From hospital to home, on the virus front line with medics around the world

From the hospital ward and the distress of patients dying, to the home front full of fear of infecting their own families, medical workers face gut-wrenching daily decisions more than ever in the fight against the coronavirus.

AFPTV journalists followed doctors, nurses, ambulance staff and caregivers on the front line of the virus in Paris, Beirut, Stockholm, Sao Paulo, Los Angeles, Dakar and Daegu at the end of April.

Here are snapshots of four of them in action:

- An intern, near Paris -

Soon after Axel Hirwe's shift begins at 8:30 am, an alarm goes off in the intensive care unit at Argenteuil hospital, 20 kilometres (12 miles) north of Paris.

Someone has gone into cardiac arrest, the team scrambles and a pulse is found but the brain has been severely damaged and the patient isn't expected to last the night.

"Unfortunately or fortunately, we get attached to patients," says intern Hirwe, 29, his eyes full of concern from behind his round glasses.

Before having to go on to a ventilator, the patient in question, he says, was breathing by himself, meaning he'd talked and they had got to know a bit about him.

"So, it's very hard after having known the patient, to realise that, in the end, he's going to die," he says.

Next, five staff are needed to position another patient, one of 40 in the unit, on his stomach to ease his breathing.

And then, there are the phone calls to families...

"We have to reassure them, but not too much, because they do remain in a serious condition, they're in intensive care, they're still intubated.

"But sometimes they need a bit of hope," the young masked medic says.

Ending the afternoon on a positive note: a diabetic patient has improved and was able to get out of bed.

At home, in Clichy, about 10 km from the hospital, Hirwe attempts to relax, not talk shop with his five housemates and rings his worried mum.

"I try to reassure her," he says. At the other end of the line, she holds up the phone so he can hear the day's 8:00 pm applause for caregivers.

- A nurse in Beirut -

Two ambulances pull up outside the coronavirus emergency department at Rafik Hariri University Hospital in the Lebanese capital.

Nurse Ali Awerke, 34, takes charge of one patient while talking to another near the entrance. "I'm coming, just let me get this patient settled and I will come and help you, OK?"

All day long, he is racing. From collecting equipment, bagging up swabs and blood samples, to answering the phone as well as looking after patients.

Awerke volunteered for the coronavirus team at the start of the crisis.

"I didn't have clothes with me, I didn't have anything. I joined the team and called my wife and told her, 'I'm going to stay here and unfortunately, I won't be able to see you all for a while'," he says.

Since then, he's been living at his parents' house in Beirut, isolated.

But this evening, after testing himself first for the disease, he's going home to his wife and daughters for the first time in two months.

As the call to prayer marking the end of the day's Ramadan fast rings out, he drives in to his village, Es Saksakiye, to surprise his family.

The reunion is emotional. Bringing flowers, he kisses his wife; his youngest throws herself into his arms.

As a family, they enjoy the evening iftar meal celebrating the end of the day's fasting.

"We're all going to sleep in the same room, we're all so happy," he says.

"I missed the house and sitting here on the veranda. It's been a long time... two months. Maybe for some people it's not that long, but for me it was ages."

- Specialist unit head in Stockholm -

Places at the ECMO (extracorporeal membrane oxygenation) unit at Stockholm's Karolinska University Hospital are few and the demand among patients in severe respiratory distress is high.

The equipment used is invasive and the treatment arduous but it can make all the difference.

"Hopefully the patients that we bring in here will survive thanks to ECMO treatment which they wouldn't do with regular ICU (intensive care unit) treatment," says its head, Lars Falk.

But every day demands difficult choices.

"We need to really select the right patients and during that selection of course we also select people away from ECMO and those are very tough decisions to make," he says.

Once home, the doctor, now sporting a two-day stubble look, recharges the batteries a bit around his family.

Often he has a sense of achievement, he says, though it can be hard to really switch off.

"I think it's more that you can dwell on some of the decisions that you've made during the day, was it correct or not correct to put this patient on ECMO," he adds.

- Husband and wife team in Sao Paulo -

A death a day is the average at the Emilio Ribas Infectious Disease Institute in Brazil's biggest city, Sao Paulo.

Its intensive care unit has been full since mid-April with seriously ill coronavirus patients.

And every day since the start of the crisis, doctor Jaques Sztajnbok, 55, has been at work.

Because the disease is new and no established protocols exist, he says that staff have to take it on a day-by-day basis, talking about every case, every day, and testing to see if what works for one patient, will also help another.

As head of the unit, he feels he has to set an example, but the doctor with dark circles under his eyes is worried all the time -- for his patients, but also for colleagues, several of whom have become ill.

"And that's a worry we've never had before, even in other epidemics," he says.

He and his wife, Fabiane Sztajnbok, 47, an infectious disease specialist at the hospital's emergency room, also worry about the risk of bringing something home with them and about their children.

