Medicare is a "Death Panel"

Medicare is a "death panel." Medicare rations care. Medicare can deny you care "...regardless as to medical necessity." Reform Medicare; do not expand it. If you support more Medicare, I suspect that you have not been deathly sick in way requiring individualized care, or you have not fought for someone else's life who needs the same. - Bradley Hennenfent, M.D., physician and economist

The fact that Medicare can deny care and that “This is true regardless as to medical necessity,” is a quote from MAXIMUS Federal Services MEDICARE Part D QIC Reconsideration Project.

Government rationing really does "pull the plug on Grandma."

www.BradMD.com

Repetitive prostatic massage therapy for chronic refractory prostatitis: the Philippine experience

Nickel JC, Downey J, Feliciano Jr. AE, Hennenfent BR:
Repetitive prostatic massage therapy for chronic refractory prostatitis: the Philippine experience. Tech Urol. 1999 Sep;5(3):146-51.

Patients frustrated with failure of traditional therapy for prostatitis have traveled to the
Philippines and elsewhere for repetitive prostatic massage combined with antibiotic therapy.
The aim of our study was to evaluate prospectively the response of patients who traveled to
Manila to undergo this treatment. Twenty-six patients consented and were registered by the
Prostatitis Foundation (B.H.) and subsequently evaluated (J.C.N., J.D.) prior to and following
treatment (A.E.F.). Evaluation at baseline and after treatment consisted of standardized
history and previously validated prostatitis-specific Symptom Frequency Questionnaire (SFQ)
and Symptom Severity Index (SSI), International Prostate Symptom Score (I-PSS) and Quality
of Life (QoL) questionnaire, the O'Leary Sexual Function Inventory (SFI), and a Subjective
Global Assessment (SGA). Treatment in Manila consisted of triweekly prostatic massage
combined with specific culture directed and/or empirical antimicrobial therapy for 6 to 12
weeks. Twenty-two patients completed at least one follow-up assessment and 12 patients
completed 2-year assessment (average follow-up of 17 months in 22 patients). There was a
significant decrease in average symptom severity (SSI) by 4 months that continued for 2
years, but less improvement in symptom frequency (SFQ) and quality of life (QoL), and no
significant improvement in voiding symptoms (I-PSS) or sexual function (SFI) at time of last
assessment. Forty-six percent of the 22 evaluable patients had >60% decrease (significant
improvement) in symptom severity (SSI), whereas 27% had similar significant improvement in
frequency of symptoms (SFQ) when last assessed. Thirty-three percent reported marked
subjective improvement (SGA) at last evaluation. Of the 12 patients who completed the 2-year
follow-up, 5 of the original 26 had a significant and sustainable improvement in objective and
subjective measurements of frequency and severity of symptoms. The combination of prostatic
massage and antibiotics for treating difficult refractory cases of prostatitis may be promising,
but its ultimate value needs to be confirmed. Studies in patients with less refractory and
shorter duration disease may allow us to predict who will respond to this therapeutic
approach.

nanobacteria levels and symptoms of nanobacteria-associated interstitial cystitis/painful bladder syndrome

Decreased nanobacteria levels and symptoms of nanobacteria-associated interstitial cystitis/painful bladder syndrome after tetracycline treatment

Urological Research Institute of PLA, Southwest Hospital, Third Military Medical University,

Chongqing, 400038, People's Republic of China.

This study was designed to detect whether nanobacteria (NB) reside in urine and bladder

tissue samples of patients with interstitial cystitis/painful bladder syndrome (IC/PBS) and

whether antibiotic therapy targeting these organisms is effective in reducing NB levels and

IC/PBS symptoms.

Twenty-seven IC/PBS patients underwent cystoscopy. Bladder biopsies and urine samples

were obtained and cultured for NB, which were identified by indirect immunofluorescent

staining and transmission electron microscopy.

Eleven bladder samples showed growth of microbes that were identified to be similar to NB.

Homologous study of the 16S ribosomal RNA gene suggested that the NB could be the

pathogen. For enrolled 11 patients, NB levels decreased dramatically after tetracycline

treatment, and they reported significant reduction in the severity of IC/PBS symptoms.

A high prevalence of NB was observed in female IC/PBS, and anti-NB treatment effectively

improved the symptoms, which suggest that NB may cause some cases of IC/PBS.

Written by:
Zhang QH, Shen XC, Zhou ZS, Chen ZW, Lu GS, Song B. Are you the author?

