MILLS & FALSE STATISTICS

TALLAHASSEE, Fla., April 22, 2011 /PRNewswire/ — The Florida Society of Pain Management Providers urges Government, Law Enforcement and the media to stop using false prescription drug data and statistics. The continued release of false and / or out of context information is solely intended to enflame the public. The misinformation that unfairly portrays Florida as ground zero in this issue has significant consequences for pain management patients and the physicians who provide legitimate care. It is unacceptable to make this a war on pain patients.

Facts have become the greatest casualty in the war on pain medications:

Recently the Kentucky Attorney General made the following false statement in his Sun Sentinel Op-Ed piece which continues to be repeated by leaders and media:

“Law enforcement officials believe that 85 percent of all oxycodone sold in the United States is sold in Florida.”

The Truth is:

Florida sold 16.8% of all oxycodone in the U.S. (DEA 2009 ARCOS 2009 populations)

And what about facts on all the other pain medications:

Source: DEA 2009 ARCOS per 100,000 populations (2009):
Tennessee sold 250% more codeine than Florida
Tennessee sold 250% more hydrocodone than Florida
Arizona sold 100% more morphine than Florida.
Maine sold 100% more methadone than Florida
Pennsylvania sold 75% more fentanyl than Florida
Kentucky was the #3 seller of hydrocodone / Florida was #21


Morphine: 10 times more potent than codeine

Oxycodone: =/ or slightly more potent than morphine

Methadone: 10 times more potent than morphine

Fentanyl: 50 to 100 times more potent than morphine

The United States has a problem with diversion and abuse of pain medications; there must be a balanced approach in finding a solution so as not to affect patient pain care.

That approach:
Most importantly: A substantial increase in affordable drug treatment programs.
State Board of Medicine rules for pain clinic standards of practice, plus inspections.
Pain management licensing that bars felons.
State Prescription Drug Monitoring Programs requiring physician participation and subpoena requirements for law enforcement access.
Physician education regarding the monitoring of patients on long term pain medication.
Patient education in the securing and disposing of their medications.

And lastly be forewarned that heroin is roaring back and soon will surpass Rx med abuse!

Leading Pain Management Experts to Present at the 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference (June 9-11; Chicago)

Chicago — Leading pain management experts will present at the upcoming 9th Annual Orthopedic, Spine and Pain Management-Driven Ambulatory Surgery Center Conference: Improving Profitability and Business and Legal Issues on June 9-11, 2011, in Chicago.

This exclusive conference will be held at the Westin Hotel on North Michigan Avenue and is presented by the Ambulatory Surgery Center Association, the national association for surgery centers, and ASC Communications, publisher of Becker’s ASC Review and Becker’s Orthopedic & Spine Review.

Leading pain management experts scheduled to present include:
Scott Glaser, MD, DABIPP, Pain Specialists of Greater Chicago
Nameer R. Haider, MD, Spinal & Skeletal Pain Medicine
Marsha Thiel, RN, MA, CEO, Medical Advanced Pain Specialists
Richard A. Kube, MD, CEO, Founder & Owner, Prairie Spine & Pain Institute
Vishal Lal, CEO, Advanced Pain Management
Amy Mowles, President & CEO, Mowles Medical Practice Management
Marsha Thiel, CEO, MAPS Medical Pain Clinics & MAPS Practice Solutions
And more!

These leaders will discuss key business, financial, clinical and legal issues facing pain management-driven ambulatory surgery centers.

Other highlights of the 9th Annual Orthopedic, Spine and Pain Management-Driven Ambulatory Surgery Center Conference include:
1. 101 sessions and 134 speakers, including 25 CEOs and 30 physician leaders as speakers
2. Last year’s event included 725 attendees and 65 exhibitors
3. Gain practical guidance that can be used immediately
4. Outstanding keynote speakers including legendary NFL player and coach Mike Ditka
5. Terrific pre-conference sessions
6. 15 CME credits available
7. Register before May 1 and save $100
8. Additional discounts when registering two or more attendees, and for ASC Association members and paid Becker’s ASC Review subscribers

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Arthritis Cures Today

2011-04-23 / Pain Management / 0 Comments

Dr. Gott: Readers inquire home remedies, drink recipes, shampoo

DEAR READER: The article to which you are probably referring can be found on my website at

There are many home remedies for nail fungus, some more successful (based on reader input) than others. I believe one of the products you are referring to is Miranel, which is available over-the-counter at Walgreens. It is applied directly to the toenail and surrounding skin daily using the applicator brush provided.

Another product that has been successful is decolorized iodine, also known as white iodine. This product may also improve weak, brittle nails.

As for soaking agents, I have received several letters regarding white vinegar. Some people soak a cotton ball and then apply it to the affected nail several times a day, while others simply dilute the vinegar with warm water and soak the whole foot. This may also help with athlete’s foot.

Others have chosen to use diluted bleach in a similar manner.

Many years ago, I recommended a foot soak using Pau d’Arco tea. The feet have to be soaked several times a day. I have since stopped recommending it because the above remedies appear to be readily available, easier, less expensive and provide better results.

DEAR DR. GOTT: Can you please reprint your colon cocktail and grape arthritis drink recipes? I clipped them out but seem to have misplaced them when I moved. Thank you.

DEAR READER: My colon cocktail is simply equal portions of applesauce, bran and prune juice. Take 1 or 2 tablespoons each morning to prevent and/or remedy constipation. Be sure to store any extra in the refrigerator. It is best to prepare it in small batches because it lasts only up to three or four days once mixed.

The arthritis drink is 8 ounces of purple grape juice mixed with 1 tablespoon of liquid pectin. This can be used up to three times a day until symptoms are under control, and then most users continue with a maintenance dose of one glass per day. Some readers have used apple or light grape juice.

Another popular remedy for arthritis is a castor-oil rub. The oil is massaged onto the affected joint once or twice a day. For those who prefer a warming or cooling effect, Castiva may be preferable because it is made with a castor-oil base and warming capsaicin.

DEAR DR. GOTT: Some time ago, you mentioned a specific shampoo that seemed to have hair-restorative properties. I forgot to write down the name of that shampoo and would like to know if you remember it. Thanks.

DEAR READER: You are likely referring to Tresemme Silk Protein Healthy Volume Shampoo and Tresemme Vitamin E Conditioner. Other readers have also had success with other types of Tresemme shampoos and conditioners that contain biotin and B vitamins.

