PARADIGM BYTES
Newsletter for Paradigm 97
July 15, 2013
PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.
Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
MISSION STATEMENT
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.
Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
MISSION STATEMENT
We believe that
nurses need each other for support during the "lean and mean" days to help
survive them. We offer research results and other ideas to enrich the nursing
experience.
***~~~***~~~***~~~***
SNIPPETS
American Family Care Clinics---- You get to see a physician, not a nurse!
May 31, 2013 -- Truth About Nursing supporters recently told us about a television commercial being aired in the southern United States by American Family Care, an aggressively expanding chain of urgent care clinics that plans to have more than 140 locations in 26 states by the end of this year. The ad featured two people texting back and forth about where to seek health care. At the end, one texter recommended that the other go to American Family Care because there you get to see "a doctor, not a nurse." We could not locate the commercial (we created the image above based on what people told us the ad was like), but American Family Care itself was not hard to find. We placed about 7 calls, 1 per day, to Felicia Fortune, the corporation's director of marketing. She never returned any calls. Then we placed a call to company CEO Bruce Irwin and left a detailed message. American Family Care's chief medical officer Glenn Harnett returned our call and had a long discussion with Truth executive director Sandy Summers-- you can listen to a recap of that phone call here in an mp3 (9 min). Harnett insisted that the care provided by physicians was better than that provided by APRNs based on the length of physicians' formal education. However, APRNS typically get as much formal health science education--4 years--as physicians do, and in any case a mountain of research in recent decades has shown that if either of the two professions has better patient outcomes, it's nurses. Harnett was not interested in the research, despite the strong and increasing emphasis on evidence-based practice in modern health care. He did, however, tell Sandy that American Family Care would pull the ad. We thanked him. Harnett said the company would replace it with an ad that went something like this: "At American Family Care, we care about you. That's why when you come to our clinics, you get to see a physician." We told him that isn't much better, since it implies that the people you're not seeing--which in the quick clinic context would only be APRNs--are inferior to the ones you are seeing. Sadly, Harnett did not see our point. And he refused to let us help the company create an ad that was not offensive or to send us a link to the new ad once it was done. By the way, we see that the company's "staff openings" section currently lists four (4) Family Nurse Practitioner positions in Alabama--we certainly hope the company "cares about" its Alabama customers as much as the others! Anyway, if you see a new version of the company's ad or related marketing efforts, please send us a copy or write to us at info@truthaboutnursing.org. Thanks very much!! (Please donate to her website !!!)
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FROM A MEMBER
(This is from Sandy Summers...a member fighting the good fight ) :
Please support The Truth About Nursing
Please support The Truth About Nursing
We need your help so we can pursue this mission together. We would be
very grateful if you could make a donation--even if it is $5, $10 or
$25. Any amount would be so helpful. To donate:. https://www.truthaboutnursing.org/members/members.html Thank you!
~~**~~**~~**~~**~~**~~
MEDICAL NEWS
~~**~~**~~**~~**~~**~~
MEDICAL NEWS
Marilyn Tavenner to be the first nurse to lead
the Centers for Medicare & Medicaid Services:
“Marilyn
brings a
nurse’s attitude, and what a great thing it would be
for the nursing profession
to have a nurse as the agency
director of the Centers for Medicaid and Medicare
Services.
She brings a nurse’s mentality, and she will do that every day on the
job. That is her first priority. Senator Kaine couldn't
have said it better. Nurses have officially made it to the
top. On May 15, 2013, the United StatesSenate confirmed Marilyn
Tavenner, MHA, BSN, RN to be the first nurse to lead the Centers for
Medicare & Medicaid Services (CMS). Due to political gridlock and
partisanship along the way, CMS has not confirmed an administrator for
over 7 ears. It was no surprise to us that Congress could agree on
Marilyn, a former intensive Care Unit Nurse. As she moved up the ladder
to become Virginia's secretary of Health and Human Services, she didn't
forget about the patients she once served in the rural areas of
Virginia. ... from ANA.com
~~**~~**~~**~~**~~**~~
INTERESTING
READING
Please
remember that the REUTERS articles usually good for only 30 days
BioMarin's cancer drug success prompts launch of pivotal trial
(Reuters) - An experimental cancer drug from BioMarin Pharmaceutical Inc has proven to be effective in treating patients with breast or ovarian cancers caused by mutation in the BRCA gene that repairs damaged DNA, early data show.
