medical news

Israel’s medical tourism at the crossroads

Income from medical tourism increased sharply in 2011 and 2012 to reach $140 million in 2012, according to data collected by the Health Ministry and the non-government organization Hatzlaha.  The Israeli government is exploring whether to curb or regulate medical tourism; despite the revenue it brings in-with worries that locals could suffer. The ministry has a dilemma that many hospitals have cited commercial issues for refusing to co-operate with official enquiries on how many medical tourists they actually get, as nobody has been able to find out the real numbers.

 The public hospitals took in NIS 291 million from medical tourism in 2012. Health maintenance organization Clalit reported that its 10 hospitals had revenues of NIS 70 million from medical tourism in 2012. Hadassah University Hospital in Jerusalem had revenues totaling NIS 108 million.

Private hospitals, including Assuta in north Tel Aviv, also had sizeable revenue from medical tourism but refused to provide numbers. One estimate indicates that Israel’s hospitals had revenues of more than half a billion shekels from medical tourism.

The public hospital with the highest medical tourism revenues was Sheba Medical Center, Tel Hashomer, with NIS 130 million a year – up nearly 70% since 2010. It was followed by Ichilov Hospital, Tel Aviv, which had revenues of NIS 99 million (up 44% since 2010), and Beilinson Hospital, Petah Tikva, at NIS 39 million – a 490% increase over the figure from 2010.Other public hospitals with medical tourism revenue were Rambam in Haifa, with NIS 36.4 million in revenues; Assaf Harofeh Hospital, Tzrifin, at NIS 15.9 million; and Schneider Children’s Medical Center, with NIS 13.6 million.

A subcommittee within the health ministry has been set up in an attempt to regulate medical tourism, which has no government oversight or standards. Many attempts have been made to set standards and regulations for medical tourism- all have failed to happen. In May 2013 the committee said that medical tourism should account for no more than 10% of a hospital’s revenues from operations. But it has yet to submit its recommendations, so this limit is not official, and it may be impossible to enforce.

Medical tourism is a very sensitive issue for Israel’s health system. Every medical tourist admitted raises the question of whether that person is taking the place of an Israeli patient, particularly given that the hospitals are very overcrowded and the wait for treatment is long.

Medical tourists come primarily from the former Soviet Union and from Mediterranean nations. They visit for a fixed duration, and may receive treatment ahead of Israelis.

For hospitals, medical tourists are very attractive and lucrative patients. Hospitals charge them much more than they receive from Israeli patients, and one of the reasons some hospitals refuse to co-operate with the ministry is a suspicion that they greatly increase the prices for medical tourists- so increased revenue may not equate with increases numbers- but be due to severe price increases and a concentration on more expensive surgery. Unlike insurers, the medical tourists pay the hospitals immediately, and in cash. The money goes into the hospitals’ parallel business operations, as opposed to the budget subject to government oversight, which means the hospital directors have more control over the money.

Source: IMTJ

How superbugs develop antibiotic resistance

A team of researchers used quantitative models of bacterial growth to discover the bizarre way by which antibiotic resistance allows bacteria to multiply in the presence of antibiotics.

According to UC San Diego biophysicists understanding how bacteria harbouring antibiotic resistance grow in the presence of antibiotics is critical for predicting the spread and evolution of drug resistance.

In the study, the researchers found that the expression of antibiotic resistance genes in strains of the model bacterium E. coli depends on a complex relationship between the bacterial colony’s growth status and the effectiveness of the resistance mechanism.

According to Terry Hwa, a professor of physics and biology who headed the research, the interaction between drug and drug-resistance is complex because the degree of drug resistance expressed in a bacterium depends on its state of growth, which in turn depends on the efficacy of drug, with the latter depending on the expression of drug resistance itself.

For a class of common drugs, the researchers realized that this chain of circular relations acted effectively to promote the efficacy of drug resistance for an intermediate range of drug doses.

The use of predictive quantitative models was instrumental in guiding the researchers to formulate critical experiments to dissect this complexity. In their experiments, E. coli cells possessing varying degrees of resistance to an antibiotic were grown in carefully controlled environments kept at different drug doses in “microfluidic” devices-which permitted the researchers to manipulate tiny amounts of fluid and allowed them to continuously observe the individual cells.

Hwa and his team found a range of drug doses for which genetically identical bacterial cells exhibited drastically different behaviours: while a substantial fraction of cells stopped growing despite carrying the resistance gene, other cells continued to grow at a high rate.

