From Warren, KD4GUA:
Last Sunday we finished the discussion on STEM CELLS.
This Sunday we will discuss BENIGN PROSTATIC HYPERTROPHY and the new methods of treatment such as: TUNA, TUIP, LASER, MICROWAVE, STENTS, BALLOONS, INJECTIONS, DRUGS. There is also a new term being used "LUTS" which stands for Lower Urinary Tract Syndrome which is often mistaken for BPH (Benign Prostatic Hypertrophy). This LUTS is responsible for all the "Gotta Go, Gotta Go! ads you are seeing on TV.
Standings will be posted next week.
Friday, June 16, 2006
Friday, June 09, 2006
MARCO Grand Rounds for June 4, 2006
From Warren, KD4GUA:
Last Sunday we had 38 check-ins--good for this time of year and sun cycle. The NL went out and hope all of you are searching the skies for nice people.
Last week we discussed the MOST fascinating subject--STEM CELLS!
Word from Germany--they have taken 300 terminally ill congestive heart failure infarcted patients whose only hope was a heart transplant (that was not available) and performed an artificial heart attack by inserting an obstructing balloon into a coronary artery for two minutes thus opening up a collateral blood flow and THEN injecting the patient's own stromal bone marrow stem cells into the collateral flow vessels---Voila--in three months there was marked improvement clinically and in cardiac output.
We will continue the discussion this week and our hematologist Bruce KM2L will be standing by for comment. Don't miss it, 14.308 Sunday 10 a.m. Eastern.
Homework assignment: Bone-up on Stem Cells for Sunday.
Last Sunday we had 38 check-ins--good for this time of year and sun cycle. The NL went out and hope all of you are searching the skies for nice people.
Last week we discussed the MOST fascinating subject--STEM CELLS!
Word from Germany--they have taken 300 terminally ill congestive heart failure infarcted patients whose only hope was a heart transplant (that was not available) and performed an artificial heart attack by inserting an obstructing balloon into a coronary artery for two minutes thus opening up a collateral blood flow and THEN injecting the patient's own stromal bone marrow stem cells into the collateral flow vessels---Voila--in three months there was marked improvement clinically and in cardiac output.
We will continue the discussion this week and our hematologist Bruce KM2L will be standing by for comment. Don't miss it, 14.308 Sunday 10 a.m. Eastern.
Homework assignment: Bone-up on Stem Cells for Sunday.
Monday, June 05, 2006
Letter About Malpractice Insurance
I had a letter to the Editor published in the Buffalo News today.
The only event that motivates me to write is the appearance of a self-serving bundle of lies submitted by a trial lawyer. The most recent example was from a guy who neglected to reveal that he was an attorney, and proceeded to bash malpractice insurance companies for gouging physicians, charging excessively high premiums to cover their investment losses.
My rebuttal made the following points:
1) The largest malpractice insurer in NY Stateis a mutual company, owned by its policy holders and managed by physicians. Thus, this joker wants us to believe that doctors are ripping themselves off for some reason.
2). Insurance companies follow a prescribed set of rules and actuarial procedures to estimate their future losses, and they are required to maintain sufficient reserves to cover those losses. The State Insurance Department rules on any requests they may have to change premium rates.
3). The lawyer pointed out that in recent years the premiums collected have significantly exceeded the claims paid, and offered this as evidence of the insurance companies' greed. I pointed out that this ratio is exactly what one should expect. The physician wins the majority of cases that go to trial, and in those cases, there are no claims paid. Win or lose, a court case costs an enormous sum, and the insurance company pays for defending the doctor.
4). Finally, I appealed to common sense with this argument: If insurers could make a profit by selling malpractice policies to doctors, then they would be in competition for my business. I would expect to see advertising for malpractice policies when I read a medical journal or opened my mail. This hasn't happened once in a 30-year career. On the other hand, No one can watch TV, listen to the radio, pick up the telephone book, or drive down the street without being assaulted by ads from personal injury law firms. So, where do you think the money is going?
I will now climb back off my soapbox and retreat to the shadows.
-KM2L
The only event that motivates me to write is the appearance of a self-serving bundle of lies submitted by a trial lawyer. The most recent example was from a guy who neglected to reveal that he was an attorney, and proceeded to bash malpractice insurance companies for gouging physicians, charging excessively high premiums to cover their investment losses.
My rebuttal made the following points:
1) The largest malpractice insurer in NY Stateis a mutual company, owned by its policy holders and managed by physicians. Thus, this joker wants us to believe that doctors are ripping themselves off for some reason.
2). Insurance companies follow a prescribed set of rules and actuarial procedures to estimate their future losses, and they are required to maintain sufficient reserves to cover those losses. The State Insurance Department rules on any requests they may have to change premium rates.
3). The lawyer pointed out that in recent years the premiums collected have significantly exceeded the claims paid, and offered this as evidence of the insurance companies' greed. I pointed out that this ratio is exactly what one should expect. The physician wins the majority of cases that go to trial, and in those cases, there are no claims paid. Win or lose, a court case costs an enormous sum, and the insurance company pays for defending the doctor.
4). Finally, I appealed to common sense with this argument: If insurers could make a profit by selling malpractice policies to doctors, then they would be in competition for my business. I would expect to see advertising for malpractice policies when I read a medical journal or opened my mail. This hasn't happened once in a 30-year career. On the other hand, No one can watch TV, listen to the radio, pick up the telephone book, or drive down the street without being assaulted by ads from personal injury law firms. So, where do you think the money is going?
I will now climb back off my soapbox and retreat to the shadows.
-KM2L
More About Stem Cells
From Warren, KD4GUA:
There was a GREAT program on TV last night about the use of stem cells in Germany ("Regenerative Medicine" on PBS' "Innovation Program"). In patients with poor left ventricular function after an acute MI they are taking the patient some time after the AMI when they go into failure and using a balloon obstructing the left anterior artery, thus creating an artifical heart attack for three minutes while they give IV stem stromal cells from the same patient's bone marrow. This tends to circulate the stem cells on the by pass vessels thus spreading them out. Then the balloon obstruction is relieved and 3 months later in the majority of the 300 cases, the patients no longer have symptoms of congestive failure. It has not been approved in the USA yet--work done at Frankfurt.
They also showed shots from Portugal where they are taking stem cells from the nasal mucosa and infiltrating them into injured spinal cords with actual return of formerly paralized limbs. What a show--and what a future! Tx for helping out this coming Sunday on Grand Rounds--none of us are experts in this field--we are all learning--and fast????
Friday, June 02, 2006
MARCO Grand Rounds for May 28, 2006
From Warren, KD4GUA:
Last week we discussed STEM CELLS and how IF we can learn the signals that turn STEM cells on and off and into what-- we may be able to decipher the cancer code that turns normal cells into malignant cells. Bone up on STEM cells and we will continue the discussion.
The first PDF Newsletter went out last seek. The printed version should be in the mail within a week. That PDF is not exactly a "piece of cake." Nor is the transcribing of the NL onto a disc for a pro. BUT, all learning curves can be extended by the wrong attitude. AND, with beer cheaper than gasoline--one can now DRINK and DON't DRIVE.
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