Other remedies include supplemental biotin, folic acid and/or B complex (which contains all the B vitamins). Over-the-counter Rogaine may also be beneficial but is relatively expensive, and any results achieved will reverse if the product is stopped.

PFIZER : Comments on ORAL Sync Tofacitinib Data in EULAR Abstract LB0005

Pfizer Inc. commented on an abstract concerning the ORAL Sync Phase 3 study of tofacitinib in patients with rheumatoid arthritis (RA) which has been posted for the European League Against Rheumatism (EULAR) conference.

In this study, four deaths were reported in the tofacitinib arms, three of which were determined by the investigators not to be study drug related. The cases reported that were determined not to be study drug related involve one case of brain injury following trauma 22 days after discontinuation of study drug; one case of worsening of RA 42 days after discontinuation of study drug; and one case of acute heart failure. In addition, one case of respiratory failure was reported by the investigator as study drug related.

Because the initial randomization design of the study includes only one-fifth of the patients on placebo (2:2:1 randomization, n = 792), and because the placebo patients are converted to active arms beginning as early as 3 months into the study, the majority of adverse events would be expected to occur in patients on active treatment.

The mortality rate from all causes across the tofacitinib RA development program, including the ORAL Sync study, is within the range of rates reported for biologic therapies for RA.

Full results of ORAL Sync will be presented in a late-breaker oral session at EULAR on May 27, 2011, at 4:20 p.m. GMT in London.

About ORAL Sync

ORAL Sync evaluated the efficacy and safety of tofacitinib doses 5 mg and 10 mg given twice daily compared to placebo in patients with moderately to severely active RA who had a previous inadequate response to a DMARD and who continued to receive background traditional DMARD therapy throughout the study.

Pfizer Inc.: Working together for a healthier world?

At Pfizer, we apply science and our global resources to improve health and well-being at every stage of life. We strive to set the standard for quality, safety and value in the discovery, development and manufacturing of medicines for people and animals. Our diversified global health care portfolio includes human and animal biologic and small molecule medicines and vaccines, as well as nutritional products and many of the world’s best-known consumer products. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as the world’s leading biopharmaceutical company, we also collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 150 years, Pfizer has worked to make a difference for all who rely on us.

DISCLOSURE NOTICE: The information contained in this release is as of April 21, 2011. Pfizer assumes no obligation to update forward-looking statements contained in this release as the result of new information or future events or developments.

This release contains forward-looking information about a product in development, tofacitinib, including its potential benefits, that involves substantial risks and uncertainties. Such risks and uncertainties include, among other things, the uncertainties inherent in research and development; decisions by regulatory authorities regarding whether and when to approve any drug applications that may be filed for tofacitinib as well as their decisions regarding labeling and other matters that could affect its availability or commercial potential; and competitive developments.

Arthritis May Benefit From Homeopathic Treatments

According to a EurekAlert! public release, research from the University of Southampton has shown that arthritis patients can improve from homeopathic treatment along with conventional treatment. The study was published on November 15, 2010 in the journal Rheumatology.
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Improved My Health
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Researchers speculated that it may not be the remedies themselves that brought improvement so much as the homeopathic consultation process. Homeopathic consultations focus on treating the whole person, unlike conventional treatments that focus on the illness.

The patients’ health improved safely suffering no adverse side effects. Decreases in symptoms were noted, with fewer swollen joints and sores, while pain levels went down and moods lifted.

According to the Mayo Clinic, about 40 percent of adults in the U.S. are exploring and many are embracing alternative and complementary medicines. Alternative therapy refers to any treatment outside of conventional Western medicine practices. Complementary therapy would be an alternative therapy used along with conventional medicine.

Homeopathy on its own is an alternative therapy. When used in conjunction with traditional Western medicine it is a complementary therapy.

The Mayo Clinic website explained that conventional doctors have been and may continue to be cautious in accepting some of these less familiar practices. They traditionally rely on research and test results, and many of these other therapies have not yet been through the batteries of tests, or the results are not yet clearly understood.

Homeopathic medicine’s foundation is that whenever possible, the body can and will heal itself. Symptoms of illness are viewed as the body’s normal responses as it moves towards health.

According to homeopathy, like cures like. A substance that might cause a particular symptom in a healthy person, is considered as a possible cure in very small amounts for an ill person. The idea is to support and enhance the body’s natural abilities to heal and regulate itself.

Remedies may be pills or liquid solutions with a very small amount of an active ingredient. These usually come from a plant or mineral.

According to, homeopathic medicines are considered safe, having been regulated in the U.S. since 1938, and may have helpful effects.
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Improved My Health
Changed My Life
Saved My Life

Critics doubt that any treatment using such small doses can make a difference and assume that any improvement must be due to the placebo effect.

But stated that studies to this end have concluded that while how homeopathic solutions work was not readily apparent, evidence clearly indicated that the effects of homeopathic solutions differed from the effects seen from placebos.

Celabolin Helps Put A Stop To Arthritis Pain… In As Little As Half An Hour

The name ‘arthritis’ actually refers to any acute or chronic abnormality of a joint as a result of inflammation. Degenerative joint disease (DJD) is the most common form of arthritis, in which the main problem is the breakdown of the cartilage that covers the ends of the bones. Celabolin, combines the power of the natural neutriceutical product, Celadrin, with no less than eight other minerals and natural anti-inflammatories. These include zinc, copper and manganese, as well as yucca extract, resveratrol, hops, black pepper and the protein-digesting enzyme bromelain.

With the passing years, many of us experience pain and inflammation in our joints. The name ‘arthritis’ actually refers to any acute or chronic abnormality of a joint as a result of inflammation. Degenerative joint disease (DJD) is the most common form of arthritis, in which the main problem is the breakdown of the cartilage that covers the ends of the bones.

Yet mainstream medicine has little to offer sufferers, as a survey carried out for Bupa in 2009 revealed. It concluded that UK health services are failing to meet the needs of millions of chronic joint pain sufferers, with a staggering 80 per cent still living with daily pain, despite following their recommended treatment.

Now, though, there’s a powerful natural supplement that not only helps relieve pain but also lubricates and restores mobility to your joints. It even encourages the re-growth of new cartilage.

Celabolin, from Life Natural Cures, combines the power of the natural neutriceutical product, Celadrin, with no less than eight other minerals and natural anti-inflammatories. These include zinc, copper and manganese, as well as yucca extract, resveratrol, hops, black pepper and the protein-digesting enzyme bromelain.

