SIGMAR1 Gene Mutation Linked To Juvenile ALS Development, Researchers Identify

From the Kingdom of Saudi Arabia, investigators have identified a mutation on the SIGMAR1 gene linked with the development of juvenile amyotrophic lateral sclerosis (ALS). Sigma-1 receptors, which are involved in motor neuron function and disease development, are affected by the gene variant, according to a study published in the Annals of Neurology, a journal of the American Neurological Association and the Child Neurology Society.

ALS, (Lou Gehrig's disease), is a progressive neurodegenerative disorder attacking brain and spinal cord nerve cells (neurons) which are responsible for controlling voluntary muscle movement. The degeneration of upper and lower motor neurons slowly weakens the muscles they control, which will ultimately lead to paralysis and death from respiratory failure.

The study revealed that yearly 1 to 3 per 100,000 individuals are affected by ALS, of which 90% of cases have no family history of the disease (sporadic ALS) with the remaining 10% of cases showing more than one family member being affected by it (familial ALS). Characterized by age of onset below 25 years, juvenile ALS is a rare and sporadic disorder which makes it hard to establish incidence rates. Having being diagnosed at 21, physicist, Professor Stephen Hawking is one of the most well known juvenile ALS patients.

Earlier investigations discovered that mutation of the superoxide dismutase 1 (SOD1) gene accounts for 20% of familial and 5% of sporadic ALS cases, while ALS2 and SETX gene mutations have been reported in juvenile ALS cases.

Dr. Amr Al-Saif from the King Faisal Specialist Hospital and Research Center in Riyadh, KSA, who is leading the present investigation, performed genetic testing on four patients from an ALS family who were diagnosed with juvenile ALS to study mutations suspected in disease development.

Using direct sequencing to detect the genetic variants, together with gene mapping on the DNA of study participants, researchers identified a shared homozygosity region in the affected individuals, and gene sequencing of SIGMAR1 showed a mutation affecting the encoded protein, Sigma-1 receptor. Cells with the mutant protein were not as resistant to programmed cell death (apoptosis) induced by stress to the endoplasmic reticulum.

What is Hemophilia, What is Haemophilia

Hemophilia is a group of inherited blood disorders in which the blood does not clot properly. Hemophilia is the standard international spelling, also known as haemophilia in the UK, other translations include: hémophilie, hemofilie, hemofili, hemofilia, hämophilie, emofilia. We will use the standard international spelling for the purpose of this section.
Bleeding disorders are due to defects in the blood vessels, the coagulation mechanism, or the blood platelets. An affected individual may bleed spontaneously or for longer than a healthy person after injury or surgery.
The blood coagulation mechanism is a process which transforms the blood from a liquid into a solid, and involves several different clotting factors. The mechanism generates fibrin when it is activated, which together with the platelet plug, stops the bleeding.
When coagulation factors are missing or deficient the blood does not clot properly and bleeding continues.
Patients with Hemophilia A or B have a genetic defect which results in a deficiency in one of the blood clotting factors.
Queen Victoria was a carrier and passed the mutation to her son Leopold, and through several of her daughters to members of the royal families of Spain, Russia, and Germany.
Tsarevich Alexei Nikolaevich, son of Nicholas II (Russia) suffered from hemophilia and was a descendant of Queen Victoria - Rasputin was successful in treating his hemophilia, it was claimed.

tuberculosis

Using the Baculillus Calmette-Guerin (BCG) - the germ commonly used to inoculate against tuberculosis (TB), researchers have found a potential new mechanism to stimulate the body's own ability to fight cancer. The discoveries are published online this week in the British Journal of Cancer.

The investigators, Dr Wai Liu and Professor Angus Dalgleish from St George's, University of London, say this new information suggests a mechanism by which vaccines may increase the anti-cancer activity of therapies which are available at present. Although, they warn that this investigation is in its primary stages and a lot more research is needed before patients will benefit.

Human tumor cells outside of the body were conducted in laboratory-based experiments; they showed that a small amount of BCG can instruct white blood cells to create chemicals called cytokines, raising the chances of tumor cells being detected by the body's immune system.

Phase 2 Trial Of Lexicon's LX1032, Telotristat Etiprate, Shows Positive Results In Carcinoid Syndrome

Lexicon Pharmaceuticals, Inc. (Nasdaq: LXRX), a biopharmaceutical company focused on discovering breakthrough treatments for human disease, announced positive, top-line proof-of-concept data from its recently completed Phase 2 study in carcinoid syndrome with LX1032, telotristat etiprate. Carcinoid syndrome is a chronic condition caused by neuroendocrine tumors that usually originate from the gastrointestinal tract. It is characterized by severe diarrhea and flushing episodes with long-term consequences including malnutrition, heart disease, and death. Symptoms of carcinoid syndrome have been linked to excess production of serotonin by metastatic tumor cells. Telotristat etiprate is designed to reduce serotonin production.

"Telotristat etiprate is our third drug candidate to demonstrate proof of concept in patients in Phase 2," said Dr. Arthur T. Sands, Lexicon's president and CEO. "Based on the positive results of this U.S. study, as well as encouraging observations from our clinical trial in Europe, we intend to discuss a Phase 3 development plan for carcinoid syndrome with the FDA."

The randomized, double-blind, placebo-controlled study was conducted in the United States in 23 patients with carcinoid syndrome who were refractory to currently available therapy. Patients in the study had metastatic carcinoid disease and were experiencing an average of about six bowel movements per day at baseline. Patients received either placebo (n=5) or one of four doses of telotristat etiprate (n=18) daily for 28 days. The primary endpoint of the study was safety and tolerability. Efficacy measures included change in bowel movement frequency, relief of symptoms, and reduction in serotonin synthesis.

Telotristat etiprate was well tolerated, and adverse events in the study were usually mild to moderate with similar frequencies overall between treatment groups and placebo. Five telotristat etiprate patients achieved clinical responses characterized by reductions of at least 30% in the number of bowel movements per day for two weeks or more during the study. Six telotristat etiprate patients reported adequate relief of carcinoid symptoms at the end of the study. There were nine telotristat etiprate patients with a complete biochemical response defined as a reduction of at least 50% in urinary 5-HIAA, a biomarker of serotonin synthesis. No patients on placebo experienced a clinical response, adequate relief of symptoms, or biochemical response during the study. The difference between telotristat etiprate and placebo in bowel movement frequency ranged between 1.6 and 2.9 bowel movements/day across telotristat etiprate doses, all favoring telotristat etiprate treatment. Also of note, all eligible patients elected to continue treatment with telotristat etiprate under an extension protocol.