The drug, BMN673, is part of a new class known as PARP inhibitors.
PARP,
or poly ADP ribose polymerase, is an enzyme used by the body to repair
broken DNA that can also be used by cancer cells to survive. By blocking
PARP, drugmakers hope to prevent cancer cells from spreading.
Mutations
in the BRCA 1 and BRCA 2 genes, which normally function by interacting
with damaged DNA to help repair it, can increase a woman's risk of
breast cancer 60 percent to 80 percent. The mutations are also
associated with a higher risk of ovarian cancer. ...
********************
Three more people have died from coronavirus.
(Reuters) - Three more people have died in Saudi Arabia
from the new SARS-like coronavirus, bringing the worldwide death toll
to 30, the World Health Organization (WHO) said on Friday.
Saudi health officials also
told the WHO of a new case in the eastern province of al-Ahsa,
increasing the number of cases worldwide to 50, WHO spokesman Glenn
Thomas told reporters at a news conference in Geneva.
The latest deaths were also in al-Ahsa, Thomas said.
Saudi Arabia has been the most affected by the virus, with 39 cases and 25 deaths so far, according to data from the WHO, a United Nations agency. The virus, which can cause coughing, fever and pneumonia, has spread from the Gulf to France, Britain and Germany. The WHO has called it the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). ...
FDA announces import of injectable drugs used in TPN to ease shortage
On May 29, the U.S. Food and Drug Administration (FDA) announces that injectable drugs used in total parenteral nutrition (TPN) will be imported into the U.S. to help ease shortages. The FDA is allowing Fresenius Kabi USA, LLC, to import trace elements and phosphate injection from its Norway plant. ... http://healthcommedia.benchmarkmails26.com/c/l?u=2619A0E&e=2E53B4&c=F275&t=0&l=242D6A&email=khDcrWqjAkeIKbHcHZqq5QSXAE%2FMRK6o
**************************
Health Tip: What's Behind Bad Breath? (Good Patient Teaching Tool)
Limit onions and garlic
(HealthDay News) -- Bad breath, also known as halitosis, should be
evaluated by a dentist to determine a possible cause and treatment.
The American Dental Association says potential causes include:
- Eating potent food, such as garlic or onions.
- Dieting excessively or not eating enough.
- Not brushing or flossing regularly to remove food particles from the teeth and gums.
- Having gum disease.
- Having insufficient saliva to help wash away food particles.
- Smoking or chewing tobacco.
- Having a medical condition, such as liver or kidney problems, a lung infection, diabetes or bronchitis.
******************
With the ubiquitousness of the Internet it is easy to forget that once upon a time the recording and passing on of knowledge was a monumentally important, even sacred task and books were frequently more valuable than gold. Now, many books aren't even worth the paper they are printed on, but those rare examples of historic publications in antiquity that are still in good condition can fetch kingly prices. Some of the most expensive books ever sold at auction are...
RANDOM FACTS:
Traite Des Arbres Fruitiers
The "Treatise on Fruit Trees" is a five volume set written in 1750. It contains illustrations and descriptions of sixteen different varieties of fruit trees. With a 2006 purchase price of $4.5 million, it has the distinction of being the most expensive book about fruit trees ever sold.
The Gutenberg Bible
There are 48 Gutenberg Bibles left of the original 180 believed to have been produced. They were printed in 1456 and were the first books produced with moveable type. A copy sold in 1987 for $4.9 million at Christie's New York.
First Folio
This book, a collection of William Shakespeare's plays, was published after his death in 1623. Seven hundred and fifty copies were published, but only 228 survived. Microsoft co-founder Paul Allen purchased a copy for around $6.1 million in 2001.
