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A new analysis of the incidence of breast cancer in Italy per 100,000 women between the ages of 0 to 84 from 2000 to 2005 shows a 72 percent spike above official estimates issued by the Ministry of Health, with the sharpest uptick of +28.6 percent found in the youngest group studied (ages 25 to 44).

The new results, which rely on hospitalization databases that track major breast surgeries rather than official estimations computed using statistical models, appear in The Journal of Experimental & Clinical Cancer Research.

“Our findings show that women under 45 who are not currently enrolled in secondary prevention programs, should be considered for receiving regular mammograms,” says Prisco Piscitelli, Ph.D., of the CROM (Cancer Research Center) in Mercogliano, Italy, one of the study’s authors. “The results also strongly suggests that measures for adopting primary preventative measures to investigate and eliminate dietary, behavioral and environmental causes of breast cancer, such as estrogen in food, hormone pills, smoking, dioxin and pollution.”

The study was done by a multidisciplinary team of researchers (epidemiologists, oncologists, radiologists and surgeons) Antonio Giordano, M.D., Ph.D., Director of the Sbarro Institute for Cancer Research and Molecular Medicine and Director of the Center for Biotechnology at Temple University in Philadelphia, PA and ‘Chiara fama’ Professor in the Department of Human Pathology & Oncology, University of Siena, Siena, Italy.

Overall, the incidence of breast cancer from 2000 to 2005 among all age groups was 26.5 percent higher than official estimations. The incidence of breast cancer per 100,000 women aged 0 to 84 years was 141.80 in the year 2000 and 160.85 in 2005, a 13.4 percent increase. This is 72 percent higher than that provided by official estimations of the Ministry of Health (93 per 100,000 women aged 0 to 84). There was an increase among all groups studied: +9.4 percent in people aged 45 to 64; +11.7 percent in people aged 64 to 75 and +15.7% over 75 years old.

But the most important finding of the study reveals that the highest increase in the incidence rate per 100,000 was observed among women below 45: +28.6 percent in people 25 to 44.

The new analysis examines the number of major surgeries (mastectomies and quadrantectomies) attributed to breast cancer over six years and by age group. Their results show that over that period, 100,745 mastectomies and 168,147 quadrantectomies were performed. A total of 41,608 major surgeries due to breast cancer were performed in the year 2000, a figure that rose to 47,200 in 2005, signifying a 13.8 percent rise over the six years.

By comparison, official estimations from the Italian Ministry of Health tallied only 37,300 cases in the year 2005.

Until now, official epidemiological data concerning the incidence of breast cancer in Italy has been computed using a statistical model (MIAMOD–Morality-Incidence Analysis MODel) based on mortality and survival data. The newly published analysis relies on hospitalization databases that track major breast surgeries.

The current study notes that while use of MIAMOD may be justified in light of the need to evaluate the incidence of all tumors, the figures may underestimate the number of breast cancers, since many deaths that occur at home or in hospital settings might be attributed to cardiovascular causes on the statistical form filled out by physicians.

Source: Sbarro Health Research Organization


Health Care Reform and Chronic Disease

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jul 3,2009

Maryland Health Care Experts Including Kathleen Kennedy Townsend Meet to Address Importance of Chronic Disease and Health Reform

In response to Congress’ debate on health care reform, state and local leaders from Maryland joined together at the Baltimore Medical System at Saint Agnes Hospital Community Care Center to call for comprehensive reforms to address the growing crisis of chronic disease in Maryland and nationwide. The Partnership to Fight Chronic Disease (PFCD) is a coalition committed to making chronic disease prevention and management a major part of comprehensive health reform.

The Maryland chapter of PFCD has 41 state partners and a distinguished panel of co-chairs in attendance today: former Lieutenant Governor Kathleen Kennedy Townsend, Sharon D. Allison-Ottey, M.D., Executive Director, The COSHAR Foundation, and Miguel McInnis, M.P.H., Chief Executive Officer, Mid-Atlantic Association of Community Health Centers

“The Partnership to Fight Chronic Disease’s broad coalition of national and state partners believes it is impossible to contain rising health care costs — and tackle other issues of coverage and quality — without addressing chronic disease,” said Dr. Allison-Ottey.

