INTERNA-UNHAS

The Senate Health Bill: Federal Micromanagement of Health Insurance

2010-02-28T21:01:00.000-08:00

Senate Majority Leader Harry Reid’s (D-NV) giant new health care bill contains the same provisions as the other House and Senate bills to establish Federal micromanagement of all private health insurance.
Like the others, the Reid bill would subject all private health insurance — whether purchased from an insurance company by employer groups or individuals, or provided through an employer or union self-insured plan — to detailed Federal regulation.
These so called “insurance reform” provisions amount to a de facto nationalization of health insurance and they would produce that effect regardless of whether or not Congress creates another, new government-run health insurance plan.
Benefit Control. Of particular concern to patients should be that the detailed benefits in their health insurance coverage will soon be determined by the Federal Department of Health and Human Services. Last week, Americans got a foretaste of what Federal health benefit regulation means when the U.S. Preventive Services Task Force changed its recommendation for breast cancer screening (mammography) for women aged 40 to 50 from “B” (recommended) to “C” (not recommended).
Normally, such recommendations would not create controversy as, until now, they have been merely suggestions to guide providers and health plans in making their own decisions for their patients or members. But under the proposed legislation they would take on the force of law, since the legislation will require all plans — starting in 2011 in the Reid bill — to provide coverage (with no patient co-pays) for, “items or services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force.”
Thus, a decision by a, heretofore, obscure HHS Task Force to recommend a specific medical service would in the future carry the force of law, and would impose additional costs on insurers and employer health plans. Conversely, any decision by the Task Force to issue a “C” or “D” rating (not recommended) — as it did last week in the case of breast cancer screening — will be henceforth viewed by insurers and employers as a justification for discontinuing coverage.
Cost Impact. Over time the more specific HHS gets in its benefit requirements — driving up the cost of coverage — the greater the incentive will be for insurers and employers to control those escalating costs by not covering anything that they aren’t absolutely required to cover by federal law.
The eventual result will be that the only medical care paid for through private health insurance will be the specific, items and services required by federal regulations promulgated by HHS. At that point, Congress will have effectively nationalized the entire American health insurance system under the supervision of the Secretary of HHS — regardless of whether or not it also sets up yet another government health insurance program in the process.
article source : http://blog.heritage.org/2009/11/20/the-senate-health-bill-federal-micromanagment-of-health-insurance/

Women's Orgasmic Capability

2010-02-08T08:03:00.000-08:00

I've often written about the various orgasms women have: clitoral, g-spot, vaginal (general, with no pinpointed target zone) and anal. I've made a mission of conveying that there is no "better" or more "normal" orgasm; the one/s you have, however you have them, are normal and the ones you aspire to are also exciting so long as you don't get hung up on judging the way you come, or don't. Still, even women with the best attitudes about pleasure sometimes wonder why she can have a vaginal orgasm just like that! without needing extra stimulation from hands or vibes or fairy dust. They ask: what makes her so different from me? And I don't always have the answer.

To many women's frustration, what we do know is that women are wired slightly differently from one another, built differently, and juggle changes in hormones, nerve conduction, and psycho-sexual attributes differently all of which contributes to the sheer diversity of our sexual responses. Knowing this, however, doesn't always satisfy the hunger to understand exactly why you can't get off the same way that your friend or sister can. Now...finally...someone claims to have a solid and potentially verifiable bit of data to feed women who aren't happy with mere generalities.

Kim Wallen, professor of psychology and behavioral neuroendocrinology at Emory University, says that a simple physiological measure may have everything to do with the ease by which a woman can orgasm during sexual intercourse without an assist from fingers, toys or tongue. This measure, which he refers to as the "C-V distance," reflects how far a woman's clitoris lies from her vagina. Clitoris-vagina distances of less than 2.5 cm or roughly 1 inch, which is approximately from the tip of your thumb to your first knuckle tend to yield reliable orgasms during sex, says Wallen. This makes sense if you think about the direct stimulation that a close-by clit would receive during sexual thrusting, pressing, and grinding.

