Monday, February 7, 2011

Hepatitis C News : Monday Feb 7

Liver Cancer Triples, NO HCV Testing Funds: Aging with HCV - (02/05/11)

HCV Sexual Transmission among MSM HIV+ in the USA: "sexual transmission is likely to be responsible for incident HCV infection" in men - (02/05/11)

The role of triple therapy with protease inhibitors in hepatitis C virus genotype 1 naïve patients - pdf attached - (02/05/11)

The role of triple therapy in HCV genotype 1-experienced patients pdf attached - (02/05/11)

Association of Dietary Patterns With Albuminuria and Kidney Function Decline in Older White Women: A Subgroup Analysis From the Nurses' Health Study - pdf attached -(01/26/11)

Changes in Blood-borne Infection Risk (HCV) Among Injection Drug Users - pdf attached - 2/05/11)

Transmission Clusters among HIV-Positive and HIV-Negative Individuals in the Australian Trial in Acute Hepatitis C - "(18%) were most likely infected through sexual exposure [men and women]" (pdf attached) -(02/05/11)
Lawmakers seek action on Cochran VA Medical Center
By Robert Koenig, Beacon Washington Correspondent
WASHINGTON - Disturbed by reports of continued problems at the Cochran VA Medical Center in St. Louis, several members of Congress are demanding action from the U.S. Department of Veterans Affairs to clear up problems at the hospital.
"Enough is enough. It's time for a full, independent review of the entire facility to determine why they consistently seem to have problems," U.S. Rep. Russ Carnahan, D-St. Louis, said in a statement on Monday. He has scheduled a meeting Thursday with Veterans Department Secretary Eric Shinseki to discuss problems at Cochran.
Meanwhile, Rep. Todd Akin, R-Town and Country, sent a letter to Skinseki on Monday demanding a full review of Cochran and threatening congressional action if steps are not taken to improve the situation...
HIV, Hepatitis C Combination Found To Be Common, Research Shows
Published by Carlos Jenkins
According to reports, hepatitis C can be transmitted through sexual contact among men who are infected by HIV. Most men have their hepatitis screening once they become infected with HIV. Yet, there are a lot of infected men who never had any screening for this kind of hepatitis.
People who are infected by both HIV and hepatitis C may not know it because the symptoms do not really manifest until the illness is in the advanced stages.
According to recent reports, hepatitis C is the number one cause of illness and the cause of death for those who are infected by HIV.
According to the research conducted by Lynn Taylor of Brown University located in Rhode Island, hepatitis screening should be done on a regular basis for those who are already infected by HIV. Screening these patients once is not enough as one can easily acquire this kind of hepatitis.
Patients and doctors alike need to be aware about the risks of having both infections. Patients may feel uncomfortable discussing it but doctors must let the patients know that hepatitis C can be transmitted through

The Heppers (Not to be confused with Lepers)
Anyone who has a form of Hepatitis knows what I mean. As soon as you say you have Hepatitis, some people take a few steps away. Though it is very common, and most people actually probably know someone with one form of it or another – whether they know it or not.

Hepers not Lepers (Part 2)
Hepatitis C (HCV) — My nemesis. Though only 20-30% of HCV patients develop cirrhosis of the liver, it is one of the leading causes of liver transplants in America. There are a small percentage of patients that can clear the virus on their own within months of contracting HCV, but most develop the....
Hepatitis E patients have been studied to determine how the biologically active substances found in their blood plasma differ from healthy individuals.A team writing in Proteome Science explain how they used mass spectrometry to enrich the peptidome fraction of subjects' plasma.They were able to identify a number of biologically active substances associated with immune response that were differentially expressed between the infected and control groups.In turn, they have created a peptide profile they say could be useful in future diagnoses of hepatitis E.The condition occurs when contaminated drinking water is consumed, according to guidance from the World Health Organization.However, it is not known to commonly be caused by person-to-person contact, during sex or during blood transfusions.Moreover, the condition is self-limiting and typically clears up, except in acute cases where fulminant hepatic failure may occur and no known course of treatment exists to alter the outcome.
Paving Contractor Joseph Bibbo avoids prison because of health
Published: Monday, February 07, 2011, 2:02 PM
Akron -- A paving contractor who admitted paying $17,500 in bribes in exchange for business with the Maple Heights School District was spared prison Monday because of a serious medical condition.

A federal judge sentenced Joseph Bibbo, 57, of Gates Mills, to six months of house arrest and five years of probation. Federal guidelines called for a sentence of 30-37 months behind bars for Bibbo's conviction but can be adjusted.