According to the Centers for Disease Control and Prevention (CDC), chronic diseases are responsible for seven out of every 10 deaths in the United States — taking the lives of more than 1.7 million Americans every year. Chronic diseases are also the primary driver of health care costs, accounting for more than 75 percent of the more than $2 trillion dollars spent each year on health care in the United States.

“We are in crisis. The cost of chronic disease is unsustainable. Our health care system is not making us healthy, and we have to change. We need to exercise, eat well, and get regular check ups,” said former Lieutenant Governor Townsend.

The financial burden in Maryland of chronic disease is tremendous. A study by the Milken Institute looked at seven common chronic diseases and found that in Maryland, the total treatment costs of these diseases amounted to nearly $5.2 billion in 2003. The total economic costs — in terms of treatment and productivity loss associated with poor health from chronic diseases — amounted to more than $25.7 billion. NOTE: STATE DATA CAN BE FOUND AT: www.chronicdiseaseimpact.org

Maryland’s chapter of PFCD is comprised of 41 statewide partners including:

Abilities Network/Epilepsy Foundation of the Chesapeake Region
Access Carroll
The AIDS Institute
American Academy of Pediatrics, Maryland Chapter
American Cancer Society, South Atlantic Division
American Lung Association of the Atlantic Coast, Inc.
Arthritis Foundation, Maryland Chapter
Asthma Allergy Foundation of America, Maryland-Greater D.C. Chapter
Baltimore County Department of Aging
Baltimore Housing Office of Community Services
Baltimore Medical System
Coalition for a Healthy Maryland
Community Free Clinic
Community Health Charities of Maryland
The COSHAR Foundation, Inc.
Eastern Area Treatment Program
Edward A. Myerberg Senior Center
Emmanuel Brinklow Seventh Day Adventists Church
Greater Baltimore Committee
The Healthcare Council of the National Capital Area
Health Resource Solutions, Inc.
Leukemia & Lymphoma Society, Maryland Chapter
Leukemia & Lymphoma Society, National Capital Area Chapter
Lutheran Social Services of the National Capital Area
Maryland Academy of Family Physicians
Maryland Chamber of Commerce
Maryland Hospital Association
Maryland Pharmacists Association
Maryland Physicians Care
Maryland Society of Health-System Pharmacists
Maryland State Conference of NAACP Branches
The Maryland State Medical Society
Mid-Atlantic Association of Community Health Centers
National Council on Alcoholism and Drug Dependency, Maryland
National Kidney Foundation of the National Capital Area
NAMI Maryland
Partners in Care
Primary Care Coalition of Montgomery County
Priority Partners MCO, Johns Hopkins Health Care
Sudden Cardiac Arrest Association
Technology Council of Maryland
Total Healthcare
Union Memorial Hospital Cancer Program
United Seniors of Maryland
University of Maryland Biotechnology Institute
XL Health
YMCA of Central Maryland

Partnership to Fight Chronic Disease

The Partnership to Fight Chronic Disease (PFCD) is a national and state-based coalition of hundreds of patient, provider, community, business, and labor groups, committed to raising awareness of the number-one cause of death, disability, and rising health care costs in the U.S.: poorly prevented and mismanaged chronic disease.

PFCD’s mission is to:

  • Challenge policymakers to make fighting chronic disease a top priority and discuss how they will address it in their health care proposals.
  • Educate the public about chronic disease and potential solutions for individuals, communities, and the nation.
  • Mobilize Americans to call for changes in how policymakers, governments, employers, health institutions, and other entities approach chronic disease.

Source: Partnership to Fight Chronic Disease


Cord Blood Registry Celebrates Families Helping to Advance Research

Despite rapid advances using a child’s own cord blood stem cells in regenerative therapies to repair damaged tissue due to injury or disease, most pregnant women today don’t learn about the ability to save their newborn’s cord blood. According to research published in the Journal of Reproductive Medicine, 3 out of every 4 pregnant women consider themselves only “minimally informed.”

July has been designated as “Cord Blood Awareness Month” by a society of the American Hospital Association with the goal of raising awareness about the medical value of newborn stem cells from umbilical cord blood, which have been used for more than 20 years to treat nearly 80 diseases. In addition, research studies are underway evaluating the use of a child’s own cord blood to help treat conditions that have no cure today, like cerebral palsy.

