NEW YORK, Nov. 16 /PRNewswire/ — Press Ganey Associates, Inc. officially announced today its elite class of 2006 award-winning health care organizations; including the unveiling of the prestigious Summit Award, which recognizes those organizations that have achieved and sustained the highest level of excellence. Press Ganey is the industry’s leading satisfaction measurement and improvement firm, and partners with more than 7,000 health care facilities to improve the quality of health care delivery.

During a ceremony Monday evening at the Press Ganey National Client Conference in New York City, Dr. Melvin F. Hall, president and chief executive officer of Press Ganey, stated, “We are proud to partner with organizations that place a premium on patient, employee, and physician satisfaction. These organizations live their mission, vision, and values every day. In an industry filled with passion and dedication, it is important to pay tribute to those organizations that are leading the charge to improve quality — the Press Ganey Awards recognize these leaders.”

More than 2,100 health care leaders were onsite at the conference to congratulate the winning organizations.

The following is the list of recipients of each of the three awards given by Press Ganey.

The Summit Award is presented to top performing organizations that have not only achieved the highest level of customer satisfaction — within the top 5% of health care organizations — but have also sustained this level of excellence consistently for a minimum of three years. The Press Ganey Summit Award is the health care satisfaction industry’s most prestigious symbol of achievement. This honor has been awarded to 61 organizations in the categories of Ambulatory Surgery, Emergency Department, Inpatient, Medical Practice, and Outpatient Services.

   Affinity Medical Center,    Massillon Campus      Massillon        OH   Emergency Department   Aurora Health Center    in Mishicot           Mishicot         WI   Medical Practice   Baptist Health    Rehabilitation    Institute             Little Rock      AR   Outpatient   Baptist Hospital       Pensacola        FL   Inpatient, Outpatient   Baptist Medical Park   Pensacola        FL   Ambulatory Surgery   Boone County Hospital  Boone            IA   Emergency Department   Calvary Hospital       Bronx            NY   Inpatient   Clinton Hospital       Clinton          MA   Outpatient   E.J. Schuck    Pediatrics, LLC       State College    PA   Medical Practice   Eastside Endoscopy    Center                St. Clair Shores MI   Ambulatory Surgery   Elliot 1-Day    Surgery Center        Manchester       NH   Ambulatory Surgery   Genesis Medical    Center, DeWitt        DeWitt           IA   Emergency Department   Goshen Health    System, The Retreat    Women's Health Center Goshen           IN   Outpatient   Greenwich Hospital     Greenwich        CT   Inpatient   Gulf Breeze Hospital   Gulf Breeze      FL   Ambulatory Surgery,                                                Emergency Department,                                                Inpatient   Gundersen Lutheran,    Inc.                  LaCrosse         WI   Emergency Department   Hamilton Ambulatory    Surgery Center, Inc.  Dalton           GA   Ambulatory Surgery   Hampshire Internal    Medicine, Elliot    Physician Network     Manchester       NH   Medical Practice   Jay Hospital/Atmore    Community Hospital    Jay              FL   Inpatient   Kansas University    Dental Associates     Westwood         KS   Medical Practice   Lancaster General    Women & Babies    Hospital              Lancaster        PA   Inpatient   Lexington Medical    Center, Irmo          West Columbia    SC   Ambulatory Surgery   Lexington Medical    Center, Lexington     Lexington        SC   Ambulatory Surgery   Lodi Community    Hospital              Lodi             OH   Emergency Department   McConnell Heart    Health Center,    OhioHealth            Columbus         OH   Outpatient   Memorial Regional    Breast Care Center    South Bend       IN   Outpatient   Methodist Medical    Group, Perinatology   Peoria           IL   Medical Practice,                                                Outpatient   Middlesex Hospital    Marlborough Medical    Center                Marlborough      CT   Emergency Department   Middlesex Hospital    Shoreline Medical    Center                Essex            CT   Emergency Department   Mississippi Baptist    Medical Center        Jackson          MS   Inpatient   New Albany Surgical    Hospital              New Albany       OH   Inpatient   Oklahoma Heart    Hospital              Oklahoma City    OK   Inpatient   OSF Medical Group -    Cullom                Cullom           IL   Medical Practice   OSF Medical Group -    Dwight                Dwight           IL   Medical Practice   OSF Medical Group -    Williamsfield         Williamsfield    IL   Medical Practice   Pekin Hospital         Pekin            IL   Home Health   Petrucci Family    Health Care, UPMC    University of    Pittsburgh    Physicians            Hermitage        PA   Medical Practice   Sacred Heart Hospital  Eau Claire       WI   Inpatient   Sharp Coronado    Hospital              Coronado         CA   Emergency Department   Shriners Burns    Hospital              Boston           MA   Outpatient   Shriners Hospitals for    Children              Cincinnati       OH   Outpatient   Southwestern Vermont    Medical Center        Bennington       VT   Emergency Department,                                                Inpatient   St. John's Medical    Center                Jackson          WY   Emergency Department   St. Joseph Hospital/    Full Circle    Midwifery             Nashua           NH   Medical Practice   St. Vincent Surgery    Center                Erie             PA   Ambulatory Surgery   The Cancer Institute    of New Jersey    Hamilton              Hamilton         NJ   Medical Practice   The John and Mary E.    Kirby Hospital        Monticello       IL   Emergency Department   The Office of Bernard    Adukaitis, DO         Frackville       PA   Medical Practice   The Office of    Christopher Justofin,    DO, Integrated Medical    Group                 West Hazleton    PA   Medical Practice   The Office of John    McGeehan, MD          Scranton         PA   Medical Practice   The Office of    Malcolm S. Thaler,    MD                    Villanova        PA   Medical Practice   Thibodaux Regional    Medical Center        Thibodaux        LA   Inpatient   Virginia Baptist    Hospital              Lynchburg        VA   Inpatient   Warren Clinic,    Pediatric Hematology/    Oncology Clinic at    St. Francis Children's    Hospital              Tulsa            OK   Medical Practice   Warren Clinic,    St. Francis Health    System                Tulsa            OK   Medical Practice   Wright Medical Center  Clarion          IA   Inpatient    

The Compass Award recognizes organizations that have shown the most improvement over two years in overall patient and resident satisfaction. A commitment to improvement characterizes recipients of the Compass Award.

   Advocate Good    Samaritan Hospital    Downers Grove    IL   Outpatient Greater than                                                 75K Procedures   Avera McKennan    Home Care             Sioux Falls      SD   Home Health   Betsy Johnson    Regional Hospital     Dunn             NC   Inpatient 100-299 Beds   Brian Center Health    & Rehabilitation    Center/Spruce Pine    Spruce Pine      NC   Nursing Home   Central Peninsula    Hospital              Soldotna         AK   Ambulatory   CHRISTUS Santa Rosa    Rehabilitation    Hospital              San Antonio      TX   Inpatient Rehabilitation   Claxton-Hepburn    Medical Center        Ogdensburg       NY   Emergency Department Less                                                 than 30K Visits   Falls Memorial    Hospital              International    MN   Ambulatory, Inpatient Less                           Falls                 than 100 beds   FirstHealth Richmond    Memorial Hospital     Rockingham       NC   Emergency Department Less                                                 than 30K Visits,                                                 Inpatient 100-299 beds   Floyd Primary Care     Rome             GA   Medical Practice   Foote Health System    Jackson          MI   Inpatient 300-449 Beds   Galion Community    Hospital              Galion           OH   Outpatient Less than 75K                                                 Procedures   Grandview Medical    Center                Dayton           OH   Inpatient 300-449 Beds   Grossmont Hospital,    Sharp HealthCare      LaMesa           CA   Inpatient Rehabilitation   Heritage Valley    Medical Center,    Beaver Campus         Beaver           PA   Inpatient 300-449 Beds   Iberia Medical    Center                New Iberia       LA   Outpatient Less than 75K                                                 Procedures   John Muir Medical    Center                Walnut Creek     CA   Oncology   Lakeland Regional    Medical Center        Lakeland         FL   Inpatient 450+ Beds   Lexington Memorial    Hospital              Lexington        NC   Outpatient Greater than                                                 75K Procedures   Little Company of    Mary Hospital         Evergreen Park   IL   Home Health   Mercy Memorial    Hospital              Urbana           OH   Inpatient Less than 100                                                 Beds   Methodist Hospital     Philadelphia     PA   Emergency Department Less                                                 than 30K Visits   Moore County    Hospital District     Dumas            TX   Ambulatory   Newport Hospital    Behavioral Health    Unit                  Newport          RI   Inpatient Behavioral                                                 Health   Norton Southwest    Medical Center        Louisville       KY   Outpatient Less than 75K                                                 Procedures   Ochsner Health System  New Orleans      LA   Inpatient 450+ Beds   Pipestone County    Medical Center,    Avera Health          Pipestone        MN   Nursing Home   Prince William    Hospital              Manassas         VA   Outpatient Greater than                                                 75K Procedures   Saint Clare's    Behavioral Health    Hospital              Denville         NJ   Inpatient Behavioral                                                 Health   Saint Mary's Nell J.    Redfield Health    Centers               Reno             NV   Medical Practice   San Jacinto Methodist    Hospital              Houston          TX   Emergency Department                                                 Greater than 30K Visits   Sioux Center    Community Hospital &    Health Center/    Royal Meadows         Sioux Center     IA   Nursing Home   Springfield Hospital   Springfield      PA   Inpatient 100-299 Beds   St. Anthony Hospital   Oklahoma City    OK   Inpatient 450+ Beds   St. Anthony    Medical Center        Crown Point      IN   Inpatient Rehabilitation   St. John Macomb    Hospital              Warren           MI   Emergency Department                                                 Greater than 30K Visits   Tuomey Healthcare    System                Sumter           SC   Emergency Department                                                 Greater than 30K Visits   University of    Virginia Health    System                Charlottesville  VA   Inpatient Behavioral                                                 Health   Valley Regional    Hospital              Claremont        NH   Inpatient Less than 100                                                 Beds   Washington Cancer    Institute at    Washington Hospital    Center                Washington DC         Oncology   Women and Infants    Hospital of    Rhode Island          Providence       RI   Oncology   Yukon-Kuskokwim    Health Corporation    Bethel           AK   Medical Practice    

The Success Stories Award recognizes organizations that have demonstrated leadership, overcome challenges, and implemented organizational change to successfully increase customer satisfaction.