Bibbo will be fitted with an electronic monitoring device and be allowed to leave his home when necessary to maintain a regimen of treatment for hepatitis C, an infectious disease that returned after he received a liver transplant in October 2009.
A local transplant surgeon named Laurel Matthews testified that she did not think the medical facilities within a federal prison would be sufficient to treat Bibbo, who takes a combination of drugs designed to fight off the hepatitis C while also preventing him from rejecting his transplanted liver.....
Steriod Abuse /HCV Transmission

Defence issues warning on steroid abuse
''Unsafe use of injecting equipment also carries with it the risk of infection with blood-borne viruses, such as hepatitis C.''Dan Oakes DEFENCE
THE Defence Force has launched a scare campaign about the dangers of abusing anabolic steroids after several special forces soldiers were sent home in disgrace from Afghanistan.The latest navy newspaper contains a fact sheet detailing the side effects of abusing the drug, warning that it can cause infertility, heart attacks, the development of breast tissue in men and enlarged clitorises in women.The Herald revealed last year that seven special forces soldiers had tested positive for anabolic steroids in Afghanistan or been found in possession of the muscle-boosting drug. All were sent home and asked to show cause as to why they should not be sacked.Because of periods of boredom and inactivity, soldiers in Afghanistan spend much of their spare time working out at improvised gyms at the bases and order protein supplements, which are delivered to them on the front line.
The supplement companies derive so many customers from the Defence Force that some send the troops windcheaters and singlets with their logo on the front and Operation Slipper - the Australian mission in the Middle East - on the back.

Some troops also give in to the temptation to boost their muscle mass in an illicit fashion.''The use of anabolic steroids is not only dangerous to your health, but threatens your career and financial wellbeing,'' the fact sheet warns. ''There are risks associated with both the injectable and tablet forms of the drug. It can be very dangerous to combine steroid use with some other drugs, such as insulin, human growth hormone or amphetamines.''Unsafe use of injecting equipment also carries with it the risk of infection with blood-borne viruses, such as hepatitis C.''
The article goes on to say that other side-effects of anabolic steroid abuse in men can include baldness, acne, heightened aggression and infertility, and in women a permanent deep voice, facial hair, and enlarged clitoris and problems with their menstrual cycle.The commander of Defence's health command, Major-General Paul Alexander, said the length of time steroids stayed in a person's urine meant steroid use could be detected weeks after the drugs were taken.

Defence recently advertised for people to set up specialised drug and alcohol rehabilitation courses in various cities across Australia after a spate of bad publicity surrounding drug use, drunkenness and alleged drug dealing.

New Jersey moves to curb steroid use by police
(Reuters) - Lawmakers in New Jersey are considering measures that would crack down on steroid use by police and firefighters, some of whom abuse the drugs in their efforts to keep physically fit, experts say.

The state Assembly bills introduced on Monday, believed to be the first of their kind in the nation, would require health evaluations before law enforcement could be prescribed anabolic steroids and growth hormones, and would add such drugs to a list of substances for which law enforcement employees are randomly tested."This is focused on uniformed public employees, but this is really a nationwide problem," said Assemblyman John McKeon, the Deputy Speaker who introduced the bills."A lot of these anti-aging clinics and charlatans are selling these products, and we need to examine the long-term health problems."
The National Conference on State Legislatures said it did not know of any similar legislation in other states and New Jersey's measures could be the first in the nation. Most steroid laws regulate high school athletes, it said.

Law enforcement steroid use is a problem around the country and, given that steroid use can cause aggression, can invite problems for police, said Larry Gaines, chairman of the Department of Criminal Justice at California State University in San Bernadino, California."Aggression is not very common but nonetheless it's a possible problem," Gaines said. "If it does occur, you could see lawsuits against police departments regarding citizens injured from steroid rage."
Competitiveness is a major reason why police and firefighters might use steroids, he said."A number of departments focus very highly on physical fitness and ability," Gaines said."Secondly, a lot of these officers see substantial dangers on the job so they feel they should be in some kind of top level of physical fitness."

The New Jersey Firefighter Mutual Benevolent Association, a state firefighters union, welcomes any initiative to crack down on steroid abuse, said president Bill Lavin."We're obviously in favor of testing and not in favor of using illegal drugs of any sort," Lavin said. "I think steroids represent a small segment of our industry, and certainly we're in favor of doing anything to curtail it."The New Jersey measures come in response to reports last month of a local doctor who illegally supplied hundreds of police and firefighters with anabolic steroids, human growth hormones and other muscle-building drugs.