What impressed us most, here at HSI, is the sound, scientific research that backs up the formula.

Celadrin ‘switches off’ pain and stiffness in as little as 30 minutes

Celadrin, the key constituent of Celabolin, has taken America by storm, since we first brought it to your attention back in the May 2007 issue of HSI. It is one of the most effective natural anti-inflammatory compounds available, containing a unique blend of fatty acids. These are similar to, but far more effective than, EPA and DHA, the fatty acids found in health-enhancing fish oils.

What makes the naturally-occurring fatty acids in Celadrin so special is their chemical form, as cetylated or esterified fatty acids. Since the body has to convert fatty acids into this form in order to use them, Celadrin delivers their benefits faster and more effectively. This means that it can rapidly ‘switch off’ the processes that lead to joint inflammation, pain and cartilage degeneration. Celadrin also acts as a physical lubricant, allowing muscles and joints to move smoothly and painlessly.

In one clinical trial, when patients with chronic arthritis of the knee took Celadrin capsules or placebo for 10 weeks, the group taking Celadrin experienced significantly less pain than the placebo group as well, as much better joint flexibility and walking ability. Celadrin has also shown outstanding results when used as a topical cream by patients with osteoarthritis of the knee, reducing pain and stiffness in as little as 30 minutes after application.

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Skin Care News

2011-04-21 / Skin Care / 0 Comments

Natural Oily Skin Facial Recipes

With the hot months just around the corner it’s time to update our skin care routine to the needs of our complexion. These natural facial recipes for oily skin will help you eliminate the sebum excess from your pores. Revitalize your skin by using the most efficient green ingredients professional beauticians also include in their secret potions.

Unclogging your pores with special treatments is one of the quick fixes to rule out the chance of any skin problems. Using similar natural oily skin facial recipes will provide you with the best remedy to eliminate the dirt and other free agents from the surface as well as depth of your complexion. Rookies in green skin care will definitely find the visible positive results of these rituals simply thrilling. Those who managed to pile up a multitude of soothing homemade facial recipes will have the opportunity to complete their personal collection with additional treatments.

People who struggle with an oily complexion know how important it is to keep dust and chemicals at a fair distance from their pores. Using skin-friendly ingredients loaded with vitamins will furnish their skin with the necessary protection to stay acne-free. These are some of the recipes you should experiment with next time you feel the need of a soothing beauty session.

Orange and Grapefruit Facial

These common ingredients can be easily purchased at the local store or market. Peel the fresh fruits and use a medium bowl in which you can crush the slices. Additionally add 2 tbs of honey to ease the application of the paste.

After you obtained the ideal texture all you have to do is apply the facial on your skin. Leave the mask on for 20-30 minutes and finish up your skin care ritual by rinsing off the paste leaving your complexion fabulously revitalized.

Watermelon Facial

This delicious fruit is also used to create soothing facials for your oily complexion. In this case all you have to do is cut a few thin slices of watermelon and crush them in a bowl. Add 2 tsp of honey to make the mixture more solid and applicable.

Cleanse your skin from dirt and sebum excess and apply the mask carefully. Leave out all the delicate spots as the area around your eyes. Leave the facial on for 30 minutes. The watermelon juice will do miracles with your pores. Finally wash it off with lukewarm water.

Cheese Facial

Dairy products when used as ingredients in different facial recipes will show you their natural astringent quality. Cleanse your oily complexion with this calming and nutritive cheese mask. In order to create the facial mix 1 tbs of cottage cheese with 1 tbs of honey. Additionally you can add also 1 tbs of mashed strawberries and 2 tbs of milk. The creamy texture allows the textbook style application of the mask. Cover the critical sections and leave on the treatment for at least 10 minutes. Afterwards you can rinse off the paste with tepid water.

Carrots and Honey Facial

Vitamin C and A are some of the nutrients our skin needs to stay super-healthy and pimple-free. If you don’t get the right amount of these elements it is high time to provide your complexion with soothing facials that include these ingredients. The following carrots and honey facial will furnish your skin cells with the necessary amino acids and minerals. First cook 2-3 carrots and crush them in a medium bowl. Add 2 tbs of honey to make the paste more solid. Apply the mixture on your skin and leave the mask on for at least 10 minutes. Give some time to ingredients to exercise their revitalizing effect, then you can wash the paste off with lukewarm water.

TRIA Beauty raises $21 million from Morgan Stanley and Silicon Valley Bank

TRIA Beauty, a maker of skincare devices, has raised an additional $21 million in debt and equity financing from Morgan Stanley Alternative Investment Partners and Silicon Valley Bank after raising $16 million last August.

The Dublin-based company now has $27 million in equity and $10 million in debt financing it plans to use for its light-based skincare products.

“We remain focused on fulfilling our promise to consumers that TRIA will continue to bring innovative skincare treatments out of the doctor’s office and into the home,” said Kevin Appelbaum, CEO of TRIA Beauty.

TRIA makes the only FDA-cleared hair removal laser available for home-use and last year introduced the Skin Clarifying System, which uses lasers and cleansers to treat acne.

“We are delighted to be bringing the resources of Morgan Stanley AIP to helping Kevin and his team as they continue to deliver great products at great value to customers around the world,” said Jamey Sperans, Manager Director, Morgan Stanley.

The company also put two new members on its board of directors: Mike Valentino, former president and CEO of Xanodyne Pharmaceuticals, and Ed Unkart, former CFO of SurgRx Inc., Novacept and FemRx Inc.

LOVE SPORT LOVE LOTIL – Skincare Must Have For All Sports Enthusiasts

Whether you’re an avid skier, skydiver, sailor or cycling fan, whatever your sporting preference, Lotil Cream ( will help protect your skin from the elements.

The rich, hydrating and gentle formula rubs in without fuss whilst providing an anti-bacterial barrier to help fight infection on any broken skin. Those in the know have favoured the deeply moisturising tried & trusted formula for over a hundred years.

As well as testing your body to its limit, sporting challenges can be gruelling on the skin: wind, rain, salt, sun and freezing temperatures can all lead to chilblains, cracks, chaps, cuts and dehydrated, broken skin. Lotil protects and promotes good skin health, contributing to optimal performance by providing maximum moisture and protection against the elements.
Lotil has been specifically formulated for all dry skin conditions. This rich, easily absorbed cream also features antiseptic, anti-bacterial and antifungal properties whilst fighting infection from top to toe, leaving you free to concentrate, with your eyes on the prize and your skin in the best possible condition.
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Tried and trusted for over 100 years, Lotil Cream successfully provides everyone with the most complete skin care and skin relief package available. Lotil Cream is accessibly priced for everyday use by all the family and is available in three handy sizes for handbag, office and home.