Preliminary data were also reported from a separate, ongoing, open-label, single-arm study of telotristat etiprate in Europe. To date, 5 out of 6 patients with refractory carcinoid syndrome have experienced sustained reductions of at least 30% in bowel movement frequency when treated with telotristat etiprate. Two of these responses were within the first 4 weeks of therapy, while three more occurred between 4 and 8 weeks of treatment under the 12-week protocol.

"The Phase 2 data clearly show a reduction in bowel movements and symptom relief in a population that has exhausted all standard-of-care treatment options," said Dr. Pablo Lapuerta, senior vice president and chief medical officer at Lexicon. "The Phase 2 data are also consistent with preliminary results from the European study, where there appear to be some early responses and additional benefit with continued treatment. We look forward to presenting detailed results at a scientific meeting later this year."

Source: Lexicon Pharmaceuticals, Inc

alergy

Prenatal pet exposure, a mother's delivery mode and race are influential factors in a child's risk of developing allergies by age 2, according to a Henry Ford Hospital study.

In a study believed to be the first of its kind, Henry Ford researchers found that babies who have indoor prenatal pet exposure have a pattern of lower levels of the antibody Immunoglobulin E, or IgE, between birth and age 2. IgE is linked to the development of allergies and asthma.

Key findings:

    IgE levels were 28 percent lower during infancy in babies who had indoor prenatal pet exposure compared to babies from pet-free homes.
    IgE levels were 16 percent lower in infants who had indoor prenatal pet exposure and were born vaginally compared to 43 percent in infants who had indoor prenatal pet exposure and were born by cesarean section.
    IgE levels were 33 percent lower in infants who had indoor prenatal pet exposure and were either European, Asian or Middle Eastern descent compared to compared to
    10 percent lower in infants who had indoor prenatal pet exposure and were African-American.

The findings are published online at The Journal of Allergy and Clinical Immunology at http://www.jacionline.org/inpress

"We believe having a broad, diverse exposure to a wide array of microbacteria at home and during the birthing process influences the development of a child's immune system" says Christine Cole Johnson, Ph.D., MPH, chair of Henry Ford's Department of Public Health Sciences and senior author of the study.

Dr. Johnson says the findings support the so-called hygiene hypothesis, which theorizes that early childhood exposure to infectious agents affects the immune system's development and onset of allergies and asthma.

Prior published research by Henry Ford's Department of Public Health Sciences has shown that pet exposure has a protective effect against early allergy development. She theorizes that babies born through the birth canal are exposed to a higher and more diverse burden of bacteria, further boosting the immune system's protection against allergies.

"Our findings may provide insight into the biological mechanisms that increase the risk for allergic disorders," Dr. Johnson says. She theorizes that "genetic variants" may explain the higher levels of IgE levels in African American newborns.

Henry Ford researchers followed 1,187 newborns August 2003 and November 2007 and collected blood samples for measuring IgE levels at birth, six months, one year and two years.

Of the birth mothers, 62 percent were African American and 33 percent were European Americans. Of the babies born, 751 were delivered vaginally and 436 were delivered cesarean. There was at least one indoor pet in the homes of 420 mothers.

The study was funded by the National Institute of Allergy and Infectious Diseases.

healthy recipes

People are seeking more healthful diets for weight loss, disease prevention and general well being. Counting carbohydrates, limiting fats and modifying portions are all popular approaches to weight loss. People who find the right balance between a varied nutritious diet and physical activity enjoy a stable weight and overall health.
Luckily, turkey adapts to all meals plans. It's a delicious, versatile protein. A 3-ounce serving of boneless, skinless turkey breast contains 26 grams of protein, 1 gram of fat and 0 grams of saturated fat. That's 8 percent more protein than the same size serving of boneless skinless chicken breast or trimmed top loin beefsteak.

health and safety at work act

health and safety at work act about Health and Safety at Work etc Act 1974

The Health and Safety at Work etc Act 1974 , also referred to as HASAW or HSW, is the primary piece of legislation covering occupational health and safety in the United Kingdom. The Health and Safety Executive is responsible for enforcing the Act and a number of other Acts and Statutory Instruments relevant to the working environment.
The full text of the Act is available at the UK legislation website link to external website, where it can also be downloaded free of charge.

    Health and Safety at Work etc Act 1974 link to external website This is current at September 2006. Please see the Disclaimer.

Statutory instruments are the secondary types of legislation made under specific Acts of Parliament. These cover a wide range of subjects, from control of asbestos at work, diving, escape and rescue from mines, ionising radiation and working at height.

See Legislation enforced by HSE for more details.

If you need further advice on legal matters concerning the workplace, please contact HSE Infoline or consult Sources of information and external advisory services.
Disclaimer

The information on this site is regularly updated and checked for accuracy and completeness. However it is important to note that legal information must be used with a degree of caution.

Users must be aware that whilst an Act or Statutory Instrument (SI) may still be in force, parts may have been superseded by later legislation or completely withdrawn. If you use a printed or online version of an Act or Statutory Instrument this will generally be in the form that it was originally produced.

Any withdrawn or amended sections will still be contained within the Act or SI and there will be nothing in the document to identify those sections that no longer apply.

There are several solutions which you can try:

healthy eating

Healthy eating is not about strict nutrition philosophies, staying unrealistically thin, or depriving yourself of the foods you love. Rather, it’s about feeling great, having more energy, and keeping yourself as healthy as possible– all of which can be achieved by learning some nutrition basics and using them in a way that works for you.
Healthy eating begins with learning how to “eat smart”—it’s not just what you eat, but how you eat. Your food choices can reduce your risk of illnesses such as heart disease, cancer, and diabetes, as well as defend against depression. Additionally, learning the habits of healthy eating can boost your energy, sharpen your memory and stabilize your mood. You can expand your range of healthy food choices and learn how to plan ahead to create and maintain a satisfying, healthy diet.

Healthy eating tip 1: Set yourself up for success  

To set yourself up for success, think about planning a healthy diet as a number of small, manageable steps rather than one big drastic change. If you approach the changes gradually and with commitment, you will have a healthy diet sooner than you think.