"Just like everybody I was outraged," said McKeon. "Being in the position I'm in, I'm even more outraged about the multiple millions of dollars that has cost our system for the years to come."The state attorney general is investigating the allegations, first reported last month by the Newark Star-Ledger newspaper, that millions of taxpayer dollars were illegally spent on the drugs, spokesman Paul Loriquet said.
McKeon said he hopes the bill will stop police and firefighters from abusing steroids, saying most of them probably do not have a medical reason to use them.(Reporting by Aman Ali;
Editing by Ellen Wulfhorst and Jerry Norton)

SF task force backs legal intravenous drug center
A San Francisco task force charged with devising strategies for reducing Hepatitis C infections has recommended making the city the first in the U.S. with a drop-in center where intravenous drug users can obtain needles and shoot up.
The 30-member committee made up of doctors, patients and public health officials unanimously supported creating a publicly funded safe injection center in a report issued last week after two years of study.

Members say that a similar facility in Vancouver has kept dirty needles off the streets, reduced overdose deaths and helped slow the spread of both Hepatitis C and HIV.
But the San Francisco Chronicle reports that the concept has been floated before and is unlikely to go anywhere now because neither the city's health director nor interim Mayor Ed Lee supports it.
Information from: San Francisco Chronicle,


FDA Approves Labeling Update for REYATAZ® (atazanavir sulfate) Capsules to Include Data Supporting the Recommended Adult Dose of REYATAZ/ritonavir 300/100 mg for HIV-1 Infected Pregnant Women

Bristol-Myers Squibb Company (NYSE: BMY) today announced that the U.S. Food and Drug Administration (FDA) has approved an update to the labeling for REYATAZ® (atazanavir sulfate) to include dose recommendations in HIV-infected pregnant women. In HIV combination therapy, treatment with the recommended adult dose of REYATAZ 300 mg, boosted with 100 mg of ritonavir, achieved minimum plasma concentrations (24 hours post-dose) during the third trimester of pregnancy comparable to that observed historically in HIV-infected adults. During the postpartum period, atazanavir concentrations may be increased; therefore, while no dose adjustment is necessary, patients should be monitored for adverse events for two months after delivery. REYATAZ is indicated in combination with other antiretroviral agents for treatment of HIV-1 infection in patients at least six years of age. REYATAZ should be used during pregnancy only if the benefit outweighs the risk and HIV-1 strains are susceptible to atazanavir. REYATAZ should not be used without ritonavir in pregnant or postpartum women. REYATAZ does not have an indication for prevention of maternal-fetal transmission of HIV-1 infection.

HIV-Positive Men Who Bareback Should Have More Frequent Hep C Testing
A new study has found that 75 percent of new hepatitis C virus (HCV) infections in HIV-positive men occurred in those with no history of injection drug use (IDU), mirroring other studies documenting a rise in cases of HCV infection in men who have sex with men (MSM) in Western Europe, Australia and urban cities in the United States. The study, published online January 31 in the journal Clinical Infectious Diseases, prompted the researchers to echo the conclusion of other cohort findings by recommending more frequent testing for HCV antibodies in those with high-risk practices, such as MSM who practice anal sex without condoms.

Hepatitis B / Hepatitis A

First Duplex Test for Parvovirus B19 and Hepatitis A Virus Now Available in the US
Roche (SIX: RO, ROG; Pink Sheets: RHHBY) announced today that the cobas® TaqScreen DPX Test for use on the cobas s 201 system is now available in the US. It is the first commercial test to quantify parvovirus B19 and detect hepatitis A virus (HAV) simultaneously in one assay in human plasma. Human plasma is used to create treatments for life-threatening and chronic diseases and disorders such as hemophilia and primary immunodeficiency diseases. Plasma is also used to treat patients who have suffered severe burns or trauma and has many other therapeutic uses."The launch of this test is an important part of our strategy," said Paul Brown, Head of Roche Molecular Diagnostics, "not only is it an important test for the continued safety of plasma products, but it also indicates our continued commitment to this vital area."The test is a state-of-the-art, in vitro nucleic acid amplification technology (NAT) test which offers complete coverage of all human genotypes of parvovirus B19 (genotypes 1, 2 and 3 DNA) and HAV (genotypes I, II and III RNA) in human plasma.

The cobas® TaqScreen DPX Test uses multi-dye, real-time polymerase chain reaction (PCR) technology which allows for the simultaneous detection and identification of individual viral targets without the use of additional discriminatory tests. A further innovative aspect of this test is that facilitates quantification of the parvovirus B19 while detecting extremely low levels of HAV.Both parvovirus B19 and HAV are difficult to inactivate by traditional methods used by the plasma industry and there have been reports on the transmission of HAV and parvovirus B19 through blood and plasma products.

Both parvovirus B19 and HAV in human plasma can be detected by NAT during the manufacturing process of plasma products, so improving the safety of these products.About Roche Blood and Plasma Screening Roche is a leader in the global NAT blood and plasma screening market, which is estimated at almost 900 million CHF. Nucleic acid-based tests enable earlier detection of active viral infections than conventional antibody or antigen assays. Roche's real-time PCR-based nucleic acid assays have been used since 1998 to screen blood and plasma products. Currently, more than 225 blood banks worldwide use Roche's automated cobas s 201 system.