Wallen is not the first investigator to check into this "C-V distance." Others have also posited that the proximity of the clitoris to the vaginal opening might be the key to orgasm. As far back as the 1920s, Princess Marie Bonaparte, a French psychoanalyst and pal of Sigmund Freud, collected C-V and orgasm data from her patients and in 1924 published her observations under a pseudonym, apparently fearing in those days that such scandalous research would destroy her credibility. Recently, Wallen analyzed Bonaparte's data and found the striking C-V correlation. His own measurement study is in the works next.

According to Wallen, only about 7% of women always have orgasms with intercourse alone, while 27% say that they never come that way. This leaves us with a generous percentage of women who might climax via intercourse sometimes but not with any predictability. And what good is the C-V span to them?

Recognition of the C-V distance, or lack, thereof, does not strike one as much of an assist in gaining greater orgasmic traction. To the contrary, it suggests that only a small percentage of physiologically unique women may have an advantage when it comes to channeling that elusive, effortless hands-free orgasm.

Why not check out your own C-V? First, take a good look at your thumb or at a large marble, or an inch thick slice of sirloin for that matter to gauge just what that 2.5 cm really looks like. Not very long, is it? Then grab a mirror and have a glance down below. Is the distance between your own clitoris and vagina as short as that? Chances are it's not.

Results of an online survey asking women to measure and report their own distance from C to V revealed that only about 33% of the C-V distances were an inch or less, while 25% of the total were at least 2 inches apart more than twice the optimal. It's interesting that a similar percentage 27% of women say they never, ever climax via intercourse alone. Could that 27% be related to the 2-inch C-V span cohort? We don't want to leap to any conclusions, because surveys are not statistically validated instruments but it's food for thought.

While the C-V numbers are fascinating, in practice they're not terribly meaningful. You can't change your C-V, and, besides, if only 7% of women come reliably through intercourse alone, even having a short C-V doesn't ensure orgasmic ease. Maybe knowing that you have a short span could inspire you to focus more attention on building sensation in your nearby clitoris during intercourse, just for the fun of seeing what your physiological "advantage" can beget. Or, these preliminary findings might give you an edge when faced with a lazy or impatient lover who whines that his previous girlfriends always came easily without any "extras." To him, you can retort that either all his girlfriends fell within a group that makes up only 7% of the female population or they were faking it. So there!

Source: www.loveandhealth.info

Obama, Democrats reassess health care

2010-02-08T07:52:00.000-08:00

WASHINGTON — Abandoning the health care overhaul is not an option, a senior White House official said Wednesday, after President Barack Obama's top domestic initiative took a devastating hit with the Democratic loss of the Senate seat in the state of Massachusetts.

Obama adviser David Axelrod said administration officials will take into account the message voters delivered Tuesday in electing Republican Scott Brown but declined to go farther.

Questioned about the fate of health care legislation, Axelrod said, "It's not an option simply to walk away from a problem that's only going to get worse."

The stinging loss Tuesday cost Obama the 60-vote Senate majority he was counting on to pass the far-reaching legislation. The outcome splintered the rank and file on how to salvage the bill, energized congressional Republicans and left Obama and the Democrats with fallback options that range from bad to worse.

A leading idea involves persuading House Democrats to pass a Senate bill that many of them have serious problems with. Another alternative calls for Senate Democrats to promise to make changes to the bill later on. Some Democrats said their big hopes would have to be scaled back.

The leader of the House, Speaker Nancy Pelosi, refused to acknowledge that as a possibility as she left the Capitol near midnight Tuesday after meeting with her top lieutenants to discuss the way forward. Pelosi and others contend that because Massachusetts already has near-universal health coverage under a state law, the upset victory by Republican state Sen. Scott Brown to take Edward M. Kennedy's old seat could not be seen as a referendum on the issue.

"Massachusetts has health care. ... The rest of the country would like to have that too," Pelosi, a Democrat, said. "So we don't say a state that already has health care should determine whether the rest of the country should."

"We will get the job done. I'm very confident. I've always been confident," she added.

Before Senate Democrats gathered Wednesday to discuss their next moves, Majority Leader Harry Reid held out hope for the bill, saying, "There are a lot of different options out there."
Others saw miles (kilometers) of bad road in any direction and suggested that regrouping was in order.

