Dr. Evans Leads Charge Against Disparities in Healthcare

As the founder and CEO/President of Community Wellness Centers of America LLC (CWCOA) and Equinox Electronic Medical Records (EMR), Dr. Robert Evans is working towards organizing and delivering required healthcare services in under-served communities that otherwise would be neglected.

As a medical physician and long time community activist, Dr. Evans understands the resources and programs required to address chronic illnesses through preventive programs, which are often absent from minority communities.

Dr. Evans has developed his companies with a primary mission to deliver state-of-the-art health programs and services, improve healthcare outcomes in underserved communities, and collaborate with hospital systems, physicians, and ancillary healthcare services. All of these steps will help to create a coordinated healthcare delivery system to provide equality in healthcare for residents through increased emphasis on prevention.

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How Big Tech Is Going After Your Health Care

By NATASHA SINGER DEC. 26, 2017  (Original Story)

CreditMinh Uong/The New York Times

When Daniel Poston, a second-year medical student in Manhattan, opened the App Store on his iPhone a couple of weeks ago, he was astonished to see an app for a new heart study prominently featured.

People often learn about new research studies through in-person conversations with their doctors. But not only did this study, run by Stanford University, use a smartphone to recruit consumers, it was financed by Apple. And it involved using an app on the Apple Watch to try to identify irregular heart rhythms.

Intrigued, Mr. Poston, who already owned an Apple Watch, registered for the heart study right away. Then he took to Twitter to encourage others to do likewise — suggesting that it was part of a breakthrough in health care.

“It’s not inconceivable, by the time I graduate from medical school,” Mr. Poston said, “that the entire practice of medicine can be revolutionized by technology.”


Daniel Poston, a second-year medical student, signed up for a heart study that is financed by Apple and uses an app on the Apple Watch. CreditErin Patrice O’Brien for The New York Times

Apple, Google, Microsoft and other tech giants have transformed the way billions of us communicate, shop, socialize and work. Now, as consumers, medical centers and insurers increasingly embrace health-tracking apps, tech companies want a bigger share of the more than $3 trillion spent annually on health care in the United States, too. The Apple Heart Study reflects that intensified effort.

The companies are accelerating their efforts to remake health care by developing or collaborating on new tools for consumers, patients, doctors, insurers and medical researchers. And they are increasingly investing in health start-ups.

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Component Of Blood Also Found In Plants

NO one can get blood from a turnip, but it might prove possible to find the blood substance hemoglobin in one.

In a new report in the journal Nature, scientists say they suspect that all plants have the genes needed to produce hemoglobin.

In animals and humans, hemoglobin is the vital substance that carries blood to all tissues of the body. It has long been known that plant equivalents of hemoglobin exist in the root nodules of many plants that can incorporate nitrogen from the air into useful compounds. The nodules are the abode of certain bacteria that are crucial to the nitrogen fixing process. It has been assumed that the hemoglobin in root nodules is used to transport oxygen needed by the bacteria, among other things.

But now scientists report evidence of hemoglobin’s presence in other plants that do not form root nodules, leading the researchers to the view that hemoglobin may be as ubiquitous in plants as it is in animals. Difficult to Find in Leaves

”Our data suggest that all plants have hemoglobin genes and imply that hemoglobin has a function, presumably associated with oxygen transport, in cells of normal roots,” the report said. The scientists used techniques of molecular biology to search for hemoglobin in non-nodule forming plant species.

They found genes for the substance in roots of Trema tomentosa, a tree that grows in tropical and subtropical areas and also found related evidence suggesting that such genes may be universal although often difficult to detect. The evidence indicated that the substance may be common to roots but difficult to find in leaves.

Close analysis of the gene in Trema suggests that it is not just a piece of useless genetic debris, but is functional and that the hemoglobin that is the product of the gene could play a role in oxygen transport.

The report was by plant physiologists of the Division of Plant Industry in Canberra, Australia, and by scientists in Paris and West Germany. The scientists suggest that hemoglobin has come down through evolution from a common ancestor of plants and animals. The researchers said genes for plant hemoglobin in roots may be ubiquitous and may have evolved differently in various species that have such genes in their root nodules. The new finding would appear to be futher evidence that all forms of life are blood kin under the skin -and in the roots.

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How 2 Kidney Transplants Yielded Real Madrid’s ‘Secret Weapon’

LIVERPOOL, England — Whenever one of Real Madrid’s galaxy of stars is injured, one of the first people the club’s medical staff contacts is usually Terry Nelson.