• Simplify. Instead of being overly concerned with counting calories or measuring portion sizes, think of your diet in terms of color, variety and freshness—then it should be easier to make healthy choices. Focus on finding foods you love and easy recipes that incorporate a few fresh ingredients. Gradually, your diet will become healthier and more delicious.
• Start slow and make changes to your eating habits over time. Trying to make your diet healthy overnight isn’t realistic or smart.  Changing everything at once usually leads to cheating or giving up on your new eating plan. Make small steps, like adding a salad (full of different color vegetables) to your diet once a day or switching from butter to olive oil when cooking.  As your small changes become habit, you can continue to add more healthy choices to your diet.
• Every change you make to improve your diet matters. You don’t have to be perfect and you don’t have to completely eliminate foods you enjoy to have a healthy diet.  The long term goal is to feel good, have more energy and reduce the risk of cancer and disease. Don’t let your missteps derail you—every healthy food choice you make counts.

Think of water and exercise as food groups in your diet.

Water. Water helps flush our systems of waste products and toxins. Yet many people go through life dehydrated—causing tiredness, low energy and headaches. It’s common to mistake thirst for hunger, so staying well hydrated will also help you make healthier food choices.
Exercise. Find something active that you like to do and add it to your day, just like you would add healthy greens, blueberries or salmon. The benefits of lifelong exercise are abundant and regular exercise may even motivate you to make healthy food choices a habit.

Healthy eating tip 2: Moderation is key 

People often think of healthy eating as an all or nothing proposition, but a key foundation for any healthy diet is moderation.  Despite what certain fad diets would have you believe, we all need a balance of carbohydrates, protein, fat, fiber, vitamins, and minerals to sustain a healthy body.

• Try not to think of certain foods as “off-limits.” When you ban certain foods or food groups, it is natural to want those foods more, and then feel like a failure if you give in to temptation. If you are drawn towards sweet, salty, or unhealthy foods, start by reducing portion sizes and not eating them as often. Later you may find yourself craving them less or thinking of them as only occasional indulgences.
• Think smaller portions. Serving sizes have ballooned recently, particularly in restaurants. When dining out, choose a starter instead of an entrée, split a dish with a friend, and don’t order supersized anything. At home, use smaller plates, think about serving sizes in realistic terms and start small.  Visual cues can help with portion sizes—your serving of meat, fish or chicken should be the size of a deck of cards. A teaspoon of oil or salad dressing is about the size of a matchbook and your slice of bread should be the size of a CD case.

Healthy eating tip 3: It's not just what you eat, it's how you eat 

Healthy eating is about more than the food on your plate—it is also about how you think about food. Healthy eating habits can be learned and it is important to slow down and think about food as nourishment rather than just something to gulp down in between meetings or on the way to pick up the kids.

• Eat with others whenever possible. Eating with other people has numerous social and emotional benefits—particularly for children—and allows you to model healthy eating habits. Eating in front of the TV or computer often leads to mindless overeating.
• Take time to chew your food and enjoy mealtimes. Chew your food slowly, savoring every bite. We tend to rush though our meals, forgetting to actually taste the flavors and feel the textures of what is in our mouths. Reconnect with the joy of eating.
• Listen to your body. Ask yourself if you are really hungry, or have a glass of water to see if you are thirsty instead of hungry. During a meal, stop eating before you feel full. It actually takes a few minutes for your brain to tell your body that it has had enough food, so eat slowly.
• Eat breakfast, and eat smaller meals throughout the day. A healthy breakfast can jumpstart your metabolism, and eating small, healthy meals throughout the day (rather than the standard three large meals) keeps your energy up and your metabolism going.

Healthy eating tip 4: Fill up on colorful fruits and vegetables 

Fruits and vegetables are the foundation of a healthy diet—they are low in calories and nutrient dense, which means they are packed with vitamins, minerals, antioxidants and fiber.
Fruits and vegetables should be part of every meal and your first choice for a snack—aim for a minimum of five portions each day. The antioxidants and other nutrients in fruits and vegetables help protect against certain types of cancer and other diseases.

Eat a rainbow of fruits and vegetables every day—the brighter the better.

The brighter, deeper colored fruits and vegetables contain higher concentrations of vitamins, minerals and antioxidants—and different colors provide different benefits. Some great choices are:

• Greens: Greens are packed with calcium, magnesium, iron, potassium, zinc, vitamins A, C, E and K, and they help strengthen the blood and respiratory systems. Be adventurous with your greens and branch out beyond bright and dark green lettuce—kale, mustard greens, broccoli, Chinese cabbage are just a few of the options.
• Sweet vegetables: Naturally sweet vegetables add healthy sweetness to your meals and reduce your cravings for other sweets. Some examples of sweet vegetables are corn, carrots, beets, sweet potatoes or yams, winter squash, and onions.
• Fruit: A wide variety of fruit is also vital to a healthy diet. Fruit provides fiber, vitamins and antioxidants. Berries are cancer-fighting, apples provide fiber, oranges and mangos offer vitamin C, and so on.

Don’t forget to shop fresh and local whenever possible

The local farmer’s market, fruit stand or Community Supported Agriculture (CSA) group are great ways to get access to fresh, local produce. To find local growers, farmer's markets, and CSAs in your area,

Healthy eating tip 5: Eat more healthy carbs and whole grains

Choose healthy carbohydrates and fiber sources, especially whole grains, for long lasting energy. In addition to being delicious and satisfying, whole grains are rich in phytochemicals and antioxidants, which help to protect against coronary heart disease, certain cancers, and diabetes. Studies have shown people who eat more whole grains tend to have a healthier heart.

A quick definition of healthy carbs and unhealthy carbs

Healthy carbs (sometimes known as good carbs) include whole grains, beans, fruits, and vegetables. Healthy carbs are digested slowly, helping you feel full longer and keeping blood sugar and insulin levels stable.
Unhealthy carbs (or bad carbs) are foods such as white flour, refined sugar and white rice that have been stripped of all bran, fiber and nutrients. Unhealthy carbs digest quickly and cause spikes in blood sugar levels and energy.

Tips for eating more healthy carbs

• Include a variety of whole grains in your healthy diet, including whole wheat, brown rice, millet, quinoa, and barley. Experiment with different grains to find your favorites.
• Make sure you're really getting whole grains. Be aware that the words stone-ground, multi-grain, 100% wheat, or bran, can be deceptive. Look for the words “whole grain” or “100% whole wheat” at the beginning of the ingredient list. In the US, check for the Whole Grain Stamps that distinguish between partial whole grain and 100% whole grain.
• Try mixing grains as a first step to switching to whole grains. If whole grains, like brown rice and whole wheat pasta, don’t sound good at first, start by mixing what you normally use with the whole grains. You can gradually increase the whole grain to 100%.

Avoid: Refined foods such as breads, pastas, and breakfast cereals that are not whole grain.