One child’s experience exemplifies the growing importance of educating all expectant parents. An in-utero stroke left Chloe Levine with cerebral palsy, causing paralysis on the right side of her body. At a year old, Chloe’s right hand remained tightly closed in a fist, which she couldn’t lift above her head. Instead of crawling, Chloe dragged her right leg behind her.

Because Chloe’s parents had stored her cord blood stem cells with Cord Blood Registry (CBR) at birth, Chloe was able to undergo a potentially life-changing experimental treatment: a re-infusion of her own cord blood. Within weeks after Chloe was infused, “things started happening that she could never do before,” said her mother, Jenny Levine. “Her progress has been dramatic.”

Today, one year post-infusion, the little girl who was nearly paralyzed on her right side can lift both arms to catch a ball. She talks up a storm. And she can run - fast. Two months post-infusion, Chloe’s physical therapist, Dottie Waldo, was shocked at the recovery of movement in Chloe’s hands and arms, saying “I’ve never seen anything turn around this fast.” In fact, Chloe Levine has progressed so much that she no longer needs physical or speech therapy.

“Regenerative therapies using cord blood stem cells are currently being researched for conditions including traumatic brain injury, cerebral palsy, stroke, type 1 diabetes, heart defects and hearing loss,” said Heather Brown, vice president of scientific and medical affairs for CBR, the global leader in the collection and preservation of newborn stem cells from umbilical cord blood. “Research indicates these cells have demonstrated the ability to go to damaged sites in the body and help induce healing. And the re-infusion of one’s own stem cells back into the body carries no risk of tumor formation or immune response.”

Chloe Levine will begin preschool in the fall. It’s yet another milestone, as Chloe no longer qualifies for special needs services at school. That simple fact is something her mom, Jenny Levine, calls “a joy beyond words.”

“Chloe’s story demonstrates that cord blood education isn’t just a good idea - it’s good health policy,” said David Zitlow, senior vice president, public affairs for CBR. “The Institute of Medicine recommends that all pregnant women should be educated about cord blood stem cells early enough in pregnancy that they can make an informed decision about the options to preserve these valuable cells.”

Recently, U.S. Rep. Jackie Speier (D-Ca) introduced HR 2107, “The Cord Blood Education and Awareness Act of 2009,” which supports the Institute of Medicine guidance to better educate expectant parents about their options for donating or banking their child’s cord blood. HR 2107 also seeks to bring healthcare professionals up-to-date on the value of cord blood banking and makes grants available to reach crucial segments of the population, such as minority communities and families with a genetic history of treatable diseases.

Cord Blood Awareness Month

July has been designated as “Cord Blood Awareness Month” by the American Hospital Association’s Society for Healthcare Strategy & Market Development (SHSMD) with the goal of raising awareness about newborn stem cells from umbilical cord blood, which have been used for more than 20 years to treat nearly 80 diseases. Today, medical researchers are using cord blood stem cells to evaluate new treatments for diabetes, brain damage, spinal cord injuries, hearing loss and other regenerative therapies. By providing education about the medical value of cord blood stem cells and the available banking options, Cord Blood Awareness Month strives to empower expectant parents to make informed choices regarding their family’s future health.

Source: Cord Blood Registry


Heart Attack Patient Receives His Own Heart Stem Cells as Part of Medical Study to Determine Safety of New Technique to Repair Injured Heart Muscle

Doctors at the Cedars-Sinai Heart Institute announced the completion of the first procedure in which a patient’s own heart tissue was used to grow specialized heart stem cells that were then injected back into the patient’s heart in an effort to repair and re-grow healthy muscle in a heart that had been injured by a heart attack.

The minimally-invasive procedure was completed on the first patient on Friday, June 26.

The procedure is part of a Phase I investigative study approved by the U.S. Food and Drug Administration and supported by the Specialized Centers for Cell-based Therapies at the National Heart, Lung, and Blood Institute and the Donald W. Reynolds Foundation. It is the first to use adult cells from a patient’s own heart to attempt to heal injured heart muscle.

