Monday, 2 June 2014

Princess Health and Princess Health andDanville is latest Ky. community to ban indoor use of e-cigarettes, following new law that classifies them as tobacco product.Princessiccia

The Danville City Commission has approved an ordinance that bans the use of e-cigs in enclosed places, placing the same restrictions on them that already exist on traditional tobacco cigarettes, though the health risk of e-cigs has not yet been determined, Todd Kleffman reports for The Advocate-Messenger.

Kleffman notes that Danville is among a few Kentucky communities leading the way on placing restrictions on e-cigs, which are battery-powered devices that emit vaporized nicotine, but not tobacco.

"Bardstown, Manchester and Madison County have placed an outright ban on public use of e-cigs, while Kenton County prohibits their use in the workplace, and Glasgow bans them in bars and restaurants, according to attorney Chris Johnson of the Kentucky League of Cities," Kleffman writes.

E-cigs have become increasingly popular as an alternative to smoking, and because the amount of nicotine can be adjusted in the vapor liquid, many use it as a means to quit smoking, although this claim has not been proven.

�Generally, it�s people who are trying to quit smoking or are looking for a cheaper, healthier, less offensive alternative,� Blayne Hogue, operator of Vapor Visions in Danville, told Kleffman. �With the younger crowd it has appeal because of the taste and because it�s kind of the new thing.�

Speaking to the concern that vaporizing products with a "candy store array of flavors carrying names like Skittles, Pluto, Mother�s Milk and John Wayne" is designed to appeal to an underage crowd, Eric Griffiths, proprietor of the e-cig store Juice Box, asked,  �Why is that we have to be marketing to kids because it has flavors? Just because it�s an adult product doesn�t mean it has to taste bad.�

Neither store allows minors.

The U.S. Food and Drug Administration announced last month that it will begin regulating e-cigs in the future, Kleffman notes, and the Kentucky General Assembly passed a law this year that puts
vapor products in the same class as tobacco cigarettes, prohibiting their sale to those under 18.

The state law, not complaints from local business owners or residents, is what prompted the Danville City Commission to enact its own ordinance banning e-cigs in enclosed public places, City Manager Ron Scott told Kleffman.

�The state now classifies them as a tobacco product. What makes them different? By our ordinance, there is no distinction,� Scott said to Kleffman. �You can�t have it both ways. We had to clarify it for our businesses as to where they can be used. Vapor products contain nicotine, and from a public health point of view, there is an unknown amount of nicotine in the exhaled vapor that could affect others, like second-hand smoke. . . . Do you err on the side of caution, or do you just disregard the potential public health risks?"

The commission vote was 3-2, with Mayor Bernie Hunstad and Commissioner Kevin Caudill voting against the ban after two citizens argued that the prohibition was premature because no reliable research has proven that the devices create a public health concern.

Princess Health and#TeamMike vs. #TeamDave.Princessiccia

The team draft has finally come and gone!  If you don't know what the #MikeVsDave team challenge is, click here to learn more.



Here's how it went down!

(1) Rock, paper, scissors
This was used to determine who gets to call the coin toss.  Mike took down Dave's paper, and thus got to call the toss.

(2) Coin Toss
At 6:45pm, the coin was tossed at practice.  Mike called tails, and the coin landed tails up.  Mike opted to go second in the draft.

(3) Draft
Here is a review of how the draft went as shown on our live twitter feed starting at 9:00pm.

Pick #1: Team Dave takes RunnerRob
Pick #2: Team Mike takes Sean Delanghe
Pick #3: Team Mike takes Brendan Hancock
Pick #4: Team Dave takes Ahmed Ahmed
Pick #5: Team Mike takes IronLuke
Pick #6: Team Dave takes Greg Dyce
Pick #7: Team Mike takes Pat Mulherin
Pick #8: Team Dave takes Chris Goldsworthy
Pick #9: Team Mike takes Nick Burt for his sub
Pick #10: Team Dave's pick is TBA

Who do you think has the better team?

Stay tuned for full info on the rosters! 

Princess Health and Princess Health andBreakthrough drugs for targeted diseases work wonders, but are very expensive; some see a trend to worry about.Princessiccia

Princess Health and Princess Health andBreakthrough drugs for targeted diseases work wonders, but are very expensive; some see a trend to worry about.Princessiccia

Drugs focusing on narrow subsets of broader diseases are now being developed for individuals with specific genetic makeups. This trend prompts questions about who covers the cost, who gets the drugs and which diseases get the investment dollars, Brady Dennis reports for The Washington Post.