Healthy eating tip 6: Enjoy healthy fats & avoid unhealthy fats

Good sources of healthy fat are needed to nourish your brain, heart and cells, as well as your hair, skin, and nails.  Foods rich in certain omega-3 fats called EPA and DHA are particularly important and can reduce cardiovascular disease, improve your mood and help prevent dementia.

Add to your healthy diet:

• Monounsaturated fats, from plant oils like canola oil, peanut oil, and olive oil, as well as avocados, nuts (like almonds, hazelnuts, and pecans), and seeds (such as pumpkin, sesame).
• Polyunsaturated fats, including Omega-3 and Omega-6 fatty acids, found in fatty fish such as salmon, herring, mackerel, anchovies, sardines, and some cold water fish oil supplements. Other sources of polyunsaturated fats are unheated sunflower, corn, soybean, and flaxseed oils, and walnuts.

Reduce or eliminate from your diet:

• Saturated fats, found primarily in animal sources including red meat and whole milk dairy products.
• Trans fats, found in vegetable shortenings, some margarines, crackers, candies, cookies, snack foods, fried foods, baked goods, and other processed foods made with partially hydrogenated vegetable oils.

Healthy eating tip 7: Put protein in perspective

Protein gives us the energy to get up and go—and keep going. Protein in food is broken down into the 20 amino acids that are the body’s basic building blocks for growth and energy, and essential for maintaining cells, tissues, and organs. A lack of protein in our diet can slow growth, reduce muscle mass, lower immunity, and weaken the heart and respiratory system. Protein is particularly important for children, whose bodies are growing and changing daily.

Here are some guidelines for including protein in your healthy diet:

Try different types of protein. Whether or not you are a vegetarian, trying different protein sources—such as beans, nuts, seeds, peas, tofu and soy products—will open up new options for healthy mealtimes.

• Beans:  Black beans, navy beans, garbanzos, and lentils are good options.
• Nuts: Almonds, walnuts, pistachios, and pecans are great choices.
• Soy products: Try tofu, soy milk, tempeh, and veggie burgers for a change.
• Avoid salted or sugary nuts and refried beans.

Downsize your portions of protein. Most people in the U.S. eat too much protein. Try to move away from protein being the center of your meal. Focus on equal servings of protein, whole grains, and vegetables.
Focus on quality sources of protein, like fresh fish, chicken or turkey, tofu, eggs, beans or nuts. When you are having meat, chicken, or turkey, buy meat that is free of hormones and antibiotics.

Healthy eating tip 8: Add calcium for strong bones

Calcium is one of the key nutrients that your body needs in order to stay strong and healthy. It is an essential building block for lifelong bone health in both men and women, among many other important functions.
You and your bones will benefit from eating plenty of calcium-rich foods, limiting foods that deplete your body’s calcium stores, and getting your daily dose of magnesium and vitamins D and K—nutrients that help calcium do its job.
Recommended calcium levels are 1000 mg per day, 1200 mg if you are over 50 years old. Take a vitamin D and calcium supplement if you don’t get enough of these nutrients from your diet.

Good sources of calcium include:

• Dairy: Dairy products are rich in calcium in a form that is easily digested and absorbed by the body. Sources include milk, yogurt, and cheese.
• Vegetables and greens: Many vegetables, especially leafy green ones, are rich sources of calcium. Try turnip greens, mustard greens, collard greens, kale, romaine lettuce, celery, broccoli, fennel, cabbage, summer squash, green beans, Brussels sprouts, asparagus, and crimini mushrooms.
• Beans: For another rich source of calcium, try black beans, pinto beans, kidney beans, white beans, black-eyed peas, or baked beans.

Healthy eating tip 9: Limit sugar and salt

If you succeed in planning your diet around fiber-rich fruits, vegetables, whole grains, lean protein, and good fats, you may find yourself naturally cutting back on foods that can get in the way of your healthy diet—sugar and salt.

Sugar

Sugar causes energy ups and downs and can add to health and weight problems. Unfortunately, reducing the amount of candy, cakes, and desserts we eat is only part of the solution. Often you may not even be aware of the amount of sugar you’re consuming each day. Large amounts of added sugar can be hidden in foods such as bread, canned soups and vegetables, pasta sauce, margarine, instant mashed potatoes, frozen dinners, fast food, soy sauce, and ketchup. Here are some tips:

• Avoid sugary drinks. One 12-oz soda has about 10 teaspoons of sugar in it, more than the daily recommended limit! Try sparkling water with lemon or a splash of fruit juice.
• Eat naturally sweet food such as fruit, peppers, or natural peanut butter to satisfy your sweet tooth.

How sugar is hidden on food labels

Check food labels carefully. Sugar is often disguised using terms such as:

cane sugar or maple syrup corn sweetener or corn syrup honey or molasses brown rice syrup

crystallized or evaporated cane juice fruit juice concentrates, such as apple or pear maltodextrin (or dextrin) Dextrose, Fructose, Glucose, Maltose,  Sucrose

health and safety

health and safety  he Health and Safety Executive (HSE) is a non-departmental public body in the United Kingdom. It is the body responsible for the encouragement, regulation and enforcement of workplace health, safety and welfare, and for research into occupational risks in England and Wales and Scotland. Responsibility in Northern Ireland lies with the Health and Safety Executive for Northern Ireland. The HSE was created by the Health and Safety at Work etc. Act 1974, and has since absorbed earlier regulatory bodies such as the Factory Inspectorate and the Railway Inspectorate though the Railway Inspectorate was transferred to the Office of Rail Regulation in April 2006. The HSE is sponsored by the Department for Work and Pensions. As part of its work HSE investigates industrial accidents, small and large, including major incidents such as the explosion and fire at Buncefield in 2005. Though it formerly reported to the Health and Safety Commission, on 1 April 2008, the two bodies merged.[1][2]

healthspan

About healthspan, what is this healthspan please tell us.

Welcome to our health blog

Dear visitors thnka this blog visit. Other health news next week here wiriting ;)

Wasted drugs

Some doctors on-prescribe, the main patients to store medicines in the country, whereas the patients also cannot take to the given drugs they, he found. Other causes of wastefulness include the medicines that are given but going later dispersed, and drugs prescribed in the hospital that is continued unnecessarily in the country. The investigation, of the national office of the intervention (NAO), examined costs that prescribed in primary care. The money could also be saved if the GPs prescribed medicines of the under-cost, said, that it would not have any detrimental effect in patient care.

The government has sent an impulsion already to call to generic doctors to prescribe statins on the described versions more expensive. Statins is taken by almost two million Briton to the lowest aid its cholesterol and the department of the health esteem that at least £85 a million year could be saved changing to cheaper trade names.