“This procedure signals a new and exciting era in the understanding and treatment of heart disease,” said Eduardo Marban, MD PhD, director of the Cedars-Sinai Heart Institute, who developed the technique and is leading the clinical trial. “Five years ago, we didn’t even know the heart had its own distinct type of stem cells. Now we are exploring how to harness such stem cells to help patients heal their own damaged hearts.”

The study is directed by the Cedars-Sinai Heart Institute, with the collaboration of the Johns Hopkins University, where Dr. Marban worked prior to joining Cedars-Sinai in 2007. The 24 patients participating in the study have hearts that were damaged and scarred by heart attacks. Once enrolled in the study, patients go through a three-step procedure.

After undergoing extensive imaging so doctors can pinpoint the exact location and severity of the scars wrought by the heart attack, the patient undergoes a minimally-invasive biopsy, with local anesthesia. Using a catheter inserted through a vein in the patient’s neck, doctors remove a small piece of heart tissue, about half the size of a raisin.

The heart tissue is then taken to a specialized lab at Cedars-Sinai, where heart stem cells are cultured using methods invented by Marban and his team. It takes about four weeks for the cells to multiply to numbers sufficient for therapeutic use, approximately 10 to 25 million.

In the third and final step, the now-multiplied stem cells are re-introduced into the patient’s coronary arteries during a second catheter procedure.

All patients in the study had to have experienced heart attacks within four weeks prior to enrolling in the research project. Four patients will receive 12.5 million stem cells and two patients will serve as controls. Later this summer, it is anticipated that 12 more patients will undergo procedures to receive 25 million stem cells, while six additional patients will be monitored as controls.

The first patient, Kenneth Milles, a 39-year-old controller for a small construction company in the San Fernando Valley, experienced a heart attack on May 10 due to a 99 percent blockage in the left anterior descending artery, a major artery of the heart. Milles’ heart attack left 21 percent of his heart muscle infarcted, or scarred. He underwent his biopsy May 24 and received his infusion of stem cells on June 29.

The patients will be monitored for six months. Complete results are scheduled to be available in late-2010.

Marban, who holds the Mark Siegel Family Foundation Chair at the Cedars-Sinai Heart Institute and directs Cedars-Sinai’s Board of Governors Heart Stem Cell Center, also said the cardiac stem cell procedure is a logical step forward from recent studies in which cardiac patients have been treated with stem cells derived from bone marrow. Studies over the past eight years have shown that more than 500 cardiac patients have experienced modest improvement when treated with bone marrow stem cells.

However, bone marrow stem cells are not predestined to regenerate heart muscle. When cardiac stem cells were discovered five years ago by various teams worldwide, Marban began developing a method for isolating heart stem cells from minimally-invasive biopsies and then multiplying the cells. Unlike bone marrow cells, heart stem cells are naturally programmed to regrow heart tissue, so they could prove more effective in healing the injury caused by heart attacks.

“If successful, we hope the procedure could be widely available in a few years and could be more broadly applied to cardiac patients,” Marban said. For example, if patients are able to re-grow damaged heart muscle via stem cell therapy, there could be lesser demand for expensive and risky treatments such as heart transplants.

The process to grow the cardiac-derived stem cells involved in the study was developed by Marban when he was on the faculty of Johns Hopkins University. The university has filed for a patent on that intellectual property, and has licensed it to a company in which Dr. Marban has a financial interest. No funds from that company were used to support the clinical study. All funding was derived from the National Institutes of Health, the Donald W. Reynolds Foundation and Cedars-Sinai Medical Center.

Source: Cedars-Sinai Medical Center


Bladder cancer no longer a death sentence

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jul 1,2009

At 51, Charles Daniels had a lot to live for. A thriving construction business, a precious 11 year old daughter and a happy long-term relationship. When he was diagnosed with bladder cancer, he was determined to beat the odds. According to TMD, a medical tourism corporation, Daniels case is typical - he tried conventional medicine until they had nothing left to offer but a poor prognosis, and then went out of the country for alternative cancer treatment and is cancer free today.