This phenomenon, called “growth bistability,” occurred as quantitatively predicted by the researchers’ mathematical models, in terms of both the dependence on the drug dose, which is set by the environment, and on the degree of drug resistance a strain possesses, which is set by the genetic makeup of the strain and is subject to change during evolution.

“Exposing this behavior generates insight into the evolution of drug resistance,” says Hwa. “With this model we can chart how resistance is picked up and evaluate quantitatively the efficacy of a drug.”

The study is published in the journal Science.

Source: ANI

Dutch sound alarm about possible risks of e-cigarettes

The Dutch Health Ministry sounded an early warning on Thursday about the possible health risks of electronic cigarettes, announcing plans to clamp down on labeling ahead of European regulations.

The move followed an analysis of existing scientific research by the National Institute for Public Health, the leading Dutch government health advisory body.

The institute said it was concerned about a lack of evidence on the possible health effects of e-cigarettes, and said that as a precaution, they should not be used by pregnant women or in the vicinity of children.

Some health experts say e-cigarettes—battery-powered metal tubes that turn nicotine-laced liquid into vapor—may be the answer to helping millions of smokers to quit cigarettes and thereby avoid the damaging health effects of smoke.

Smoking tobacco causes lung cancer and other chronic respiratory diseases and is a major contributor to cardiovascular disease, the world’s number one killer.

Tobacco has an annual death toll of six million people, and the World Health Organization says that could exceed eight million by 2030 unless something urgent is done to stop people smoking.

All the top tobacco companies are investing in e-cigarettes, which some analysts have predicted may outsell conventional cigarettes in 10 years.

But they are far from universally accepted as a public health tool—with some critics worried they will not break nicotine addiction and may be a “gateway” to regular cigarettes—and the fast-growing market is largely unregulated.

The Dutch institute also recommended banning flavor and scent enhancers in e-cigarettes that contain nicotine because of concerns they may attract children to smoking.

Citing the institute’s findings, Dutch deputy health minister Martin Van Rijn argued that e-cigarettes are as addictive as tobacco cigarettes because they contain nicotine, and he said there was no proof of claims by manufacturers that they help smokers quit.

“There is insufficient scientific evidence to be able to say whether the quantities of toxins in the exhaled air are dangerous for bystanders,” Van Rijn wrote in a letter to parliament on Thursday.

“In advance of European regulations, I will take measures in national legislation in regard to advertising, safety, quality and labeling of e-cigarettes,” the letter said.

Additional research will be conducted by the institute to learn more about e-cigarettes, the ministry said.

The warning came as Britain signaled it would force tobacco companies to scrap branded cigarette packaging on Thursday in an attempt to reduce the number of children who may be drawn to smoking by striking and brightly colored packs.

The Dutch institute raised concerns on its website last week that e-cigarettes are attractive to young people because of bright colors, flashing lights and jewelry-like appearance.

Roughly 11 to 18 percent of Dutch smokers have tried the e-cigarette, while about 5 percent said they use it regularly, the ministry said.

Market consultant Euromonitor estimates the world market for electronic cigarettes was more than $2 billion last year, with the United States accounting for a quarter of that.

A few countries have banned them outright—such as Brazil, Norway, and Singapore—while others are opting for varying degrees of regulation, in some cases including limits on advertising and curbs on their use in public places.

Big tobacco companies are grappling with declining sales of tobacco in a number of markets due to increasing government regulation and more health-aware consumers, as well as smuggling and an economic downturn.

Philip Morris International Inc, the maker of Marlboro cigarettes, said this month it plans to enter the e-cigarette market next year, saying it is the “greatest growth opportunity”.

Imperial Tobacco Group plans to launch two electronic cigarettes in its new fiscal year.

Source: GMA

1163 HIV positive people in Meghalaya: MACS

 

Health authorities in Meghalaya today said the number of people living with HIV/AIDS virus has increased many folds since 2007 when only 14 persons were tested positive.

Today 1163 persons are living with the virus and authorities believed there could be more who are yet to come forward to test.

For a small state with a population of about three million people, the number is staggering and the trend is increasing every year with as many as 79 positive people have succumbed to the virus in which the international watchdogs on HIV have categorized the state as ‘low prevalence but high risk.’

“The cumulative figures till October this year is 1163 positive cases in the state,” Meghalaya Aids Control Society (MACS) director F Kharkongor said.