Once home, they remove everything in the hallway, shower and wash their clothes.

Nevertheless COVID-19 is still present. "At dinner we always talk about what happened during their shifts," says their 10-year-old son Daniel.

The Sztajnboks say they feel the need to talk about their days more than ever. Fabiane wakes in the night simply because she is "worried and anxious".

But on this day, it's Jaques' 55th birthday.

As he blows out his candles and looks at the cards from his children, he says: "Brave, I think that's an adjective they didn't use to write on earlier birthday cards."

Agence France-Presse

Artificial intelligence gives doctors a hand

BEIJING — Anhui Provincial Hospital became China’s first intelligent hospital in August, using artificial intelligence-enabled systems to help doctors with medical diagnoses and treatment.

Four months later, the hospital, in Hefei, Anhui’s provincial capital, was renamed the First Affiliated Hospital of University of Science and Technology of China.

Yan Guang, the hospital’s deputy head and the man in charge of its intelligent transformation, said that when it launched an AI-enabled smartphone application in 2016, doctors and nurses were keen to use it.


Developed by iFlytek, an AI company based in Hefei, the system uses speech-recognition technology to type up medical records and image-recognition technology to help doctors read medical images.

“The users of the app, which is a tailored edition for the hospital, soon reached a satisfying number,” Yan said. “Then we found there were also nurses among the users, while the system was designed to serve doctors.

“Nice numbers are definitely not all we want. It is the doctors using the app who can help the system improve.”

He said he subsequently had to limit use of the app among nurses.

Doctors said the AI-enabled systems have made their work more effective and efficient, although there are still some problems to overcome.

Qi Yinbao said that in his first four years as a neurosurgeon at the hospital, beginning in 2013, he had to spend much of his time writing up patients’ medical records every day.

“I usually wrote them between surgeries, and very often would stay in the office after working hours to finish them,” he said. “Sometimes I found I forgot some important information and needed to go through all the print records of examination results to refresh my memory.”

With the app developed by iFlytek, Qi and the hospital’s more than 1,300 doctors now have speech-recognition technology to help them record their diagnoses.



Special dictionary

To open the app, Qi can log in with either a fingerprint or a combination of face and voice recognition. He then just speaks into his smartphone and the app types up the information precisely.

Because doctors use many professional medical terms, iFlytek engineers said they built a special dictionary to make speech recognition more precise.

“The system also features deep learning technology, which means the more doctors use the system, the more precise the results will be,” said Lu Xiaoliang, deputy general manager of iFlytek’s intelligent healthcare business.

Some senior medical specialists found typing up records on a computer tedious, so the hospital previously had to arrange an assistant for each of them.

“With AI technology, the senior experts can now also work alone well, saving a lot of human resources for the hospital,” Yan said.

Qi said the speech-recognition technology could help dentists even more, as they were not able to spare a hand to write up records when working on patients’ teeth.

“They just need to keep the speech-recognition function working,” Qi said.

The function also works on a computer with a microphone, but it keeps typing as Qi keeps speaking, even though some of the things he says have nothing to do with his diagnosis, and he needs to delete them when he ends the recording.

That could prevent a dentist from chatting with a patient to relieve their anxiety, because there would be too much information to delete afterward.

The results of certain examinations of patients are automatically entered into the app, allowing Qi to check them anytime, anywhere.

“In the past, before making ward rounds to the patients’ rooms, we were first offered many print records and then asked the patients about their health conditions and took notes before returning to the office to type on computer-based systems”, Qi said.

But part of the preparatory work can now be done ahead of time, even when a doctor is on a bus or subway train.

Yan said a more important feature of the system is that it can help doctors read medical images to speed up diagnosis and prevent misdiagnosis.

Take CT scans for example. A doctor could spend minutes reading a CT case, which usually consists of many－sometimes hundreds－of images, before making an initial diagnosis, but Lu said it takes less than a second for the AI system to do the same thing.

“Best of all, the system won’t get tired,” he said.

The AI-enabled system has helped interpret thousands of CT images, Lu said, and the accuracy for detection of lung nodules, one of the indicators of potential lung cancer, has reached 99.4 per cent.

To build the intelligent hospital, Yan said several AI-enabled systems have been launched since 2016 in co-operation with iFlytek and other firms, including internet giants Alibaba and Tencent.

“None of the systems can work perfectly, but in the long run they will improve over time,” he said. “The medical sector will inevitably become more intelligent, and we cannot miss the chance to lead the trend.”

The hospital has not paid iFlytek a penny since they began co-operating in 2016.

“They don’t need to,” said Chen Liang, an iFlytek employee who leads a team of more than 10 engineers working in the hospital. “It will be by learning from the hospital what they really need that we can develop better systems.”