    -- Baptist Health South Florida       Coral Gables, FL    -- The Emory Clinic, Inc.             Atlanta, GA    -- Hudson Valley Hospital Center      Cortlandt Manor, NY    -- McKee Medical Center               Loveland, CO    -- OhioHealth                         Columbus, OH    -- Spectrum Health                    Grand Rapids, MI     About Press Ganey  

For over 20 years, Press Ganey has been committed to providing insightful information that allows our more than 7,000 health care facilities to continuously improve their performance. Our foundation for success is built upon dedication to scientific integrity, relentless responsiveness to our clients’ changing requirements, and an overall passion for helping our clients succeed. By pursuing and acting upon input from our clients, we are consistently able to develop and deliver the newest innovations. We continue to succeed by exchanging knowledge with our clients, and facilitating the exchange of knowledge between our clients.

Press Ganey Associates, Inc.

CONTACT: Matt Mulherin of Press Ganey Associates, Inc., +1-800-232-8032,[email protected]

ARLINGTON, Va., Nov. 16 /PRNewswire/ — Pearson Government Solutions was awarded a $440 million contract by the Centers for Medicare and Medicaid Services (CMS) to manage the Beneficiary Contact Center program. The contract expands and continues Pearson’s work with CMS for an additional two and a half years in support of the 1-800-MEDICARE Help Line, considered one of the largest citizen contact management programs in the Federal government. Pearson Government Solutions has successfully managed the program since 2002.

“We are extremely proud that the Centers for Medicare and Medicaid Services continue to place their trust and confidence in Pearson for this important program by allowing us to be the sole provider of the Beneficiary Contact Center program,” stated Mac Curtis, President and CEO, Pearson Government Solutions. “We look forward to continuing our partnership with CMS and helping the agency meet its mission of providing complete, accurate, and consistent answers to over 43 million Medicare beneficiaries who rely on 1-800-MEDICARE for critical information about their health.”

Under the new contract, Pearson Government Solutions will manage all 1-800-MEDICARE calls. With over 20 million calls annually, the Help Line is accessible 24 hours a day, 7 days a week in English or Spanish in all 50 states, Washington, D.C., Puerto Rico, Guam, American Samoa and Northern Mariana Islands. Medicare beneficiaries call the Help Line to receive general information and printed materials on Medicare and Medicare health plan options and the new Medicare Prescription Drug Program known as Part D. In addition, Pearson will manage Medicare claims calls and written correspondence.

This award represents the first task order under the Contact Center Operations Indefinite Delivery-Indefinite Quantity (IDIQ) valued at $9 billion over 10 years. In addition, Pearson also won the Contact Center Systems and Support IDIQ valued at $1 billion over 10 years. The two contract vehicles represent a combined total of $10 billion in potential new health business opportunities for Pearson Government Solutions over the next decade.

“Pearson has done well working with CMS over the past four years implementing the Prescription Drug Discount Card and Prescription Drug Coverage under the Medicare Modernization Act. CMS has greatly benefited from working with a capable, flexible partner during times of significant change. We are confident they will continue to deliver world class customer assistance to Medicare beneficiaries,” stated Mary Agnes Laureno, Director, Beneficiary Information Services Group, Center for Beneficiary Choices at the Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services.

Pearson Government Solutions has more than 20 years experience in managing award-winning, customer interaction centers for federal agencies in the U.S. and internationally. Pearson has four major domestic contact centers and over 3,000 information specialists who serve as the voice of the federal government including 1-800-4-FED-AID for the U.S. Department of Education Student Financial Aid program, 1-800-CDC-INFO for the Centers for Disease Control and Prevention and 1-800-MEDICARE for the Department of Health and Human Services, Centers for Medicare and Medicaid Services.

About Pearson Government Solutions

With over 5,500 employees worldwide, Pearson Government Solutions, Arlington, Va., serves the U.S. federal, state and local and international governments; higher education institutions and student financial aid entities. The company designs, builds, and operates solutions that optimize the performance of public sector entities in delivering information, benefits, and services to their constituents. Clients include the Centers for Medicare and Medicaid Services, the U.S. Departments of Education, Health and Human Services, Homeland Security, Justice, Labor, and Veterans Affairs; the Equal Employment Opportunity Commission and the U.S. Office of Personnel Management.

Pearson Government Solutions is a business of Pearson, the international publishing, education and professional services company, including the Financial Times Group, and the Penguin Group.

Pearson Government Solutions is ranked #36 on Washington Technology’s annual “Top 100” list of federal prime contractors, #38 on Government Executive’s list of Top 200 Government Contractors, and #14 on Government Executive’s list of Top 100 Civilian Agency Contractors.

Pearson Government Solutions

CONTACT: Eileen Rivera of Pearson Government Solutions, +1-703-284-5674

By Kathirasen

YOU have Hepatitis A, the doctor announced, quite cheerily.

I gaped at him with jaundiced eyes. Literally. The stranger’s face in my mirror and the tell-tale yellow eyes had already warned me.

But hepatitis? There’s something about the names of illnesses with an A, B or C attached that disturbs me. This was one A that I neither wanted nor needed.

Seeing my pitiful attempt at raising my eyebrows, the good doctor assured me that it was nothing to worry about. Nothing, he declared, that a good rest couldn’t cure.

He could give me some medicine, he said. “But,” he added in a conspiratorial tone, “you will recover faster if you opt for traditional Indian medicine.”

Being one who sees a doctor mainly for a diagnosis and a prognosis – and takes drugs only if the situation is bad – I heartily agreed.

The doctor recommended a herb, called keelanelli in Tamil. I was to grind it, roll it into a ball and swallow it with goat’s milk. Twice a day.

He called in the clinic helper, an older woman, and told her to show me a keelanelli (Phyllanthus amarus) plant.

Escorting me outside the clinic in Sungai Petani, she pointed out the thin and short plant. She told me I could find it anywhere – in the garden or by the roadside.

True enough, I found the plants growing abundantly by the road in front of my house and in my garden. I had always thought of them as weeds. Now they were medicine.

The word keelanelli means the “nellikai that is underneath”, for the plant has tiny “fruits” that resemble the nellikai or amla (Indian gooseberry or Emblica officinalis) under the leaves.

A week on keelanelli and goat’s milk restored my health. That was some 20 years ago.

I was reminded of this after reading a New Straits Times’ article on Oct 24 quoting Natural Resources and Environment Minister Datuk Seri Azmi Khalid as saying that traditional medicine had helped him on three occasions, including saving him from blindness.

Azmi said this after reading an Oct 22 article in the NST on psychic healers – people who could heal using chakra therapy, verses from holy books or by a touch of their hands.

One of the practitioners, Parvathy Amma, from Kajang, claimed that the incorporeal figures of famous dead doctors performed the surgery on her patients and that she merely acted as the channel. She swore she could see these ghostly beings.

Since my colleague Annie Freeda Cruez wrote that article, she has been inundated with more than 500 phone calls and some hundred emails. To say she is astounded would be an understatement.

The callers, of different racial and religious backgrounds, wanted more details and contact numbers.

When we are ill and need a cure, neither the race nor religion of the doctor or healer matters.

But when we are agitated over some perceived wrong, we don’t hesitate to run down an entire race or religion, forgetting that many of its members – such as doctors, shopkeepers and rubbish collectors – have helped us directly or indirectly.

Isn’t this hypocrisy?

I remember my father taking me to a Chinese medium when I was a child. The medium went into a trance and whipped himself.

I remember the man writing something in Chinese characters on a piece of yellow paper. I remember him lighting it and holding it over a cup of water as it burned, allowing the ashes to fall into it.

I remember being told to drink the water.

I recall my father carrying me on his bicycle to a mosque where an elderly man held a glass of water in his hands and recited some Quranic verses in the direction of the water.

I recall drinking the water.

Yes, my father was one of those people who believed that all religions lead to God.

Although a Hindu, he did not see anything amiss in visiting the houses of worship of other religions, or seeking treatment at these holy places.

Yes, my father also took me to the hospital when he thought it was necessary.

At one time, traditional medicine was the favoured method but as English education spread, allopathic medicine became king.

Many frowned on those who sought traditional treatment.

Today, as more and more Westerners turn to Eastern and traditional medicine – such as siddha medicine, ayurvedic treatment and acupuncture – after discovering that allopathic medicine is not the cure-all they once supposed it to be, Malaysians are also doing likewise.

Why is it that we so frequently take the cue from the West?

Even when it comes to our own heritage?

But, like allopathic medicine, there is no guarantee that traditional medicine will work for everyone or work all the time.

I am one of those averse to taking medicine. I have a particular distaste for those large pills that refuse to enter my oesophagus quietly, and do a dance in my throat as they deliberate whether to come out or go in.

But I don’t fear drugs.

I just do not want any side effects. For, almost every drug has some sort of side effect.

And doctors, I find, often like to experiment with drugs. I once had some tiny black spots in the neck area and went to see a doctor.

That’s when I discovered doctors could perform miracles. His ointment turned the black dots white.

Another doctor gave me some tablets, a different ointment and a bar of soap. The dots began to happily multiply, as though they were high on fertility pills.

Declaring that I had been given wrong medication, another doctor prescribed a different ointment and more tablets.

To cut the story short, four doctors later, I saw a skin specialist who refrained from touching my skin.

Perhaps that’s why his medicine did not work.

Another three doctors later, I saw another specialist. His medicine worked.

My friend Visvamitran feels that the Hippocratic Oath no longer applies at private hospitals.

“They are just hungry for money. They ask you to take all sorts of tests and scans, some of which are unnecessary.

“To them, doctoring is not about healing,” he charges, “it’s about profits.”

This may be so. But one should not forget the tremendous good that allopathic medicine has done, especially in the realm of public health.

Millions are alive today thanks to allopathic medicine.

The art of medicine consists in amusing the patient while nature cures the disease.

– Voltaire

(c) 2006 New Straits Times. Provided by ProQuest Information and Learning. All rights Reserved.

Human Papillomavirus (HPV), the most common sexually transmitted disease in America, can be transmitted through sexual contact or by the use of donor sperm. Infection with certain strains of HPV can cause cervical cancer, which is the second leading cause of cancer-related death among women in the world. Fairfax Cryobank is the first and only sperm bank that protects its female patients by using DNA genetic analysis to test sperm donors for high-risk strains of HPV known to cause cervical cancer.