The MACS chief said that only 527 positive persons have turned up for treatment at the three Anti Retroviral Therapy (ART) Centers set up in the state even as she expressed concerned at the low turnout of the patients at the designated hospitals.

The first tests were started in 2007 in which 14 persons only were tested positive, she said, adding that the figure increased every year, 54 in 2008, 131 in 2009, 245 in 2010, 452 in 2011, 731 in 2012 and 1008 till March 2013.

The number of deaths has also increased every year since 2008 when only one patient died, in 2009 four died, in 2010 eight patients died taking the cumulative figure to 12, Kharkongor said.

The cumulative deaths in 2011 increased from 12 to 22 and then 37 the following year, she said, adding that the number of victims almost increased almost doubly during the period from March 2012 to March 2013 with 25 deaths.

From March to October this year the number of deaths recorded stands at 17, also the highest during the same period in the past six years, the official said.

According to a data compiled the MACS, 43 per cent of the victims are of the age group from 25-34 and mostly are the active inject drug users.

However, the female sex workers working in the coal belts and along the National Highways in the state also constitute a huge chunk of those people living with the HIV virus.

The others are men who have sex with men and children born out of positive parents.

Source: Press Trust of India

 

35 percent Indians use tobacco despite ad ban

Thirty-five percent of Indians still use tobacco despite growing awareness and ban on tobacco product advertisement said a tobacco control policy report released Friday.

The report also highlighted the need for stronger tobacco control policies and a change in the current prices of tobacco products in India to create social environments that are supportive of quitting.

“Current regulations on tobacco advertising in India still allows for exemptions which created loopholes for tobacco industries to focus its marketing efforts in unregulated venues such as point of sale. There is thus an urgent need for Indian central and state governments to take strong measures to close loopholes and to act swiftly to reduce affordability of all tobacco products,” said S. Pednekar, director (development and research), Healis Sekhsaria Institute for Public Health.

The Tobacco Control Policy Report is a collaborative effort of researchers at the Healis Sekhsaria Institute for Public Health and the University of Waterloo, Canada and based on the result of survey of adult tobacco users and non-users.

“Tobacco use accounts for nearly half of all cancers among males and a one-quarter of all cancers among females and is also a major cause of cardiovascular and respiratory disease. Educating the users about the health hazards of tobacco use and effective pictorial warnings on tobacco products can help people to quit and may also dissuade others from embracing this deadly habit,” said Surendra S. Shastri of Tata Memorial Hospital.

Source: Business Standard

 

4 ways to prevent a hangover

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Try these tips for preventing a hangover and avoid the nasty symptoms of drinking too much

How much should you drink?

There’s no set rule for how much you can drink and avoid a hangover, although of course the more you drink, the more likely you’ll get one, and the worse it’ll be. The Centre for Addiction and Mental Health (CAMH) in Toronto advises women to have no more than two standard drinks per day and nine per week. “These are low-risk, but not no-risk, guidelines,” says Wende Wood, a psychiatric pharmacist with CAMH. “They differ depending on the person. In general, women should drink less than menbecause we have a higher percentage of body fat versus water.” That means you’ll reach a higher blood-alcohol concentration than your male counterpart—even if you consume the same number of drinks.

Here are four simple strategies that you can try at your next get-together to keep a hangover at bay.

1. Eat before you drink

Food slows down the absorption of alcohol. Plus, you’ll feel fuller, and may drink at a slower pace.

2. Slow down

Don’t have more than one drink per hour. This is the maximum rate at which most people’s bodies can process alcohol.

3. Switch it up

Alternate between alcoholic and non-alcoholic drinks (or water). You will stay hydrated and slow the pace at which the alcohol gets absorbed into your bloodstream.

4. Stick with light-colored drinks

Think vodka, gin or white wine. Dark-colored drinks such as rum, whisky and red wine contain chemicals called congeners, which are more likely to produce hangover symptoms.

Source: Best Health

 

Ethiopia Steps Up Education Budget to Over 25 Billion Birr

Ethiopia has stepped up its budget for education to over 25 billion Birr with a view to satisfy the nation’s growing demand for trained workforce, Ministry of Education has said. A consultative forum aimed at lobbying for the active involvement and support of partners and the public was held in Adama town on Tuesday.