Yan is prudent when discussing the potential of AI-enabled systems, but they are already helping to guide patients around the hospital and allowing it to link up with hospitals around the province.

Another example is work on an intelligent emergency medical system.

“Once you call the emergency centre for first aid, your health information, based on all of your hospital records, will be provided to the first-aid personnel in the ambulance and doctors at the hospital,” said Yan, who was in charge of the hospital’s emergency medical centre from 2004 to 2007.

All the necessary advice on tailored first-aid solutions will be given to the medical personnel through the AI technology and they will see the advice via a smartphone app, he said.

The hospital has invested millions of yuan in the project, just dealing with its own medical records, and Yan said expanding the practice will require more effort.

The provincial authorities have launched a plan to build personal healthcare profiles, which can be shared between hospitals, for every citizen, and the project is progressing well, he said.

Intelligent healthcare is becoming a trend in hospitals. Hefei has also established a municipal-level intelligent hospital and the provincial authorities plan to set up six more at the provincial level and at least 15 at the municipal level this year.

First standard

Gao Junwen, deputy head of the Anhui Provincial Health Commission, said there must be some standards hospitals can refer to.

To build an intelligent hospital, the USTC hospital released its own 47 pages of standards, which won recognition from the provincial authorities. “It is the country’s first official standard for intelligent hospitals, and the national standard is expected to be drawn up using this one as an important reference,” Gao said.

Yan said there should be standards for different levels of intelligent hospital. “A county level intelligent hospital can by no means be built with a standard for a provincial-level one,” he said.

A recent article in the journal Chinese Digital Medicine, which is published by the National Health Commission, said there are still some technical difficulties to overcome in applying speech-recognition technology in diagnosis and treatment.

Written by a team of doctors from the General Hospital of the Guangzhou Command of the People’s Liberation Army, the article said background noise and doctors’ accents could affect the accuracy of the recognition process.

Speaking about a patient’s health conditions in an office shared by several doctors also failed to protect the patient’s privacy, it said, adding that solving the problem requires more investment to rearrange doctors’ offices by, for example, giving them more private space.

As the intelligent healthcare business heats up, Lu said competition between companies is getting fiercer.

“Some of the firms act as if they can change the world overnight, while we believe making healthcare intelligent still needs great efforts to improve technology,” Lu said.

“In the past, say about two years ago, some medical experts were too cautious about the business while some others’ opinions on it were too negative.

“Nowadays, their understanding of the business is getting more rational－the current technologies are not perfect but they can be improved.”

He said the business is very reliant on government support, because the authorities are always very cautious about the healthcare sector.

source: technology.inquirer.net

Acupuncture–now it’s also for instant facelifts

To give the face an instant lift, Dr. Vicki Belo now uses acupuncture, an ancient form of traditional Chinese medicine that involves pricking the skin, nerves and muscles with needles to alleviate pain and cure a host of ailments.

Combined with a more conventional and noninvasive “lunchtime” procedure like Rev Light, acupuncture is said to instantly tighten sagging muscles and improve blood circulation for a more glowing complexion.

Belo used to go to Hong Kong regularly to have facial acupuncture until she was able to convince her Chinese acupuncturist to fly to Manila to train her and her team of doctors.

“We started offering acupuncture late last year,” she says. “Our knowledge is limited to the face, but acupuncture is known and accepted even in the West to help treat various conditions.”

Because of the facial muscles’ “unique” composition, acupuncture is able to address a person’s sagging facial muscles without her having to go under the knife. People in their 40s, 50s and even in their 60s are the best candidates for this procedure, Belo adds.

While noninvasive procedures such as Ulthera, Thermage, Fraxel and even Rev Light stimulate the skin to contract and increase collagen production, they don’t address sagging facial muscles and poor blood circulation. As a person ages, her facial blood vessels also shrink, resulting in dark, uneven skin tone.



“The face is the only part of the body where skin and muscles are stuck together,” says Belo. “When a person is young, the muscles of the face are rounder, shorter and more contracted. Thus, you can see the contours of a young person’s face.”

Misconception

Many people—and even some beauty doctors—have this misconception that only fat gives the face volume. It turns out that muscles also make the face look rounder, younger and more relaxed, says Belo. As a person ages, these facial muscles become longer and looser.

You can do all sorts of noninvasive laser and radio-frequency procedures aimed at tightening the skin, but the effects are limited because the sagging muscles underneath remain untouched. Between skin and muscles, the muscles prevail in the end because they’re thicker and heavier than skin.

“That’s why the effects of Ulthera and Thermage last only about a year, two at the most,” says Belo. “If there’s nothing weighing down the face, laser-treated skin would be able to hold up longer.”

The only noninvasive procedure that causes facial muscles to contract is acupuncture, “a thousand-year old practice that takes only 15 minutes to do,” she says.