“Women who use donor sperm shouldn’t have to worry about being infected with HPV,” says Harvey Stern, M.D., Medical Director of Fairfax Cryobank. “We urge every woman who is planning to use donor sperm to investigate the scientific testing and screening performed on that sperm.”

As many as 20,000 women are estimated to use donor sperm each year to try and achieve pregnancy. Fairfax Cryobank initiated HPV testing on all its sperm donors in 2001, shortly after it was demonstrated that detecting the virus in sperm was possible.

Over 100 types of HPV have been identified. Many are harmless (including those that cause skin warts on hands and feet). About 30 types affect the genital area. Some cause genital warts, but others (in particular HPV-16 and HPV-18) can lead to cervical cancer.

The Center for Disease Control (CDC) estimates that 20 million Americans are currently infected with the genital types of HPV. Approximately 50% of sexually active adults will get HPV in their lifetime. There are 6 million new cases every year.

Many HPV types do not manifest signs or symptoms. Any genital contact, even without intercourse can transmit the virus. Most women discover they have HPV as the result of an abnormal pap smear.

On physical exam, men who carry high-risk strains HPV 16 or HPV 18 can appear healthy. Although sperm used in donor sperm insemination is ‘washed’ to remove impurities, scientific studies show that the HPV virus cannot be entirely removed from the sample by this process.

Because testing of donor sperm for HPV using DNA genetic analysis reduces the risk of transmitting the virus during donor insemination, Fairfax Cryobank is committed to providing this extra level of protection for its clients.

Fairfax Cryobank (www.fairfaxcryobank.com) was founded in 1986 as a division of the world-renowned Genetics & IVF Institute, the world’s largest, fully integrated, specialized provider of infertility treatment and genetic services. Fairfax Cryobank, with facilities in Austin TX, Roseville MN, Fairfax VA and Philadelphia PA, provides the highest quality donor semen to all 50 states and many international clients. The company enjoys a long-standing reputation, not only for the most comprehensive donor screening and testing procedures, but also for caring customer service with a personalized touch.

YONKERS, N.Y., Nov. 15 /PRNewswire/ — CureMark(TM), a privately held specialty biotechnology company focused on the treatment of neurological and other diseases by addressing certain key gastrointestinal/pancreatic secretory deficiencies, announces today the signing of a licensing and development agreement to utilize Balchem Corporation’s novel drug delivery technologies to optimize CureMark’s proprietary enzyme formulation.

Under the agreement, Balchem has granted CureMark an exclusive license for using its patented and proprietary drug delivery technology, PharmaShure(TM) in all of CureMark’s digestive/pancreatic enzyme products. CureMark has found that autistic children suffer from a pancreatic secretory deficiency and has demonstrated in empirical studies that a specific pancreatic enzyme formulation can positively impact many aspects of autism.

“This is a major step in our strategy of developing highly effective, stable and proprietary enzyme formulation products for the treatment of Autism and other dysautonomic diseases and disorders,” said Dr. Joan Fallon, CEO of CureMark. “We recognize the need to provide a safe, stable and uniform enzyme product for patients with Autism, cystic fibrosis and other diseases. The use of PharmaShure will be a key part of our anticipated clinical trials for our lead products for autism and cystic fibrosis in 2007.”

The Balchem technology is proven, unique and highly flexible encapsulation system that allows for the incorporation of multiple drug delivery features, including intestinal localization, and modified pharmacokinetic profiles.

Dino Rossi, CEO of Balchem, said, “We are confident that with the complement of Balchem’s technology, CureMark will provide effective treatments for autism and other afflictions, To be on the ground-floor with CureMark in the development of novel therapies for people with special needs is a great source of pride and satisfaction for our company.”

About Balchem

Balchem Corporation consists primarily of three business segments: ARC Specialty Products, BCP Ingredients and its Food, Pharma & Human Nutrition Division, which is one of the world’s leading providers of microencapsulated ingredient solutions. The Encapsulated/Nutritional segment provides proprietary microencapsulation solutions to an expanding variety of applications. Its proprietary PharmaShure(TM) Taste-Masking and PharmaShure(TM) Modified Release technologies bring together coating chemistry, material science and cGMP manufacturing to accelerate the NDA, ANDA or OTC product development process. For more information, visit http://www.balchem.com/.

About CureMark

CureMark is a drug development company focused on the treatment of neurological and other diseases by addressing certain key gastrointestinal/pancreatic secretory deficiencies. These deficiencies are thought to play a role by altering the availability and absorption of key amino acids and other components that may be needed for the synthesis of neurotransmitters and possibly other agents important for the proper functioning of various organ systems including but not limited to the central nervous system. CureMark has initially focused its efforts on the development of a therapeutic product for the treatment of Autism. CureMark has a substantial patent portfolio, which it plans to commercialize in the areas of autism, ADD ADHD, Parkinson’s, diabetic neuropathy and other conditions. For further information please go to http://www.cure-mark.com/.

Forward-Looking Statements

The information contained herein includes forward-looking statements. These statements relate to future events or to our future financial performance, and involve known and unknown risks, uncertainties and other factors that may cause our actual results, levels of activity, performance, or achievements to be materially different from any future results, levels of activity, performance or achievements expressed or implied by these forward- looking statements. You should not place undue reliance on forward-looking statements since they involve known and unknown risks, uncertainties and other factors which are, in some cases, beyond our control and which could, and likely will, materially affect actual results, levels of activity, performance or achievements. Any forward-looking statement reflects our current views with respect to future events and is subject to these and other risks, uncertainties and assumptions relating to our operations, results of operations, growth strategy and liquidity. We assume no obligation to publicly update or revise these forward-looking statements for any reason, or to update the reasons actual results could differ materially from those anticipated in these forward-looking statements, even if new information becomes available in the future. The safe harbor for forward-looking statements contained in the Securities Litigation Reform Act of 1995 protects companies from liability for their forward-looking statements if they comply with the requirements of the Act.

   Contact:   CureMark   Dr. Joan Fallon   914-779-9300   [email protected]   

This release was issued through eReleases(TM). For more information, visit http://www.ereleases.com/.

CureMark

CONTACT: Dr. Joan Fallon of CureMark, +1-914-779-9300,[email protected]

Web site: http://www.cure-mark.com/http://www.balchem.com/

By SARA WALLIS

IAM freezing cold. So bitterly cold, in fact, that I can’t think straight. It’s -120C – that’s one hundred and twenty degrees below freezing – and I am wearing almost nothing.

It’s as if I have been dropped into the Antarctic in my nightie.

But I am not at the South Pole, where temperatures have only ever sunk to a positively balmy -89.2C. I am in a building in South-West London, a stone’s throw from where Victoria Beckham does her shopping.

This is the London Kriotherapy Centre, at the heart of the latest health fad to hit Britain, a fad that’s already popular with sportsmen willing to pay pounds 30 for a few minutes in the freezer.

Devotees apparently include players from Bolton Wanderers, Irish rugby captain Brian O’Driscoll, rugby international Will Green and golf champion Padraig Harrington.

And now it’s certain to attract the rich and famous with its promises to help a list of ailments, from cellulite to fatigue and depression, at pounds 300 for a 10-visit package.

The treatment involves spending three minutes in a sealed room at temperatures as low as -135C but as a beginner I will get the “gentle” first-time treatment. That’s two minutes at -120C, a temperature so cold I cannot even comprehend it.

Some enthusiasts claim Wholebody Kriotherapy can relieve symptoms of everything from rheumatism, arthritis, multiple sclerosis, osteoporosis, sleep problems, back pain, depression and asthma.

The science is a bit tricky but I understand it has to do with what happens to the body when it warms up afterwards. What the hell, I’ll give it a go.

After I sign a disclaimer saying I am healthy, specialist cryotherapy nurse Renata Sinicka does a biological age reading. She checks my blood pressure and then my pulse.

She then announces that on account of my stress levels, hydration levels and heart rate, I have a biological age of 44. I am actually 27…

“Have you had a stressful day?” she asks. I am now – it’s the fear of being shut in a freezing chamber at sub-zero temperatures.

I am ushered into a changing room where I am confronted with a not-very-fetching two-piece towelling outfit, complete with long white socks, white clogs, white headband and a mask. I look like an extra in Dr Who.

Every item must be made of natural fibres so as not to freeze solid in the chamber. The gloves and socks are to keep my extremities from freezing off, the face mask is to protect my lips and nasal lining. I am beginning to get nervous.

Director of the centre, Charlie Brooks, is the man who brought cryotherapy to the UK. A 43-year-old former racehorse trainer, he became interested in cryotherapy – which is a recognised treatment in Poland – as a means of helping injuries from training.

“Don’t worry,” he says, escorting me into the coldest place on Earth. “It’s only two minutes and I’ll show you how to open the door so you don’t feel nervous that you can’t get out.”

We walk into a pre-chamber which Charlie says is “only minus 60C”.

So, half as cold as the main chamber then. “It’s really not that cold, is it?” he says. I don’t answer, although it’s not actually that bad. Charlie regularly has sessions of three minutes at -135C, which he says is the optimum temperature for your body to respond.

It’s my turn now. We move further in and the heavy door shuts on the six-foot square room. It is very, very, very cold.

Charlie leads me round, keeping me walking and talking, telling me what I should be feeling.

“No pain, no gain,” he says. “Think of how great you’ll feel afterwards.”

He tells me that pins and needles in my legs is good, it means it’s working. Fortunately I don’t have much time to think about it. Just as I start wondering if I can stand the bitter cold, the door opens and Renata ushers me outside.

My first thought was “Oh, is that it?” It wasn’t that scary at all.

But the big chill was just the beginning. Charlie tells me that my face will now go bright red as my blood vessels expand to four times their normal size. This is where it begins to work.

“You’ve got quarter of a million temperature receptors in your skin,” he says. “This treatment challenges those receptors. They tell the brain that the body is being challenged and the brain sends messages to the body systems.”

He tells me blood will pump around my body more efficiently and I will have increased levels of cortisol which combats depression. Now specialist Irvind Sihota takes me through a 20-minute session in the Vibro-gym. This helps warm you up. I burn off 500 calories – although if I’d tried harder it could have been 1,000.

I am certainly feeling warmer, although still a little shaky in the legs, and am overjoyed when Renata steers me away from the gym and towards what looks like a foot spa. This is more like it.

The “pure ionic spa” involves soaking up a lot of sodium chloride through the soles of your feet. This helps remove lactic acid from the muscles and lowers toxins.