The newest "breakthrough" pharmaceutical is a new lung cancer drug named Zykadia, Dennis reports. The Food and Drug Administration released it four months ahead of schedule.

This drug is not designed to treat everyone who has lung cancer, which kills an estimated 160,000 Americans each year, including 3,500 Kentuckians. Kentucky's lung cancer death rate is almost 50 percent higher than the U.S. rate, placing Kentucky first in the nation for new cases and deaths from lung cancer.

Zykadia is designed to treat only about 5 percent of patients who fit into a specific subset of the disease: those who have advanced, non-small-cell lung cancer, and a specific gene mutation that causes tumors to resist other treatment, Dennis writes. For them�and only them�the drug has the proven potential to shrink tumors and extend lives.

�It�s a new world,� Wendy Selig, president of the Melanoma Research Alliance, told Dennis. �We�re segmenting what we thought of as large diseases into smaller populations of patients that are defined by genetic distinctions. .?.?. The goal is to match the right therapy to the right patient and to do it with minimal collateral damage.�

Since 2011, the FDA has approved numerous new treatments for melanoma, or skin-cancer patients with certain types of genetic mutations, specific cancers and a small proportion of people with cystic fibrosis, Dennis notes.

The FDA told Dennis that almost 40 of the nearly 50 drugs it has designated as potential �breakthroughs� involve targeted therapies. These targeted therapies often offer recipients earlier and better diagnoses, more effective treatments and even possible cures�or at least more time�for people who previously had little hope.

"But the trend toward targeted medicine also is forcing hard questions on regulators, drug makers, insurers and patients alike: Who should pay for the growing number of specialized drugs, which can cost hundreds of thousands of dollars a year? How does society ensure that everyone who might benefit�rich or poor�can receive treatment? What about patients whose specific conditions or mutations have not attracted investment dollars or the attention of researchers, leaving them to watch and hope from the sidelines?" Dennis writes.

Private insurers and Medicare generally cover the high drug costs, which currently account for only a fraction of overall health-care spending, Dennis reports.

But Barry Werth, an author and journalist who has spent decades writing about the pharmaceutical industry, asks, "What happens when targeted drugs become the rule rather than the exception? Will insurers refuse to cover some of them? Will the government ponder rationing them? Will only the wealthy be able to afford the best and newest treatments?"

This scenario could be happening with Sovaldi, a "groundbreaking new treatment" for the estimated 3 million Americans infected with hepatitis C, Dennis reports. Insurers are publicly rebelling against the drug's price of $1,000 per pill, or $84,000 for a 12-week treatment.

"The worry is that Sovaldi is the poster child for a �tsunami of expensive medicines� that collectively threaten to bankrupt the health-care system," John Rother, president of the National Coalition on Health Care, which represents insurers, employers, consumer and religious groups, health-care providers and some drug manufacturers, told Dennis.

�We�ve been able to absorb it so far because there are very few of them and because they are consumed by very small numbers of people,� Rother said of specialty drugs. �[But] if they�re all priced at the same level Sovaldi is, we really won�t be able to absorb it in the current system. It�s not sustainable.�

Edward Abrahams, president of the Personalized Medicine Coalition, an advocacy organization that includes drug makers, medical providers and patient and research groups, told Dennis that the cost of creating targeted drugs cost billions of dollars and often takes a decade or more to develop. Without the ability to recoup those costs, he said, "research will wither."

�As a society, we�re schizophrenic about this,� Abrahams told Dennis, adding that everyone wants to cure cancer and other diseases. �But at the other end, you have to be willing to pay for these products. .?.?. When you develop a drug for a segmented population, the cost of that drug is likely to be higher than if it worked for everybody.�

Saturday, 31 May 2014

Princess Health and Princess Health andSmoking increases risk of getting lung cancer by up to 20%, but add other carcinogens and it can go up as much as 300%.Princessiccia

If you smoke, your risk of getting lung cancer is as much as 20 times greater than if you don't. But if you smoke and are exposed to other carcinogens such as radon, asbestos, arsenic or chromium, your risk could be 300 times greater, according to "a growing body of research, including two studies under way at the University of Kentucky," reports Laura Ungar of The Courier-Journal.

See below for example of how to use interactive version of map
"The studies help explain why Kentucky�s lung-cancer and death rates are so much higher than for the rest of the nation," Ungar writes, citing experts. The state leads the nation in lung cancer, "and some Appalachian counties� rates are more than double the national average. While Kentucky�s adult smoking rate of 28 percent is the highest in the nation, it�s not enough to account for the state�s sky-high lung-cancer rates."