Belo sticks about a dozen or so needles on various points of the face before removing them one by one a few minutes later.

Belo’s acupuncture program comprises 10 sessions (P5,000 per session). The first two sessions are done within a week, while the remaining eight sessions are done once a month.



Laser procedure

To address dull, aging skin, Belo has paired acupuncture with Rev Light (P9,000 per session), a laser procedure designed to diminish wrinkles, shrink pores, even out skin tone and eliminate unsightly pigmentation. Depending on the condition of a person’s skin, clients normally undergo four sessions of Rev Light once a week.

She likens pigmentation to a big chunk of rock on the face. When a person has even skin, light that falls on her face is able to shine back, making her look younger.

Pigmentations, which are brown, map-like discolorations resulting from sun exposure and uneven melanin production, leave splotchy shadows on a person’s face.

“Rev Light should go hand in hand with acupuncture,” says Belo. “You undergo Rev Light first to blast away pigmentations into tiny chunks or particles. These particles are eliminated first through your lymphatic drainage system before they go down to your tummy and out.”

If circulation is impeded, these pigments are likely to stay on your complexion longer. That’s why you need to undergo acupuncture after every Rev Light procedure to help jump-start circulation and remove those pesky pigments, pronto.

“The beauty of acupuncture is its two-pronged effect,” says Belo. “It stimulates energy flow and circulation while promoting muscle contraction.”

Short-term effect

But acupuncture has a rather short-term effect. After going through 10 sessions of acupuncture, you have to do it all over again after three months or so to keep your facial muscles from sagging. Through a so-called embedded thread procedure, Belo is able to extend acupuncture’s tightening effects for as long as one year.

“We usually do Rev Light and acupuncture first,” she says. “The effect is instant. If the patient likes the results, and he or she would want a more long-term effect, we proceed by putting embedded thread.”

Like acupuncture, the embedded thread procedure (P1,800 per thread) also involves pricking the skin with needles—at least 40 needles per treatment. But this time, a so-called protein thread is attached to each needle. When a needle is removed, the protein thread, which is designed to stimulate the skin and muscles, gets left inside.

“Unlike Apthos Thread, embedded thread doesn’t physically support anything because each thread is small,” says Belo. “But since each thread is in permanent contact with an acupuncture point, it causes the muscles to contract continuously. The effect can last from six months to one year without you having to undergo acupuncture again.”

source: lifestyle.inquirer.net

Doctor finds patients comforted by prayer before surgery

Dallas — At 83, Carl Smith found himself facing quadruple-bypass surgery and the real possibility that he might not survive.

Within hours on this spring morning, Dr. Mark Pool would temporarily bring Smith’s heart to a stop in an attempt to circumvent its blocked passages.

And to help his patient confront the uncertainty, Pool did something unusual in his profession: He prayed with him.

The power of healing: Medicine and religion have both had their day, and they haven’t always been able to coexist. But as today’s medical treatment becomes more holistic, doctors are increasingly taking spirituality into account.

Studies show a majority of patients want their spirituality recognized, and most med schools now have classes related to the topic. In general, the new thinking asks doctors to note their patients’ spiritual leanings and open doors to expression, especially when life is at risk.

Pool, a highly regarded heart and lung surgeon at Texas Health Presbyterian Hospital Dallas, is fervent about his Baptist faith. For about a year, he’s routinely asked patients if they’d like him to pray with them pre-surgery — a gesture he says is always appreciated but one that exceeds advocates’ suggested bounds.

“A physician should be open to a patient’s spirituality but shouldn’t push religion on patients,” says Nathan Carlin, assistant professor at the University of Texas Health Science Center at Houston. “That’s confusing personal and professional roles.”

An inherent power differential divides doctors and patients, says Christina Puchalski, director of George Washington University’s Institute for Spirituality and Health and co-editor of the recently published Oxford Textbook of Spirituality in Healthcare.

“They’re coming to us for something other than prayer,” Puchalski says. “If I, as a patient, perceive (a surgeon) as having my life in his hands, and he asks me to pray and I say no, he may not treat me well. And that’s putting undue pressure on the patient.”

As the saying goes, there are no atheists in foxholes: The idea that your fate is out of your hands offers fertile ground for re-examination.

“The moment somebody tells you that you have cancer,” says Methodist Dallas Medical Center’s Rohan Jeyarajah, a gastrointestinal surgeon who prays with patients, “you’re going to believe in something.”

But the situation, he says, requires caution: “We have to be careful about being in a position of perceived authority and not overstepping that bound. This is like a teacher-student relationship. There’s a chance you could be inappropriate.”

Pool pushes forward, eager to share the belief that drives him without making people feel awkward or flouting that power imbalance.

“I don’t want to exploit their situation,” he says. “At the same time, I want to give them the opportunity to explore the faith that I know.”