"We shouldn't show the arrogance of not getting the message here," said liberal Rep. Anthony Weiner, a Democrat, contending independents had turned against the bill and the Democratic base had lost its enthusiasm. "I don't think it would be the worst thing to take a step back" and turn the focus to jobs, in conjunction with scaled-back health care goals.

Republicans said do not even bother: The election of Brown over the once-favored Democrat Martha Coakley in the Democratic stronghold sent a message that the health legislation should be scrapped altogether. Losing the Massachusetts seat will cost the Democrats the 60th vote needed to overcome Republican efforts to block legislation in the 100-member Senate. Sixty votes are needed to close off debate and move legislation to the full Senate floor.

Republican Party Chairman Michael Steele said Americans were breathing "a sigh of relief" over the potential derailing of the health care bill.

"People across the country are saying, 'Slow it down," Steele said Wednesday on ABC television's "Good Morning America."

But David Plouffe, who led Obama's presidential campaign, rejected calls to scrap the bill. "We have a good health care plan," he said on ABC. "We need to pass that. We have to lead."

Senate Democrats were scheduled to meet Wednesday, and a sign of their intentions could emerge then. Obama will have to exert a mighty influence to keep jittery moderates from giving up on the effort.

Democrats do not appear to have enough time to resolve differences between the two bills passed by the House and Senate — and get cost and coverage evaluation estimates back from the Congressional Budget Office as required — before Brown is sworn in.

Moderate Sen. Jim Webb, a Democrat, said the Senate should not hold any further votes on health care until Brown is seated.

The legislation would expand coverage to more than 30 million Americans now uninsured, while attempting to rein in the growth of health care costs. Democratic lawmakers will have to move in virtual lockstep to enact the bill now, even as Republican opposition intensifies.

That could be too much to ask from rank-and-file Democrats demoralized by losing a seat held in an almost unbroken line by a Kennedy since 1953. Efforts to woo Republican Sen. Olympia Snowe as a convert could increase. But with polls showing voters souring on health care legislation, the president could be abandoned by lawmakers of his own party.

Article source : http://www.poughkeepsiejournal.com

Need for N95 respirators in H1N1 prevention uncertain

2010-01-08T05:48:00.000-08:00

PHILADELPHIA -- A revised analysis of data on the ability of N95 respirators to prevent transmission of viral infections, including influenza, to health care workers raised new doubts about the appropriateness of recent guidance from the Centers for Disease Control and Prevention on N95 use for influenza protection.

The new analysis of results from an Australian and Chinese study that compared the efficacy of N95 respirators and surgical masks in blocking transmission of influenza and other viruses to health care workers showed that the relatively expensive and uncomfortable respirators were not significantly better than surgical masks for preventing transmission, Holly Seale, Ph.D., reported at the annual meeting of the Infectious Diseases Society of America (IDSA).

The report by Dr. Seale revised high-profile findings reported in September by the senior investigator of the study, Dr. C. Raina MacIntyre, at the annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). Dr. MacIntyre reported that use of N95 respirators led to statistically significant improvement in protection against viral infection, compared with the control, a loose-fitting cloth mask. That analysis failed to show similar benefit from a surgical mask, leading to the inference that N95 respirators had an advantage over surgical masks.

The findings are believed by several infectious diseases experts to have led to controversial guidance on N95 use by health care workers caring for patients infected with pandemic influenza A(H1N1) that the CDC issued on Oct. 14 (www.cdc.gov/h1n1flu/guidelines_infection_control.htm).

The guidance said the CDC recommends "use of respiratory protection that is at least as protective as a fit-tested, disposable N95 respirator for health care personnel who are in close contact with patients with suspected or confirmed 2009 H1N1 infection."

In a second study of N95 respirators and surgical masks, researchers at eight Ontario hospitals randomized 225 nurses to exclusive surgical mask protection and 221 to N95 respirators during a 2.5-month period in fall 2008. The incidence of laboratory-confirmed influenza was nearly identical between the two groups (JAMA 2009;302:1865-71).

"The CDC's current position is that additional data are needed to more clearly determine the most effective methods for protecting health care workers and patients from acquiring influenza infection in the health care setting," CDC spokesperson Thomas W. Skinner said in an interview.