Hepatitis B to be part of routine immunizationTNN,
Feb 7, 2011, 11.41am
Bhubaneswar: Hepatitis B vaccine will be part of routine immunization schedule offered for free by the government. After reviewing the pilot project results in Sundargarh district, the government has decided to include it in routine immunization schedule across the state, a health department statement said on Sunday. Unicef will offer training to health workers in the state for vaccination against the disease, which spreads mainly through the blood route. Besides, the government will also provide a second dose of measles in the routine immunization to children.
Cirrhosis Patients at Increased Risk of Extrahepatic Cancer
Monday, February 07, 2011.Patients with liver cirrhosis have more than double the risk of developing extrahepatic cancer than the general population, and they also have a significantly increased risk of hepatocellular carcinoma, according to a study published in the February issue of Clinical Gastroenterology and Hepatology..(HealthDay News) —

Patients with liver cirrhosis have more than double the risk of developing extrahepatic cancer than the general population, and they also have a significantly increased risk of hepatocellular carcinoma (HCC), according to a study published in the February issue of Clinical Gastroenterology and Hepatology..Evangelos Kalaitzakis, M.D., of the University of Gothenburg in Sweden, and colleagues investigated the incidence of malignant neoplasms in patients diagnosed with cirrhosis between 1994 and 2005. Of the 1,019 patients, 68 percent were men, 48 percent had alcoholic liver disease (ALD), 10 percent had hepatitis C virus (HCV), and 12 percent had both ALD and HCV.

The researchers found that, compared to the general population, patients with cirrhosis were at increased risk of HCC (26-fold); cholangiocarcinoma (13-fold); colorectal cancer (four-fold); and cancers of the esophagus (eight-fold), pancreas (five-fold), and lung (five-fold). HCC occurred more frequently among patients with HCV than other diseases, and the risk of HCC among patients with HCV was similar whether they had ALD or not.

Patients with non-ALD cirrhosis were at increased risk for cholangiocarcinoma; whereas, the risk for extrahepatic cancers increased mainly among patients with ALD and cirrhosis./"This study confirms the association of liver cirrhosis with HCC and further indicates that non-HCC malignant neoplasms may be more common in patients with cirrhosis compared with the general population," the authors write.
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Treating Cancer By Modifying Cancer Stem Cells
by Stuart Kauffman
In some future Star Trek century, doctors cure using an intelligent probe. In the 21st Century, medicine, though far from that fictional world, is itself poised for major advances in an emerging area of science called Systems Biology. In turn Systems Biology has major implications for cancer therapy.

Study shows cytokines lymphotoxin can lead to liver cancer
PMVIENNA, Feb. 3, 2011 (Xinhua News Agency) -- Austrian scientist Johannes Haybaeck discovered that increased levels of cytokines lymphotoxin could cause liver infection and develops to liver cancer later.
The findings made him win the Pfizer (NYSE:PFE) Research Awards 2011 presented by Medical University Graz, Austria, on Thursday.Accordingly, a high-level concentration of cytokines lymphotoxin (LT) alpha and beta and their receptor LT beta R can be found in the liver tissue of patients infected with hepatitis B- or hepatitis C virus.The lymphotoxin ultimately led to a liver infection that developed to liver cancer later.

In addition, the altered liver cells form metastases that spread within the liver.In addition to chronic alcohol abuse, drug abuse or fungal toxins, virus infection was believed to be one of the most common causes of liver inflammation and liver cancer.The scientists obtained the results by conducting tumor therapies in mice. They produced a lot of LTs to the liver tissues of the mice though a genetic material change and finally came to the experimental results.Whether the observations in the mice can also play a role in the human liver tumor cells is still unclear. Hayb?ck and his research colleagues are underway.

Healthy You

Non-surgical approach to treat hepatic hydatid cysts
Concerning treatment, until recently the only definitive treatment for hydatid disease had been surgery. Different surgical techniques and procedures have been carried out and even in some cases, a liver transplant has been required. Advances in drug therapy has been influenced by the introduction of albendazole and accelerated by addition of praziquantel, but this requires a long period of treatment i.e. up to a year or more, and is not effective for everyone.
A research article to be published on February 7, 2011 in the World Journal of Gastroenterology addresses this question. In this study, the authors assessed the value of percutaneous drainage with adjuvant medical therapy in 26 patients with confirmed 32 hepatic hydatid cysts (HHC) over an average follow-up period of 10 years.