•••

Pool comes from a religious background. His father, his grandfather, his father-in-law, his brother-in-law: all ministers. Family members joke was that he started going to church nine months before he was born.

By age 6, he was well versed in Bible basics, but then something odd happened. One day at a prayer meeting, Pool says, he was touched by — well, not quite a vision, but an awareness.

“I had already understood that Jesus came to save the world,” he says. “That was nice. But then I understood: Jesus came to save me. And that changed everything.”

He’s pursued a path of faith ever since. Medicine seemed like a good way to help people. Even so, as a med student, Pool pondered ditching the whole thing to go to seminary instead.

As a member of First Baptist Dallas, he and wife Jessica lead relationship classes on Sundays for dozens of young married couples.

And as a cardiothoracic surgeon, another realization has set in: “I have a ministry. I don’t need to be standing in a pulpit. I have found a ministry I did not expect. I am able to minister to people in times of need.”

Since Texas Health is a faith-based hospital system, he felt at ease taking that step.

“The vast majority of people believe in God,” he says, “and yet when people come to the hospital, that’s completely ignored by doctors. If anything, they call the chaplain. It’s unfortunate that more doctors don’t try to engage that part of a patient’s life.”

That’s starting to change. Two decades ago, barely a few med schools offered classes on spirituality. Now, three-fourths of them do.

“Medicine has figured out that we ignore the more human sides of health care at our own peril,” says Craig Borchardt, interim chairman of humanities and medicine at Texas A&M University.

Studies show 60 to 80 percent of patients want their beliefs noted, he says — not as affirmation but as a sign that the doctor actually cares. But fewer than 20 percent of doctors bring it up.

The push has met with some backlash — from busy doctors reluctant to take time away from other concerns or others who don’t like talking about it.

“Some staff are more comfortable with it than others,” says Mark Grace, vice president of mission and ministry for Baylor Health Care System.

He doesn’t reject the idea of doctors offering to pray, but “if you don’t listen to the answer, that’s where you get into problems. ... The doctor needs to be prepared if the patient says no.”

George Washington University’s Puchalski says the bottom line is doing what’s best for the patient.

“Physicians are generally not trained to lead prayer,” she says.

•••

It’s 6 a.m., and Pool, shiny black boots poking from beneath blue scrubs, briefs Smith on his surgery. At 83, Smith is fit, mowing the yard occasionally, an active driver.

But coronary artery disease caught up with the retired Farmers Branch pharmacist, slowing his blood flow and causing chest pain. Over time, it could lead to a heart attack.

Madge Smith, his wife of 63 years, and Leah Wilson, his youngest daughter, are near. Scott Smith, his son, would join later.

Pool explains his plan: He’ll make an incision down Smith’s breastbone, then take arteries from his left and right side, and a vein from his leg, to form new channels for blood to flow through his heart.

“So,” he tells Smith, “you told me you’re a Sunday school leader. ... Would you mind if I said a prayer for you?”

Smith is touched. Pool places his hand on Smith’s shoulder and begins:

“God, thank you for Mr. Smith. We ask that you would guard his life, keep him safe and bring him through this operation. Replace any anxiety that he may have. Give him a great assurance of your love and your power.

“I ask you to watch over our team, that you give us all clarity of thought, that you guide my hands as they move. We pray these things in Christ’s name. Amen.”

“Amen,” Smith says.

Later, as Smith’s family awaits the outcome, his wife says: “I have never had a doctor do that. It just meant so much to us. We just thought it was sent from God.”

Pool initially wondered if his praying might give patients pause, whether they’d worry he wasn’t confident enough in his own skills to get through the surgery.

“It’s been the opposite,” he says. “They value the humility.”

Not long ago, Pool contacted a local evangelistic organization. “So I could up my game,” he says. He wants to learn how to share his faith without being a “turn or burn” proselytizer.

“I wouldn’t want for somebody to make a decision in a moment of crisis that they wouldn’t make otherwise,” he says. “I don’t want to say, ‘It’s your last chance: Smarten up or else.’

“It doesn’t mean I can’t share my faith just because it might upset somebody in the world. This nation was founded on Christian ideals.”

Pool pauses when asked if he’d pray with followers of Islam, a faith he considers antagonistic and unforgiving.

“I don’t think they would get the same meaning” from it, he says. “Not that they would feel offended, but ... not comforted.”

He tries to avoid a holier-than-thou air and doesn’t claim only certain believers get into heaven.

“It’s not my job to get somebody to make certain decisions,” Pool says. “All I can do is live a life that makes it appealing to somebody and then share it with them. If I share and they say, ‘I’m not interested,’ I say no problem and move on. But seeds can be sown that you never see the fruit of.”

•••

Smith’s operation was a success. Six weeks later, Pool meets with him one last time.