Cryotherapy is not for the faint-hearted. People with poor circulation, heart problems, epilepsy or claustrophobia should avoid it. But some people swear by it.

Maria Kowalska, 29, from Poland, claims the treatment has vastly improved her depression.

“When I lost my job I didn’t want to see or talk to anyone about what had happened,” she says. “I felt very sad and disappointed.

“I didn’t want to get up in the mornings and spent a lot of time in bed. I wasn’t feeling very well and felt quite depressed, so my doctor sent me to cryotherapy. “I had 20 sessions in July in Poland and felt better after four treatments. I felt much better and motivated, far happier.”

I have to say I am not yet feeling quite so energetic but I’ve been assured that by tomorrow I will feel the benefits. But was I biologically any younger?

Renata smiles when she studies my afterfreeze results.

I am officially less stressed and – as a result – I am now only 31 years old. Still older than my real years, but not bad for two minutes in the fridge…

FOR more information or to book sessions call The London Kriotherapy Centre on 020 7627 1402, email [email protected] or visit www.

kriotherapy.com

COLDEST PLACES ON EARTH

-20C home freezer

-25C British Antarctic Survey Laboratory, Cambridge

-30C Supermarket freezer

-35C North Pole -70C Verkhoyansk in Siberia

-78C South Pole

-120C THE LONDON KRIOTHERAPY CENTRE

FOR AND AGAINST

DOCTORS have mixed views about the cryotherapy treatment. Dr George Rae of the British Medical Association is sceptical.

He says: “We need evidence if this is something to be used on many patients for conditions like rheumatism and arthritis.

“The side effects are something of concern. We need to know what the outcome would be. I don’t think you would find the average doctor to be at all keen to advance patients to this treatment.

“It is not inconceivable that reduced temperatures might have quite substantial side effects.”

Dr Richard Freeman is a specialist in sports medicine who works at the Accrington Victoria Hospital and acts as an adviser for the London Kriotherapy Centre.

He says: “I work with Bolton Wanderers and the whole team love it.

“I’ve used it. Once you get past the feeling of claustrophobia and the fear that you won’t come out alive, it’s actually great.”

[email protected]

MTS Medication Technologies, Inc. (AMEX:MPP) (www.mts-mt.com), an international provider of medication compliance packaging systems, has begun testing its newest product, MedTimes, as part of a development agreement with one of its pharmacy customers and a nursing home in St. Petersburg, Florida.

The new product, MedTimes, is the second in a family of automated dispensing systems to be developed by the MTS Medication Management Solutions Group. MedTimes expands the pharmacy inventory control features of the previously released MedLocker™ system by including all prescriptions routinely ordered for nursing home residents, not just those required for first-time or emergency dosing. This allows for the complete management of medications throughout the nursing home.

MedTimes also provides nurses with a computerized medication administration record, helping to ensure the five “rights” of medication administration (right patient, right medication, right dose, right time and right route). Additional system benefits include improved patient safety, reduction in operating costs, efficient data capture of patient information and medication orders, and a significant reduction of waste from unused and destroyed medications.

“We believe MedTimes fundamentally changes how medications are dispensed and administered in skilled nursing facilities and can therefore dramatically improve the medication administration process,” says Todd E. Siegel, President and Chief Executive Officer. “We recognize there will be significant challenges related to legislative and regulatory acceptance, but we believe the benefits of the system are so compelling that public and private payers, state boards of pharmacy and departments of health will understand the importance of working with legislators to modify necessary laws and guidelines to pave the way for the product’s adoption.”

Most regulations provide for patient-specific dispensing, in which all nursing home residents receive their prescribed medications in individually labeled punch cards or other specialized packages that bear a prescription label. For example, if five residents are using the exact same medication, currently there will be five distinct prescriptions, one labeled for each resident’s use. The MedTimes model is based on drug-specific dispensing, with the MedTimes system tracking the medications needed to be administered to which patient and when. This means those same five patients can receive their medications from one inventory source (punch card) reducing inventory and drug waste from discontinued medications. The system presents a picture of the medication as well as the individual patient, so the drug can be accurately identified, verified and then given to the correct patient.

Siegel adds, “In the past, we have alluded to a second product in development behind MedLocker but were not ready to articulate our full product plan until the product was installed and tested. However, we are now on track to move MedTimes from an alpha to a beta project status, and anticipate a beta release of MedTimes at the American Society Consultant Pharmacists tradeshow Nov. 15, 2006 in Phoenix. We then expect to expand the beta to additional pharmacies and nursing homes in our fourth quarter ending March 31, 2007, and we are optimistic that the general release of this exciting new product as early as the first quarter of fiscal 2008.

“We believe MedTimes represents an unprecedented paradigm shift in our industry. Although there are regulatory and legislative barriers to overcome in the short term, we feel the quality enhancement and cost saving features are so compelling that we will ultimately be successful in gaining approval in a number of states.” Siegel explained that MTS has already identified several states in which MedTimes could be implemented and others in which the Company believes the system could be deployed in the near future.

“We believe the market potential, even at this early stage, is significant. We were recently instrumental in supporting legislative changes in California that will now allow for the use of the system. In addition to California, three additional target states — Florida, Texas and Maryland — represent almost 20 percent of the total skilled nursing beds in the United States — a market opportunity in excess of $150 million dollars. “We will work with individual state regulatory entities to seek to ensure that a level of understanding and support exists for MedTimes,” says Siegel. “We also intend to aggressively look to demonstrate the merits of the system and attempt to effect appropriate regulatory and legislative changes in key target states.”

The anticipated selling price of the MedTimes system is approximately $15,000 – $18,000 for a system that can manage 25 to 35 residents — a typical-sized wing in a nursing home. A pharmacy could fully automate a 100-bed nursing home’s medication administration process with a state-of-the-art electronic medication record and inventory control system for $70,000 to $80,000.

Siegel concludes, “This is the first automated dispensing and administration system we are aware of that actually eliminates significant costs as opposed to shifting costs from one party to another. Although there is still significant work to be done to ensure that MedTimes is successful, we expect this to be a significant market opportunity in the United States and in the United Kingdom. This certainly has given us a substantial incentive to pursue this initiative.”

About the Company

Founded in 1984, MTS Medication Technologies (www.mts-mt.com) is an international provider of medication compliance packaging systems designed to improve medication dispensing and administration. MTS manufactures automated packaging machines and related consumables for prescription medications and nutritional supplements. The Company serves approximately 8,000 pharmacies worldwide.

This press release contains forward-looking statements within the meaning of that term in Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Additional written or oral forward-looking statements may be made by the Company from time to time, in filings with the Securities and Exchange Commission or otherwise. Statements contained herein that are not historical facts are forward-looking statements made pursuant to the safe harbor provisions described above. Forward-looking statements may include, but are not limited to, projections of revenue, income or losses, the value of contracts, capital expenditures, plans for future operations, the elimination of losses under certain programs, financing needs or plans, compliance with financial covenants in loan agreements, plans for sale of assets or businesses, plans relating to products or services of the Company, assessments of materiality, predictions of future events and the effects of pending and possible litigation, as well as assumptions relating to the foregoing. In addition, when used in this discussion, the words “anticipates”, “estimates”, “expects”, “intends”, “believes”, “plans” and variations thereof and similar expressions are intended to identify forward-looking statements. In particular, all statements regarding the continuing of any trend or expected sales are forward-looking statements, as is any statement regarding the potential growth of our MedTimes, OnDemand and MedLocker products or statements concerning the market demand for such products. In particular, there can be no assurance that we will gain regulatory approval in many jurisdictions for our MedTimes product.

Forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified based on current expectations. Consequently, future events and actual results could differ materially from those set forth in, contemplated by, or underlying the forward-looking statements contained herein. Statements in the Press Release describe factors, among others, that could contribute to or cause such differences. Other factors that could contribute to or cause such differences include, but are not limited to, unanticipated increases in operating costs, changes in the United Kingdom healthcare regulatory system, labor disputes, customer rejection of any installed OnDemand machine, market acceptance of MedLocker, developments relating to customer initiatives, capital requirements, increases in borrowing costs, product demand, pricing, market acceptance, hurricanes, intellectual property rights and litigation, risks in product and technology development and other risk factors detailed in the Company’s Securities and Exchange Commission filings.

Readers are cautioned not to place undue reliance on any forward-looking statements contained herein, which speak only as of the date hereof. The Company undertakes no obligation to publicly release the result of any revisions of these forward-looking statements that may be made to reflect events or circumstances after the date hereof or to reflect the occurrence of unexpected events.

When the open enrollment period for 2007 Medicare prescription drug plans begins tomorrow, Medicare beneficiaries in Florida will be able to consider a new low-priced option from UnitedHealth Group that carries the exclusive endorsement of AARP, the largest and most respected membership organization serving older Americans. The AARP MedicareRx Plan – Saver is one of the lowest priced Part D Plans in the state that offers comprehensive drug coverage and high-quality customer service.

“It’s important for Florida Medicare beneficiaries to see what’s new for 2007, because there are plans available with lower costs and more comprehensive coverage,” said Tom Paul, chief pharmacy officer for Ovations, the UnitedHealth Group business dedicated to serving the health and well-being of people age 50 and older. “We listened to what people wanted from their prescription drug coverage and worked with AARP to develop the AARP MedicareRx Plan – Saver and other plans that we believe meet the needs of older Americans.”

With a monthly premium of $12.30, a low deductible, and copayments as low as $5, the AARP MedicareRx Plan – Saver was designed to be affordable and stable for the long term. Beneficiaries can count on a prescription drug list that includes every brand-name prescription drug or its generic version covered by Medicare Part D. Members can save even more by using preferred mail-order services that provide a 90-day supply of Tier 1 generic drugs with only one copayment and $15 dollars off a 90-day supply of Tier 2 and Tier 3 brand-name drugs.

After the inaugural 2006 enrollment period, 4.4 million Americans or 10 percent of those eligible for prescription drug coverage through Medicare, still had not enrolled in a Part D plan and had no creditable form of prescription drug coverage1. UnitedHealth Group is reaching out to Medicare beneficiaries in communities across the country to help them better understand their prescription drug coverage options and enroll in a plan that best suits their individual needs.