Just before Christmas 2007, Daniels urinated blood. He went right to his primary care doctor, who did an ultrasound and X-rays, which were inconclusive. Suspecting an infection, his doctor gave him antibiotics. Within 24 hours, the blood was no longer visible. But a follow up visit showed microscopic blood in his urine, and he was sent to a urologist. A cytoscopy exam (where a small camera is inserted into the bladder) and intra-venous pyelogram (an X-ray with contrast that provides pictures of the entire urinary system) found bladder cancer. “I was shocked,” Daniels said. “I was in perfect health, I felt good, and I thought I just had an infection.”

This year, almost 71,000 Americans will be diagnosed with bladder cancer. According to the National Cancer Institute, the survival rate for stage III bladder cancer is 50%; stage IV is rarely survived. Symptoms include blood in the urine and frequent, painful or urgent urination.

Risk factors are smoking, chemical exposure to dyes, rubber and pesticides, chronic infections and parasites. Women undergoing chemotherapy and radiation for cervical cancer also have an increased risk of developing bladder cancer.

Daniels’ oncologist recommended surgery to remove the tumor. While his doctor was cautiously optimistic, further testing confirmed the invasive tumor had penetrated the muscle wall. “My doctor wanted to remove my bladder, prostate and surrounding lymph nodes, and create a new bladder from my intestines. He said with this surgery I had a 90% survival rate. I wanted to live, and 90% sounded like a good number.”

Daniels expected to wake up after surgery and be cancer free. But his surgeon found that the tumor had grown outside the bladder wall and surrounding lymph nodes tested positive. His survival rate dropped from 90% to 40%. Despite an aggressive chemotherapy program, his next CAT scan revealed three new tumors in his liver. He now was stage IV. At this point, mainstream medicine offered no hope of cure, and his life expectancy dropped to around nine months. The chemotherapy left him feeling exhausted and sick, and he suffered weight and hair loss. Permanent side effects included hearing loss, tingling in his extremities and ‘chemo brain’.

Next, Daniels underwent Radio Frequency Ablation (RAF), a guided imagery surgery where a needle like probe transmits microwaves into tumors causing the destruction of tumor cells. The RAF destroyed the tumors, but he was told they would come back - there is no mainstream cure for his cancer.

Daniels then began researching alternative treatments. He sent emails with his medical history to clinics throughout the United States and Mexico. He interviewed doctors and talked to patients. When he asked about success rates, the answers he received ranged from “we’ll make you more comfortable” to “complete remission”.

Finally, he learned about a fairly new cancer treatment called SonoPhoto Dynamic Therapy (SPDT). This non-invasive treatment uses a non-toxic sensitizing agent along with sound and light to destroy cancer cells. Dr. Antonio Jimenez, medical director of the Hope4Cancer Institute south of San Diego, California in Baja, Mexico, has successfully treated bladder and other cancers with this program. Although this is a natural treatment without side effects, SPDT is considered a mainstream cancer treatment in 25 European countries. SPDT has proven effective against ovarian, prostate, colon, lung, pancreatic, liver and breast cancers, among others. It has not yet been approved in the United States.

Daniels decided to travel to Mexico for two weeks of SPDT treatment followed by a two month home program. “My doctors were not opposed to this,” Daniels says. “They had nothing left to offer me.”

“From the minute I walked into this clinic I had hope.” Daniels says the doctors were upbeat and the staff was exceptionally caring. “The treatment was painless and there were no side effects. When I finished the program, my CAT scans were absolutely clear and my blood work was normal. I continue to have testing done every few months, and I am still completely cancer free. I stay on a maintenance program. I am going to watch my daughter grow up. I married my long time sweetheart. I only wish I would have found this treatment sooner.”

Source: TMD Limited Corporation


Answer to health care crisis can save lives, money

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jun 30,2009

New White Paper Reveals Power of Statins in Fighting Cardiovascular Disease

The adverse health and financial impact of cardiovascular disease - the number one killer of men and women in America - can be significantly reduced through the well monitored use of statins according to a major white paper release by the non-profit Senior Center for Health and Security (SCHS).

The white paper, Saving America’s Seniors With Statins: Solving a Health Care Crisis, explores the ramifications of heart disease and stroke in America, and the critical role that cholesterol-lowering drugs called statins can play in addressing it. Along with physician supervised diet and exercise programs, the correct statin for each individual patient can significantly lower the risk of heart disease, help prevent heart attack and stroke, and reduce health care expenditures.