The study, of sir main Juan Bourn of NAO, said drugs of the under-cost of the commutation could save the primary confidences of the care (PCTs) more than £200 a million year. It found ample variations in prescribing of cheaper drugs - in the second trimester of 2006/07, the proportion of varied prescriptions of statin of the under-cost from 28% until 86% through PCTs in England. A total of £200 a million year could be saved if all the PCTs at least reached the standard of more efficient 25%, the report this. If all the prescribed PCTs as efficiently as superior 10% of PCTs, then more than £300 million could be saved.

hearth health

The disease was the cause of death in 34 percent of Australians in 2006, and more than half of them are women.

Tony Stubbs, the ACT Heart Foundation, said that the Go Red for Women campaign is also promoting a healthier lifestyle.

"Cardiovascular disease is the leading cause of death for women is a fact that only three out of every 10 women are aware that came from an investigation of recent Newspoll," he said.

"So we are really trying to promote the message that heart disease is a major problem for women and that is also largely preventable."

osteoporosis is not without possible side effects

The thought absolutely puns, Dr. Thomas B. Dodson explained, " 'Related of Bisphosphonate osteonecrosis of the jaw' is a mouthful." His expertise is another mouthful - Oral and maxillofacial surgery at Massachusetts Hospital. He is an expert. . . Let's call it fair BRONJ.

The problem has been linked to drugs called bisphosphonates, 10 located in sales in the U.S. among all categories of drugs, according to IMS Health, which analyzes markets for pharmaceutical and health care. Most cases come after someone has been treated for cancer with powerful and intravenous forms of drugs. About 1 in 10 cancer patients treated with IV bisphosphonate of the problem develops jaw.

But a handful of cases have appeared in women who take much smaller doses of drugs to treat osteoporosis.

Bisphosphonates, sold as Actonel Ca, Aredia, Boniver, Didronel, Fosamax, Fosamax Positive D, Reclast, Zometa and Skelid, meanings are to increase bone density in the short term by reducing the portion of the bone-loss of the life cycle of bone. But some scientists think that drugs could eventually hurt the ability of the jaw to heal after, say, a tooth extraction or dental grafting.

Estimates on the number of people who may experience the range of jaw problem of 1 in 2,000 to as much as 1 in 300 people who take drugs for osteoporosis.

In the U.S., 55 million prescriptions for bisphosphonates are written annually, according to a 2007 report in the journal Osteoporosis International. Even if not all of those prescriptions are filled, and even if many of the women who begin taking the drug stopped, the number of women who perhaps have the problem in dentists' chairs is safe climb.

Most of the commonly, these people will see or feel that a bone exposed in the mouth, as the dead bone works its way by rubber or fabric, but without the pain. In such cases, these people are just using an antibacterial rinse. If there is pain or discomfort, and the area of exposed bone are small, a dentist will try to smooth the exposed area.

In rare cases, the area of dead bone is large. "So people are at risk of breaking the jaw, because the area is so big," Dodson said.

So why does a drug that circulates through the entire body has resulted in a punch to the jaw pharmacist? Researchers have only theories.

It could be, Dodson said that in mandible bone metabolism at a faster rate than in other parts of the body as more of the drug is deposited there. And because there are more bacteria in the mouth and teeth area, that could add to inflammation, worsening the problem.

Or it could be, he says, that the mechanism of the drug are at work. Bisphosphonates inhibits the cells that dissolve bone. "But dissolve bone is part of a healthy life cycle," he said. The natural balance between bone-dissolving and making new bone is broken and the bone-producing cells now dominate. But when they die away, there are fewer cells for cleaning them, and they remain a dead body.

The dental procedures - the extraction of teeth, dental transplants, oral surgery - may increase the risk of a problem because of trauma to the jaw. That's why the American Assn. of Oral and Maxillofacial Surgeons recommend that if a woman starts taking a drug for osteoporosis, she had the dental work done before it begins.

If she has been taking the drug for three years or more, the association recommends a vacation of the drug for three-months prior to having non-emergency oral surgery.


But for women who have been on drugs, an urgent problem - like a toothache that late - should be dealt with immediately, although there may be a 1 in 300 chance that she has BRONJ.

Colonoscopy

The cheapest option less intrusive might persuade more people to be investigated for cancer of the colon.

And some experts believe that the new method can increase the rate of the investigation of 50 percent for cancer that is a murderer second largest in America.

"We talked for the first time really in the investigation of the population," said Dr. Carl Jaffe, an expert on imaging the National Cancer Institute who was not involved in the investigation.

In the new study, the largest of its kind, the so-called "virtual colonoscopy" identified nine out of 10 people who had cancer and the growths seen by large regular colonoscopies.

But there was damage, too. Among them: The radiologists read wrong sometimes radiography, the leading mark polyps that were not there. That led to unnecessary follow-up test.

The value of the real test of the x-ray can be in the action that really needs a regular colonoscopy - was preferable in ruling out cancer in that discernment, suggests the report in the New England Journal of Medicine on Thursday.

Colorectal cancer claim about 50,000 lives this year. The point of the investigation, widely recommended at the age of 50 years, is to find growths before they turn cancerous.

Colonoscopy is the gold standard, in which a long, thin tube equipped with a small camcorder is Meander along the large intestine see the forum. Any growth can be removed during the procedure.

It involves sedation and a day lost from work, not to mention the preparation that uses pills or liquids to clean the intestines.

The study focused on CT colonography, also known as virtual colonoscopy. It's a super X-ray of the colon that is faster, cheaper and easier on the patient that traditional colonoscopies.

It also requires the cleansing of intestines and has a potentially serious problem - radiation.

Colonoscopies costing up to $ 3,000. The test of the X-ray costs $ 300 to $ 800; most insurers do not cover so far, but the federal Medicare insurance program for the retiree is considering.

Insurers likely weighed heavily in the new study by reach their decisions, said Dr.. Brooks lasted, which oversees the programs of colorectal and prostate cancer at the American Cancer Society.

The preliminary, unpublished data from the new study and helped persuade the company to turn off cancer and other patterns in March that added virtual colonoscopy and a stool DNA test recommended to the arsenal of research for colon cancer, said the Arroyos .

In the new study, that the standard colonoscopy and X-ray test were given to 2531 people in 15 medical centers in the U.S.

The scrutinized shown great growth in about one in every six people, although some false alarms were not confirmed by colonoscopy.

Of the patients with growths checked by colonoscopy, 90 percent was noted by radiography escudriña.