“We’re connecting with beneficiaries to make sure they understand their choices and have the information they need to make good health care decisions,” said Tom Paul. “We also understand the important role caregivers and relatives play in beneficiaries’ lives, and will support them in helping their friends and family members choose a plan that best meets their needs.”

2007 AARP MedicareRx Plans offerings:

For 2007, UnitedHealth Group’s Part D offerings include three stand-alone plans that carry the exclusive endorsement of AARP, the largest and most respected membership organization serving older Americans:

AARP MedicareRx Plan — Enhanced

Monthly premium of $45.60

Coverage for Tier 1 generic medications through the “coverage gap.”

Bonus drug list that includes medications not typically covered by Part D, such as prescription-strength Vitamin B.

No deductible. Consumers will have first-dollar coverage on prescription drugs.

Formulary includes 100 percent of the drugs covered by the Medicare Part D program.

AARP MedicareRx Plan

Monthly premium of $27.60.

No deductible. Consumers will have first-dollar coverage on prescription drugs.

Formulary that includes 100 percent of the drugs covered by the Medicare Part D program.

AARP MedicareRx Plan — Saver

The lowest premium and copayments. Monthly premium of $12.30.

Formulary includes every brand-name prescription drug or its generic version covered by Medicare Part D.

The company’s Part D plans are designed to address the full spectrum of beneficiaries’ needs — from low-cost options to plans with comprehensive formularies that not only bridge the coverage gap, but also include a Bonus List of drugs not covered by Part D. All three AARP MedicareRx Plans will be available in all 50 states, the District of Columbia and all five U.S. Territories.

The Open Enrollment period for 2007 Medicare Part D begins November 15 and ends December 31. Beneficiaries and their caregivers wishing to learn more about and enroll in AARP MedicareRx Plans can do so online at www.AARPMedicareRx.com or by calling toll-free at 1-866-255-4835. TTY users can call toll-free at 1-877-730-4192.

About Ovations

Ovations offers a diverse and comprehensive array of products and services that respond to the health and well-being needs of adults of all ages, with a particular focus on those age 50 and above. Among its most popular services are: Medicare Prescription Drug plans, Medicare Advantage plans, Medigap offerings, independent living services, special needs and hospice services, group retiree solutions and insurance plans for pre-Medicare retirees ages 50-64.

About UnitedHealth Group

UnitedHealth Group (NYSE:UNH) is a diversified health and well-being company dedicated to making health care work better. Headquartered in Minneapolis, Minn., UnitedHealth Group offers a broad spectrum of products and services through six operating businesses: UnitedHealthcare, Ovations, AmeriChoice, Uniprise, Specialized Care Services and Ingenix. Through its family of businesses, UnitedHealth Group serves approximately 70 million individuals nationwide. Visit www.unitedhealthgroup.com for more information.

1 Source: Kaiser Family Foundation Data Update: “Prescription Drug Coverage Among Medicare Beneficiaries,” June 2006

By Allen G. Breed THE ASSOCIATED PRESS

Filmmaker Dick Colthurst went to Mount Everest hoping to learn why people risk their lives trying to reach the world’s tallest summit. After spending 48 days in that unforgiving landscape and slogging through hundreds of hours of footage, he has to admit that he failed.

“While I admire what they do and how they do it, and the sheer mental and physical strength that it takes to do it, I’m honestly no nearer to understanding why they do it,” Colthurst, an executive producer for London-based Tigress Productions, said in an interview with The Associated Press.

But Colthurst and his crew did succeed in capturing in vivid and often disturbing detail the hell climbers put themselves through to be able to say they’ve been to “the roof of the world.”

“Everest: Beyond the Limit,” which begins its six-week run tonight at 10 on the Discovery Channel, chronicles the journey of eight men during the 2006 spring climbing season — the second- deadliest on the Himalayan peak that rises over 29,000 feet.

It’s hard to imagine a more motley cast of characters.

There’s the asthmatic school teacher from Denmark who is trying to reach the top without supplemental oxygen; the former Hells Angel whose near-fatal motorcycle wreck left him with two metal plates in his head, one in his left knee, 10 screws in his left foot and a steel cage holding his lower back together; a Los Angeles firefighter who sold his Harley-Davidson and mortgaged his house to finance a failed summit attempt the year before; a 62-year-old Frenchman who two months earlier had a cancerous kidney removed through his belly so the incision wouldn’t impede his ability to carry a backpack.

The series’ “star” is New Zealand mountaineer Mark Inglis. He lost both legs just below the knee to frostbite 24 years ago and is seeking, on specially designed carbon legs with spiked feet, to become the first double amputee to summit Everest.

Leading the expedition is New Zealander Russell Brice, who has put more people on Everest’s summit than any other commercial guide and had never suffered a casualty in 13 trips to the mountain.

The series skips the niceties of Katmandu and the picturesque Buddhist monasteries that cling to the valley aside Everest, and takes you straight to base camp — at 17,060 feet already higher than any peak in the Rockies.

At the expedition’s start, Brice lays down the law. He says that while the climbers are his paying customers, the Sherpa guides and porters are like his family.

“It’s not their job to die alongside you because of your ambitions,” he says. “If I see that that’s going to happen, I’m going to call the Sherpas away. I will deal with that in court later — and you will die.”

Bouncy, topsy-turvy footage shot by cameras mounted on the Sherpas’ helmets gives the viewer the queasy, almost stomach- churning illusion of climbing. The camera is unflinching.

You see a climber with brain swelling so severe that his eyes bulge from their sockets. You hear men cough until they retch. You watch as insomnia and oxygen deprivation transform a strapping firefighter into a hollow-eyed ghost stumbling through a place where hunger fades, digestion falters, and the body literally begins to feed upon itself.

Watching Inglis inch upward on his spindly black prosthetics, blood from his raw-rubbed stumps staining the pristine snow, it’s hard to know whether to feel inspired by his guts or infuriated at his foolhardiness.

“It’s a view to die for,” one climber says without a hint of irony in his voice.

Each episode ends in a genuine cliffhanger. Will the rebellious biker heed Brice’s order to turn around before his oxygen runs out? Caught in a traffic jam behind a line of incompetent amateurs, will the team physician lose his fingers to frostbite?

There are dramatic rescues. And there is death.

The Tigress crew was there when members of Brice’s expedition discovered British climber David Sharp, who froze to death as dozens passed on their way to the summit. The incident made international headlines and brought widespread condemnation down on Brice’s head for not mounting a rescue.

A Sherpa’s helmet-cam captured Sharp’s last words. But Discovery honored his family’s request not to show the footage.

Since the 1920s, Everest has claimed more than 200 lives. During this season, 11 would die.

The series’ greatest achievement is how it illustrates the dangerous commercialization of Everest, capturing both the heroism and hubris of the climbers who go there. For some of Brice’s clients the journey brought peace; for others, disappointment and pain.

In the final episode, one climber soaks his blackened, swollen fingers in a futile effort to save them from frostbite.

“I don’t regret anything,” he tells the camera.

You almost believe him.tonight

“Everest: Beyond the Limit” follows a group of physically challenged people as they ascend Mount Everest. The six-week series premieres at 10 tonight on the Discovery Channel and will air a new episode every Tuesday through Dec. 19.

(c) 2006 Daily Breeze. Provided by ProQuest Information and Learning. All rights Reserved.

By Roger Dobson

It hurts, makes a loud rattling noise, and travels at up to 60 miles an hour. Over the next few months, it will be responsible for more than two million visits to GPs, and more than [pound]500m will be spent on medicines this year trying to stop it. The cough is one of Britain’s biggest health problems. In a full year, the costs to the economy are now estimated to have reached [pound]1bn.

While in some cases it can be a symptom of more serious underlying diseases or problems from asthma to cancer, or a side effect of a drug, a consequence of smoking, or a tic, in most cases it is the result of the common cold or flu.

And cough medicines are the main remedies. The problem for sufferers is that there is a bewildering choice, including suppressants, expectorants, decongestants, antihistamines and codeine, as well as alternative remedies.

But do they work? Is the money well spent? “Experts say much of it is wasted money,” says a report from Harvard University. “According to American College of Chest Physicians guidelines, many of the active ingredients in over-the-counter cough remedies are ineffective. You’d be better off taking an early generation antihistamine and a nasal decongestant.”

“There is some debate as to whether cough medicines work,” says NHS Direct. “They usually contain only small amounts of the active ingredients. But they do appear to work for some people.”

Much of any impact they do have may also be down to the placebo effect: “In clinical trials on cough medicines, up to 85 per cent of the reduction in coughs is associated with the placebo treatment and the active pharmacological component of the medicine only contributes 15 per cent of the reduction,” says a report from Professor Ron Eccles of the Common Cold Centre at Cardiff University.

Sweet cough syrups

According to research at Cardiff University, 58 out of the 60 over-the-counter sweet cough syrups contain a sweetener such as sucrose, glucose, honey, or treacle, and may woork through their sweet taste and the plaacebo effect.

“The review proposes that the major bene-fit of cough medicines for treatment of coughs associated with common cold is rellated to the placebo effect rather than the pharmacological effect of an active ingredient,” says Professor Eccles. The report says the sweet or in some cases bitter taste of a medicine may trigger salivation and the secretion of mucus. “Placebo-controlled clinical trials have discredited most tra-ditional cough medicines as they have ussually concluded that the cough medicine is little more effective than a matched placebo medicine.”

Expectorants

These medicines work by affecting the production and clearance of mucus, and help bring up phlegm so that coughing is easier.

Some studies show they are effective, whhile othershave found no or little effect: “If you want a free, reliable way of loosening mucus, just try drinking plenty of water the next time you have a cold,” says the Harvard Unniversity report.

Suppressants

They act on the brain to hold back the cough refflex, and are usually used for dry coughs.

According to new American College of Chest Physicians guidelines, they may have limited effect incoughs caused by colds. “There is no clinical evi-encede that over-the-counter cough expectorants or suppressants relieve coughs,” says Dr Richard Irwin of the University of Massachusetts Medical School, who led the team that drew up the guidelines.

Decongestants

Designed to work by constricting blood vessels, which shrinks swollen membranes and allows more air to pass through the nose.

“Decongestants can be wonderfully effective in the short run but they also present problems. You can become dependent on nose drops which contain oxymetazoline,” says the Harvard report.

Antihistamines

These drugs work in hay fever by blocking histamine, but in coughs and colds the older types of antihistamines like brompheniramine and chlorpheni-ramine have another effect – making you sleepy and inhibiting coughs.