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Cancer Treatment News

2011-04-20 / Cancer News / 0 Comments

New cancer treatment developed at VGH freezes tumours

Cancerous tumours are being engulfed within ice balls, then thawed and frozen again until they wither and die as part of a new technique being pioneered at Vancouver General Hospital.

The process involves sending argon gas through long thin hollow needles into tumours, plunging the cancer cells to temperatures of -100 Centigrade, then thawing the cells with helium gas.

“The tumour cells are killed by the combination of freezing and thawing. The freeze, thaw, freeze cycle results in complete tumour cell disruption,” said Dr. Peter Munk, an interventional musculoskeletal radiologist at VGH.

Called percutaneous cryoablation, the technique is being explored as a less painful alternative to some other procedures used to deal with cancer. And because the ice ball that surrounds the tumour is visible to surgeons, they can track what is happening to it as well as avoid injury to surrounding tissue and organs.

A pilot project to evaluate the safety and efficacy of the procedure is expected to begin at VGH in a few months after final approvals from a University of B.C. ethics review panel.

The project will involve up to 15 patients with metastatic disease -cancer that has spread to muscle and bone -who need help to relieve extreme pain, said Munk.

Pain can be severe for such patients and conventional therapy, such as radiation or pain medications, may not be effective, he said. The new technique can also be used to either cure or treat the pain associated with liver, lung or kidney tumours.

“With the cryo method, it’s less painful than other procedures because it involves freezing,” said Munk.

“It has an anesthetic, numbing effect. Patients can get a local freezing before the probes go in, and a sedative, and then they can leave after the procedure.”

He noted that other methods -such as radio-frequency ablation, which uses heat -may require a general anesthetic, requiring patients to stay in hospital for a few days after.

Another major advantage was cited by University of Wisconsin doctors in a 2008 study describing a series of cases involving cryoablation.

They noted the ice ball that surrounds the tumour is visible on CT scanning technology, which means that tumour death can be observed, as can the status of surrounding structures, like nerves and organs. That is important because doctors don’t want to damage such nerves and organs.

The study also said cryoablation appears to be less painful than other methods, not only during the procedure, but in the immediate aftermath.

The process involves using CT scanning technology as an imaging guide to insert needlelike probes through the skin to the targeted tumour.

The insulated probes are connected to a generator box that provides the argon gas that then flows through the steel tubes. Most tumours require the placement of multiple probes positioned at different angles. The temperature at the uninsulated tips of the probes drops to -100 Centigrade.

After a certain length of time, the frozen tissue is then thawed by helium gas passed through the same probes, and then the freezing cycle is repeated.

Although the cost of each case varies, Munk concedes it is expensive because the $1,000 probes are disposable (one use only) and several might be required for each case. Although the capital cost of the generator box is relatively inexpensive ($50,000), other costs, which can add up to many thousands of dollars, relate to the medical and CT technology staff required.

The cost of the Vancouver Coastal Health Research Institute study will be sponsored by Galil Medical, which manufactures the equipment acquired by VGH with donor funds. Munk’s collaborator in the study is Dr. Paul Clarkson, an orthopedic surgeon who specializes in bone and soft tissue cancers.

Dr. Stephen Ho and Dr. David Liu are interventional radiologists at VGH who have also started using the method.

Cryoshock causing death is the most serious adverse effect that has been described in the medical literature about the technique.

But Munk, who is editor of the Canadian Association of Radiologists Journal, said of the 30 patients who have had cryoablation at VGH since the technology was acquired last year, there have been no serious complications during or after the procedures.

The benefit of the trial is that the cases will be documented and the data peer reviewed and published for close examination of the results.

Melbourne dentist wins cancer therapy case

Health and consumer advocates have vowed to continue fighting after a legal case against a deregistered dentist who claimed to successfully treat cancer sufferers failed.

Victoria’s health services commissioner Beth Wilson said better ways must be found to deal with unregistered practitioners who could exploit vulnerable people, after the Victorian Supreme Court challenge brought by Consumer Affairs Victoria (CAV) collapsed.

CAV had alleged that Noel Rodney Campbell made misleading claims that his alternative treatments could kill cancer and extend the life of patients with a terminal diagnosis.
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Mr Campbell offered treatments such as photo dynamic therapy, radio wave therapy, ozone therapy and high doses of vitamin C at his business, the Hope Clinic in Glenroy.

The clinic was promoted via a website which Mr Campbell set up after his Collins Street practice closed two years ago following a damning report by the health services commissioner.

That report found Mr Campbell’s Hope Clinic acted unethically when it failed to inform patients there was no scientific basis for his treatments.

After the case against Mr Campbell was dismissed on Tuesday, Ms Wilson, who said her office had been grappling with unregistered “alternative” health providers for a decade, expressed dismay.

“Getting redress for people who have been harmed physically, emotionally and financially has been very difficult,” she said.

“I was hoping this case would provide us with assistance in that regard.

“We need better ways of dealing with those unregistered practitioners who exploit vulnerable people.”

Mr Campbell, who represented himself in court, is not a medical doctor nor is he qualified in oncology, but has practised as a dentist for 30 years.

CAV pointed to 37 claims on his clinic’s website it said amounted to misleading and deceptive conduct and breached the Fair Trading Act.

The case against Mr Campbell was essentially that the therapies provided by the Hope Clinic were not sanctioned by conventional medicine, Justice Tony Pagone said in his judgment.

Justice Pagone said he was not satisfied the statements were false and misleading, because the clinic’s website made the distinction that its treatments were alternative and did not pretend to be orthodox medicine.

Outside court, Mr Campbell continued to insist his clinic did not promote a cancer cure.

“We’ve never claimed to cure cancer,” he said.

“Most of the people we see are at stage four, and they’re going to die within a period of time and our aim with those people is to extend their life.”

Mr Campbell was deregistered as a dentist in Victoria in 1998 after being found guilty of professional misconduct for providing grossly negligent dental treatment.

He remains registered in NSW.