All 32 cysts showed evidence of immediate collapse after completion of the procedure, and before discharge from hospital, ultrasound examination showed fluid reaccumulation in all cysts. Serial follow-up showed a progressive decrease in the size and change in the appearance of cysts. To confirm the sterility of these cystic cavities, seven cysts were re-aspirated on average 3 mo after the procedure. Investigations revealed no viable scolices.
The study might provide some confirmation of the efficacy of a non-surgical approach to the treatment of liver hydatidosis.
Source: World Journal of Gastroenterology

Another Reason for Hep C Patients to Abstain from Alcohol
Most of us know that alcohol is not good for someone with the Hepatitis C virus. In addition to alcohol's ability to speed up the progress of liver disease, there is now proof that drinking during antiviral therapy nullifies the effectiveness of Hepatitis C treatment.
Read more.

Public release date: 6-Feb-2011
Chocolate is a 'super fruit'
It is widely known that fruit contains antioxidants which may be beneficial to health. New research published in the open access journal Chemistry Central Journal demonstrates that chocolate is a rich source of antioxidants and contains more polyphenols and flavanols than fruit juice.

When researchers at the Hershey Center for Health & Nutrition™ compared the antioxidant activity in cocoa powder and fruit powders they found that, gram per gram, there was more antioxidant capacity, and a greater total flavanol content, in the cocoa powder.
Similarly when they compared the amount of antioxidants, per serving, of dark chocolate, cocoa, hot chocolate mix and fruit juices they found that both dark chocolate and cocoa had a greater antioxidant capacity and a greater total flavanol, and polyphenol, content than the fruit juices. However hot chocolate, due to processing (alkalization) of the chocolate, contained little of any.
Dr Debra Miller, the senior author of the paper, says that, "Cacao seeds are a "Super Fruit" providing nutritive value beyond that of their macronutrient composition". Which is great news for chocolate lovers.

Grapes may ease liver disease:
UQ study Feb 5University of Queensland Diamantina Institute PhD student, Veronique Chachay, hopes to determine if a nutrient found in grape skin could hold the key to better managing non-alcoholic fatty liver disease (NAFLD). Ms Chachay is currently recruiting people to participate in an eight-week clinical trial. She is interested in hearing from men aged between 18 and 65 years with abdominal obesity, who have been diagnosed with fatty liver, and who are not taking any diabetic medication.

Resveratrol (RSV), an antioxidant nutrient found in about 300 plants including grape skin, peanuts and berries, has been found to benefit cardiovascular health, and early clinical trials are under way to determine any benefits for cancer prevention and treatment, degenerative and ageing diseases such as Alzheimer's disease. Ms Chachay said that the study could offer insights into a sustainable solution to a growing problem, with 30 percent of the general population and up to 98 percent of patients with morbid obesity and type 2 diabetes showing the signs of NAFLD, but no pharmacological treatment currently available. "By 2020, NAFLD is predicted to become the main reason for referrals to liver transplants.

If RSV can help before the disease progresses to liver failure, it could help reduce significantly the burden on the healthcare system," Ms Chachay said. She said preliminary findings had been encouraging that RSV may assist in maintaining better metabolic and liver health despite high-energy diets and sedentary lifestyles. "Weight loss is a good solution to healthier livers, but it is often hard to achieve and maintain over time. RSV could work together with lifestyle changes to offer a more sustainable solution to the long-term management of NAFLD," Ms Chachay said. If you are interested in participating in Ms Chachay's trial, contact her on .
Media: Dr Jodi Clyde-Smith (07 3176 5938 or 0434 602 949) or Shirley Glaister at UQ Communications (07 3365 2802).

February: Heart Month or Marketing Month?
By: Dr. Wes February 04, 2011
Heart disease and February. What relationship could be more cozy?From the scary risks of shoveling snow (yep, you could DIE, so be sure to lift a little at a time!), to the Diet Coke-sponsored red dress parades and government-sponsored National Wear Red Day®, to tips for identifying heart attacks in women (men, you need a different month, I guess), February has all the important stories to improve your "awareness."

Such a polite term, "awareness."But I wonder, now that the Internet is upon us and people are seeing their insurance rates and co-pays skyrocket, if maybe we're shooting ourselves in the foot with all this heart month marketing hype. People are sick and tired of testing "just to be sure." It's starting to directly cost them a fortune, and people are pissed at having to pay a fortune for health care, let alone heart care.I know, I know, I should be at the forefront of working with patients to stomp out heart disease. And goodness, people DO need to be attuned to diet, exercise, and weight loss. But the reality is, if we're giving you the ten latest tips on how to detect a heart attack, we're probably a bit too late.