“Meeting your cholesterol goal is a top priority for good heart health,” said SCHS Policy Director Al Cors. “There are many different statin options available and it’s important to talk with your doctor to determine which statin is the right statin to help you reach that goal.”

Studies demonstrate that the six most widely used statins can save lives and lower health care costs, but the white paper notes that statins are not identical to each other prompting SCHS to urge patients, insurers and health care professionals to consider the different pharmacological properties of different statins in concert with differing patient risk factors including age, sex, race, heredity and other unique case considerations.

The SCHS paper notes several clinical studies of different statins in the report. A November 2008 study showed that men and women using one particular statin suffered half as many strokes, heart attacks and deaths from cardiovascular causes as those taking a placebo. A different study on a different statin that same month demonstrated an important correlation between improved kidney function and use of that statin. A third study showed that men who took a third variety of statin for five years experienced fewer deaths and heart attacks 10 years later even though most had stopped taking the drug.

Statin use can also result in lower health care costs, according to the white paper. For 2009, the cost of treating stroke and heart disease in the U.S., combined with lost industrial productivity due to disability and death, is estimated at $475 billion. These costs will increase as the population ages and SCHS notes that statin use can play a significant role in controlling these rising costs.

Cors stressed the need for comprehensive communication between patients, doctors and insurance providers, calling it critical to determining the best statin regimen for cardiovascular health. “Costs for brand name medicines and insurance formularies are always changing and the only way to know is through good communications,” Cors concluded. “Many patients don’t know they have affordable access to the most effective medications.”

The full report is available online at http://www.seniorsforcures.org/6-22-09_statins.html


Focus on Asia expected to kickstart more collaborations and encourage increased government support

Rising healthcare standards together with the growing demand for more affordable treatment will keep the Asian market for medical tourism buoyant, according to experts speaking at the Healthcare Travel Exhibition & Congress today at Fairmont Hotel, Singapore. Worldwide gross medical tourism revenue is projected to grow from US$56 billion to reach US$100 billion by 2012, with Asia as a major driver of this growth.

“Buoyed by the success stories of earlier waves of medical tourists, consumers, insurance companies as well businesses fully recognise the reliability and affordability of going overseas for medical procedures. Patients who choose to undergo treatments in Asia can pay just 10% of the cost of comparable treatment conducted in developed countries like the United States or United Kingdom. This differential cost, coupled with today’s sophisticated travel industry, provides an excellent catalyst to the growth of medical tourism,” said Mr. Andrew Keable, Divisional Director, Informa Life Sciences.

Asia is well-placed to grow in medical tourism as healthcare standards and technology adoption continue to improve. Hospitals in Korea, Malaysia, Thailand, India and Singapore have made it a point to implement state-of-the- art medical technologies to improve patient care.

Healthcare Travel Exhibition & Congress 2009 is Asia’s premier event focusing on two of the world’s largest industries: healthcare and tourism. The event brings together professionals, government officials and decision makers from the healthcare and travel industries, giving them the opportunity to network and share best practices, insights and knowledge to further develop Asia’s thriving healthcare travel market.

Leading edge technology is on display at the exhibition portion of the event, where close to 30 exhibitors including leading medical suppliers, healthcare travel facilitators, medical spas and hospitals are showcasing their innovations and services. Governments too have begun to recognise the economic potential and are responding by actively participating in the promotion of their respective countries as attractive healthcare destinations.

The conference themes at the Congress portion of the event include:

  • 29th - 30th June: The global healthcare travel outlook, new challenges and opportunities in healthcare travel, payment and accreditation standards
  • 29th - 30th June: Healthcare insurance trends in Asia, best practices, and emerging partnerships
  • 29th June: Travel Business Day co-organised with Pacific Asia Travel Association (PATA), covering medical tourist requirements, business cases, misconceptions and the healthcare travel ecosystem
  • 1 July: Minimizing legal liabilities in global healthcare travel
  • 1 July: Health insurance risk management for new markets

“We have an impressive line-up of industry leaders and luminaries who will be sharing key topics specifically designed for the medical tourism industry. The exclusive congress segment ensures the unique position of Healthcare Travel Exhibition & Congress as Asia’s leading medical tourism event”, said Ms. Rebecca Wolfe, Divisional Director, Informa Life Sciences.