The American College of Chest Physicians guidelines advise adults with acute coughs to use an older variety of antihistamine combined with a decongestant. “There is considerable evidence that older type antihistamines help to reduce coughs.”

Chicken soup

It’s a traditional remedy for cold and coughs, and includes onions, sweet potato, carrots, celery and parsley as well as poultry.

Folklore says it works, and so too do researchers at the University of Nebraska. They found that it acts as an anti- inflammatory, and it speeds up the discharge of mucus to ease the symptoms of coughs and colds. Just what does it is not clear, but it may be the combination of ingredients.

Menthol/essential oils

Essential oils containing menthol and eucalyptus have been used for centuries for treating coughs and colds. Menthol works as a mild anaesthetic and is used to relieve sore throats. It also makes the mouth and throat feel cooler.

“Menthol provides relief from nasal congestion by causing a cool sensation in the nose and also relieves the symptoms of sore throats and

coughs by a local anaesthetic action. It may also help to inhibit infection of the airway,” according to the Cardiff Common Cold Centre.

Duck liver

Oscillococcinum, a medicine made from the heart and liver of the duck, is said to be effective in treating flu symptoms.

“A clinical trial on the treatment of influenza-like symptoms demonstrated superiority of the homeopathic medicine oscillococcinum over placebo,” the Cardiff Common Cold Centre reports.

Echinacea ( above left)

A daisy-like purple flower, it is a traditional native American treatment for coughs, colds and sore throats. It is now one of the bestselling herbal remedies in the UK, with sales of [pound]30m predicted for this year.

Some research suggests it is little better than placebo, while other work shows beneficial effects. According to the Cardiff Common Cold Centre: “There is some scientific evidence which indicates that echinacea does affect our immune system by stimulating the activity of white blood cells. Lozenges containing echinacea may help prevent infection by boosting the immune system and could in theory abort a common cold infection and prevent the development of symptoms.”

Codeine

A standard ingredient in cough remedies, it works as a mild narcotic. A University of Manchester study suggests it may be no more effective than placebo at treating coughs. Researchers who studied patients with chronic lung disease found that after the placebo treatment the patients’ coughing fell from an average of 8.27 seconds an hour to 7.22 seconds, and after codeine to 6.41 seconds. “Although there was a significant reduction after codeine, from a statistical standpoint there was really no difference between codeine and placebo – despite the fact that the dose of codeine used far exceeds that in over-the-counter cough remedies.”

Chocolate

An ingredient in chocolate could help stop persistent coughs. Researchers have discovered that theobromine suppresses vagus nerve activity involved in causing coughing.

According to research at Imperial College, theobromine is nearly a third more effective in stopping persistent coughs compared to codeine: “Not only did theobromine prove more effective than codeine, at the doses used it was found to have none of the side effects. Normally the effectiveness of any treatment is limited by the dosage you can give someone. With theobromine having no demonstrated side effects in this study it may be possible to give far bigger doses, further increasing its effectiveness,” says Professor Maria Belvisi.

Sesame oil

Widely used as a traditional remedy, it is a thicker syrup said to ease the symptoms of coughs, especially in children. Research at the University of Beirut shows that the oil reduces cough symptoms more than a placebo, but the difference was not statistically significant: “Sesame oil did not result in marked improvement in cough symptoms.”

Steam

Works by making secretions looser and easier to cough up. Can be done with the head-over-a-bowl-approach, or by adding moisture to air with a steam vaporiser or cool-mist humidifier.

According to Dundee University: “Inhalations with steam help. Boil some water, pour it into a basin, drape a towel over your head, inhale the steam for four or five minutes, several times a day (be careful not to scald your nose). Frequent hot drinks also help.”

So what should you take?

The Harvard University report concludes: “For your everyday cough from a common cold, the new guidelines advise taking one of the allergy medicines that combine an older antihistamine and a decongestant. The only older antihistamine that is specifically recommended is brompheniramine, but it’s not unreasonable to try products that contain other older antihistamines, like diphenhydramine or chlorpheniramine. The guidelines also say that naproxen might be helpful. But these are just guidelines. If you think a product is working fine, it probably won’t hurt you, although you may be paying for a placebo effect rather than a proven remedy.”

Professor Eccles adds: “I think the analgesics aspirin, paracetamol and ibuprofen are the first line in treating colds and flu.”

Coughing: the facts

More than [pound]500m is spent in the UK every year on over-the- counter medicines for coughs and colds.

The cost of acute cough to the UK economy is estimated to be at least [pound]979m.

A cough can travel at up to 60mph.

A cough can be a symptom of many ill-nesses including asthma, bronchitis, colds, flu, smoking, some medicines including ACE- inhibitors used for heart failure, and whooping cough. It can also be a symptom of serious conditions, including lung cancer.

Different types of cough

A dry cough occurs when the throat is inflamed, but no phlegm is produced.

A chesty cough is usually when phlegm is produced, often as a result of an infection.

Acute coughs last less than three weeks and account for more GP visits than any other complaint.

Chronic coughs last eight weeks plus, are more common in females and the obese, and account for one in 10 hospital referrals.

25 per cent of chronic cough cases cannot be attributed to a specific cause.

What happens when we cough?

Our bodies sense there is something in the airway, and without thinking, we breathe in and inflate the lungs.

The glottis, the top of the windpipe, is briefly closed.

Contraction of muscles generates high pressure of air from the lungs against the closed glottis.

When the pressure has built up, the glottis automatically opens, and pressurised air explodes out, forcing out any debris along with it.

A Los Angeles dietitian says night-shift workers have a tougher time maintaining weight because night work upsets the normal circadian rhythm.

Some night shift workers eat at work in order to maintain their stamina, then go home and eat with their families, said Netty Levine, a registered dietitian and certified diabetes educator at Cedars-Sinai Medical Center.

People working the night shift may consume large amounts of caffeine-laden beverages to stay awake, then — if they are parents — they may be forced to stay awake during the day in order to drive their children to and from school and other activities. Recent students have shown that people who do not get sufficient sleep are more prone to being overweight.

Levine advises night-shift workers to exercise midway through their shift to help maintain alertness and overall cardiovascular health. She also recommends:

— Eat small, regular meals with a balance of whole grain carbohydrates, protein, and heart-healthy fats before 1 a.m.

— A frozen, low-fat, low-sodium frozen dinner can be supplemented with a piece of fruit, vegetables.

— For snacks, bring fruit, vegetables, low-fat yogurt, cottage cheese, whole wheat crackers, pretzels or popcorn.

— Avoid caffeine at least five hours before bedtime.

Lisa Zuckerman has been named Vice President of Treasury Services for Catholic Healthcare West, effective December 4, 2006.

Zuckerman comes to CHW from Standard & Poor’s Corporation in San Francisco, where she served as a director in Standard & Poor’s Credit Market Services division, in the Not-for-Profit Health Care Group. She has more than 16 years of leadership experience in finance, not-for-profit health care analysis and bond markets.

In her new position, Zuckerman will manage CHW’s treasury services and direct the system’s investment strategy.

“I am delighted that Lisa has agreed to join us in this vital role,” said Michael Blaszyk, executive vice president/chief financial officer for CHW. “She has a deep understanding of what success means for mission-driven health care systems. I believe Lisa’s contributions will be crucial as we continue to build and strengthen our healthcare ministry in the years ahead.”

Zuckerman replaces Jesse Bean, who has announced his retirement after 14 years of service with CHW. Bean will remain with CHW managing special projects through mid-2007.

“Bringing my expertise to help serve those in need has been a long-term career vision for me,” said Zuckerman. “CHW is a perfect fit and I am excited to begin working with such a dynamic and growing organization during this time of industry-wide change and challenges.”

Before starting her tenure at Standard & Poor’s in 1996, Zuckerman served as principal analyst at Harvey M. Rose Corporation, and as an analyst at a major investment bank.

She earned an undergraduate degree Harvard University and a master’s degree in public policy at the University of California, Berkeley. Zuckerman is a member of the Board of Governors of the National Federation of Municipal Analysts and an advisory group member to the California Health Care Foundation.

About Catholic Healthcare West

Catholic Healthcare West (CHW), headquartered in San Francisco, CA, is a system of 42 hospitals and medical centers in California, Arizona and Nevada. Founded in 1986, it is the eighth largest hospital system in the nation and the largest not-for-profit provider in California. CHW is committed to delivering compassionate, high-quality, affordable health care services with special attention to the poor and underserved. The CHW network of more than 7,800 physicians and approximately 44,000 employees provides health care services to more than four million people annually. In 2006, CHW provided $803 million in charity care, community benefits, and unreimbursed patient care. For more information, please visit our website at www.chwHEALTH.org.

 Contact: Tricia Griffin (415) 438-5524  

SOURCE: Catholic Healthcare West

SOMERVILLE, N.J., Nov. 10 /PRNewswire/ — Results from a multicenter, prospective clinical trial showed that nine out of 10 women undergoing treatment with GYNECARE THERMACHOICE* III Uterine Balloon Therapy System to treat menorrhagia, or heavy menstrual periods, returned to a normal bleeding rate or less. The data were presented earlier this week at the American Association of Gynecologic Laparoscopists meeting in Las Vegas.

Women in the 250-patient trial were randomized to receive postablation curettage (PAC) or to no postablation curettage (NPAC) following treatment with GYNECARE THERMACHOICE III. The success rates in the two groups were comparable. At the 12-month follow up point, the intent-to-treat analysis showed that 37 percent of women experienced amenorrhea (or no menstrual bleeding). The study also compared this amenorrhea rate to that of historic patient-matched controls. Among the intent-to-treat matched patients, the amenorrhea rate was 32.6%, which is significantly greater than the 13.7% reported in the matched patients from the THERMACHOICE I study.

Additionally, more than 50 percent of women reported experiencing no premenstrual symptoms, including severe pain, fatigue and bloating following treatment. In fact, almost 90 percent of participants reported less pain associated with their periods (dysmenorrhea).

“These results show that GYNECARE THERMACHOICE III is a safe and effective choice for women who are candidates for endometrial ablation therapy,” said Jose Garza Leal M.D., lead investigator of the study. “In addition, this treatment can actually help to ‘normalize’ a woman’s menstrual flow so that it no longer interferes with her day-to-day activities, helping improve her quality of life.”