Reference:
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Sep 17. Epub ahead of print.
doi:10.1007/s00192-009-0994-7

PubMed Abstract
PMID:19760079

CONSORTIUM OF RESEARCHERS DISCOVER RETROVIRAL LINK TO CHRONIC FATIGUE SYNDROME

From an NIH press release. A very important new finding that a virus may be linked to Chronic Fatigue Syndrome. - BRH

CONSORTIUM OF RESEARCHERS DISCOVER RETROVIRAL LINK TO CHRONIC FATIGUE SYNDROME

Scientists have discovered a potential retroviral link to chronic fatigue syndrome, known as CFS, a debilitating disease that affects millions of people in the United States. Researchers from the Whittemore Peterson Institute (WPI), located at the University of Nevada, Reno, the National Cancer Institute (NCI), part of the National Institutes of Health, and the Cleveland Clinic, report this finding online Oct. 8, 2009, issue of Science.

"We now have evidence that a retrovirus named XMRV is frequently present in the blood of patients with CFS. This discovery could be a major step in the discovery of vital treatment options for millions of patients," said Judy Mikovits, Ph.D., director of research for WPI and leader of the team that discovered this association. Researchers cautioned however, that this finding shows there is an association between XMRV and CFS but does not prove that XMRV causes CFS.

The scientists provide a new hypothesis for a retrovirus link with CFS. The virus, XMRV, was first identified by Robert H. Silverman, Ph.D., professor in the Department of Cancer Biology at the Cleveland Clinic Lerner Research Institute, in men who had a specific immune system defect that reduced their ability to fight viral infections.

"The discovery of XMRV in two major diseases, prostate cancer and now chronic fatigue syndrome, is very exciting. If cause-and-effect is established, there would be a new opportunity for prevention and treatment of these diseases," said Silverman, a co-author on the CFS paper.

Commonality of an immune system defect in patients with CFS and prostate cancer led researchers to look for the virus in their blood samples. In this study, WPI scientists identified XMRV in the blood of 68 of 101 (67 percent) CFS patients. In contrast, they found that eight of 218 healthy people (3.7 percent) contained XMRV DNA. The research team not only found that blood cells contained XMRV but also expressed XMRV proteins at high levels and produced infectious viral particles. A clinically validated test to detect XMRV antibodies in patients' plasma is currently under development.

These results were also supported by the observation of retrovirus particles in patient samples when examined using transmission electron microscopy. The data demonstrate the first direct isolation of infectious XMRV from humans.


"These compelling data allow the development of a hypothesis concerning a cause of this complex and misunderstood disease, since retroviruses are a known cause of neurodegenerative diseases and cancer in man," said Francis Ruscetti, Ph.D., Laboratory of Experimental Immunology, NCI.

Retroviruses like XMRV have also been shown to activate a number of other latent viruses. This could explain why so many different viruses, such as Epstein-Barr virus, which was causally linked to Burkitt's and other lymphomas in the 1970s, have been associated with CFS. It is important to note that retroviruses, like XMRV, are not airborne.

"The scientific evidence that a retrovirus is implicated in CFS opens a new world of possibilities for so many people," said Annette Whittemore, founder and president of WPI and mother of a CFS patient. "Scientists can now begin the important work of translating this discovery into medical care for individuals with XMRV related diseases."

Dan Peterson, M.D., medical director of WPI added, "Patients with CFS deal with a myriad of health issues as their quality of life declines. I'm excited about the possibility of providing patients, who are positive for XMRV, a definitive diagnosis, and hopefully very soon, a range of effective treatments options."

The Whittemore Peterson Institute for Neuro Immune Disease exists to bring discovery, knowledge, and effective treatments to patients with illnesses that are caused by acquired dysregulation of both the immune system and the nervous system, often resulting in lifelong disease and disability. www.wpinstitute.org.

The Lerner Research Institute is home to Cleveland Clinic's laboratory, translational and clinical research. Its mission: to promote human health by investigating in the laboratory and the clinic the causes of disease and discovering novel approaches to prevention and treatments; to train the next generation of biomedical researchers; and to foster productive collaborations with those providing clinical care. More than 1,200 people in 11 departments work in research programs focusing on cardiovascular, cancer, neurologic, musculoskeletal, allergic and immunologic, eye, metabolic, and infectious disease. The Institute also is an integral part of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.