The Canterbury Tales
There are only 12 known first edition copies left since its publishing in 1477, and only one is in a private collection. The book was originally purchased in 1776 and not sold again until 1998 with a purchase price of $7.5 million by Christie's of London.
Birds Of America
This three and a half foot tall book depicts 400 life size North American bird species known to the Audubon Society in the 19th century. Only 200 complete first editions were produced, and 120 exist today. In 2010, one was sold for $11.5 million, but a 2012 copy sold for only $7.9 million.
The Gospels Of Henry The Lion
Commissioned by Henry the Lion for the alter of the Virgin Mary at Brunswick Cathedral, the German government purchased this 266 page book in 1983 for $11.7 million.
The Codex Leicester
Da Vinci wasn't only an artist, but also a scientist. This 72 page notebook is a handwritten journal chronicling his thoughts on everything from fossils to what makes the moon glow. Microsoft founder Bill Gates purchased the book for $30.8 million and had it scanned to use as a screensaver for Windows 95.
*************************
Merck melanoma drug shrinks tumors in 38 percent of patients
http://in.reuters.com/article/2013/06/02/health-cancer-melanoma-merck-idINL2N0EE00320130602
********************
Sugary drink consumption down among U.S. kids
In 2010, U.S. children got an average of 68 fewer calories per day from sugary drinks than in 2000, according to the analysis in the American Journal of Clinical Nutrition. Both children and adults are drinking less sugar at meals and at snack time, the study also found.
http://www.reuters.com/article/2013/05/29/us-sugary-drink-idUSBRE94S14N20130529?feedType=RSS&feedName=healthNews
********************
RANDOM FACT:
There are not 24 hours in a day. There are 23 hours, 56 minutes and 4 seconds - the time it takes Earth to rotate on its axis, called a sidereal day.
***
Bonus Fact:
Despite the towering heights of the Himalayas and the depths of the deepest ocean, compared to its circumference Earth is smoother than a bowling ball. Mountains and ocean trenches make up only 1/500th of the Earth's circumference.
************************
Drug-resistant strains of H7N9 bird flu discovered
Drug-resistant cases of a deadly new strain of bird flu have been identified. In a study published in The Lancet on May 28, researchers detailed three patients with the new avian flu strain that's hit China, known as H7N9, whose sickness could not be treated by Tamiflu (oseltamivir) and similar drugs. ...
http://www.cbsnews.com/8301-204_162-57586515/drug-resistant-strains-of-h7n9-bird-flu-discovered/
**************************
Learn more by reading the continuing education program "Interstitial cystitis - chronic, common, and sometimes complicated to treat."
http://healthcommedia.benchmarkmails26.com/c/l?u=2783650&e=304B43&c=F275&t=0&l=242D6A&email=khDcrWqjAkeIKbHcHZqq5QSXAE%2FMRK6o
Study: Effect of Noise on Auditory Processing in the Operating Room
Effective communication is a critical component of patient care in the operative room (OR). However, the presence of loud equipment, a large number of staff members, and music can contribute to high levels of background noise. In a setting in which crucial tasks are performed continuously, distractions and barriers to communication can result in harm to both patients and OR personnel. The purpose of this investigation was to simulate OR listening conditions and evaluate the effect of operating noise on auditory function.
A study in May’s Journal of the American College of Surgeons found that operating room (OR) noise can decrease the ability of surgeons to correctly hear, particularly when music is also present. The authors recommend reducing ambient noise levels to avoid miscommunication.
http://healthcommedia.benchmarkmails26.com/c/l?u=256AB41&e=2D5CCF&c=F275&t=0&l=242D6A&email=khDcrWqjAkeIKbHcHZqq5QSXAE%2FMRK6o
************************
Sleep apnea therapy appears to cut PTSD nightmares
Treating military veterans' sleep apnea with continuous positive airway pressure was associated with a reduction in the incidence of nightmares for patients with post-traumatic stress disorder, according to a small study in the U.S. The better the veterans complied with their treatment plan, the fewer nightmares were reported, but the reasons for the association were not clear. The findings were reported at the annual meeting of the Associated Professional Sleep Societies. ... (it has made a tremendous difference for me...CPAP)
http://r.smartbrief.com/resp/eBrbDrrXoMfSeHeQfDcXdUfCnSxX?format=standard
********************
As many of you know, I have an autistic grandson, Bryan. He is a great guy....and is very like this Michael in the video:
"My autistic brother" Please watch...