Speaking on the occasion, Education Minister, Shiferaw Shigute the government has stepped up its budget for education to 25.4 billion Birr with a view to satisfy the nation’s growing demand for trained workforce. The Minister highlighted the key role of partners and the public to address drawbacks in the sector as well as ensure both access and quality.

The forum reached agreement to work harder to augment student intake capacity, cut the rate of school dropouts and repetitions, ensure a 1:1 student-book ratio, furnish school libraries and laboratories, and build information technology capacity. At the end of the consultation, participants expressed readiness to play their part.

Source: article.wn

New Churches Damage Fight Against HIV in Liberia – Govt Official

An upsurge in ‘new generation’ churches that claim to be able to heal or perform miracles is having a damaging effect on Liberia’s progress in fighting HIV/AIDS, a government official said today.

Speaking in the week before World AIDS Day, Health Ministry official David Logan said there had been a dramatic increase in new generation churches that link their preaching to prevailing local beliefs in healing or miracle cures, with the result that people with HIV were not seeking proper medical treatment.

“Unlike traditional Catholic, Lutheran or Episcopalian churches, the new churches claim to be able to give spiritual deliverance, provide healing or perform miracles.

This is an attractive option for many people living in an impoverished, post-conflict Liberia,” Logan told Thomson Reuters Foundation by telephone from Monrovia.

“Transport and opportunity costs as well as the stigma associated with coming out with HIV has meant that patients from outlying communities are more likely to seek help in these nearby local new churches rather than medical centres based in the capital,” Logan said.

Liberia, a West African country still recovering from almost 15 years of civil war, has around 18,000 people who need anti-retroviral therapy (ART), the standard medical treatment for those living with HIV.

Only 6,000 people are currently enrolled in therapeutic programmes, and a further 10,000 are “in care” because they do not qualify for treatment under WHO guidelines, which stipulate that the patient must have a CD4 count of 350, or be at clinical stage 3 or 4, Logan said.

Most healthy adults have between 500/mm3 and 1,000/mm3 CD4 cells, which form part of the immune system, designed to fend off disease when the body is fighting infection.

A One Campaign report released today shows that Liberia is the only non-conflict country in sub-Saharan Africa in which progress towards the “tipping point” in the battle against HIV has been reversed. Mali is the only other country where the battle against HIV is being lost.

“The tipping point is the point where the number of people being treated exceeds the number of new infections. Liberia treated many more people in 2012 than it has in 2013, resulting in negative progress,” Erin Hohlfelder, the report author, told Thomson Reuters Foundation by telephone from Washington.

“We’re hoping it is just a blip, rather than the beginning of a new trend,” Hohlfelder said, adding that funding from traditional bilateral donors has been static over the last two years, leaving many African countries to fill the gap from their own budgets.

Logan said he hoped that funding provided by the Global Fund and the ESTHER Project would help to pay for outreach workers to reach isolated communities and ensure ART retention and follow-up, and that international days like World AIDS Day would help persuade local communities not to stigmatise those living with HIV.

New WHO guidelines released this year will increase the number of people eligible for treatment for HIV by raising the CD4 threshold for starting treatment to a count of 500/mm3, Logan said.

“The national programme is now working closely with these new churches so that they direct known HIV cases to our designated centres for medical care while they provide spiritual support,” he said.

Source: All Africa

 

Report Warns Future Smoking Epidemic Among African Youth

A new report from the American Cancer Society warned that Africa will face a severe health threat from the fast-growing increase in tobacco use.  The report combines African smoking rates and cigarette consumption with population trends, and found that without aggressive intervention, the continent will experience a significant increase in smoking in the near future.

The report, “Tobacco Use in Africa: Tobacco Control through Prevention,” reveals that Africa as a region has the smallest number of smokers and smallest rate of tobacco use in the world.  About two percent of all cigarettes are consumed by smokers in Africa, but they make up about six percent of the world’s smokers.

While the numbers are small for now, Evan Blecher, a Cape Town, South Africa based senior economist for the American Cancer Society said these small numbers also provide the greatest for growth.

“That means along with it will come an increase among tobacco-related, smoking-related diseases in an environment where health systems are already significantly over-stretched because of infectious diseases like malaria and HIV,” said Blecher.

While adult smoking among both among men and women is low in Africa, he pointed out that’s not the case with youth.