The National Cancer Institute (NCI) leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI Web site at http://www.cancer.gov or call NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit .
-------------------------------
REFERENCE: Lombardi VC, Ruscetti FW, Gupta JD, Pfost MA, Hagen KS, Peterson DL, Ruscetti SK, Bagni RK, Petrow-Sadowski C, Gold B, Dean M, Silverman RH, and Mikovits JA. Detection of Infectious Retrovirus, XMRV, in Blood Cells of Patients with Chronic Fatigue Syndrome. Online October 8, 2009. Science.
--------------------

U.S. Department of Health and Human Services
NATIONAL INSTITUTES OF HEALTH NIH News
National Cancer Institute (NCI)
Embargoed for Release: Thursday, October 8, 2009, 2 p.m. EDT

CONTACTS:
NCI Office of Media Relations, 301-496-6641,

Whittemore Peterson Institute, Frankie Vigil, 775-336-4555,

Cleveland Clinic Corp. Communications, Megan F. Pruce, 216-445-7452,

PROSTATE TUMORS CAN CHANGE THE FUNCTION OF IMMUNE CELLS IN MICE

From an NIH press release:

PROSTATE TUMORS CAN CHANGE THE FUNCTION OF IMMUNE CELLS IN MICE

Researchers have discovered that prostate tumors in mice can cause immune cells known as CD8+ T cells to change their function from cells that have antitumor activity to cells that suppress immune responses. This finding, by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health, has important implications for the design of immune-based therapies for cancer. The new study, available online, appears in the Oct. 15, 2009, issue of the Journal of Immunology.

"The conversion of CD8+ T cells into suppressor cells may be one of the mechanisms by which tumors restrict the immune system's ability to control tumor growth," said Arthur A. Hurwitz, Ph.D., head of the Tumor Immunity and Tolerance Group at NCI's Center for Cancer Research. "Studying this process in mice may help explain why some cancer patients have an initial response from their immune-based therapy, but this response fails with time."

In mice and humans, when the immune system encounters a pathogen or other foreign invader, it responds by mounting an immune response. Part of this response involves the recruitment and activation of CD8+ T cells, which are also called cytotoxic T cells or killer T cells, to help destroy the invader. CD8+ T cells also play a role in immune responses against tumor cells. Other T cells, known as CD4+ T regulatory cells, work to suppress CD8+ T cell activity. Immune suppression by these regulatory T cells helps prevent the body from attacking its own cells. A high level of CD4+ T regulatory cells is also associated with poor prognosis of some cancers. Moreover, research in mice has shown that blocking the immune suppressive activity of these regulatory T cells enhances the body's immunity against tumors, causing tumor growth to slow and improving the antitumor immune responses elicited by cancer vaccines.

Recent evidence in mice has suggested that CD8+ T cells can develop suppressive activities similar to those of CD4+ T regulatory cells. In addition, CD8+ suppressor cells have been found in cancer patients. The presence of these suppressor cells could explain earlier findings by Hurwitz's team that prostate tumor-specific CD8+ T cells injected into prostate tumor-bearing mice migrate to the tumors but then become unresponsive, or tolerized, to the tumor cells. It remained unclear, however, whether the suppressive CD8+ T cells have suppressor activity before they reach the tumor or whether they are converted into suppressor cells by the tumor.

In the new research, Hurwitz's team found that CD8+ T cells acquire immune suppressive functions after they enter the mouse tumor microenvironment, which encompasses nearby noncancerous cells and immune cells in addition to tumor cells. The researchers found that tumor-specific CD8+ T cells isolated from the tumors were able to suppress the proliferative capacity of nonspecific T cells, whereas tumor-specific CD8+ T cells isolated from lymph nodes of the mice were unable to do so.

This anti-proliferative activity appeared to be caused, in part, by substances secreted by the CD8+ T cells after they had been converted to suppressor cells. One of these substances, TGF-beta, is a protein that controls cell proliferation and differentiation and plays a role in cancer and other diseases. TGF-beta is thought to be involved in the immune-suppressive activity of CD4+ T-regulatory cells.

Next, the team investigated whether the conversion of tumor-specific CD8+ T cells to suppressor cells could be prevented. To do this, they administered tumor-specific CD4+ and CD8+ T cells to prostate tumor-bearing mice. Some CD4+ T cells act as helper cells and enhance the activity of other immune cells, including CD8+ T cells. The researchers found that, under these conditions, CD8+ T cells isolated from the prostate tumors no longer suppressed the proliferation of other T cells. Moreover, these cells produced less TGF-beta than cells that were not exposed to CD4+ T cells.

The researchers propose that activated CD4+ T cells that enter tumors may secrete factors that support the CD8+ T cell antitumor functions, or may help other immune cells located in the tumor block the processes by which CD8+ T cells acquire their suppressive activity.

Future work by this team will focus on defining the mechanisms by which tumor-specific CD8+ T cells gain their suppressive functions upon entering the mouse tumor microenvironment. "It is important to understand how these cells become suppressive and how they mediate suppression to find approaches to block these processes," said Hurwitz. "This will enhance our ability to generate more effective antitumor T cell responses in mice, which then might be translated to human."