That's the problem with all these press releases: while there's a need to raise "awareness" of heart health, there's also a very real need for people to take us, heart disease professionals, seriously to help cut costs in health care here. The last thing our health care system needs is more frivolous testing. Yet this is exactly what all this marketing does for our health care system: and it helps those with the largest PR budgets most of all.Of course, there are researchers who depend on a portion of the funds raised to continue their work. After all, research is ridiculously expensive. There really is a need to raise funds for these scientists if we're going to continue our tradition of creative innovations in cardiovascular health care.Maybe that should be the story line.Maybe it would be nice to highlight these researchers' work and what that work hopes to bring to people, rather than splashing a big feel-good red dress parade all over the media. Maybe we could focus on real life stories and less on the hyperbole. Maybe we could focus on the challenges, rather than the accolades and perfection.Maybe then we'd have people take us seriously.-Wes

World Journal of Gastroenterology

Natural history of heartburn
A research team from Iceland studied the natural history and prevalence of heartburn at a 10-year interval, and the effect of heartburn on various symptoms and activities. The results showed that heartburn is a common and chronic condition. Subjects with a body mass index below or higher than normal weight are more likely to experience heartburn. Heartburn has a great impact on daily activities, sleep and quality of life. Medical Research Fund of the National Hospital of Iceland, Medical Research Fund of Wyeth, AstraZeneca, GlaxoSmithKline, Icelandic College of Family Physicians
Contact: Ye-Ru 86-105-908-0039World Journal of Gastroenterology

Review of data supports virus link to diabetes
Posted: 2011-02-04 11:14
People with type I diabetes might be ten times more likely to have enteroviral infections than healthy people, according to a new study published yesterday. The analysis, led by Maria Craig of the University of Sydney, reviewed data from 26 studies involving more than 4,400 people with type 1 diabetes that measured enterovirus levels in the blood, gut or pancreas.
Enteroviruses, which cause a wide range of sickness, including the common cold and flu, come into the body through the gastrointestinal tract.
“What we are showing from studies across the world is that enteroviruses are found in children before they get diabetes, so it’s an initial trigger of the disease,” Craig says.
Researchers in the late 1960s first noticed a link between enteroviral infections and type 1 diabetes, which usually strikes children and leads to the loss of insulin-producing cells. Some scientists remain skeptical, in part because not all people with diabetes have a history of enterovirus infections. However, says Didier Hober of the University of Lille in France, this could be because these viruses are only occasionally released from the gut and may at times go undetected.

Craig now hopes researchers consider a new approach to prevent the progression and ultimately the onset of the disease.
“There has been huge efforts targeting the immune system and none of them have worked,” says Craig. “It’s time we look at a different strategy. Rather than targeting the immune system, why don’t we try targeting the virus?”
However, it is easier said than done to create a type I diabetes vaccine. There are hundreds of enteroviruses, and Craig, estimates that a dozen or so of them are implicated in the disease. Still, Hober voices optimism that scientists will be able to narrow in on the possible cause, “it is not hopeless.”
Image of a Coxsackie virus implicated In Diabetes, CDC

Off The Cuff

Common Issues Cause Hospital Rx Errors
Just a few common issues often cause most painkiller prescription errors in the hospital, according to a study of one academic medical center.

Public Release: 7-Feb-2011
Facebook users more prone to developing eating disorders
The results of this new study showed that the more time girls spend on Facebook, the more they suffered conditions of bulimia, anorexia, physical dissatisfaction, negative physical self-image, negative approach to eating and more of an urge to be on a weight-loss diet. Extensive online exposure to fashion and music content showed similar tendencies, but manifested in fewer types of eating disorders.

Beverly Hills Surgery Center Blamed for Multiple Deaths
LOS ANGELES (CN) - Top Surgeons, Almont Ambulatory Surgery Center and Beverly Hills Surgery Center caused multiple deaths by performing lap band surgery on morbidly obese people, a class action claims in Superior Court. The lead plaintiff, a widower, says the medical offices are run by two brothers with checkered histories, one of whom is on medical probation, and one of whom lost his medical license after California accused him of "dishonesty, unprofessional conduct, [and] failing to disclose criminal convictions." Lead plaintiff John Faitro claims his late wife, Laura Lee Faitro, "saw and heard defendants' advertisements on TV and as a result, hired and paid defendants, and each of them, to perform a Lap-Band surgical procedure on Laura Lee Faitro." The Faitros paid $12,220 for the lap-band surgery, about $3,000 of which was covered by insurance, according to the complaint. Faitro claims that on July 21, 2010, "Ishan Najib Shamaan, M.D., assisted by Au Lee, M.D., performed a Lap-Band laparoscopic surgery on Laura Lee Faitro at Top Surgeon's ambulatory surgical suite located at 7320 Woodlake Avenue, Suite 320, West Hills, California. During her surgery, Dr. Shamaan lacerated the liver of Laura Lee Faitro in three (3) places, and had to call another Top Surgeon doctor, Kevork George Tashjian, M.D., to assist him to complete Laura Lee Faitro's Lap-Band surgical procedure." None of those doctors, however, are named as defendants. The defendants are Top Surgeons Inc., Top Surgeons LLC, 1 800 Get Thin LLC, Almont Ambulatory Surgery Center, Beverly Hills Surgery Center, Kambiz Beniamia Omidi, and Dr. Michael Omidi.