Impasse***
When someone reaches an "impasse" today, the sense is usually
political: A negotiation has broken down, a bill has failed to pass on
the floor of Congress. The original sense of the term was more
ordinary. In the crowded cities of medieval France, winding alleys
often ended at a stone wall, a dead end that could not be gone through.
Thus, impasse, "not passable."
souvenir*** In French, a souvenir is something that just happens to pop into your mind while you are going about some other business, including a pleasant memory of a happy time somewhere. This sense of mental image came to be transferred to something that called up such an image: a statuette, say, of the Eiffel Tower as a reminder of a fine holiday in Paris. When we say "souvenir" in English, we now mean the object, and not the memory.
With the ubiquitousness of the Internet it is easy to forget that once upon a time the recording and passing on of knowledge was a monumentally important, even sacred task and books were frequently more valuable than gold. Now, many books aren't even worth the paper they are printed on, but those rare examples of historic publications in antiquity that are still in good condition can fetch kingly prices. Some of the most expensive books ever sold at auction are...
RANDOM FACTS:
Traite Des Arbres Fruitiers
The "Treatise on Fruit Trees" is a five volume set written in 1750. It contains illustrations and descriptions of sixteen different varieties of fruit trees. With a 2006 purchase price of $4.5 million, it has the distinction of being the most expensive book about fruit trees ever sold.
The Gutenberg Bible
There are 48 Gutenberg Bibles left of the original 180 believed to have been produced. They were printed in 1456 and were the first books produced with moveable type. A copy sold in 1987 for $4.9 million at Christie's New York.
First Folio
This book, a collection of William Shakespeare's plays, was published after his death in 1623. Seven hundred and fifty copies were published, but only 228 survived. Microsoft co-founder Paul Allen purchased a copy for around $6.1 million in 2001.
The Canterbury Tales
There are only 12 known first edition copies left since its publishing in 1477, and only one is in a private collection. The book was originally purchased in 1776 and not sold again until 1998 with a purchase price of $7.5 million by Christie's of London.
Birds Of America
This three and a half foot tall book depicts 400 life size North American bird species known to the Audubon Society in the 19th century. Only 200 complete first editions were produced, and 120 exist today. In 2010, one was sold for $11.5 million, but a 2012 copy sold for only $7.9 million.
The Gospels Of Henry The Lion
Commissioned by Henry the Lion for the alter of the Virgin Mary at Brunswick Cathedral, the German government purchased this 266 page book in 1983 for $11.7 million.
The Codex Leicester
Da Vinci wasn't only an artist, but also a scientist. This 72 page notebook is a handwritten journal chronicling his thoughts on everything from fossils to what makes the moon glow. Microsoft founder Bill Gates purchased the book for $30.8 million and had it scanned to use as a screensaver for Windows 95.
*************************
Merck melanoma drug shrinks tumors in 38 percent of patients
(Reuters) - A Merck & Co drug
designed to unmask tumor cells and mobilize the immune system
into fighting cancer helped shrink tumors in 38 percent of
patients with advanced melanoma in an early-stage study, U.S.
researchers said on Sunday.
The findings on the melanoma drug lambrolizumab were
published in the New England Journal of Medicine and presented
at the American Society of Clinical Oncology meeting in Chicago
this weekend.
The research may heap pressure on market leader
Bristol-Myers Squibb, maker of Yervoy - the only
approved immune system drug for the treatment of advanced
melanoma, the deadliest form of skin cancer. ...
http://in.reuters.com/article/2013/06/02/health-cancer-melanoma-merck-idINL2N0EE00320130602
********************
Sugary drink consumption down among U.S. kids
(Reuters Health) -
More evidence that Americans are heeding calls to cut back on sugary
drinks appears in a report from researchers at the U.S. Centers for
Disease Control and Prevention (CDC).