"That is very good news," said Dr. C. Daniel Johnson, the lead author of the study. He is a researcher at the campus of Mayonnaise Clinic in Scottsdale, Arizona, with financial ties to a virtual colonoscopy, GE Healthcare.

Support to false alarms - one in four of those patients diagnosed with a growth had a really, MD. Robert Fletcher noticed, a retired professor of Faculty of Medicine at Harvard who wrote an editorial accompanying the study. He is a paid consultant for a company that makes a test of DNA research for cancer of the colon.

today in health

In a press release, the pharmaceutical company Centocor, which makes ustekinumab and sponsored the study, called the new drug "superior" to Enbrel.

But Amgen, the pharmaceutical company that makes Enbrel, notes that the study only lasted for 12 weeks and not addressed the long-term security.

Both ustekinumab as Enbrel are biological drugs. Ustekinumab focuses on two chemicals inciting, interleukin 12 and interleukin 23. Enbrel is a blocker of TNF, that is, inhibits tumor necrosis factor (TNF).

In the new study, 903 patients with moderate to severe plaque psoriasis or ustekinumab achieved (in a dose higher or lower) or Enbrel for 12 weeks.

Patients in groups of ustekinumab got a shot of the experimental drug in their assigned dose when the study began and another shot four weeks later. Patients in the Enbrel group got two shots of Enbrel each week for 12 weeks. Results of the study

By the end of the study, 65% of patients in the group of ustekinumab of lower-dose and almost 71% of those in the group of ustekinumab higher-dose was at most minimal signs of their psoriasis, according their doctors, compared to 49% of patients treated with Enbrel.

Both drugs were generally well tolerated and were taken similar profiles of security during the study, according to data presented in Paris at the European Academy of Dermatology and Venereology Congress.

"This study is significant for the community of dermatology, as in the first test of Comparator biological therapies for psoriasis," researcher Christopher Griffiths, MD, FRCP, University of Manchester in England, said in a news release from Centocor .

"The treatment with ustekinumab ... has demonstrated clinical efficacy with significant injections of rare-be administered. These are important factors in assessing the burden of disease for many patients living with moderate to severe psoriasis who are candidates for and a biological treatment, "notes Griffiths.

In an e-mail, Sonia Fiorenza, the director of corporate communications for Amgen, WebMD said that "the big question with any new therapy, especially a focus on a new path, not the short term effectiveness, safety is long term. This study of 12 weeks does not direct that question. "

Fiorenza said Enbrel "continues to have a consistent profile of security," has been used for 16 years, is "the number prescribed a biological psoriasis, and in 80% of patients are extremely satisfied with Enbrel."

Centocor ustekinumab has been submitted for FDA approval. In June, an advisory panel recommended that the FDA approve ustekinumab. The FDA often follows the recommendations of its panels consultants, but has not compelled to do so.

healt news today

Obesity, which is believed to be linked with dietary fat, high, and typical Western, has been commonly associated with hypertension, especially in the African American population.



For the study, David M Pollock and colleagues at the Medical College of Georgia, Augusta, GA tested the effect of the high-fat diet in the tension of Dahl salt-sensitive rats.



The rats were monitored for their bad blood pressure (MAP) for a week before and during 4 weeks of eating a high fat diet (fat 36 per cent). The salt-resistant rats were used as controls.



In a high-fat diet for a period of 4 weeks, the salt-sensitive rats experienced a surge in the 125-MAP-line background mmHg to 150 mmHg while the controls did not experience any significant increase in MAP: 102 bottom line mmHg to 109 mmHg after against fat diet, high and 4 weeks.



The high-fat diet also did the salt-sensitive rats more susceptible to the effects of environmental stress in tension. TRACE in rats in the high-fat diet was 38.7 mmHg compared to 22.5 mmHg in those on a normal diet.



The results along with additional research support the hypothesis that "a high-fat diet contributes to hypertension and an exaggerated response of stress in rats genetically susceptible." the authors wrote in their report.



At the same conference, a new Italian study led by Dr. Rosa Maria Bruno of the University of Pisa found that vitamin C can be delivered intravenously to lower the tension by as much as 7 percent.



Another new Italian study also presented at the exhibitions of the conference that about half of people with excessive weight to the stage 1 hypertension or high blood pressure can achieve its voltage normalized by losing just 5 to the weight of 12 per cent and standardize their BMI.



The study was conducted by Roberto Fogari and colleagues at Universita 'di Pavia in Pavia, Italy.



The researchers meant to assess the role of weight loss in value of tension in people with excessive weight of stage 1 hypertension who had never received any medicine to treat his hypertensive condition.



The study involved 189 people from excessive weight (BMI 25 to 29.9 kg/m2) with stage 1 patients with hypertension (SBP tension = 140-159 mmHg or systolic and diastolic tension or DBP 90 - 99mmHg). The participants were given nutritional advice I 120 to 360 mg of Orlistat per day to achieve a 5 percent loss in weight in 6 months.



Those who successfully lost the weight concentrated in 5 percent of the treatment continued for another 6 months and the stress and weight was measured every month. At the bottom line, 6 and 12 months of treatment, ambulatory 24-hour tension was evaluated and blood samples were drawn to test leptin plasma renin and aldosterone assets.


The researchers found that 111 participants or 59 percent of the subjects of the study achieved a reduction of 5 percent in weight.



Has found that those who lost their targeted amount of weight experienced a significant drop in SBP and DBP (-6.9 and -4.2 percent respectively) and high weight loss resulted in the reduction in high tension.



Among those who managed the loss of 5 percent in weight, fifty three or 48 percent normalized their BMI and 28 of them or 53 percent normalized their tension.

FDA Considers the Risks of Mobile Medical Apps

As technology continues to advance, just about everything is becoming more readily available. Ask and you shall receive. In fact, just imagine something you may have never thought possible and there’s an app for that, or will be in the near future.
If you have an iPhone, iPad, Android, PDA or any other mobile device, you may have come across new medical apps such as iHealth’s Blood Monitoring System or AirStrip Technologies’ AirStrip Cardiology app. These are the types of products that the FDA will be reviewing in order to determine whether or not they need to be more closely monitored.
The agency plans to regulate only a small subset of mobile medical apps that present the greatest risk to patients. More specifically, any applications that market the diagnosis, cure, treatment or prevention of a disease or other condition will be more closely reviewed. The guidelines also indicate that applications that require patient-specific information are highly likely to be part of that subset.
Some of these products act as an accessory to medical devices used by doctors or transform a mobile device into a regulated medical device with the use of attachments or adapters. Others give patients medical advice based on specific data that is entered into the application. For example, WellDoc’s Diabetes Manager functions as a virtual coach for type 2 diabetes patients. Users are prompted to log their medication, carbohydrate intake, and blood glucose in order to receive reminders as well as recommendations regarding their health.
The FDA recognizes the possible risks that these types of applications may create. Devices do not always work properly. Results could get mixed up. Although many of these applications are supposed to provide the analyses that doctors would traditionally provide, those recommendations might not always be right. Therefore, the FDA has a duty to current, as well as prospective, patients to evaluate these applications and their intended functions.
Guidance documents for these regulations are still being reviewed and the agency is welcoming feedback from the public for the next 90 days.