Faitro claims Top Surgeons discharged his wife despite her complaints of severe abdominal pain, and that the pain was so intense it forced her to seek help at the Simi Valley Hospital emergency room. She died on July 26 of "multi-organ failure and infarction due to shock, secondary to bleeding and sepsis in the abdominal cavity," according to the complaint. Faitro claims that in 2009, California accused Dr. Tashijian of "gross negligence arising from surgeries performed on three patients, two of whom died as a result of his gross negligence." He claims that "despite the fact that the state of California was, at all relevant times, and is attempting to revoke Dr. Tashjian's medical license ... the defendants, and each of them, have failed and continue to fail to disclose these material facts to their clients and patients on whom Dr. Tashjian continues to perform Lap-Band surgeries." The serious allegations continue. Faitro claims that Kambiz Beniamia Omidi aka Julian Omidi is president of Top Surgeons Inc., principal of Top Surgeons LLC, president of Almont Ambulatory Surgery, and CEO of the Beverly Hills Surgery Center.

Faitro says that California revoked Omidi's physician and surgeon's license on June 19, 2009, "for dishonesty, unprofessional conduct, failing to disclose criminal convictions, and a 'penchant for dishonesty, to bend his position and shade his statements to suit his needs, without consistent regard for the truth." The complaint continues: "Despite the fact that his physician and surgeon's certificate has been revoked by the Medical Board of California ... Julian Omidi owns and manages defendants Top Surgeons, Almont Ambulatory Surgery Center, and Beverly Hills Surgery Center, all of which routinely perform Lap Band surgeries." Defendant Dr. Michael Omidi is chief of staff and director of surgery for Top Surgeons, Almont Ambulatory Surgery Center, and Beverly Hills Surgery Center, according to the complaint. Faitro says, "the state of California revoked Michael Omidi's physician and surgeon's license effective Oct. 3, 2008 for aiding and abetting the unlicensed practice of medicine and for gross negligence in the treatment of three (3) patients, but his license revocation has been stayed for a period of three (3) years of probation. According to the Medical Board of California, Michael Omidi holds no board certification." Despite their checkered histories, the complaint states, Julian and Michael Omidi advertise themselves as "top rated surgical specialists" and "specially trained, hand-picked board certified surgeons" who provide "a higher level of care" with a "nationally recognized, expert and caring team," who "go beyond the standard of care."

Faitro says the Omidis know that is not the case, that their "representations are false and deceptive and highly likely to deceive consumers," and that the Omidis' claims "go far beyond mere 'puffery.'" The complaint adds: "On December 7, 2010, the Health Officer for Los Angeles County requested the FDA to investigate the defendants' advertising of their Lap-Band surgeries because the advertising 'inadequately informs consumers of potential risks' and 'fail to provide the relevant warnings, precautions, side effects, and contraindications related to the procedure.'"

The complaint also object to "defendants' use of "fake newspaper headline stating, 'Insurance Reform May Stop PPO Insurance Coverage for the Lap-Band.'" The class claim this ad "conveys a sense of urgency that if the consumer doesn't rush and make an appointment, he or she may lose the chance to get the Lap-Band surgery paid for by their PPO insurance coverage." Also, the class claims: "Defendants have advertised that their Lap-Band surgeries are 'safe' and a '1-Hour' procedure ... [but] the Lap-Band surgery requires several hours of post-operative recovery in an out-patient setting and is not a simple '1 hour' process as advertised by defendants." Finally, the class claims that "the published morbidity rates for Lap Band surgeries are between 0.02% - 0.05% (or between 2 and 5 deaths per 10,000 patients). However, plaintiffs are aware of at least four (4) patients of the defendants who died within days of undergoing Lap Band surgeries performed by the Defendants. ... Even assuming defendants have performed 5,000 Lap Band surgeries (which is highly doubtful), these four (4) deaths alone exceed the published mortality rates."(Parentheses in complaint.) Joining Faitro as a class representative are Arturo and Elvia Renteria, for the estate of Ana Renteria. The class seeks "restitution and disgorgement and damages for unfair competition and false advertising. They are represented by Alexander Robertson IV of Westlake Village.