In 2010, U.S. children got an average of 68 fewer calories per day from sugary drinks than in 2000, according to the analysis in the American Journal of Clinical Nutrition. Both children and adults are drinking less sugar at meals and at snack time, the study also found.
The
results are consistent with previous studies showing a decline in
consumption of sugar generally, and soda specifically, between 1999 and
2008, said lead author Dr. Brian Kit of the CDC's National Center for
Health Statistics in Rockville, Maryland.
There has been no corresponding dip in obesity rates over the decade, though, Kit noted.
"During our 12-year study duration, obesity prevalence, although high, has largely remained stable," he told Reuters Health. ...
http://www.reuters.com/article/2013/05/29/us-sugary-drink-idUSBRE94S14N20130529?feedType=RSS&feedName=healthNews
********************
RANDOM FACT:
There are not 24 hours in a day. There are 23 hours, 56 minutes and 4 seconds - the time it takes Earth to rotate on its axis, called a sidereal day.
Despite the towering heights of the Himalayas and the depths of the deepest ocean, compared to its circumference Earth is smoother than a bowling ball. Mountains and ocean trenches make up only 1/500th of the Earth's circumference.
************************
Drug-resistant strains of H7N9 bird flu discovered
Drug-resistant cases of a deadly new strain of bird flu have been identified. In a study published in The Lancet on May 28, researchers detailed three patients with the new avian flu strain that's hit China, known as H7N9, whose sickness could not be treated by Tamiflu (oseltamivir) and similar drugs. ...
http://www.cbsnews.com/8301-204_162-57586515/drug-resistant-strains-of-h7n9-bird-flu-discovered/
**************************
Bacteria remain in towels used to clean hospital rooms even after laundering; findings suggest towels reduce effectiveness of hospital-grade
disinfectant
ROSWELL, Ga., May 29, 2013 /PRNewswire/ -- New study results published online in the American Journal of Infection
Control found that 93 percent of tested laundered towels used to clean hospital rooms contained bacteria that could result in healthcare-associated
infections (HAIs). Most people don't expect to leave the hospital sicker than when they came in, but HAIs are a significant problem, with an estimated
1.7 million cases reported annually in the United States(i) . While stringent disinfecting practices are in place to combat HAIs, study results show
that traditional hospital laundering practices are not sufficient to remove all viable bacteria from the laundered towels. ...
http://tinyurl.com/contaminated-towels
**************************
Interstitial cystitis - chronic, common, and sometimes complicated to treat
Issue Date: November 2010 Vol. 5 No. 11
Author: Cherrilyn F. Richmond, MS, FNP/WHNP-BC
Carole Cranford, age 52, comes to the outpatient clinic
complaining of pain and pressure in the bladder area, which she rates as
a 10 on a 1-to-10 scale, as well as urinary urgency and frequency. She
says she has been voiding 20 or more times per day for the past year.
She reports pain during and after sexual intercourse, which at times has
deterred her from having sex. The pain increases when her bladder is
full, isn’t relieved when she voids, and isn’t cyclic or timed with her
menstrual cycle.
Which condition would you suspect as the cause of Ms. Cranford’s
symptoms? Most likely, you’d place interstitial cystitis (IC) at the top
of your list. Also called painful bladder syndrome, IC is marked by
pelvic and bladder pain of varying severity and lasting for an extended
time, along with urinary frequency. Many patients with IC have pain on
bladder filling and urination, as well as with sexual intercourse. They
void frequently to decrease pain by eliminating urine in the bladder.
Pain commonly occurs in the general pelvic region, inguinal area, inside
of the thighs, in the labia or vaginal lips, deep inside the vagina,
urethra, clitoris, and in the perineum.
The cause of IC remains unknown. Diagnosis and treatment can be
controversial, and for many patients, the treatment is complicated. New
research indicates IC is more prevalent than originally thought.