COPYRIGHT 2009 International Medical News Group
COPYRIGHT 2009 Gale, Cengage Learning

article's source : http://bnet/internal medicine news, Nov 15,2009, by Mitchel L. Zoler

Sex After Herpes - Yes You Can Still Have a Fulfilling Sex Life If You Have Genital Herpes

2009-12-06T05:07:00.000-08:00

When you first get diagnosed with herpes, it can feel like the end of the world. You may feel like life as you know it is over, and one of the most common misconceptions about genital herpes is that you'll never have a normal sex life again. Well, I'm here to tell you that simply isn't true. With a few precautions and a lot of common sense, you'll find that you can have sex after herpes, and a varied and fulfilling sex life at that.

The first thing you have to realise is things are going to be a bit different from now on, and you are probably going to have to be a bit more careful than you were in the past. The first thing to know is you'll absolutely need to avoid penetrative sex if you or your partner is currently experiencing a herpes outbreak on your genitals. This is the main unfortunate downside to sex after herpes.

If both you and your partner between outbreaks, you can have full penetrative vaginal, anal or oral sex with very little risk, provided the herpes sufferer is on suppressive antivirals, and you use adequate protection such as a condom or dental dam.

And don't forget, there are a myriad of ways to explore lovemaking if you or your partner are having an outbreak of sores. You can try mutual masturbation, using toys or if the partner with the outbreak has doesn't suffer from oral herpes as well, he or she can safely perform oral sex on the non-infected partner.

Just be sure to always use protection and keep up your daily medication to help keep the risk of shedding the virus down. If you do have some intimacy during an outbreak, make sure you both wash your hands and body thoroughly afterwards. Sex after herpes might be a little different, but with a bit of care and some variety and imagination, you can still experience a satisfying and fulfilling sex life.

Visit Fitter Healthier today to read our free guide on herpes home treatments and check out our reviews of the most effective genital herpes treatments available today.

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Article Source: http://EzineArticles.com/?expert=Kat_Samson

What Kind of Gout Medicine Can Relieve Gout Pain?

2009-12-04T06:30:00.000-08:00

Gout pain can be very debilitating and can often restrict your movement. How do you get rid of this pain or what kind of gout medicine should you take to get some relief? Here is a list of gout medicines to take so that you can get relief from gout pain.

A popular gout medicine used to treat gout patients is colchicines, this medicine works by restricting the function of white blood cells, they can't move from one site to another. The patient is recommended 0.6 mg tablet every two hours till the pain subsides. Stop the medicine if you start feeling nauseous or have diarrhea.

This medicine also functions as a prophylactic drug, in other words it acts as a preventive medicine. During the initial six months of treatment when the medicine will work to reduce the uric acid level in blood, the patient may strangely have more attacks. After six months the patient can discontinue the use of colchicines.

The side effects of colchicines are also numerous so cautions should be observed while using it. Overuse can lead to kidney failure, calcium deficiency, heart problems, bone marrow suppression, lung failure, liver problems, rashes and even death.

How an individual's body responds to a particular medicine differs, often one gout medicine may completely work for one person while for the other there might be endless problems. When a patient takes cyclosporine along with colchicines there is likelihood of there being damage to the kidneys.

Patients who take colchicines on a regular basis should be monitored at regular intervals. This should include RBC count, liver and kidney function test and urine analysis.

Another drug that is commonly used in the treatment of gout is probenecid; it is a drug that helps in the excretion of excessive uric acid through urine. It blocks the process of the absorption of uric acid by kidney. This drug should be administered when the patient's health is stable and not when he is undergoing an attack.

The dosage begins with 500 mg once a day and later becomes 500 mgs twice a day. To ensure that probenecid is effective the kidney should function normally. The patient should also ensure good flow of urine by constant flow of urine.

Patients who suffer from kidney stones should not use probenecid.

Losartan a medicine for blood pressure also lowers uric acid levels in blood.

The above mentioned drugs should not be taken without consulting a medical practitioner so he/she can find what gout medicine is right for you.

Get gout relief today by learning more about gout medicine and what you can do to cure your gout.

Discover other alternatives to prescription medicines by visiting gout relief to avoid harmful side effects.