Nelson is many things — inventor and entrepreneur, amputee and erstwhile athlete — but he is not a doctor or a surgeon. Regardless, Real Madrid’s in-house physicians tend to get in touch with him almost as soon as a player is sidelined. Often, they will apprise Nelson of their plans for the player’s rehabilitation. Sometimes they just seek his counsel. He makes an unlikely first port of call for the most powerful club in the world, but then everything about Nelson’s story is unlikely, and it is only getting started.

Nelson, 55, is known to Real Madrid as the creator and designer of what its former manager José Mourinho used to call the club’s “secret weapon,” a buoyancy suit that is used primarily to help injured players train in water, enabling them to build their fitness when they are unable to run normally.

He first sold his suits, made from Lycra, nylon and foam padding, to the club in 2012. After a single demonstration at the club’s training facility at Valdebebas, Real’s medical department ordered 50 on the spot. They now form a core part of Madrid players’ recovery work.

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Is Your Doctor Getting Drug Kickbacks?

Doctors are making money – LOTS of money for prescribing drugs to you and your family. Chemotherapy kickbacks are the worst. How much are they getting? Check out the detailed infographic below for the shocking statistics. This revenue windfall absolutely has the potential to sway prescribing decisions. Any doctor who claims otherwise is in La La Land.

The practice of drug kickbacks to doctors is a big reason for the the ever increasing prices of drugs and the huge problem of drug affordability.

Laws that will took effect in 2013 required all pharmaceutical companies to disclose their payments to doctors.  This is not enough, however, as doctors asked about their drug kickbacks usually report biased information that their patients readily believe.
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CVS Is Said to Be in Talks to Buy Aetna in Landmark Acquisition

In addition to its pharmacies, where it runs walk-in clinics, CVS is one of the nation’s top three pharmacy benefit managers. CreditChristian Hansen for The New York Times

CVS Health, the giant drugstore chain that also runs walk-in clinics and a pharmacy benefit business, is in talks to buy Aetna, one of the nation’s largest health insurance companies, according to people briefed on the talks.

Negotiations between the two companies could still fall apart, these people say. But if consummated, the deal could be worth more than $60 billion based on Aetna’s current market value, which would make it one of the largest corporate acquisitions this year and one of the largest in the history of the health industry.

The proposed combination reflects the blurring of traditional boundaries in health care, as established companies seek to find their footing in a rapidly changing environment. Congress is deadlocked over the future of the Affordable Care Act, and employers and consumers are struggling to contain rising medical costs, particularly skyrocketing drug prices.

“I think this deal has been a long time coming,” said Adam J. Fein, president of Pembroke Consulting, a management advisory and business research company. “CVS has been positioning itself as a health care company and not a pharmacy for a long time.”

The negotiations are also taking place as the online retail giant Amazon encroaches on the turf of well-established players — and the pharmacy business could be next. In industries ranging from book sales to groceries to television programming, Amazon has displaced stalwarts that had enjoyed decades of limited competition and rarely interrupted growth.

The talks between CVS and Aetna appear to be in part an attempt to fend off a move by Amazon into the drug-selling business — or at least to insulate the companies in case Amazon does invade. Signs are emerging that Amazon has designs on the pharmacy industry, with The St. Louis Post-Dispatch reporting on Thursday that Amazon had gained licenses in 12 states to become a wholesale prescription drug distributor.

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How Do People Die From Diabetes?


CreditStuart Bradford

(original article)

Q. How do people die from diabetes?

A. People who have diabetes cannot regulate their blood sugar levels and if the disease isn’t tightly controlled, blood sugar can spike to abnormally high levels, a condition called hyperglycemia, or dip below normal, a condition called hypoglycemia. Both conditions are potentially life-threatening and can lead to coma and death if not promptly treated.

But complications resulting from the disease are a more common cause of death. Heart disease strikes people with diabetes at significantly higher rates than people without diabetes, “and we don’t fully know why,” said Dr. Robert Gabbay, chief medical officer at Joslin Diabetes Center in Boston. People with diabetes develop heart disease at younger ages and are nearly twice as likely to die of heart attack or stroke as people who do not have diabetes.

People with Type 2 diabetes, which is the more common form of the disease, are more likely to have elevated cholesterol, high blood pressure and obesity, Dr. Gabbay said, all risk factors for cardiovascular disease. “The good news,” he said, “is that a lot of treatments, like those for lowering cholesterol, are even more effective at lowering risk in people with diabetes than in people without.” Some new classes of diabetes medications used for Type 2 diabetes have also been shown to reduce cardiovascular risk, he said.

People with Type 1 diabetes are also at increased risk for heart disease, though the reasons are less clear.