According to the RAND IC Epidemiology (RICE) Study, the largest IC
epidemiology study undertaken, about 3 to 8 million women in the United
States (roughly 3% to 6% of all women) may have IC. Findings from the
Boston Area Community Health (BACH) survey show that roughly 1 to 4
million men have IC. However, that number is probably lower than the
true rate because IC in men may be mistaken for another disorder, such
as chronic prostatitis or chronic pelvic pain syndrome. IC can start in
childhood, although studies haven’t been done to establish its
prevalence in this age group. ...
Learn more by reading the continuing education program "Interstitial cystitis - chronic, common, and sometimes complicated to treat."
http://healthcommedia.benchmarkmails26.com/c/l?u=2783650&e=304B43&c=F275&t=0&l=242D6A&email=khDcrWqjAkeIKbHcHZqq5QSXAE%2FMRK6o
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Study: Effect of Noise on Auditory Processing in the Operating Room
Effective communication is a critical component of patient care in the operative room (OR). However, the presence of loud equipment, a large number of staff members, and music can contribute to high levels of background noise. In a setting in which crucial tasks are performed continuously, distractions and barriers to communication can result in harm to both patients and OR personnel. The purpose of this investigation was to simulate OR listening conditions and evaluate the effect of operating noise on auditory function.
A study in May’s Journal of the American College of Surgeons found that operating room (OR) noise can decrease the ability of surgeons to correctly hear, particularly when music is also present. The authors recommend reducing ambient noise levels to avoid miscommunication.
This is a prospective investigation of 15 subjects ranging from 1 to
30 years of operative experience. All surgeons had normal peripheral
hearing sensitivity. The surgeons' ability to understand and repeat
words were tested using the Speech in Noise Test–Revised in 4 different
conditions chosen to simulate typical OR environments. These included
quiet, filtered noise through a mask and background noise both with and
without music. They were tested in both a tasked and in an untasked
situation.
It was found that the impact of noise
is considerably greater when the participant is tasked. Surgeons
demonstrated substantially poorer auditory performance in music than in
quiet or OR noise. Performance in both conditions was poorer when the
sentences were low in predictability.
http://healthcommedia.benchmarkmails26.com/c/l?u=256AB41&e=2D5CCF&c=F275&t=0&l=242D6A&email=khDcrWqjAkeIKbHcHZqq5QSXAE%2FMRK6o
************************
Sleep apnea therapy appears to cut PTSD nightmares
Treating military veterans' sleep apnea with continuous positive airway pressure was associated with a reduction in the incidence of nightmares for patients with post-traumatic stress disorder, according to a small study in the U.S. The better the veterans complied with their treatment plan, the fewer nightmares were reported, but the reasons for the association were not clear. The findings were reported at the annual meeting of the Associated Professional Sleep Societies. ... (it has made a tremendous difference for me...CPAP)
http://r.smartbrief.com/resp/eBrbDrrXoMfSeHeQfDcXdUfCnSxX?format=standard
********************
As many of you know, I have an autistic grandson, Bryan. He is a great guy....and is very like this Michael in the video:
"My autistic brother" Please watch...
http://www.wimp.com/
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*************************
http://www.npuap.org/resources/white-papers/.
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About all those critters we want to be GONE !
Consider a Bat House
Consider a Bat House
Bats, surprisingly, eat hundreds mosquitoes each night. Though it may
seem unappealing, consider keeping a bat house in your backyard to keep
your yard mosquito free in the summer.
Make Your Own Spray
Can’t stop getting bit by these annoying insects? Before you reach
for the bug spray, mix one cup of mouthwash with seven drops of lavender
oil for a natural way to keep them at bay.
Invest in Fans
According to Rodale,
mosquitos are dormant when wind speeds exceed 10 miles per hour. Next
time you’re having an outdoor party, set up strong rotating fans to keep
the mosquitos from ruining the fun.
Add Garlic to Your Diet
If you can handle it, try drinking apple vinegar and eating garlic to
keep your body free from ticks this summer. However, for a less intense
approach, mix rose geranium oil with vodka to form a spray.
Reconsider Your Wardrobe
If you’re out hiking or camping and really concerned with ticks,
choose a light colored outfit. You’ll be more apt to spot a tick on
lighter clothes.