Article Source: http://EzineArticles.com/?expert=Rich_Rollend

Eliminating Gout Forever

2009-12-04T06:26:00.000-08:00

Gout is a type of arthritis that is characterized by sudden burning pain, stiffness and swelling in a joint, often the big toe. The disease is hallmarked by elevated levels of uric acid in the bloodstream, caused by deposits of monosodium urate crystals which accumulate in the joints. It is normal for some uric acid to be present in the blood stream because the body is continually breaking down cells and forming new ones. The risk of gout is higher if the individual is overweight, drinks alcohol or eats food high in purines consistently. Familiar foods such as fish or meats can be high in purines and are precursors of uric acid. Purines are the colorless crystals which metabolize into uric acid, and when the kidneys cannot eliminate enough in the urine, the uric acid level becomes abnormally high.

The cause of gout is too much uric acid in the blood stream forming hard crystals inside the joints. It is a condition which affects men more than women and therefore eliminating gout forever is in their best interest.

Attacks of gout occur without warning often at night, accompanied by severe pain in one or more joints. The joint becomes swollen and the skin reddens and becomes extremely painful to the touch. The disorder most often affects the joint at the base of the big toe, but it can also commonly occur in the instep, ankle, knee, wrist and elbow. The first few attacks usually affect only one joint and can last a few days or many weeks before it is resolved. As the crystals dissolve from the joint area, the pain and discomfort will subside normally over a two week period. Some individuals may remain free from another flare-up for many months or years while others may never get another attack for the rest of their lives.

However, if the gout attack is not treated and the disorder progresses the affected joint can be permanently damaged. Severe, chronic gout will cause the joint to become stiff and have limited mobility. Eliminating gout forever is especially critical for those individuals suffering the chronic stage of this condition and experiencing the persistently painful joints, swelling and tenderness common with gout.

Gout is often diagnosed on its symptoms and joint examination. A high uric acid level in the blood will support the diagnosis as well as joint aspiration to pull out fluid in the joint affected. This fluid is sent to the lab and viewed under a polarized microscope. With early diagnosis and treatment and long term dietary changes in lifestyle choices, many individuals will never reach the chronic stage. The changes which are required in eliminating gout forever and to ensure that the chronic stage is never reached are minor compared to the suffering endured by these chronic gout symptoms.

The first step is to relieve the pain and to stop the acute inflammation. Sometimes the same needle used to remove fluid will be used to inject medication to effectively terminate the inflammation caused by urate crystals. The second step is to prevent further attacks. This involves maintaining adequate fluid intake, reducing weight, dietary changes and reduction in alcohol consumption. Long term treatment and prevention is essential for the health of the individual and in eliminating gout forever.

The author, John Donnelly, has spent many hours researching the problems associated with gout, and highly recommends the website below help in your quest for eliminating gout forever.

Article Source: http://EzineArticles.com/?expert=John_Donnelly

Value of Inflammation Marker in Patients with Intercritical Gout Arthritis

2009-06-23T09:25:00.000-07:00

Writer : Endy Adnan
(supervised by Edu S Tehupeiory)

Background. Intercritical gout arthritis is an acute gout in intermittent period, caused by inflammation process neither with tofus. Inflammation is a complex mechanism among pathogenic agents, parenchymal cell, tissue and blood vessels either with plasma or blood cellular. Inflammation induced by uric crystal in the joint is a patomechanismin gout arthritis and than activated and release celluler, humoral or complement mediators. The aim of this study to investigatigate the value of leucocyte, ESR, CRP, C3 components and C4 components in intercritical gout arthritis.
Subject and Method. This is an observational study with case control approach conducted in 20 subjects with intercritical gout arthritis (case) and 20 with asymptomatic hyperuricemia (control). Eclusioc criteria were rheumatoid arthritis, septic arthritis, psoriatic arthritis, osteoarthritis, chronic infection disease, and history of trauma, diagnosed as anemia, chronic kidney disease, malignancies, during consumption diuretics or AINS.
Result. We found mean age 54,93 year old, uric acid 9,445 mg/dl, 5 with positif CRP. Mean value of leucocyte both case and control were 9988,25 +- 2819,936 / mm3 vs 9540,5 +- 2333,656 / mm3 (p=0,153). No correlation between intercritial gout arthritis and the higher value of leucocyte (p=0,11), (OR 1.625; Cl 0.869-3.038). Mean value of ESR were 58,70 +- 12,650 vs 36,75 +- 7,587212 (p=0.343) and the statistical correlation between value of C4 and intercrtitical gout arthritis was uncalculated because of invariant data.
Conclusion. The higher value of ESR and CRP were correlated in intercritical gout arthritis comparing with asymtomatic hyperuricemia, while leucocyte, C3 and C4 were not correlated.