Healthcare Travel Exhibition & Congress is sponsored by Singapore Medicine, CKMP-Council for Korea Medicine Overseas Promotion and National Healthcare Group. The event is also supported by International Enterprise Singapore, International Medical Travel Association (IMTA), Life Insurance Association, Pacific Asia Travel Association (PATA), Spa and Wellness Association Singapore, Thai Spa Association, and Spa Association Singapore.

Source: Informa Life Sciences


More gene mutations linked to autism risk

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jun 28,2009

Combination of Inherited and New Genetic Mutations Acting Together

More pieces in the complex autism inheritance puzzle are emerging in the latest study from a research team including geneticists from The Children’s Hospital of Philadelphia, the University of Pennsylvania School of Medicine and several collaborating institutions. This study identified 27 different genetic regions where rare copy number variations - missing or extra copies of DNA segments - were found in the genes of children with autism spectrum disorders (ASDs), but not in the healthy controls. The complex combination of multiple genetic duplications and deletions is thought to interfere with gene function, which can disrupt the production of proteins necessary for normal neurological development.

“We focused on changes in the exons of DNA–protein-coding areas in which deletions or duplications are more likely to directly disrupt biological functions,” said study leader Hakon Hakonarson, M.D., Ph.D., director of the Center for Applied Genomics at The Children’s Hospital of Philadelphia and associate professor of Pediatrics at the University of Pennsylvania School of Medicine. “We identified additional autism susceptibility genes, many of which, as we previously found, belong to the neuronal cell adhesion molecule family involved in the development of brain circuitry in early childhood.” He added that the team discovered many “private” gene mutations, those found only in one or a few individuals or families — an indication of genetic complexity, in which many different gene changes may contribute to an autism spectrum disorder.

“We are finding that both inherited and new, or de novo, genetic mutations are scattered throughout the genome and we suspect that different combinations of these variations contribute to autism susceptibility,” said co-author Maja Bucan, Ph.D., professor of Genetics at the University of Pennsylvania School of Medicine and Chair of the Steering committee for Autism Speaks’ Autism Genetic Resource Exchange (AGRE). “We are grateful to families of children with autism spectrum disorders for their willingness to participate in genetic studies because family-based studies have many advantages. We have learned a lot both from genetic analyses of children with autism as well as analyses of their patents and their unaffected siblings.”

The researchers compared genetic samples of 3,832 individuals from 912 families with multiple children with ASDs from the AGRE cohort against genetic samples of 1,070 disease-free children from The Children’s Hospital of Philadelphia. This study also uncovered two novel genes in which variations were found, BZRAP1 and MDGA2 - thought to be important in synaptic function and neurological development, respectively. Interestingly, key variants of these genes were transmitted in some, but not all, of the affected individuals in families.

The findings were published in the June 26 edition of the journal PloS Genetics.

By further refining the genetic landscape of ASDs, the current study expands the findings of two large autism gene studies published in April, led by Hakonarson and co-authored by Gerard Schellenberg, Ph.D., professor of Pathology and Laboratory Medicine at the University of Pennsylvania School of Medicine, Bucan and others. One study was the first to report common gene variants in ASDs. The other identified copy number variants that raise the risk of having an ASD. Both studies found gene changes on two biological pathways with crucial roles in early central nervous system development. Hakonarson and Bucan said the latest findings reinforce the view that multiple gene variants, both common and rare, may be interacting to cause the heterogeneous group of disorders included under autism spectrum disorders.

Source: The Children’s Hospital of Philadelphia


A new report from The George Washington University School of Public Health and Health Services, Department of Health Policy challenges the notion that fraud is a problem only in public health insurance markets and finds that fraud is a system-wide problem affecting private and public health insurance alike.