CAV acting director Geoff Browne said the watchdog would now “consider its options” but did not back away from the action taken against Mr Campbell.

“We hope this action will encourage anyone suffering from terminal cancer and their families to thoroughly research any alternative medical treatments before … handing over tens of thousands of dollars,” he said.

Cancer Treatment – Key To Reducing Cancers In Developing Countries Revealed

Administration of human papillomavirus (HPV) vaccine doses over a longer period of time to adolescent girls in Vietnam resulted in antibody concentration levels that were comparable to the standard vaccine schedule, according to a study in the April 13 issue of JAMA, a theme issue on infectious disease and immunology.

Kathleen M. Neuzil, M.D., M.P.H., of PATH, Seattle, presented the findings of the study at a JAMA media briefing at the National Press Club in Washington, D.C.

Cervical cancer is an important cause of illness and death among women throughout the world. “Each year, new cases of cervical cancer occur in approximately 529,000 women and 275,000 women die. An estimated 88 percent of deaths due to cervical cancer occur among women residing in developing countries,” according to background information in the article. Human papillomaviruses are the primary cause of cervical cancer. “Combined with continued strengthening of simple evidence-based screening and treatment approaches, effective HPV vaccine programs could reduce cervical cancer rates in developing countries to the low levels currently observed in many developed countries. One challenge to broadly implementing HPV vaccination programs in developing countries will be delivering the currently recommended 3 doses of vaccine to adolescents within 6 months (dosing schedules at 0, 2, and 6 months or at 0, 1, and 6 months),” the authors write. Even in settings in which such vaccination schedules are feasible, alternative schedules may have advantages, such as lower cost (the vaccine could be delivered with other health interventions) or increased coverage (it may be easier for girls and their families or for vaccinators).

Dr. Neuzil and colleagues conducted a randomized noninferiority trial (predetermined measured outcome of intervention not worse than that of standard dosing schedule) in northwestern Vietnam to determine the immunogenicity (the ability of the vaccine to stimulate an immune response) and reactogenicity (the capacity of a vaccine to produce adverse reactions) of alternative schedules of quadrivalent HPV vaccine. The study, conducted between October 2007 and January 2010, assessed 4 schedules of an HPV vaccine delivered in 21 schools to 903 adolescent girls (ages 11-13 years at enrollment). Intramuscular injection of 3 doses of quadrivalent HPV vaccine was delivered on a standard dosing schedule (at 0, 2, and 6 months) or one of 3 alternative dosing schedules (at 0, 3, and 9 months; at 0, 6, and 12 months; or at 0,12, and 24 months). Of the 903 girls, 809 (89.6 percent) received all 3 doses of vaccine and had a serum sample available for testing after the final dose of the HPV vaccine.

For all 4 vaccination schedule groups and vaccine types, the HPV geometric mean titers (GMTs; a measure of antibody concentrations) were low at the beginning of the study and increased significantly after receipt of 3 doses of the vaccine. For the intention-to-treat population and compared with the standard schedule group at 0, 2, and 6 months, the alternative schedule groups at 0, 3, and 9 months and 0, 6, and 12 months met noninferiority criteria (as gauged by level of antibody concentrations) for the anti-HPV-16 and anti-HPV-18 (HPV types) responses at 1 month after receipt of the third dose. Compared with the standard schedule group, the alternative schedule group at 0, 12, and 24 months met noninferiority criteria for HPV-18 but not for HPV-16.

The vaccine was generally well tolerated in each dosing schedule group. Pain at the injection site was the most common adverse event. No serious adverse events were found.

“The similarity of the immunogenicity and reactogenicity profiles of the HPV vaccine reported from this predominantly ethnic minority population in a low-resource area of Vietnam and other populations throughout the world is reassuring and supports more widespread introduction of the vaccine. The World Health Organization acknowledges that programmatic constraints must be considered in the decision to commence national HPV immunization programs. The option of delivering HPV vaccine on flexible schedules will allow countries to minimize costs and maximize feasibility according to local vaccination practices,” the authors write

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Healthy Nutrition Today

2011-04-19 / Nutrition & Diets / 0 Comments

Surprisingly Healthy Easter and Passover Foods

Holiday meals are all about tradition, and some of the most customary foods served during Easter and Passover slyly pack a pretty significant health punch. Here are five reasons to feel a little virtuous this season:

Eggs get a bad wrap they truly don’t deserve. Yes the yolk is where all the cholesterol is, but dozens of studies confirm that saturated and trans fats are the true heart disease triggers, not cholesterol — eggs are low in saturated fat and are trans fat free. In addition to high quality protein the yolk is also where the vitamin D (linked to a number of health benefits including weight control) and choline are found. Adequate choline is tied to brain health, muscle control, memory and reduced inflammation — a known trigger of aging and disease — and heart health.

Spuds have earned a reputation as nothing more than a fattening waste of calories, but they’re actually one of the healthiest foods on the planet. In addition to providing fiber, antioxidants, vitamin C and B vitamins, when cooked then cooled, taters are also loaded with resistant starch, a unique kind of carb that’s been shown to naturally up your body’s fat-burning furnace. Like fiber, you can’t digest or absorb resistant starch and when it reaches your large intestine, it gets fermented, which triggers your body to burn fat instead of carbohydrate.

This condiment with kick opens up the sinuses to support breathing. It’s also been shown to boost immunity, and rev up metabolism. Pretty big benefits for a whole lot of flavor and a zero calorie price tag.

Many people dismiss parsley as nothing more than a decorative garnish, but it’s actually a nutritional powerhouse. This Mediterranean herb is rich in immune supporting vitamins A and C and loaded with potent anti-aging, cancer fighting substances. In animal research one of parsley’s volatile oils halted the growth of lung tumors and was shown to neutralize cancer-causing substances like those found in cigarette smoke.

Red wine has come to be thought of as a health food these days, but don’t discount white. A recent Spanish study looked at the effects of each type (6.8 ounces a day) over a 4 week period in a small group of nonsmoking women and both varieties upped “good” HDL cholesterol levels and lowered inflammation, two keys to keeping your heart strong and healthy.

Understanding nutritional labels on food

Reading a nutrition label is a no-brainer. But figuring out what it means can feel like it requires a math degree. Ever since nutrition labelling became mandatory for all prepackaged foods in December of 2007, Canadian consumers have struggled to understand what food companies are trying to say on their products’ Nutrition Facts labels.