Daily Diet: Accuracy of Menu Calorie Counts Challenged

The old adage “Let the buyer beware” is now applicable to the stated calorie count of restaurant meals. While the Health Care bill included a section which requires that chain restaurants with 20 or more locations display nutritional and calorie information, and many are coming into compliance, the accuracy of that calorie count has come into question.
As a consumer, you expect to get what you paid for, and while getting more than you asked for may seem like a bonus or a bargain, it could be packing on unwanted pounds. For example, when you order a burger at a fast food restaurant that is listed as containing 500 calories, you expect the 500 calories, no more. Such is not the case, according to new research out of Tufts University in Boston.
Research centered on 42 quick-serve and sit-down restaurants in Massachusetts, Arkansas and Indiana. The team tested 269 different menu items and revealed that almost 20 percent packed 100 or more excess calories—a finding that was most often found in lower-calorie foods. Only 7 percent of the sampled French fries, burgers and other food were within 10 calories from the stated values.
Sit-down restaurant were more often incorrect in serving portions. “There were several cases where we just got a lot more than we thought they were going to give us," said team leader Lorien Urban, a nutrition researcher at Tufts.
It’s not all bad news, however; 52 percent of tested food had 10 fewer calories or more than stated on the menu. Of course, some people might think they were getting cheated out of the food they paid for in this instance.
Nutritional labeling is a benefit for consumers, whose waistlines have continued to grow. Providing nutrition or calorie labeling on restaurant menus has proven to help consumers be more conscious and make better decisions about what they are eating. The New York Department of Health and Mental Hygiene released findings last year of an analysis on the impact of the city’s menu-labeling laws, which was mandated in 2008.
Results indicate that consumers have become more selective in choosing food with fewer calories. In fact, people purchased lower calorie meals at 9 of 13 fast-food restaurant and coffee chains that were included in the study.

Stopping Daily Aspirin Regimen Linked to Increased Risk of Heart Attack

For people diagnosed with heart disease, stopping their daily dose of aspirin puts them at greater risk of suffering a heart attack. A new study out of Spain suggests that the risk of heart attack is significantly increased by discontinuation of a daily low-dose aspirin regimen prescribed by a doctor. The study report was recently published in an online edition of the British Medical Journal.
Taking a daily aspirin in a low dosage that typically ranges between 75 and 300 milligrams is recommended for heart patients to aid in the prevention of blood clots and decrease their risk of secondary cardiovascular events. However, as many as half of patients who begin an aspirin regimen, abruptly stop taking their daily medication.
The results of the new study indicate that the increase in risk for heart attack among those who discontinue the preventative treatment is real. According to lead researcher, Dr. Luis Garcia Rodriguez, director of the Spanish Center for Pharmacoepidemiologic Research in Madrid, these heart patients “should be advised that unless there is a high risk of serious bleeding or otherwise recommended by a doctor, aspirin should never be discontinued given its overwhelming benefits.” He further cautioned, “Also, patients who need to discontinue aspirin should do so for the minimum time necessary.”
For their analysis, the researchers gathered data on 39,513 patients ranging in age from 50 to 84 years,whose medical records were part of a large database in the United Kingdom,known as the Health Improvement Network. The patients in the study had all been prescribed low-dose aspirin therapy between the years 2000 and 2007 as an aid for preventing various cardiac complications that include heart attack.
After approximately three years of follow-up, the research team discovered that a 60 percent increase in the risk of suffering a non-fatal heart attack existed among those patients who stopped taking their daily does of aspirin.
The findings remained the same no matter the duration of a patient’s aspirin regimen prior to stopping their daily meds. This accounts for a total of 4 additional heart attacks per1,000 patients who quit taking aspirin on a daily basis.
The study authors said that the results of their invegestigation supportconclusions of previous studies involving secondary care, and that the latestfindings are applicable to the general population. “Any day off aspirin is a day at risk for patientswith previous cardiovascular disease.”

Menopause and Your Changing Body

Menopause and Your Changing Body

middle-aged womanIn our culture, menopause is frequently seen as a negative milestone, a time of loss and is sometimes viewed as a disease or medical condition requiring a cure. With messages like this from the medical establishment and the media, it's no wonder many healthy women in the midst of this transition develop negative feelings towards their bodies.

What's an average woman to expect regarding her body as she travels through her perimenopausal years (typically her mid- and late- 40s)? Should she yearn for the 30-year old physique she may once have had? Is it possible to achieve that objective? What's a healthy and realistic goal for women hoping to optimize their body composition as well as their body image as they move through the last endocrinological change in their life?

Here are some facts. An average woman can expect to gain from two to five pounds during the menopausal transition, usually ending up in the lower tummy area. The main reason women experience this weight gain is the decline of estrogen. Fat cells in the hip, thigh and buttock areas have receptors for estrogen. Estrogen, in most women, drives most fat storage to the lower part of the body. As estrogen levels begin to decline, however, estrogen loses its hold on fat storage below the waist and instead, fat starts to show up in the "pinch an inch" area of the waistline. It usually extends from the belly button down to the top of your pubic hairline. It's like a small, soft pouch. I refer to this as the "menopot" and the great news is that it is not associated with life-threatening medical illnesses.

Unfortunately, many women are at risk for greater weight gain during the perimenopause and this excess fat usually is deposited deep inside the tummy, under the abdominal muscle wall. I call this Toxic Weight since this fat is unique in its ability to increase a woman's risk for diabetes, heart disease and cancer.

A woman notices that she is fighting the tendency to shape shift from a pear to an apple. Along the way, she is may be experiencing mental frustration about the weight shifts and gains.

By menopause, most women have a rich and fulfilling life history making them prouder and wiser. However, it's tough to focus on self-acceptance and emotional well being when your body feels like it has a life of its own and is gaining weight and getting harder to manage.