For more information on Dr. Hurwitz's research, please go to .

NCI leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI Web site at or call NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit .

------------------------------------
REFERENCE:
Shafer-Weaver, KA, Anderson, MJ, Stagliano K, Malyguine, A, Greenberg, NM, and Hurwitz AA. Cutting Edge: Tumor-Specific CD8+ T Cells Infiltrating Prostatic Tumors Are Induced to Become Suppressor Cells. J Immunol. Oct. 15, 2009. Vol. 183, No. 8.


U.S. Department of Health and Human Services
NATIONAL INSTITUTES OF HEALTH NIH News
National Cancer Institute (NCI)
For Immediate Release: Wednesday, October 7, 2009

CONTACT: NCI Office of Media Relations, 301-496-6641,

H1N1 - Swine Flu Video

This is the best H1N1, swine flu, video that I have seen so far.

H1N1 Video

NIBIB SCIENTISTS COMBINE MICROSCOPY METHODS TO INCREASE IMAGING EFFICIENCY IN CELL STRUCTURE STUDIES

This is an excellent new advance in microscopy. - BRH

NIBIB SCIENTISTS COMBINE MICROSCOPY METHODS TO INCREASE IMAGING EFFICIENCY IN CELL STRUCTURE STUDIES

New Method Produces High-Resolution Images of Thicker Specimen Samples

Scientists in the National Institute of Biomedical Imaging and Bioengineering (NIBIB) Laboratory of Bioengineering and Physical Science have developed a new technique that allows researchers to visualize fine details of cell structure three-dimensionally in thick sections, thus providing greater insight into how cells are organized and how they function. The work is described in a report published online this week in Nature Methods.

The new electron tomography method, referred to as BF STEM tomography, lets researchers image samples that are more than three times the thickness of typical samples.

Electron tomography is carried out at the nanoscale on individual cells. Conventionally, high-resolution imaging of biological specimens has been accomplished by cutting cells into thin sections (300 nanometers or less) and imaging each section separately. Although reconstructing an entire structure from thin sections is laborious, thin sections are used because images of thicker sections typically are blurred. Serial BF STEM tomography accomplishes the same work using fewer yet thicker specimen sections, leading to faster reconstruction of intact organelles, intracellular pathogens, and even entire mammalian cells.

Drs. Alioscka Sousa, Martin Hohmann-Marriott, Richard Leapman and colleagues in NIBIB, in collaboration with Dr. Joshua Zimmerberg and colleagues in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), demonstrated feasibility and advantages of BF-STEM tomography in a study of red blood cells infected with Plasmodium falciparum, a parasite that causes malaria. High-resolution 3D reconstructions of entire cells were generated by serially imaging just a few thick sections. The intricate system of red blood cell and parasite membranes, as well as several organelles, can be seen in detail.

"We believe that the new technique, which was conceived by Dr. Sousa on the project team, will lead to improved 3D visualization of larger internal structures in mammalian cells at a nanoscale. And it will complement cryo electron tomography and super-resolution optical imaging approaches," according to Dr. Leapman.

Most high-performance electron microscopes can readily be equipped to utilize the BF STEM tomography approach. "This exciting new method, with its ability to provide nanoscale structural details over three dimensions, has the potential for broad application in cell biology," says NIBIB Director Roderic Pettigrew. "This should open new vistas in the understanding of the interplay between cellular structure and function, and is a great example of NIBIB-supported research that moves medical science forward through technological innovation."

This work was supported by the Intramural Research Programs of the NIBIB and the NICHD at the National Institutes of Health. In addition, Dr. Hohmann-Marriott received support through the Joint NIST/NIBIB Postdoctoral Associateship Program of the National Research Council, USA.

NIBIB, a component of NIH, is dedicated to improving health by bridging the physical and biological sciences to develop and apply new biomedical technologies. Additional information and publications are available at .

The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute's Web site at .

The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit .
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REFERENCE: Nanoscale 3D cellular imaging by axial scanning transmission electron tomography. Martin F Hohmann-Marriott, Alioscka A Sousa, Afrouz A Azari, Svetlana Glushakova, Guofeng Zhang, Joshua Zimmerberg & Richard D Leapman. Published online: 30 August 2009 | doi:10.1038/nmeth.1367.

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This NIH News Release is available online at:
.


U.S. Department of Health and Human Services
NATIONAL INSTITUTES OF HEALTH NIH News
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
For Immediate Release: Thursday, September 3, 2009

CONTACT: Cheryl Fee, 301-451-6772,