A Health Canada survey reported last summer that consumers were especially confused by the right-hand column which displays what percentage of a day’s worth of nutrients the serving provides. Serving sizes, too, were criticized for being inconsistent and not realistic.

The result of that survey is what is driving the current nutrition-facts education initiative, a TV, print and website campaign developed by Health Canada and Food & Consumer Products of Canada. Front and centre is the issue of percentage Daily Value (% DV) – a component which has been previously ignored or misunderstood by many of us. (Take calcium, for instance: Is the % DV based on 1,000 mg a day or 1,500 mg per day? For other nutrients is the % DV the same for men and women, the elderly and the young?)

Perhaps it doesn’t matter, because Health Canada is now advising consumers to think more simply: Instead of trying to make a whole lot of sense of the % DV, use it to see if the amount of food shown on the label has a little or a lot of a nutrient. Say you’re looking for low-fat yogurt and you compare two brands – one has 4% of fat per one cup and one has 8% of fat per one cup. The right choice, then, would be the 4%. Little or a lot: Simple.

If there is a right choice, that is.

“When reading a label, I tell my patients to look for what they need to know,” says Fran Berkoff, the Toronto Sun nutrition columnist and a registered dietitian in private practice. “For example, if you want more calcium or iron in your diet, then look to see if a product is giving you a lot or too little – say, 20% of a recommended daily allowance or 1%.

“If I am looking for calcium for my diet and I have a glass of milk, the % DV can show me that the glass of milk provides a third of the calcium I need for a day. That makes it a really good choice because I’m well on my way. If the label indicates it’s giving me 1%, then I can see that’s not very much and not as good a choice if it’s calcium that I’m looking for.”

Berkoff says that nutrition labels can educate but “you still need some extra knowledge on the side to know where, say, to look for the calcium.” (In the dairy section, to start with.) “And not everybody has to look for everything on a label,” says Berkoff, who says the % DV can be helpful to consumers trying to increase or decrease their intake of a specific nutrient. “If you were trying to increase your iron, for example, you would compare two or three cereals for their % DV of iron to see which one has the most.”

Likewise, if you were trying to lose weight you might compare calories and choose the product with fewer calories. But here is where labels can be easily misunderstood, says Berkoff. “Someone trying to lose weight might compare low-fat and not low-fat labels and find that the calories are exactly the same or even higher in the low-fat product. You could be looking for a snack and think a certain food is good because it’s low in fat, but in fact it is higher in calories because it has more sugar.”

Use the labels to compare each for each: Yogurt against yogurt, cracker against cracker: “Know what’s important to you so you don’t get overwhelmed with the information,” Berkoff advises. “You need to have a basic starting point – say, knowing what foods contain iron if you’re looking for iron. But you don’t have to read everything on the label because some of the things won’t matter to your particular circumstance and might confuse you.”

Do the math

Cracker A’s serving is nine crackers and weighs 23 grams. Cracker B’s serving is four crackers and weighs 20 grams. Cracker A has 13% DV for fats, 12% DV for sodium and 4% DV for fibre. Cracker B has 2% DV for fats, 4% DV for sodium, and 12% DV for fibre. The healthier choice? Cracker B – lower fats and sodium, higher fibre.

Look, read, choose

Nutrition Facts are based on a specific amount of food. Compare this to the amount you actually eat.

Read the % DV. 5% DV or less is a little of the nutrient listed; 15% DV or more is a lot.

Choose the healthier product. For example, one with less fats and sodium, and more fibre, Vitamin A, Calcium, and Iron.

What’s in it?

“The ingredient list is helpful because the ingredients are listed in descending order by weight,” says registered dietitian Fran Berkoff. In chicken soup, for instance, choose the product that lists chicken broth rather than water as its first ingredient. “The list of ingredients can also provide vital information if you have food allergies.”

Do I really need to know?

Making healthy food choices can help reduce your risk of nutrition-related chronic diseases including cancer, diabetes, heart disease and stroke.

Labels needed

These foods are not required by to have a Nutrition Facts label: Fresh fruits and vegetables, raw meat and poultry (unless ground), raw fish and seafood, foods prepared or processed at the store; foods containing very few nutrients such as coffee or herbs, alcoholic beverages.

A Good Diet Includes Many Cancer-Fighting Foods: Expert

Losing weight can help reduce your risk of cancer if you’re overweight or obese, but not all diet plans are effective in lowering that risk, an expert says.

Diets that help protect against cancer are those that encourage long-term changes in eating habits and also provide a variety of options from all food groups, explained Daxaben Amin, a senior clinical dietitian in the clinical nutrition department at the University of Texas M.D. Anderson Cancer Center.

The Mediterranean-style diet promotes a life-long commitment to good nutrition and also meets many of the dietary guidelines for preventing cancer and heart disease, including:
Plenty of fruits, vegetables and other plant-based foods.
Using herbs and spices to flavor foods instead of salt.
Limiting consumption of red meat and alcohol.
Using healthy fats such as olive and canola oils instead of butter.
Eating fish and poultry at least twice a week.

Another good diet is the whole-body type of diet, which involves eating six to seven small meals a day instead of the usual three large meals. It offers the following cancer prevention benefits:
Fruits, vegetables and whole grains in at least half your daily meals.
Limiting foods high in fats.
Eating lean protein.
Daily physical activity.

“Diet plans that encourage short-term change usually don’t provide the nutrients your body needs on a daily basis. These diets make our ‘bad’ list,” Amin said in a cancer center news release.

Gluten-free diets are becoming popular but people shouldn’t go gluten-free unless they have celiac disease, Amin advised. Going gluten-free means avoiding foods with whole grains, which are high in fiber, vitamins and minerals — all of which protect cells from damage that can lead to cancer.

Carbohydrate-free diets are another bad choice. Completely eliminating carbohydrates deprives the body of its primary source of energy and of some important cancer-fighting foods — vegetables, fruits, whole grains and beans.

“Instead of going carb-free, choose your carbohydrates wisely. Pick whole grains rather than cakes, cookies and other foods made with processed or refined grains and sugars,” Amin suggested.

Become your own personal nutrition assistant – Roll up your sleeves: taking control of your eating habits is easier than you might think

Wouldn’t it be great to have a personal nutrition assistant? An expert who stocked the fridge regularly with appetizing plates of fruit for snacks and vegetables ready to be tossed into meals? She’d keep the kitchen tidy and have at hand the best tools for making quick work of meal preparation.