A growing number of women feel less attractive as they reach menopause. Recent American Society of Plastic and Reconstruction Surgeons statistics show cosmetic surgery has risen 47 percent for 51 to 64 year old women over the past five years. The media tells mature women to focus on "slowing down the ravages of time", and "reducing telltale signs of aging". These messages can affect our ideas about ourselves. The older a woman gets the harder it is to live up to the beauty standards set by an 18 year old supermodel.

So what's the answer? Stop listening and agreeing with the media hype about negativity in the menopausal years. Reject these negative messages now. Women today have many options as they undergo natural, physical changes due to menopause. You can promote peace between your mind and body during this complex life transition.

Here are some tips to help you get started.

    Physical activity has been scientifically proven to increase body confidence and sense of pleasure in life. It is also the key predictor of healthy weight maintenance.

    Check your nutritional status. One of my patients summed this up eloquently when she said, "You know, when I eat crap, I feel like crap!" No kidding. Seems simple, yet so many of us aren't eating healthful foods.

    Get a life! Find some activities you enjoy and start doing them. If you are lonely, seek out new forms of social support or reconnect with old friends. Make the time to do this.

    Be mindful and fully present each day. Each day is a gift just for you. Grasp the moment and enjoy.

    Take walks or hikes in nature. Being in nature is one of the best ways to reclaim the feelings of connectiveness to the world. Gardening can also be extremely uplifting for the spirit.

While menopause is a normal transition and a biological certainty, every woman's experience is unique. Let's take the lead from many nonwestern cultures where women look forward to the joys of aging. Drastic measures to preserve youth such as extensive cosmetic surgery are not valued in these cultures. Certainly, they should never be used as a substitute for healthy living.

Finding meaning in volunteerism and work, spending time with your family and friends, being in nature and seeing the glory in the ordinary are all roads to self and body image acceptance.

Your body is there to help you "do life" in the most meaningful way. Realizing and being thankful for this will help you appreciate, celebrate, and take care of your body.

99.5% of Hospitals Report Drug Shortages

By Katherine Hobson

Two new surveys give a snapshot of how bad the drug-shortage problem has become.

The Institute for Safe Medication Practiceshas called the recent rash of shortages“unprecedented.” Today, the American Hospital Association and American Society of Health-System Pharmacists reported what their members are saying. (The WSJ wrote about this issue earlier this year.)

The AHA says that 99.5% of the 820 community hospitals that responded to the group’s June survey reported experiencing at least one drug shortage in the past six months. A full 44% reported shortages of 21 or more different drugs.

All treatment categories were affected, hospitals said, with 80% or more respondents experiencing shortages of surgery/anesthesia, emergency care, cardiovascular, gastrointestinal/nutrition, pain or infectious disease drugs. And 66% of hospitals reportedshortages of cancer drugs. Some 47% of hospitals reported experiencing a shortage of at least one drug on a daily basis.

Shortages occur for a variety of reasons, including the unavailability of raw ingredients, FDA enforcement actions that halt production, voluntary recalls, poor inventory management, changed product formulations and even shortage rumors, which can prompt hoarding, according to the ISMP. (Indeed, 85% of the hospitals surveyed by the AHA reported that they’ve purchased “excess inventory” of certain drugs to be sure they’re not caught short-handed.)

In addition, most hospitals in the AHA survey say they’ve implemented rationing or restrictions for certain drugs and that as a result of shortages, drug costs have risen. A separate analysis released in March estimated shortages were costing hospitals at least $200 million annually.

The consequences for patients may include delayed treatment, receiving a less effective drug or not getting a recommended treatment, though most hospitals reported those things happened “rarely,” the AHA says. The ISMP reported last September on near misses and deaths resulting from drug shortages.

Meantime, the American Society of Health-System Pharmacists  surveyed directors of pharmacy and of the 353 that responded, more than 90% agreed shortages were associated with a greater burden and higher costs compared to two years ago. And 70% felt the available information on managing shortages was inadequate. It estimated an annual labor cost of $216 million a year.

The ASHP, AHA and other groups recommend that an early warning system be established that might give signs of a looming shortage, that obstacles be removed so that the FDA can streamline approval of drugs in short supply and that incentives be explored that might encourage drug makers to produce the drugs that are most needed.

Americans Have Access to Dental Care

By Katherine Hobson


We don’t typically consider oral health as part of overall health, and that’s a mistake, according to a new report from the Institute of Medicine.

Because the diseases of the mouth are inextricably linked to overall health, “the unmet oral health needs of millions of Americans cannot be neglected,” the report says.

“Almost one third of the population reports some difficulty in accessing dental care,” Caswell Evans, Jr., an author of the report and associate dean of prevention and public health sciences at the University of Illinois at Chicago College of Dentistry, tells the Health Blog.

Some people lack dental insurance even though they have private health insurance.  (The CDC reported last year that of the 172 million Americans under age 65 with private health insurance, about 27% don’t have dental coverage.)

Others who lack coverage are retired — Medicare doesn’t cover dental care, with some exceptions when it’s in connection with covered procedures, like a jaw reconstruction. Some are poor; states aren’t required to provide dental coverage to adults under Medicaid. And while kids are covered by Medicaid and the Children’s Health Insurance Program, payment rates are so low many have trouble finding a dentist who will treat them.

The report calls for a host of systemic changes intended to improve access to care, including training non-dental health pros such as pediatricians and nurses to play a bigger role in oral care, a reassessment of state practice laws to be sure they promote access to care, establishing CMS-funded state demonstration projects to include essential health benefits in adult Medicaid coverage and increasing Medicaid and CHIP reimbursement rates. (A study appearing in this week’s edition of the Journal of the American Medical Association found that higher Medicaid reimbursement rates were associated with more kids and teens getting dental care.)

In a statement, the American Dental Association praises the focus on oral health access but reaffirms its opposition to allowing non-dentists to perform functions like extractions. “Everyone deserves a dentist,” the ADA says. State laws vary greatly in what they permit non-dentists to do without supervision — seven states require a dentist to be present when a hygienist applies sealants, the report says. Specially-trained dental therapists in Alaska, meantime, can drill and fill cavities — but only in Alaska Natives.

The authors said they were cognizant of the financial pressures facing the federal and state governments. Evans says marginal increases in Medicaid reimbursement rates wouldn’t be terribly burdensome, though. And the authors said they hope that providing access to basic care might save money in the long run by preventing patients from showing up in the ER with more advanced complaints.

More than a decade ago, a U.S. Surgeon General’s report also called for a “national effort to improve oral health among all Americans.”