Before receiving treatment, 80 percent of the women reported missing social activities due to their heavy periods. After treatment, more than 90 percent of women said they had not missed a social occasion or activity because of their period. Similarly, prior to treatment, more than half of women reported missing work because of their period. After 12 months, less than 3 percent reported absences.

Participants were premenopausal women, aged 30 years or older, who had completed childbearing, used contraception, and either failed or refused medical therapy.

   The study was funded by ETHICON Women's Health & Urology.    About Menorrhagia  

Menorrhagia, or heavy periods, wreaks havoc on the lives of approximately 10 million pre-menopausal women ages 30 to 55 in the United States each month. These women lose 10 to 25 times the normal amount of blood during their menstrual cycle and must often contend with iron deficiencies, pain, fatigue and inability to participate in normal daily activities.

About GYNECARE THERMACHOICE

The GYNECARE THERMACHOICE III Uterine Balloon Therapy System is a one-day treatment option designed to end heavy menstrual flows by removing the lining of the uterus. This medical device resolves heavy menstrual bleeding due to benign causes in premenopausal women who have completed childbearing. Unlike hysterectomy, which takes out the entire uterus, the device only treats the lining of the uterus with heat through a process called endometrial ablation.

GYNECARE THERMACHOICE is used in a minimally-invasive procedure that can be performed in a hospital, outpatient or office setting. Recovery is fast and most women can return to their normal activities by the next day. The treatment has been used to treat more than 500,000 women worldwide.

As with all endometrial ablation procedures, GYNECARE THERMACHOICE III should not be used in women who might want to become pregnant in the future. There is still a chance that pregnancy could occur, however, so it is very important that women use birth control correctly and consistently after any endometrial ablation procedure.

All surgical procedures present risks. Rare but possible safety risks include blood loss, heat burn of internal organs, electrical burn, perforation (hole) or rupture of the wall of the uterus, and leakage of heated fluid from the balloon or tissue into the cervix.

GYNECARE THERMACHOICE is from ETHICON Women’s Health & Urology, a division of ETHICON, Inc., a Johnson & Johnson company. For more information, visit http://www.endheavyperiods.com/.

About ETHICON Women’s Health & Urology

ETHICON Women’s Health & Urology is dedicated to providing innovative, minimally invasive treatments for common urologic and women’s health conditions. The division offers solutions for enlarged prostate (benign prostatic hyperplasia); female stress urinary incontinence; pelvic floor repair; post-surgical adhesions; heavy periods (menorrhagia); and benign uterine conditions, such as fibroids and polyps.

ETHICON Women’s Health & Urology

CONTACT: Jackie Russo Jankewicz for ETHICON Women’s Health & Urology,+1-908-218-2764, or [email protected]

Web site: http://www.endheavyperiods.com/

By Dr MIRIAM STOPPARD

Dear Miriam MY husband and I went away for the weekend and our 17- year-old son threw a party. When we arrived home it was still in full swing and we found two of his friends nearly naked in our bed.

The other rooms were in a terrible mess and littered with used condoms. I’ve been too scared to confront my son in case he admits he’s been having sex. To me he’s still my little boy. What should I do?

IF there’s one issue parents feel uncomfortable facing when it comes to their teenage children, it’s sexual activity. You need a reality check. Little boys don’t usually organise boozy parties and your son is all grown up.

Studies show teenagers who feel they can talk with their parents about sex are less likely to engage in high-risk behaviour than those who don’t.

If you’ve talked with your son about sex and discussed ways he can have it responsibly then, unless he’s having sex with a girl under 16, he’s not doing anything wrong.

(c) 2006 Daily Mirror. Provided by ProQuest Information and Learning. All rights Reserved.

Meritain Health, Inc., a leading provider of health plan management services and a division of health care services company Prodigy Health Group, announces an agreement with Aetna Signature Administrators which will allow current Meritain clients and prospective clients immediate access to Aetna’s national PPO network and Aetna Stop Loss Insurance.

For Meritain, already one of the largest independent health plan administrators in the country, the Aetna Signature Administrators PPO network option is another example of how the company is using its size and strength to create compelling health plan offerings for its clients. The Aetna network option is also in keeping with Meritain’s commitment to help employers control the long-term cost of health care while providing superior customer service and flexibility.

Ian Gordon, President of Meritain Health, said, “We are thrilled to be working with Aetna who has an outstanding national network of providers. Not only will we be able to offer clients even more attractive cost savings opportunities, but we will also be able to penetrate new markets where the Aetna network is particularly strong.”

Dan Fishbein, M.D., Head of Aetna’s Health Plan Alliances Business, notes, “We are very excited to partner with Meritain Health. Their administrative expertise and excellent reputation for serving the self-funded community create a natural partner for Aetna Signature Administrators.”

About Meritain Health

Meritain Health is one of the country’s largest independent providers of services for self-funded health plans. Meritain Health serves over 400 self-funded clients nationally, with nearly 500,000 members in more than 30 major industries. The company provides plan administration, innovative wellness, medical management, disease management, network management, and cost management services. Meritain Health is also a pioneer and now the leading independent provider of Consumer Directed Health Plans. Meritain Health employs over 750 people, with regional offices in Baltimore, MD; Boston, MA; Canton, OH; Cleveland, OH; Columbus, OH; Evansville, IN; Houston, TX; Indianapolis, IN; Memphis, TN; St. Louis, MO; Okemos, MI; as well as the company headquarters in Buffalo, NY. www.meritain.com

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 29.8 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans and government-sponsored plans. www.aetna.com

CLEVELAND, Nov. 9 /PRNewswire/ — Paul G. Matsen, a former Delta Air Lines marketing executive, has joined Cleveland Clinic as Chief Marketing, Planning and Communications Officer. He will provide strategic marketing leadership and support for Cleveland Clinic’s growing national and international market initiatives such as its operations in Canada and Abu Dhabi, United Arab Emirates.

“Cleveland Clinic is broadening its services to patients and geographic reach at an accelerated rate,” said Delos M. “Toby” Cosgrove, M.D., CEO and President of Cleveland Clinic. “To accommodate this growth and maximize potential market opportunities, we are expanding Cleveland Clinic’s focus and capabilities in the areas of strategic planning, marketing and new program execution.”

In this new role, Mr. Matsen brings international experience that will enable Cleveland Clinic to successfully plan and execute its strategic planning, marketing, communications and new program development. Jim Blazar, who has served as a key leader in building the Clinic’s marketing efforts, will maintain responsibilities in marketing as well as take on an additional role in key initiatives related to Cleveland Clinic’s Canyon Ranch and EMedicine Ventures.

“Paul brings an impressive record of achievement and a set of skills that are extremely pertinent to the Clinic’s emerging needs,” Dr. Cosgrove said. “His combination of skills and international experience outside of healthcare will strengthen Cleveland Clinic’s ability to become the best health care system in the world and complement the already successful marketing efforts at the Clinic.”

“It’s truly an exciting time to be in health care — especially with a world class organization like Cleveland Clinic — which is expanding internationally, focusing on new technologies and eMedicine as well as initiating numerous wellness programs for its employees and in the community,” says Matsen. “I’m thrilled to be a part of the Cleveland Clinic team, a national and international leader in health care.”

Mr. Matsen has held executive positions in operations, communications, marketing and account management with Delta Air Lines and Young & Rubicam, a prominent advertising firm in New York City. At Delta he oversaw marketing and promotion, pricing, and sales and distribution. He led the creation of the SkyTeam global alliance with Air France and managed Song, Delta’s low-fare airline. Mr. Matsen also directed Delta’s e-business activities and successfully developed and implemented Delta’s first-ever strategic plan and amassed significant international experience.

Mr. Matsen, his wife Leslie, and their three daughters will be relocating to Cleveland from the Atlanta area.

Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and hospital care with research and education. Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Approximately 1,500 full-time salaried physicians at Cleveland Clinic and Cleveland Clinic Florida represent more than 100 medical specialties and subspecialties. In 2005, there were 2.9 million outpatient visits to Cleveland Clinic. Patients came for treatment from every state and from more than 80 countries. There were nearly 54,000 hospital admissions to Cleveland Clinic in 2005. For more information, visit http://www.clevelandclinic.org/.

Cleveland Clinic

CONTACT: Eileen Sheil of Cleveland Clinic, +1-216-444-8927

Web site: http://www.clevelandclinic.org/

WILMINGTON, Del., Nov. 9 /PRNewswire-FirstCall/ — AstraZeneca today announced a new program that provides significant savings to Medicare Part D beneficiaries who may have difficulty affording their medicines. Beginning Nov. 15, people who qualify and enroll will be able to go to their participating local pharmacy and immediately receive savings on AstraZeneca products, including NEXIUM(R) (esomeprazole), CRESTOR(R) (rosuvastatin), SEROQUEL(R) (quetiapine fumarate), TOPROL XL(R) (metoprolol succinate) and ARIMIDEX(R) (anastrozole). This is a unique offering in comparison to other patient assistance programs because it gives people convenient savings on their medicines at the pharmacy counter.

AZ Medicine & Me(TM) for people in Medicare Part D is special because it’s easy to sign up, has no enrollment fee, and will be available at local pharmacies. The program is designed specifically to help qualifying Medicare Part D enrollees receive additional savings on their AstraZeneca medicines. Enrollees will pay no more than $25 for a typical 30-day supply of AstraZeneca medicines available through Medicare Part D.

“We support AstraZeneca in its efforts to assist Medicare Part D enrollees who lack the means to afford their prescription drugs,” said National Health Council President Myrl Weinberg. “We hope this will ensure that additional beneficiaries — especially those with chronic conditions and disabilities — will continue to have access to certain medications.”

“AstraZeneca is to be applauded for helping people with Medicare find even more savings. We encourage more companies to follow their lead,” said James Firman, the President & CEO of the National Council on Aging. NCOA, the Access to Benefits Coalition (which NCOA chairs) and AstraZeneca are continuing to work together on My Medicare Matters, a grassroots community education and outreach campaign, helping those people with Medicare who have limited resources access the programs and benefits that can improve their health.

“Today’s expansion of AstraZeneca’s patient assistance offerings further reflects our ongoing commitment to helping to ensure uninterrupted, affordable access to medicines for people,” said Tony Zook, President and CEO, AstraZeneca US. “We are committed to helping people in need get the medicines they need at a cost they can afford, including Medicare prescription drug plan enrollees, and we believe AZ Medicine & Me(TM) will do just that.”