With this kind of help, it would be so much simpler to focus on healthy eating.

But let’s re-enter the real world. Since the vast majority of us don’t have access to kitchen staff, if we’re seriously committed to weight loss or maintaining a healthy weight we have to be our own kitchen assistant.

For permanent success, it’s an absolute requirement to get the area in order. So roll up your sleeves and refresh your own kitchen.

Put particular emphasis on five areas:

1. The fridge. This is vitally important. To ensure fresh vegetables and fruit comprise half the plate in most meals and snacks, they have to be easily accessible. Clean your fridge. Get rid of items you won’t eat. Then start shopping for fresh produce at least twice each week. Put it away in an organized fashion. Keep a crisper of washed and cut up carrots and celery. Stock at least three additional vegetables and three kinds of fruit for use each week. Keep a shopping list handy to add items as you start to run low.

2. Canned goods. There are several canned goods worth having on hand for use in healthy recipes. Particularly good choices are salmon, tuna and sardines, canned tomatoes, chickpeas, black beans, lentils and other legumes, and canned fruit packed in its own juice. There are also poor choices: clear out anything that’s of low quality and unworthy of your improved eating habits, including salty canned pastas and soups.

3. Grain products. Take time to sort through your pasta, rice, bread, cereals and crackers. Ensure most are whole grain and supply at least two grams of fibre per serving. For cereal, check that the sugar is below eight grams per serving and fat is less than two grams. If crackers, cookies and chips are too easily relied on for snacks, stop buying them. These foods often supply excess sodium, and the more salt you eat, the more you want.

Replace these snacks with more nutritious ones like novel tropical fruits, fresh vegetables with a tasty low-fat dip, toasted almonds or pecans.

4. The freezer. Whether it’s massive or just the one in your fridge, the freezer is a vital tool in a healthy eating plan. Keep frozen blueberries, peaches and other fruit for adding to smoothies and healthy desserts, a variety of whole grain bread products such as sliced bread, English muffins or tortillas, lean meats like chicken and fish, and a selection of frozen vegetables with no added sauces. If you haven’t discovered Brussels sprouts, they’re one of the best frozen veggie options.

5. The tools. It’s tough to eat the requisite quantity of vegetables and fruit if your preparation equipment is lousy. Invest in a new, rustproof vegetable peeler, a clean cutting board and a sharp paring knife or two. A decent non-stick pan, a couple of saucepans and roasting pans are also required tools for healthy eating. Parchment paper is worth using for simple clean up after roasting.

Storage supplies are other key tools. Items like plastic containers with lids and plastic or foil wrap make it easy to store leftovers or pack along to fuel a busy day.

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Hair Loss Prevention News

2011-04-16 / Other / 0 Comments

AQ Skin Solutions Launches Growth Factor Technology to Deliver Advanced Anti-Aging Skin Care and Hair Loss Prevention

MISSION VIEJO, Calif., April 14, 2011 /PRNewswire/ — AQ Skin Solutions, a leading research and development lab in the skin care industry, today announced the worldwide launch of its Growth Factor (GF) technology, a cutting edge technology producing human growth factors to be used in topical skin care products. AQ Active Serum®, AQ Eye Serum®, and AQ Advanced Hair Complex+® make up the new line of advanced skin care products focused on resolving multiple skin conditions, including hyper-pigmentation, discoloration, acne and lines, wrinkles, and hair loss.

The new line of AQ Skin Solutions products is based on Growth Factor technology, a patent pending procedure of human growth factors production. Growth factors are a group of specialized proteins with many functions—the most important being the activation of cellular renewal. GF can be found in many different cell types in the human body, turning essential cellular activities “on” and “off”, and playing a variety of roles that help to maintain the skin’s youthful appearance, particularly increasing cell renewal, cell defense, blood circulation, and collagen and elastin production.

“GF technology is the future of skin care,” said Dr. Ahmed Al-Qahtani, professor of medicine, and founder of AQ Skin Solutions. “In recent decades, scientific research into GF biological functions has shown that GF technology is related to resolving many cell developmental diseases. And when applied to skin care, GF technology can help people achieve a more youthful and vibrant look without expensive plastic surgery or other cosmetic treatments.”

Weaves lead to scarring, hair loss, scalp problems

Seems like everyone these days suddenly has the long, luscious locks of Rapunzel.

Weaves have allowed many of us to have the hair that nature didn’t give us.

But these weaves are now causing health issues for many African American women.

A recent study found that braids, weaves and other types of hair extensions may be contributing to scarring of the scalp and hair loss in African American women.

Researchers at the Cleveland Clinic in Ohio issued questionaires to 326 African American women about hair loss. Hair loss in the center of the scamp and clinical signs of scarring were seen in 59 percent of the women who responded.

Type 2 diabeties was also higher in the women with hair loss, suggesting that metabolic irregularities may contribute. Bacterial scalp infections and braids and weaves also seemed to contribute.

So, ladies, although you may want hair down your back, think of the consequences that may come with getting it. Maybe lay off the weaves and be glad about what you have naturally.

Cap device could reduce chemotherapy hair loss

For many women facing the emotional and physical whirlwind of breast-cancer treatment, the possibility of losing their hair is one more trauma to go through.

“It’s typically two of the first questions I get – will I lose it, and when will I lose it,” said Dr. Susan Melin, who specializes in treating breast cancer as an associate professor of internal medicine – hematology and oncology – at Wake Forest Baptist University Medical Center, in Winston-Salem, N.C.

“They feel like it is a declaration to the world of their condition and the chemotherapy that they’re about to go through.”

Melin hopes that a feasibility study of a scalp-cooling device – just under way at Wake Forest Baptist – will enable her to eventually answer “no” more often to those questions.

“Preventing chemotherapy-induced hair loss by using the scalp-cooling cap may relieve severe psychological and emotional stress and improve the patient’s quality of life,” Melin said.

The Food and Drug Administration has approved Wake Forest Baptist and the University of California at San Francisco for an investigational device exemption for DigniCap, which is made by Dignitana of Lund, Sweden. The study is the first step required to gain FDA approval. Melin is the principal investigator for the Wake Forest Baptist study.

The device, aimed at patients with Stage 1 breast cancer, is already in clinical use in Canada, Europe and Japan. According to the Dignitana website, more than 80 percent of the patients have kept their hair during chemotherapy.