Association Between C-Reactive Protein Level and Components of the Metabolic Syndrome

2009-06-23T08:48:00.000-07:00

Writer : Daniel Josten
(supervised by John M.F. Adam)

Association between C-reactive protein, a sensitive marker for inlammation, and the development of atherosclerosis disease had been observed in experimental and epidemological studies. Interest in CRP was increased along with problem of metabolic syndrome because basically all components of metabolic syndrome were inflammation process. In Indonesia, the same study was so limited, eventhough according to WHO prevelance of obesity was increased in developing countries so do in developed countries wich will increase the metabolic syndrome population. The aim of this study is to know association between CRP level and components of metabolic syndrome. We studied 138 apparently health subjects aged 35-65 years old whoparticipated in the East Indonesia Diabetes Epidemiology Group (EIDEG) in November 2005 until January 2007. Method in this study was observational study with cross sectional approach. Anamnesis and complete physical examintaion was performed to all subjects included blood pressure and waist circumference. After 12-h fasting, blood was taken for fasting plasma glucose (FPG), HDL-cholesterol, triglyseride and C-reactive protein (CRP). For the diagnosis of Mets we used criteria defined by the International Diabetes Federation (IDF) 2005. The result of this study showed there were a statistically significant positive correlation between CRP and waist circumference (r=0.1), TG (r=0.3), FPG (r=0.2), blood pressure (r=0.3) (all p<0.05). A negative correlation was found between CRP and HDL cholesterol (r=0.3) (p=0.02). Mean CRP levelth 0 components of the metabolic syndrome were 1.04, 1.52, 3.15, 4.21, 4.65, and 6.33 mg/l respectively (r=0.54, p <0.0001). From this study we concluded that CRP leel were associated with components of metabolic syndrome.

The Relation Between Components of Metabolic Syndrome with Plasminogen Activator Inhibitor-1

2009-06-21T08:13:00.000-07:00

Writer :Himawan Dharmayani Sanusi

(supervised by John MF Adam, A. Fachruddin Benyamin)

Plasminogen activator inhibitor-1 is an acute phase protein that regulate fibrinolysis from hemostatic process and plays an important role in the pathogenesis of atherothrombosis. Subject with metabolic syndrome are high risk of cardiovascular complication. The aim of this study is to find out of relation between PAI-1 and the component of metabolic syondrome. In this study, we enrolled subject of age varied from 30 – 65 years. Those with diabetes mellitus, and clinical cardiovascular complications were excluded. History taking and complete physical examinations were performed to all subject. After 12 hour fasting,blood was taken for the examinations of fasting HDL –cholestrol ,triglyceride fasting flasma glucose and PAI -1.PAI -1 was measured by sensitive enzyme immunoassay technique for the diagnosis of metabolic syndrome, the AHA/NHLBI guideline was used with the modification of waist circumeference fro Asian population.Statistical analysis using SPSS 12 for windows.

During the study,183 subjects can be covered , 41% males and 59 % females. PAI – 1 levels was statistical significant higner among patients with metabolic syndrome compared to normal subjects,18.01 ± 9.33 mlU/ml and 4.33± 4.83 mlU/ml subsequently [ P= 0.000 ] . there was significant positive correlation between fasting hyperglycemia , triglycerides,waist circumference,blood pressure with increased of PAI – 1 and significant negatife correlation between HDL – chosterol with increased levels of PAI – 1 [p<> 7 IU /ml as a high level,statistical analysis showed that subjects with high trigly cerydes had the higner risk for hig PAI – 1 activity compared to correlation between the componenst of metabolic syndrome with the increasing of PAI – 1 levels, being the highest among those with five components .[r =0.828 and p=0.000]

In conclusion , there was a corelation between the components of metabolic syndrome and levels of plasminogen activator inhibitor – 1 those with hypetriglycerides had the highest risk to have high levels of plasminogen activator inhibitor – 1.