Keep Your Pets Safe
If you’re a pet owner, fleas may be one of your biggest concerns when
it comes to your animal. However, combine lavender oil, cedar oil and
witch hazel for a mixture that’s sure to keep them away.
Apple Cider Vinegar To the Rescue Again
Similar to ticks, fleas are repelled by the smell of apple cider
vinegar. If you want to protect your pet this summer, add a tablespoon
of apple cider vinegar to your animal’s water bowl to keep them safe.
Plants Can Help, Too
Believe it or not, there are also certain plants that serve as
mosquito repellant. For instance, the Citronella Grass plant is used as
a natural ingredient is most mosquito repellents. Therefore, consider
planting some of these in your yards to limit mosquitos.
Some Weeds Have Benefits
Catmint, also known as catnip, is also a strong mosquito repellant.
Coming from the mint family, this commercial plant and weed is
considered extremely effective.
Rosemary For More Than Cooking
More common than Citronella Grass and Catmint, Rosemary is an herb
that also helps keep mosquitoes away. Considering planting Rosemary in
your garden to not only keep bugs away but add some flavor to your
cooking.
(Thanks to BAcello (Barbara) we have an excellent article for you) : Bee Venom Kills HIV: Nanoparticles Carrying Toxin Shown To Destroy Human Immunodeficiency Virus A new study has shown that bee venom can kill the human immunodeficiency virus (HIV). Researchers at Washington University School of Medicine in St. Louis have demonstrated that a toxin called melittin found in bee venom can destroy HIV by poking holes in the envelope surrounding the virus, according to a news release sent out by Washington University. Visit Washington University's website to read more about the study. Nanoparticles smaller
than HIV were infused with the bee venom toxin, explains U.S. News & World Report. A "protective bumper" was added to the nanoparticle's surface, allowing it to bounce off normal cells and leave them intact. Normal cells are
larger than HIV, so the nanoparticles target HIV, which is so small it fits between
the bumpers. “Melittin on the nanoparticles fuses with the viralenvelope,” said
research instructor Joshua L. Hood, MD, PhD, via the news release. “The melittin forms little pore-like attack complexes and ruptures the envelope, stripping it off the virus.” Adding,
“We are attacking an inherent physical property of HIV. Theoretically, there isn’'t any
way for the virus to adapt to that. The virus has to have a protective coat, a double-layered membrane that covers the virus.” http://www.usnews.com/news/articles/2013/03/08/study-bee-venom-kills-hiv ****************************
Plastic and Reconstructive Surgery - Global Open:
doi: 10.1097/GOX.0b013e318294e41d
Increased Flap Weight and Decreased Perforator Number Predict Fat Necrosis in DIEP Breast Reconstruction
ABSTRACT
Increased Flap Weight and Decreased Perforator Number Predict Fat Necrosis in DIEP Breast Reconstruction
ABSTRACT
Background: Compromised perfusion in autologous breast reconstruction results in fat necrosis
and flap loss. Increased flap weight with fewer perforator vessels may
exacerbate imbalances in flap perfusion. We studied deep inferior
epigastric perforator (DIEP) and muscle-sparing transverse rectus
abdominis myocutaneous (MS-TRAM) flaps to assess this concept.
Methods: Data from patients who underwent
reconstruction with DIEP and/or MS-TRAM flaps between January 1, 2010
and December 31, 2011 (n = 123) were retrospectively reviewed.
Patient demographics, comorbidities, intraoperative parameters, and
postoperative outcomes were collected, including flap fat necrosis
and donor/recipient site complications. Logistic regression analysis
was used to examine effects of flap weight and perforator number on
breast flap fat necrosis.
Results: One hundred twenty-three patients who
underwent 179 total flap reconstructions (166 DIEP, 13 MS-TRAM) were
included. Mean flap weight was 658 ± 289 g; 132 (73.7%) were single
perforator flaps. Thirteen flaps (7.5%) developed fat necrosis. African American patients had increased odds of fat necrosis (odds ratio, 11.58; P < 0.001). Odds of developing fat necrosis significantly increased with flap weight (odds ratio, 1.5 per 100 g increase; P < 0.001). In single perforator flaps weighing more than 1000 g, six (42.9%) developed fat necrosis, compared to 14.3% of large multiple perforator flaps.