Both U.S. medical centers will enroll 10 patients. The first patient at Wake Forest Baptist is set to undergo chemo treatment while wearing the cap on Wednesday. UCSF has at least five patients enrolled.

The device is a tight-fitting silicone cap placed directly on the head, and an outer neoprene cap that insulates and secures the inner one. The cap is connected to a cooling and control unit with touch–screen controls. The design leaves the ears uncovered.

A coolant circulates throughout the inner silicone layer. The cap is designed to deliver consistent cooling to all areas of the scalp. The device features safety sensors that monitor and optimize the treatment temperature, typically around 42 degrees. A lower temperature is recommended for patients with thick hair.

When a cap is applied to the head, the temperature of the scalp is lowered over a 20- to 30-minute period. Blood vessels surrounding the hair roots contract, resulting in a significant reduction of cytotoxins to the follicle.

Reduced blood flow leaves a smaller amount of chemotherapy available for uptake in the cells. The decreased temperature results in less absorption of – and reduced effects from – the chemotherapy.

The treatment cycle, depending on the patient, would range from four times over a two–month period to eight times over a four-month period, Melin said.

Melin said there have been few side effects with the cap, primarily headaches. “One of the goals with the study is determining it is safe with no side effects,” she said.

Patients will have follow-up visits of three, six, nine and 12 months to determine whether hair has grown back.

Melin said that a larger efficacy study would include patients with Stage 1 and Stage 2 breast cancer.

“Basically, the DigniCap would be used for certain patients who have a moderate chance of their cancer recurring,” she said.

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Anxiety Treatment News

2011-04-15 / Mental Health / 0 Comments

End of Chemo Treatment, Relief or Anxiety?

There is no question that completing a course of chemotherapy treatment is a milestone in the life of a patient. Tomorrow, my 89-yr-old mother will receive her sixth and final dose of chemotherapy for lymphoma. She was initially hesitant about chemo and the effects it would have on her but eventually agreed to go through treatment. As she approaches her final dose, I honestly wonder whether it’s time for celebration or anxiety.

Chemotherapy gives the patient the ability to confront cancer cells head on. The possible side effects are a reminder that the toxins are doing their job and crushing the cancer cells. The chemotherapy has been a ‘body guard’ of sorts for my Mom, attacking her tumor with a prescribed course of action. After tomorrow, my Mom will part ways with this powerful partner and protector and be on her own. Without the toxic soldiers on her side, I imagine she might feel vulnerable, anxious, and alone. My role as her caregiver and advocate will change again as I encourage and support her as she gets back to living life as a cancer-free woman.

Cognitive behaviour therapy (CBT) for anxiety and depression in adults with mild intellectual disabilities (ID): a pilot randomised controlled trial

Several studies have showed that people with intellectual disabilities (ID) have suitable skills to undergo cognitive behavioural therapy (CBT). Case studies have reported successful use of cognitive behavioural therapy techniques (with adaptations) in people with ID.

Modified cognitive behavioural therapy may be a feasible and effective approach for the treatment of depression, anxiety, and other mood disorders in ID. To date, two studies have reported group-based manaulised cognitive behavioural treatment programs for depression in people with mild ID.

However, there is no individual manualised programme for anxiety or depression in people with intellectual disabilities. The aims of the study are to determine the feasibility of conducting a randomised controlled trial for CBT in people with ID.

The data will inform the power calculation and other aspects of carrying out a definitive randomised controlled trial.

Methods: Thirty participants with mild ID will be allocated randomly to either CBT or treatment as usual (TAU). The CBT group will receive up to 20 hourly individual CBT over a period of 4 months.

TAU is the standard treatment which is available to any adult with an intellectual disability who is referred to the intellectual disability service (including care management, community support, medical, nursing or social support). Beck Youth Inventories (Beck Anxiety Inventory &Beck Depression Inventory) will be administered at baseline; end of treatment (4months) and at six months to evaluate the changes in depression and anxiety.

Medication Plus CBT Effective for Anxiety in Primary Care

Cognitive behavior therapy (CBT) in combination with psychotropic medication is highly effective for treating most anxiety disorders in primary care, new research suggests.

In a study of more than 1000 patients, those who underwent the Coordinated Anxiety Learning and Management (CALM) collaborative care program had significantly decreased symptoms of principal generalized anxiety disorder (GAD), panic disorder (PD), and social anxiety disorder (SAD), and comorbid SAD than did those randomized to receive usual treatment from their primary care physician.

“The purpose of this study was to address disorder-specific outcomes for each participant’s constellation of anxiety disorders,” write Michelle Craske, PhD, from the Department of Psychology at the University of California, Los Angeles, and colleagues.

They note that the study was designed to compare the CALM intervention and usual care for both principal and comorbid disorders “while mimicking real-world conditions” — and is the first to do so in a generalizable sample population.

The study is published in the April issue of Archives of General Psychiatry.

Learning to Stay CALM

The investigators note that it is common for people with anxiety disorders to seek treatment in primary care, “where evidence-based mental health treatments often are unavailable or suboptimally delivered.”

For this study, 1004 patients (70.9% female; mean age, 43.7 years) diagnosed as having GAD (n = 549), PD (n = 262), SAD (n = 132), or posttraumatic stress disorder (PTSD; n = 61) were enrolled at 1 of 17 primary care clinics in Seattle, Washington, San Diego, California, Los Angeles, California, or Little Rock, Arkansas, between 2006 and 2008.

The patients were randomized to receive either the CALM intervention (n = 503) for up to 12 months or usual care (n = 501).

Usual care consisted of continued treatment of medication and/or counseling by the current primary care physician and referral to a mental health specialist, if needed.

The CALM intervention included pharmacotherapy, computer-assisted CBT, or both, depending on patient preference.

“Given the relative dearth of highly trained mental health providers available in primary care settings, we designed the CBT program to be used by persons with minimal or no training in mental health,” report the researchers, adding that that the computerized program was developed to guide both the provider and patient.

The collaborative care pharmacotherapy model allowed patients to continue being treated by their primary care physicians while healthcare managers or anxiety clinical specialists relayed advice from psychiatrists and helped manage medications.

All study participants were evaluated at baseline and at follow-ups conducted by telephone survey 6, 12, and 18 months later.

Measurement tools included the Generalized Anxiety Disorder Severity Scale, Panic Disorder Severity–Self-report Scale, Social Phobia Inventory, and PTSD Checklist–Civilian Version. These tools for used to assess both GADs and comorbidities.

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