“You’re doing extremely well,” Pool says. “I’m going to fade away now. You don’t have to come back and see me.”

“I’d be six feet under if it wasn’t for you,” Smith says.

Pool dismisses the thought. “I’d like to say a prayer with you,” he says.

Smith bows his head and closes his eyes.

“Lord,” Pool begins, “thank you for getting Mr. Smith out of the hospital and getting him home. We ask that you continue that process of healing and give him a spring in his step once again. In Jesus’ name we pray.”

Smith is upbeat. He believes the gesture will help him get better. And in the end, that might be the most important thing of all.

source: lasvegassun.com

More evidence of prostate cancer, omega-3 link

WASHINGTON—US scientists said Wednesday they have confirmed a surprising 2011 study that found a higher risk of prostate cancer among men who consume omega-3 fatty acids, raising new questions about the safety of supplements.

The research in the Journal of the National Cancer Institute reported a 71 percent higher risk for dangerous high-grade prostate cancer among men who ate fatty fish or took fish-oil supplements, which are often touted for their anti-inflammatory properties.

“We’ve shown once again that use of nutritional supplements may be harmful,” said Alan Kristal, researcher at the Fred Hutchinson Cancer Research Center and senior author of the paper.

Scientists are still puzzled as to why omega-3s appear linked to a greater risk of prostate cancer, but they said the findings suggest they are somehow involved in the formation of tumors.

The same team of researchers published similar findings in 2011, linking high blood concentrations of DHA to a more than double risk of high-grade prostate cancer, which is more likely to be fatal than other types.

A large European study also found the same omega-3 and prostate cancer link.

“The consistency of these findings suggests that these fatty acids are involved in prostate tumorigenesis and recommendations to increase long-chain omega-3 fatty acid intake, in particular through supplementation, should consider its potential risks,” the US study said.

The difference in blood concentrations of omega-3 fatty acids between the highest and lowest risk groups was about 2.5 percentage points (3.2 percent vs. 5.7 percent), or just higher than the effect of eating salmon twice a week, Kristal said.

The latest study was based on an analysis of specimens and data from a large randomized, controlled trial that tested whether selenium and vitamin E would reduce prostate cancer risk.

The trial, known as SELECT (the Selenium and Vitamin E Cancer Prevention Trial), found that vitamin E raised the prostate cancer risk and selenium showed no impact either way.

For the July 11 study in the Journal of the National Cancer Institute, researchers analyzed the data on 834 men diagnosed with prostate cancer and compared them to a random sample of 1,393 taken from the SELECT trial.

Those who had high blood concentrations of the fatty acids EPA, DPA and DHA were shown to have a 71 percent increased risk of high-grade prostate cancer.

The increased risk of low grade prostate cancer was 44 percent higher in those with elevated fatty acid levels, and the combined risk was 43 percent for all prostate cancers.

Due to the nature of the study, it was not possible to tell for certain whether the elevated blood levels were due to men taking supplements or eating fish rich in omega-3s.

However, Franklin Lowe, associate director of the department of urology at St. Luke’s-Roosevelt Hospital in New York, said the findings should remind consumers that supplements may not help, and may even do harm.

“In general, there is nothing that has been proven to actually limit the risk of prostate cancer,” said Lowe, who was not involved in the study.

“For the most part, doctors do not recommend this stuff because it is unclear what the true benefits are for most of the supplements that people take.”—Kerry Sheridan

source: lifestyle.inquirer.net

California, Nevada take opposite stances when disciplining the same doctor

Dr. Sean S. Steele was able to practice medicine in both California and Nevada until last year.

That’s when the California Medical Board revoked his license, based on evidence and testimony from a woman who said he sexually assaulted her in the back of a Mercedes during an evening of drinking in Las Vegas.

According to the official decision, the California Medical Board concluded that Steele had “brutally sexually attacked” the woman and then lied about it under oath. The board called his behavior “unbecoming to a member in good standing of the medical profession, and which demonstrates an unfitness to practice medicine.”

The board revoked Steele’s license, effective April 17, 2012.

In Nevada, however, Steele, an internist, is still licensed and has privileges at University Medical Center, MountainView Hospital, Valley Hospital Medical Center, Summerlin Hospital Medical Center and Centennial Hills Hospital Medical Center, according to the hospitals.

The Clark County District Attorney's office had charged him with felonies, including sexual assault — and then accepted Steele’s no contest plea to a lesser charge of misdemeanor battery.

Later, the Nevada State Board of Medical Examiners issued a “non-public action,” a sanction so negligible that it is not disclosed. A search of the board’s website shows no sanction against Steele.

In other words, there is no public disclosure by the Nevada State Board of Medical Examiners of an incident involving a doctor that was deemed so serious by California authorities that the doctor was prohibited from seeing patients there.