Here are two possible causes: Appalachian counties are high in arsenic and chromium, and Central Kentucky has high potential for radon gas, which can accumulate under buildings. "The National Cancer Institute says radon by itself is the second-leading cause of lung cancer in the United States, and most radon-related deaths occur among smokers," Ungar notes. "Kentucky has no laws requiring radon testing for single- or multi-family homes, schools or businesses; and no laws mandating radon-resistant construction of new homes," according to Ellen Hahn, a UK professor of nursing and public health.

"While doctors aren�t sure how smoking interacts with such carcinogens in the body," Ungar writes, "some theorize that when smoking damages lung cells� DNA, the lungs become more susceptible to damage from other toxins." (Read more) The map above is interactive on the Kentucky Cancer Registry website. Here's an example of how to display county data, which also shows the beginning of the county list ranked by lung-cancer rate; a map of county lung cancer death rates is also available:

Princess Health and Princess Health andUK researchers work to improve identification of lung cancer patients eligible for participation in clinical trials for new treatments.Princessiccia

Princess Health and Princess Health andUK researchers work to improve identification of lung cancer patients eligible for participation in clinical trials for new treatments.Princessiccia

At the University of Kentucky, researchers are developing better strategies to identify lung cancer patients who could participate in clinical trials for new treatments. Lung cancer causes more deaths than any other kind of cancer worldwide, and Kentucky's rates of lung cancer and mortality are the highest in the nation.

Unfortunately, fewer than 1 percent of lung cancer patients participate in clinical trials in part because identifying and recruiting eligible participants is difficult and time-consuming, Mallory Powell writes for UK. The disease is often diagnosed so late that there is little time for clinical trials.

"The combination of the burden of lung cancer in Kentucky and the urgency of identifying patients who are eligible for clinical trials motivated Dr. Eric Durben and his team to devise a more efficient method for screening patient eligibility," Powell writes. Durben is director of the Cancer Research Informatics Shared Resource Facility at UK's Markey Cancer Center and an assistant professor in the division of biomedical informatics in the College of Public Health.

Durbin and his team are using unique electronic data sources managed by UK's Center for Clinical and Translational Science, the Institute for Pharmaceutical Outcomes and Policy, the Markey Cancer Center and the Kentucky Cancer Registry to create system system to identify patients who for clinical trials. The two-year project is in its seventh month.

"Clinical trial recruitment is critically important to the Markey Cancer Center if we're going to get lifesaving therapeutics to our patients," said Dr. Susanne Arnold, associate professor in medical oncology and radiation medicine at Markey. "It's also how we make progress in cancer treatment."

While the project is geared toward lung cancer, its results could address other cancers. "What's really exciting about Dr. Durbin's study is that it has the potential to greatly improve clinical research not only in the lung cancer but in other cancers and disease conditions as well," said Dr. Nathan Vanderford, assistant director for research at Markey. (Read more)

Princess Health and Princess Health andPrescribing antibiotics for viral infections must stop; overuse of antibiotics causes antibiotic-resistant 'superbugs'.Princessiccia

Bronchitis is a viral infection, and antibiotics are not effective for treating viral infections.

Doctors know this, yet they continue to prescribe antibiotics to patients with bronchitis and other viral infections anyway, Ezra Klein reports on his new website, Vox.

Research shows that doctors prescribe antibiotics for acute bronchitis about 71 percent of the time even though they know that overuse of antibiotics is the leading cause of "superbugs," or organisms that are resistant to some if not all antibiotics, Klein reports. They do this because it makes patients feel better to walk out of the doctor's office with a treatment.

Klein goes on to paint a picture of a post-antibiotic future that could result from doctors prescribing antibiotics for viral infections. Klein reports that  patients must stop thinking that good physician care is the result of being treated with an antibiotic, especially in the treatment of bronchitis.

Kentucky and its Southern neighbors overuse more than their share of antibiotics.  The southeastern states are the highest users of antibiotics, with twice as many antibiotic prescriptions as states in the Pacific region, according to a study by the Center for Disease Dynamics, Economics & Policy, part of the federal Centers for Disease Control and Prevention.

CDC recommends that every hospital in this country have an antibiotic stewardship program and track their resistance and prescribing patterns. Half of all hospital patients get antibiotics and one-third of the antibiotics prescribed are inappropriate or are unnecessary, CDC Director Tom Frieden told Klein.

Frieden said the world is at risk of losing antibiotics to resistance created by over-prescribing, but a "modest investment" can thwart the most dangerous drug-resistant organisms. Working toward creating new antibiotics and then not falling into the same patterns of abuse must also be part of the solution, Frieden said. (Read more)