Both types of diabetes can also lead to other long-term complications, like kidney disease, that may result in premature death. Problems like vision loss, nerve damage and infections that may lead to amputations can increase the likelihood of injuries and accidents. Good disease management starting early in the disease process helps people avoid some of these complications, Dr. Gabbay said.

Do you have a health question? Ask Well

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America’s 8-Step Program for Opioid Addiction

CreditAnthony Russo

(original article)

Opioid addiction has developed such a powerful grip on Americans that some scientists have blamed it for lowering our life expectancy.

Drug overdoses, nearly two-thirds of them from prescription opioids, heroin and synthetic opioids, killed some 64,000 Americans last year, over 20 percent more than in 2015. That is also more than double the number in 2005, and nearly quadruple the number in 2000, when accidental falls killed more Americans than opioid overdoses.

The President’s Commission on Combating Drug Addiction and the Opioid Crisis said in July that its “first and most urgent recommendation” was for President Trump to declare a national emergency, to free up emergency funds for the crisis and “awaken every American to this simple fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon will.” The commission’s final report is due out in a month.

Mr. Trump has not declared an emergency, and “bold” would not describe the steps the White House has taken so far. The president’s 2018 budget request increases addiction treatment funding by less than 2 percent, even including $500 million already appropriated by Congress in 2016 under the 21st Century Cures Act.

Families across the United States are demanding that more be done to end the despair and devastation of addiction. Here are eight steps to take — now. They include some of the recommendations of the president’s commission.

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Hospitals in the ER: Resuscitating NY’s public health system

Not Released (NR)

A costly system


A new physician will shortly be attending at the city’s financially hemorrhaging public hospital system, and not a moment too soon. Dr. Mitch Katz, late of Los Angeles, must act aggressively to save New York Health + Hospitals — not by funneling ever more money into a failing model, but by transforming the way hidebound institutions deliver care.From Bellevue to Woodhull, the network of 11 hospitals and myriad community clinics is in deep, deep trouble.

Patients are fleeing as people newly covered under the Affordable Care Act make appointments elsewhere.

That leaves the public hospital system and its 45,000 employees increasingly caring for the uninsured and chronically sick, notably undocumented immigrants and people with severe mental illness.

Resulting budget deficits exceed $1 billion a year and growing. Those would be far worse if not for massive recent infusions of cash from the mayor and City Council and the system’s takeover of jail health care, together amounting to $1.8 billion a year.

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Bring On the Exercise, Hold the Painkillers

Phys Ed

Taking ibuprofen and related over-the-counter painkillers could have unintended and worrisome consequences for people who vigorously exercise. These popular medicines, known as nonsteroidal anti-inflammatory drugs, or NSAIDs, work by suppressing inflammation. But according to two new studies, in the process they potentially may also overtax the kidneys during prolonged exercise and reduce muscles’ ability to recover afterward.

Anyone who spends time around people who exercise knows that painkiller use is common among them. Some athletes joke about taking “vitamin I,” or ibuprofen, to blunt the pain of strenuous training and competitions. Others rely on naproxen or other NSAIDs to make hard exercise more tolerable.

NSAID use is especially widespread among athletes in strenuous endurance sports like marathon and ultramarathon running. By some estimates, as many as 75 percent of long-distance runners take ibuprofen or other NSAIDs before, during or after training and races.

But in recent years, there have been hints that NSAIDs might not have the effects in athletes that they anticipate. Some studies have found that those who take the painkillers experience just as much muscle soreness as those who do not.

A few case studies also have suggested that NSAIDs might contribute to kidney problems in endurance athletes, and it was this possibility that caught the attention of Dr. Grant S. Lipman, a clinical associate professor of medicine at Stanford University and the medical director for several ultramarathons.

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For Millions, Life Without Medicaid Services Is No Option


TUSCALOOSA, Ala. — Frances Isbell has spinal muscular atrophy, a genetic disorder that has left her unable to walk or even roll over in bed. But Ms. Isbell has a personal care assistant through Medicaid, and the help allowed her to go to law school at the University of Alabama here. She will graduate next month.

She hopes to become a disability rights lawyer — “I’d love to see her on the Supreme Court someday,” her aide, Christy Robertson, said, tearing up with emotion as Ms. Isbell prepared to study for the bar exam in her apartment last week — but staying independent will be crucial to her professional future.

“The point of these programs is to give people options and freedom,” said Ms. Isbell, 24, whose family lives a few hours away in Gadsden.

The care she gets is an optional benefit under federal Medicaid law, which means each state can decide whether to offer it and how much to spend. Optional services that she and millions of other Medicaid beneficiaries receive would be particularly at risk under Republican proposals to scale back Medicaid as part of legislation to repeal and replace the Affordable Care Act.

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