The case raises questions about how closely Nevada monitors its medical professionals. Legislators, members of the Nevada medical community and others have long criticized the Nevada State Board of Medical Examiners’ ability to effectively regulate, investigate and sanction doctors.

Through her attorney, Robert Murdock, the woman declined to comment. The Las Vegas Sun does not name the victims of sexual assaults.

A request to interview Steele was sent by email to his attorney, Russell Iungerich. The attorney did not respond to that request.

Steele is appealing the decision of the California Medical Board on the grounds that his due process rights were violated because Iungerich was ill on the day of the woman’s testimony and therefore she was not cross-examined.

In its ruling, the California Medical Board concluded, “(The victim) is telling the truth and (Steele) lied to the Medical Board investigators, lied in the civil suit and lied under oath in the present proceedings.”

source: lasvegassun.com

Physician Licensure Examination Result 2013

February 2013 Physician Licensure Examination Result











TOP 10

1. CHICCO XERXES DE LEON PANGAN - University of Sto Tomas

2 . DENVER FRANCISCO SAPO- Our Lady of Fatima University Valenzuela

3. KRISTINA ANNE BALCE CO - Our Lady of Fatima University Valenzuela

4. FRANCIA VICTORIA ABARCAR DE LOS REYES - University of the East Ramon Magsaysay Mem  Med Center

    MARIE ANGELIE FERNANDEZ SO - San Beda College

5. JENA ANGELA TANDUYAN PERANO - Our Lady of Fatima University Valenzuela

6 . ALEXANDREA CASTILLO BULANDOS - Our Lady of Fatima University Valenzuela

     HAZEL KAREN NOVIDO RAZ - Far Eastern University- Nicanor Reyes Medical Foundation

7.  HAROLD PABILLAR ITURRALDE - Our Lady of Fatima University Valenzuela

     JAN PAOLO ISAIS SANTOS - University of Perpetual Help System -Laguna

8.  LITO JAY PANGAN MACARAIG - Manila Central University Caloocan City

9. RANDELL SANTOS ARIAS - Far Eastern University- Nicanor Reyes Medical Foundation

    VANESSA MARIE VIOLAGO CALABIA - Our Lady of Fatima University Valenzuela

    MICHELLE JAY GONZALES FRANCISCO - Southwestern University -College Of Medicine

10.  MARJAN ORATA HEIDARI - Far Eastern University- Nicanor Reyes Medical Foundation

Cancer gene mutation more complex than previously thought: study

LONDON (Reuters) - Taking a sample or biopsy from just one part of a tumor might not give a full picture of its genetic diversity and may explain why doctors, despite using genetically targeted drugs, are often unable to save patients whose cancer has spread, scientists said.

A study by British researchers found there are more genetic differences than similarities between biopsies taken from separate areas of the same tumor, and yet further gene differences in samples taken from secondary tumors.

That might help explain why, despite recent development of a wave of highly targeted drugs designed to tackle cancers of specific genetic types, the prognosis remains poor for many patients with so-called solid-tumor disease like breast, lung, or kidney cancer that has spread to others parts of the body.

But the researchers, whose study was partly funded by charity Cancer Research UK and published in the New England Journal of Medicine, said it also pointed to a way forward.

The team carried out the first ever genome-wide analysis of the genetic changes or faults in different regions of the same tumor.

They looked at four patients with cancer in their kidneys, taking samples from different regions of the primary tumor and also from other organs where the tumor had spread.

They found that the majority of gene faults, around two-thirds, were not the same in one sample as in another, even when the biopsies were taken from the same tumor.

Samples taken from secondary tumors - which are a result of the disease spreading to other parts of the body - had yet more different genetic faults, suggesting that basing treatment decisions on just one primary tumor sample is not sufficient.

"We've known for some time that tumors are a patchwork of faults, but this is the first time we've been able to use cutting-edge genome sequencing technology to map out the genetic landscape of a tumor in such exquisite detail," said Charles Swanton, of University College London's cancer institute, who led the study and presented its results at a briefing in London on Tuesday.

He said they had uncovered "an extraordinary amount of diversity" at a genetic level both within tumors and within a single patient, with more differences between biopsies from the same tumor than similarities.

"The next step will be to understand what's driving this diversity in different cancers and identify key driver mutations that are common throughout all parts of a tumor," Swanton said.

PERSONALISED MEDICINE

Genetic profiling of patients and their tumors has become more common in cancer treatment in wealthy countries as drug companies develop new generations of so-called "personalized medicines" that target cancers with specific genetic features.

Roche's blockbuster breast cancer drug Herceptin is designed to treat only women who make too much of the HER2 protein, for example, while Novartis's Afinitor targets mTOR, a protein that acts as an important regulator of tumor cell division, blood vessel growth and cell metabolism.

James Larkin, an oncologist at London's Royal Marsden Hospital who also worked on the study, said the findings suggest the reality of personalized cancer treatment is far more complex than previously thought.