“We found that African children smoke at comparable levels, and sometimes even higher than other developing regions of the world, particularly Asia.  What’s driving this is unclear, but it must be because of significantly more aggressive tactics from the tobacco industry itself.  But, also it’s in an environment where children aren’t protected from advertising, marketing… in the way that they are in places like the United States,” explained Blecher.

In addition he said,–that while smoking rates are lower in Africa than other regions, it doesn’t mean there is no variation in smoking patterns within the continent.

“On the one hand, we’ve got a lot of countries with really low smoking prevalence, like Ghana for instance, or Nigeria,” said Blecher. “And that’s compared to countries of very high smoking prevalence like South Africa or Mauritius, which have prevalence more similar to what we see in the developed world.

“But, what we do know is that smoking is declining in those markets like South Africa and Mauritius, and increasing in markets like Ghana and Nigeria.

“These other markets which have smaller smoking prevalence are more concerning to us because these are places with much larger populations, which creates a situation where we expect both the number of smokers and smoking prevalence to increase dramatically over the next generation or two,” explained the senior economist.

Blecher attributes the decline in smoking in countries such as South Africa and Mauritius to very strict tobacco control policies like advertising bans, smoke free areas, and very aggressive tax policies.

“Tax policies are critically important in environments where incomes are growing rapidly, because as incomes grow, everything becomes cheaper and more affordable, including cigarettes.  So you need for tax policies to be able to ensure that tobacco products are not becoming more affordable.  So in a country like South Africa where we’ve seen tax rates increase dramatically over the last 20 years–we’ve also seen smoking prevalence plummet.  Twenty years ago, 33 percent of South African adults smoked, and nowadays only 20 percent of them smoke.  It’s a result of deliberate action, rather than luck,” said Blecher.

There is a broader movement in Africa towards comprehensive tobacco control policies like advertising bans and smoke free areas, be said, but these efforts are not enough.

“Tax policy is something that hasn’t really been pursued by African governments with respect to tobacco, partly because the tax systems aren’t as developed as they are in places like South Africa and Mauritius.  So the technical capacity to implement, enforce and administer tax policies is just not where it needs to be at the moment,” stated Blecher.

In addition, he said more needs to be done to educate Africans on the dangers of smoking.  While most Americans are aware of the risk of disease and even death caused by smoking, the idea that smoking is harmful is mostly not known in Africa, especially in rural areas.

As more African countries pursue tobacco control policies, Blecher said people will become more knowledgeable about the harmful effects of smoking. It is not by accident that people in the United States are aware of the dangers of smoking, it is through deliberate action, he said.

Source: Voice Of America

 

GE unveils ultra high frequency mobile X-ray

GE mobile xrayBengaluru: GE Healthcare on Thursday announced the launch of Brivo XR115, a next-generation ultra high frequency (200KHz) mobile X-ray system designed and developed in India for the world. The new GE Brivo XR 115 addresses five critical problems faced by radiologists and radiographers — image quality from mobile machines of critical anatomies like the spine, patient discomfort which can occur while shifting from hospital bed to the X ray room, higher radiation uncontrolled patient movement that occurs during paediatric imaging, and the potential safety issues that can exist moving equipment between wards, according to a statement by GE Healthcare.

X-ray is the primary and most widely used imaging tool in healthcare. India is home to about 100,000 traditional X-ray systems producing an estimated 100 billion X-ray images a year. The majority of these X-ray systems are old generation technology plagued by critical problems.

GE’s new Brivo XR115 ultra high frequency 100 ma mobile X ray provides a solution with great images of all anatomies, lower radiation dose on account of ultra high frequency technology, freedom of mobility for its light weight design, lower maintenance cost due to safe design and, the added peace of mind for radiographers, radiologists and patients, the statement said.

“We are attempting to address the severe challenges faced by Indian healthcare providers by building a healthier India through technology innovation. Our customers asked us to make X-ray imaging, the first step in better diagnosis safer, more affordable and accessible. Here we are, with Brivo XR 115 addressing all their challenges and helping build a healthier India,” said Terri Bresenham, president and CEO, GE Healthcare, South Asia.

“The Brivo XR115 will bring complete peace of mind to the radiologist, radiographer and patient alike. Keeping in mind the concerns of radiologists and physicians, our research team and designers have created a safer imaging environment by reducing X-ray exposure time, lowering radiation dose and providing exceptional images,” said Shireesh Sahai, director, DGS (detection and guidance solutions) and surgery, GE Healthcare, South Asia.

Source: India Medical Times