American Family Association calls for reversal of partner benefits
The decision by the Michigan Civil Service Commission to authorize partner benefits for state employees is — predictably — coming under fire by the American Family Association of Michigan.
Gary Glenn, the group’s leader, has asked Republican leaders Gov. Rick Snyder, House Speaker James ‘Jase’ Bolger and Senate Majority Leader Randy Richardville to ask Attorney General Bill Schuette to issue an opinion as to whether the MSCS decision violated the state’s prohibition on recognition of any relationship “similar” to marriage. Voters amended Michigan’s Constitution in 2004 to define marriage as between one man and one woman, and prohibited the recognition of any other relationship.

In 2008, the Michigan Supreme Court ruled that domestic partner benefits provided for just same-sex couples by pubic employers were a violation of the so-called “Marriage Protection Amendment.” In response, public employers developed a program to offer health care and other benefits to other eligible individuals. To qualify, the named individual and the employee must show intermingled finances as well as other standards.
Glenn has said those programs are legal in the past — as has former Republican Attorney General Mike Cox.

But now Glenn is backing off supporting those programs.
“As we made clear in public statements as far back as the ballot campaign for the amendment in 2004, we believe an unrestricted benefits policy that allows a state employee to cover anyone he chooses, including family members such as parents, siblings, or grandparents, probably would be constitutional since it obviously would not be based on treating the employee’s relationship as similar to a marriage,” Glenn said in a press release Thursday. “But that’s not what the Civil Service Commission did.”

Glenn continued:
But there’s a big distinction between the question of constitutionality and whether such a plan is good public policy, Glenn said. AFA-Michigan would oppose such an unrestricted plan, even if constitutional, because it would increase the tax burden on Michigan families even more than the Civil Service Commission’s plan. Attorneys for the University of Michigan agreed in the Pride at Work case, arguing in court that because of the cost, the university should not be compelled to broadly offer benefits to any individual an employee chooses in order to be allowed to continue covering employees’ homosexual partners.
In his letter to the Republican leadership, Glenn says “when our state is already drowning in red ink, forcing taxpayers to fund new benefits for any new group of beneficiaries — especially one at severely elevated risk of substance abuse and expensive life-threatening diseases such as AIDS, cancer, and hepatitis — is all the more unthinkable and will further increase both the state budget deficit and the cost of health care for everyone.”
What Glenn fails to note is that many Lesbian, Gay, Bisexual and Transgender people who suffer the very ills he cites often end up on Medicaid rolls — meaning state taxpayers end up paying for the medical care as it is.

“Equality Michigan recognizes that there are strong social, financial, and health benefits to relationship recognition. That assertion doesn’t serve as a defense of restricting health benefits to marriages between a man and a woman,” says Emily Dievendorf, policy director at Equality Michigan. “Once again, it shows that the legal recognition of domestic commitments, and the protections that come with it, provides the kind of stability to a household that elevates a community on every level – fostering progress for economic, social, and public health. Therefore, the families that will be strengthened by these benefits exemplify the case for not allowing our personal biases to get in the way of bringing Michigan forward.”

Schuette has attempted to push legislation to prohibit domestic partner benefits in the past. As a state senator, Schuette pushed legislation that would prohibit public entities from approving such benefits. The bills came as public universities like Western Michigan University, Wayne State University and others passed benefits programs. His legislation failed.
Dievendorf issued the following statement in defense of the MCSC decision:
“The Civil Service Commission (CSC) recognized that when any member of a household lacks health benefits it creates vulnerability for the household that impacts the whole community and, in turn, the State of Michigan. The only thing more expensive to taxpayers than providing our neighbors, families and co-workers health benefits is NOT providing our neighbors, families and co-workers health benefits. Access to health care serves as prevention and ultimately saves taxpayers money.

The Civil Service Commission did not extend a ‘same-sex benefit plan’ to state employees. In this particular situation, the progress made was not a victory specific to the LGBTQ community and addressed one factor that is currently disabling the families of state of Michigan employees across the board. Same-sex couples constitute a minority of those eligible to benefit from the decision. As our new Attorney General, Schuette is no longer in a position to allow his own ideology to direct his focus the way he could as a legislator. Were the Attorney General’s office to cave to Gary Glenn’s plea to challenge the CSC, we feel that the due diligence required of the AG for such pursuits would uncover the validity of the fundamental fairness intended by the CSC and discourage the reversal of progress by the State’s highest law enforcement office.”
It should be noted that the argument about the policy increasing spending is a red herring. The state has estimated that this benefit will cost $6 million per year, or approximately .003 percent (three one-thousandths of a percent) of this year’s estimated deficit.
Blog Updates
February 2011 Newsletter;HCV Advocate
Alan Franciscus, Editor-in-Chief
Alan Franciscus, Editor-in-Chief
Lucinda K. Porter, RN
Lucinda K. Porter, RN

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