"The molecular changes that drive the growth of the cancer once it has spread may be different from those that drive the growth of the primary tumor," he said.

The researchers compared genetic faults in various tumor samples taken from the four patients.

They found 118 different mutations - 40 of which were "ubiquitous mutations" found in all biopsies, 53 "shared mutations" that were found in most but not all biopsies, and 25 "private mutations" only found in a single sample.

By analyzing where the shared mutations were in relation to the whole tumor, the researchers were able to trace the origins of certain subtypes of cancer cells back to what they called key "driver mutations." This allowed them to create a map of how the pattern of faults might have evolved over time.

Swanton likened the findings to a tree, in which the trunk is the primary tumor and the branches the secondary tumors from the cancer's spread.

While he stressed the results would need to be replicated with larger numbers of patients and in different types of cancer, he said these early indications showed "the importance of targeting common mutations found in the trunk of the tree as opposed to those found in the branches."

"It may also explain why surgery to remove the primary kidney tumor can improve survival," he added, since cutting out a tumor reduces the risk that cells resistant to drug treatment could go on to re-grow the tumor or spread elsewhere.

source: mb.com.ph

Jack Tips, ‘naturopathic’ doctor, wants to help the body heal itself

I don’t want to work with conventional medicine, pharmacological drugs and insurance companies,” said Jack Tips, a naturopathic doctor. “They have an agenda to keep people on drugs and dictate to doctors what treatments are supposedly right for the individual.”

Tips is known for his work in the natural health field through his private consultations, lectures and books.

“From the natural health perspective, each person is biochemically, emotionally, mentally and spiritually individual; and must be treated accordingly,” he said. “This is why natural health is a creative engagement with the individual’s vitality, rather than a standardized process.”

Tips advocates methods of health restoration by using the body’s own capacity to express optimal health. He does this through a combination of homeopathy, nutritional and herbal supplements and diet guidelines.

Eyes

Based in Austin, Texas, Tips recently visited Manila to give a talk on approaches to natural healing.

His lecture was organized by the Comprehensive Iridology Practitioners Association of the Philippines (Cipap), the members of whom include graduates of the advanced course on Comprehensive Iridology of the International Iridology Practitioners Association based in the US.

A sclerologist himself, Tips explained that both sclerology and iridology are methods of diagnosing a person’s health by looking at patterns and colors of the sclera (white part of the eye) and iris (colored part of the eye).

Cells need energy

Tips’ talk featured the topic of cellular healing and how to restore and improve health by addressing the causes (instead of just symptoms) on the cellular level.

Cells use ATP (adenosinetriphosphate), which is produced by the body, to transport chemical energy for metabolism. “Poor health is the result of diminished ATP production within the cells. The goal is to restore energy to the cells so the cells can perform optimally.”

“When the cells have energy to spare, they repair their own genetic code and thus tissue function can improve dramatically.

“There are many supplements that help people daily—ionic minerals, omega-three fatty acids, vitamin D, ubiquinol. Supplementation is done to apply nutrients to address the key ‘points of leverage’ that interfere with the body’s desire to restore its health to the most optimal expression.

“In health, energy is everything, not vitamins, minerals, enzyme, anti-oxidants, proteins, fats, carbohydrates, or any other nutritional commodity, and certainly not any drug that causes side effects,” said Tips.

Homeopathy

Tips was sickly as a child. His mother brought him to homeopaths who helped cure his ailments. He started studying “the tools and principles of natural health including vitamins, minerals, amino acids, enzymes and herbs.”

He took formal studies with different experts in the fields of diet, naturopathy, tissue-mineral ratios, kinesiology, among others. He is a certified clinical nutritionist and has doctorates in clinical nutrition and naturopathy.

“The principle involved in homeopathy is ‘like cures like,’” he says. “The law of similars states that a remedy can cure a disease if it produces in a healthy person symptoms similar to those of the disease.

“Symptoms that we experience are what our bodies do to overcome perceived threats to its integrity. Thus it uses fever, diarrhea, coughs, vomiting, headaches, discharges, eruptions, etc. to help restore health.

“No one knows better than the body how to heal itself. Homeopathy elicits a pathway for the body’s own adaptive resources to correct its expressions of discomfort.

“The classical homeopath never ‘treats a disease’ but only helps the person’s innate vitality to correct the cause, and thus the effects, of any discomfort; the homeopath is a specialist in how the body’s ‘vital force’ struggles to adapt and survive.”

Cipap organizes talks on iridology and other natural health topics that are open to the public. E-mail admin@cipap.org; tel. 0920-9073075; visit www.cipap.org.

source: http://lifestyle.inquirer.net/32935/jack-tips-naturopathic-doctor-wants-to-help-the-body-heal-itself