The report finds that some of the most striking examples of fraud come from fraud committed directly by the private insurance industry itself. In 2007, when the U.S. spent nearly $2.3 trillion on health care and public and private insurers processed more than 4 billion health insurance claims, fraud was estimated to reach as much as 10 percent of annual health care spending. At this rate, the losses in 2007 alone -over $220 billion - would have been enough to cover the uninsured. The National Health Care Anti-Fraud Association (NHCAA) has estimated conservatively that 3 percent of all health care spending–or $68 billion–is lost to health care fraud.

The report finds that no segment of the health care industry or geographical area is immune from fraud. It is estimated that 80 percent of healthcare fraud is committed by medical providers, 10 percent by consumers, and the balance by others, such as insurers themselves and their employees. Fraudulent billing, kickbacks, up-coding services and bundling are common examples of fraud. Avoidance of sick and high need members, along with the systematic misrepresentation of the cost of care to group plan sponsors, represent major examples of fraud in the private insurance industry.

The report also notes the distinction between fraud and improper payments. Fraud is a misrepresentation of the truth or concealment of material facts. Improper payments, on the other hand, tend to involve technical questions associated with verification of claims or related matters. The report also describes recent efforts to improve fraud detection and recovery across the public and private insurers, including Medicare and Medicaid.

“The evidence presented in this analysis should put to rest the notion that the problem of fraud is limited to public programs. Because fraud can arise in any sector of the health industry, comprehensive efforts to both detect and deter fraud system-wide are essential to national health reform,” said Sara Rosenbaum, Professor and Chair, Department of Health Policy.

“Health Insurance Fraud: An Overview” is available at http://www.gwumc.edu/sphhs/departments/healthpolicy/dhp_publications/pub_uploads/dhpPublication_EFDAD1BC-5056-9D20-3D3D36632A4F2163.pdf%20ht


New Snapshots Show States Vary Widely in Providing Quality Health Care

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jun 27,2009

The Agency for Healthcare Research and Quality’s annual release of state-by-state quality data continues to give states mixed reviews for the quality of care they provide. As in previous years, AHRQ’s 2008 State Snapshots show that no state does well or poorly on all quality measures.

The U.S. Department of Health and Human Services is also releasing state-by-state reports on the health care status quo. The reports are available at www.HealthReform.gov.

The 2008 State Snapshots provide state-specific health care quality information, including strengths, weaknesses and opportunities for improvement. The state-level information used to create the State Snapshots is drawn from the 2008 National Healthcare Quality Report, which was released in May by HHS Secretary Kathleen Sebelius and contributes to a national portrait of health care quality.

“The State Snapshots are an invaluable resource for state officials, health care providers and purchasers to help them better understand the extent of health care quality and disparities in their states,” said AHRQ Director Carolyn M. Clancy, M.D. “With this information, they can take the necessary steps to improve health care quality and address persistent gaps in access to health care.”

The 2008 State Snapshots summarize health care quality in three dimensions: type of care (preventive, acute and chronic care), setting of care (hospitals, ambulatory, nursing homes and home health care) and by clinical areas (cancer, diabetes, heart disease, maternal and child health and respiratory disease). The 2008 State Snapshots allow users to explore whether a state has improved or worsened compared with other states in several areas of health care delivery.

New features in the 2008 State Snapshots provide more ways to analyze the quality of health care for each state compared with all states, as well as states in the same region. Enhanced features include:

  • A new Focus on Asthma section: This section includes state-specific information on the prevalence of adult self-reported asthma rates; potentially preventable hospitalizations for children, adults and the elderly; and potential returns on investment of asthma care quality improvement programs for Medicaid, state employees and privately insured Americans.
  • An expanded Focus on Disparities: This section includes state-specific information on disparities in the quality of care compared with the nation overall by looking at care received by various racial/ethnic and socioeconomic groups. This section also includes new information on prevalence of diabetes that includes a U.S. map showing the adult self-reported prevalence of diabetes by state.
  • Enhanced Dashboards: The dashboard for each state now contains revised graphics that succinctly display all of the summary measures on health care quality and allow a clear view of the range of each state’s performance.

AHRQ’s annual State Snapshots are based on data drawn from more than 30 sources, including government surveys, health care facilities and health care organizations. To access this year’s State Snapshots tool, go to: http://statesnapshots.ahrq.gov/snaps08/.

Source: Agency for Healthcare Research & Quality


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