Conclusions: Flaps with increasing weight have increased risk of fat necrosis. These data suggest that inclusion of more than 1 perforator may decrease odds of fat necrosis
in large flaps. Perforator flap breast reconstruction can be performed
safely; however, considerations concerning race, body mass index,
staging with tissue expanders, perforator number, and flap weight may
optimize outcomes.
Reconstruction with autologous tissue remains a sound option for many women following mastectomy.1,2
Among the strengths of autologous reconstruction is achievement of a
natural consistency and pleasing aesthetic outcome. However, the main
limitation can be donor site morbidity following flap harvest.3
Modifications in surgical technique and flap design using the
muscle-sparing transverse rectus abdominus myocutaneous (MS-TRAM) flap
and the deep inferior epigastric perforator (DIEP) flap have decreased
donor site morbidity.4–8
However, advancements in preserving the integrity of the rectus muscle
in the abdominal wall, that is, by focusing on single perforator
dissection, may result in compromised flap vascularity and an increase
in perfusion-related flap complications.5,9
Fat necrosis is a consequence of either inadequate arterial inflow or relatively poor venous outflow in a DIEP flap. Development of fat necrosis
requiring reoperation can result in significant aesthetic deformity and
emotional and financial costs: treatment often requires breast imaging
studies, tissue biopsy, and/or excision and may cause significant
anxiety in patients with a history of breast cancer. ...
http://click.email.mylwwjournals.com/?qs=1f890412c7459ab3eab5f971d7c0de252c82b5ab4c81fb305d62e49b9f000934
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White papers are authoritative reports and guides designed to help solve a problem, answer a question, or clarify a subject. It is primarily intended to engage discussion on known and emerging issues and provide education. This may provide the foundation for consensus topics, position statements, publications and/or continued research. These documents were accurate and appropriate at the time they were produced. They are unofficially reviewed by NPUAP members. Questions and concerns should be directed to the lead author or the Public Policy Committee.
White papers are authoritative reports and guides designed to help solve a problem, answer a question, or clarify a subject. It is primarily intended to engage discussion on known and emerging issues and provide education. This may provide the foundation for consensus topics, position statements, publications and/or continued research. These documents were accurate and appropriate at the time they were produced. They are unofficially reviewed by NPUAP members. Questions and concerns should be directed to the lead author or the Public Policy Committee.
http://www.npuap.org/resources/white-papers/.
1. Friction Induced Skin Injuries – Are They Pressure Ulcers?
https://www.npuap.org/wp-content/uploads/2012/01/NPUAP-Friction-White-Paper.pdf
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WORD ORIGINS:
souvenir*** In French, a souvenir is something that just happens to pop into your mind while you are going about some other business, including a pleasant memory of a happy time somewhere. This sense of mental image came to be transferred to something that called up such an image: a statuette, say, of the Eiffel Tower as a reminder of a fine holiday in Paris. When we say "souvenir" in English, we now mean the object, and not the memory.
*********************QUIZ TIME:Which statement about the use of systemic corticosteroids in asthma is correct?a. They should be given monthly. b. They should be given daily. c. They should be used for long-term control in patients with moderate persistent asthma. d. They should be used for long-term control only in patients with the most severe, hard-to-control asthma. Answer at the end of the Newsletter.“2013 Medication Adherence in America: A National Report 2013” gives people in the U.S. with chronic medicalconditions a C+ grade. The report, from the National Community Pharmacists Association, says that key predictors ofmedication adherence include patients’ personal connection with a pharmacist or pharmacy staff, how easy it is forpatients to afford medications, and the level of continuity patients have in their health care. ...http://healthcommedia.benchmarkmails26.com/c/l?u=2783644&e=304B43&c=F275&t=0&l=242D6A&email=khDcrWqjAkeIKbHcHZqq5QSX E%2FMRK6o ************
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