AZ Medicine & Me(TM) is not part of the government’s Medicare program but rather is an independent offering from AstraZeneca designed to help people enrolled in Medicare Part D who need assistance in getting their medicines. Beginning Nov. 15, people may sign up by calling the AZ Medicine & Me(TM) hotline at (1-800-957-6285) or visiting http://www.azmedicineandme.com/. To qualify for AZ Medicine & Me(TM) an applicant must meet the following criteria:

   1. Be enrolled in Medicare Part D.   2. Have an annual individual income at or below $30,000, or an annual      income at or below $40,000 per couple.    3. Be taking AstraZeneca medicine(s).   4. Have spent at least 3% of their annual household income on prescription      drugs during the calendar year.   

People who qualify for the program will pay no more than $25 for a typical 30-day supply of their AstraZeneca medicine, and will receive the assistance at the pharmacy counter immediately upon initial qualification. Once the person completes the application process, they will have the choice of getting a 30-, 60- or 90-day supply of medicine filled at their local pharmacy, with additional savings for the 60- and 90-day fills. A typical 60-day retail supply will cost no more than $37.50 and a typical 90-day retail supply will cost no more than $50.

AstraZeneca has received a favorable advisory opinion from the U.S. Department of Health and Human Services Office of Inspector General (OIG) affirming that the company’s extension of coverage to Medicare Part D beneficiaries in its new program is consistent with OIG guidelines.

About AstraZeneca and Our Commitment to Patient Assistance

Last week, AstraZeneca also announced new efforts to help people without prescription drug coverage. Also beginning November 15th, the AstraZeneca Patient Assistance Program will expand to help those in the middle class as well as those with lower incomes. This means that a family of four earning $60,000 or less, couples earning $40,000 or less, or individuals earning $30,000 or less, who do not have prescription drug coverage, may qualify to get their AstraZeneca medicines for free.

AZ Medicine & Me(TM) for People in Medicare Part D is just one of several patient assistance offerings that provide AstraZeneca medications at significant savings or free of charge to qualifying individuals and families. For nearly three decades, AstraZeneca has offered drug assistance programs side by side with its medicines. In 2005, through the AstraZeneca drug assistance programs, AstraZeneca provided more than $751 million in savings to more than 712,000 patients without drug coverage throughout the U.S. and Puerto Rico.

AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of prescription pharmaceuticals and the supply of healthcare services. It is one of the world’s leading pharmaceutical companies with healthcare sales of $23.95 billion and leading positions in sales of gastrointestinal, cardiovascular, neuroscience, respiratory, oncology and infection products. In the United States, AstraZeneca is a $10.77 billion healthcare business with more than 12,000 employees. AstraZeneca is listed in the Dow Jones Sustainability Index (Global) as well as the FTSE4Good Index.

For more information about AstraZeneca, please visit: http://www.astrazeneca-us.com/.

AstraZeneca

CONTACT: Abigail Baron, +1-302-885-3578, [email protected],or Emily Denney, +1-302-885-3451, [email protected], both ofAstraZeneca LP

Web Site: http://www.astrazeneca-us.com/http://www.azmedicineandme.com/

Connetics Corporation (NASDAQ: CNCT), a specialty pharmaceutical company that develops and commercializes dermatology products, today announced the nationwide U.S. commercial launch of Verdeso™ (desonide) Foam, 0.05%, for the treatment of mild-to-moderate atopic dermatitis in adults and children as young as three months of age. Verdeso, a low-potency topical steroid, is the first commercial product formulated in Connetics’ proprietary VersaFoam-EF™ emulsion formulation foam vehicle, and is the first Connetics product to include a pediatric indication. Verdeso is available in 50g and 100g trade unit sizes.

“Our trained and highly motivated sales force has introduced Verdeso to dermatologists and pediatricians,” said Tom Carey, Senior Vice President, Commercial Operations for Connetics. “The launch is supported with patient education materials, product samples, physician speaker programs and an innovative marketing campaign designed to emphasize the value that Verdeso brings to physicians and their patients. In addition to the considerable efforts of our sales organization, our marketing team has designed a creative journal advertising campaign, direct mail programs and an interactive web site, www.Verdeso.com, designed to educate healthcare professionals and their patients.”

Greg Vontz, President and Chief Operating Officer for Connetics, said, “Verdeso provides a great opportunity for our sales force to leverage the reputation of our leading Luxíq® and OLUX® brands, both of which are formulated in VersaFoam®, by demonstrating the advantages of our new VersaFoam-EF technology to a large market. The VersaFoam-EF vehicle is designed to be non-stinging and contains ingredients with moisturizing properties that we believe will lead to increased patient satisfaction and compliance, and accelerated adoption of Verdeso. We also believe Verdeso will be particularly appealing to the pediatric market.”

The launch of Verdeso allows Connetics to offer a complete range of potencies in topical steroids, including mid-potency Luxíq and super high-potency OLUX, and to address the full $1.1 billion topical steroid market. Approximately 7.7 million prescriptions are written annually in the U.S. by dermatologists for low-potency steroid products, and desonide is the leading topical corticosteroid in this market.

About Atopic Dermatitis

Atopic dermatitis (AD), commonly referred to as eczema, is a chronic skin disorder characterized by scaly and itchy rashes. People with atopic dermatitis often have a family history of allergic conditions such as asthma, hay fever or eczema. AD is most common in infants, and at least half of those cases clear by age three. In adults AD generally is a chronic, or recurring, condition. In AD a hypersensitivity reaction (similar to an allergy) occurs in the skin, causing chronic inflammation. The inflammation causes the skin to become itchy and scaly. Chronic irritation and scratching can cause the skin to thicken and develop a leathery texture. Exposure to environmental irritants can worsen symptoms, as can dryness of the skin, exposure to water, temperature changes and stress. Symptoms of AD can include intense itching, blisters with oozing and crusting, skin redness or inflammation around the blisters, and rash.

About Connetics

Connetics Corporation is a specialty pharmaceutical company focused on the development and commercialization of innovative therapeutics for the dermatology market. The Company’s commercial products are OLUX (clobetasol propionate) Foam, 0.05%; Luxíq (betamethasone valerate) Foam, 0.12%; Soriatane® (acitretin) capsules; Evoclin® (clindamycin) Foam, 1%; and Verdeso (desonide) Foam, 0.05%. Connetics is developing Primolux™ (clobetasol propionate) Foam, 0.05%, a super high-potency topical steroid formulation to treat atopic dermatitis and plaque psoriasis; Extina® (ketoconazole) Foam, 2%, to treat seborrheic dermatitis; and Velac® (a combination of 1% clindamycin and 0.025% tretinoin) Gel, to treat acne. Connetics’ product formulations are designed to improve the management of dermatological diseases and provide significant product differentiation. For more information about Connetics and its products, please visit www.connetics.com.

Forward-Looking Statements

Except for historical information, this press release includes “forward-looking statements” within the meaning of the Securities Litigation Reform Act. All statements included in this press release that address activities, events or developments that Connetics expects, believes or anticipates will or may occur in the future, including, particularly, statements about sales opportunities associated with Verdeso, Verdeso’s impact on patient satisfaction and compliance, patient adoption of Verdeso, Verdeso’s appeal to the pediatric market, and the timing and outcome of submissions to the FDA, are forward-looking statements. All forward-looking statements are based on assumptions made by Connetics’ management based on its experience and perception of historical trends, current conditions, expected future developments and other factors it believes are appropriate under the circumstances. Such statements are subject to a number of assumptions, risks and uncertainties, many of which are beyond Connetics’ control, and which could cause actual results or events to differ materially from those expressed in such forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to, risks and other factors that are discussed in documents filed by Connetics with the Securities and Exchange Commission from time to time, including Connetics’ Annual Report on Form 10-K/A for the year ended December 31, 2005 and the Form 10-Q for the quarter ended June 30, 2006. Forward-looking statements represent the judgment of the Company’s management as of the date of this release, and Connetics disclaims any intent or obligation to update any forward-looking statements.

Press release code: CNCT-G

RESEDA, Calif., Nov. 8 /PRNewswire/ — Skirball Hospice, a community program of the Los Angeles Jewish Home for the Aging, has been awarded accreditation by the National Institute of Jewish Hospice. The accreditation acknowledges what the Skirball Hospice has been doing since its founding — building upon the Home’s nearly century of service to the Jewish community by highlighting Jewish history, ethics and traditions as part of its overriding philosophy of care.

Skirball Hospice is available to any adult 21 or older throughout the greater Los Angeles area needing hospice services, whether in their private home, a nursing facility or residential care facility. In addition, the Skirball Hospice staff sees patients at the Jewish Home’s palliative care unit within the Goldenberg-Ziman Special Care Center on the Home’s Eisenberg Village campus.

“Life is precious on a variety of levels, especially at the end of life,” said Rabbi Kalman Winnick, director of spiritual life at the Jewish Home. “Our hospice mission includes providing appropriate, high-quality care for the needs of the body accompanied with sensitive, compassionate care addressing issues of feelings, culture and faith.”

Skirball Hospice features a specially trained, interdisciplinary team that includes rabbis and chaplains as well as licensed nurses, social workers, dietitians, home health aids, bereavement counselors, and volunteers specializing in hospice and palliative care. Working together with the patient and family, this team provides education and support regarding all end-of-life issues with particular attention focused on providing physical, psychosocial and spiritual comfort.

“Jewish tradition supports the idea that each person has the right to face the end of life with freedom from pain and with dignity,” said Rabbi Malka Mittelman, chaplain at Skirball Hospice. “Our team and our approach help to provide this for our patients.”

Skirball Hospice is a licensed, Medicare- and Medi-Cal-certified hospice agency open to all adults regardless of faith, culture or ethnicity. Further information on the program may be obtained by calling 818-774-3040 or visiting http://www.jha.org/hospice.htm.

The National Institute for Jewish Hospice was established in 1985 and works with hospices, hospitals, family service, medical organizations and other healthcare agencies to ensure they have a basic understanding of the ethical and cultural considerations relevant to Jewish persons during the final phase of their lives.

Founded in 1912, the world-renowned Los Angeles Jewish Home for the Aging is one of the foremost continuing residential-care facilities for seniors in the United States and is the largest single-source provider of senior housing in Los Angeles. Each year, nearly 1,000 women and men are sheltered on two village campuses (spanning 16 acres), which feature independent-living “Neighborhood Home” accommodations, residential care, skilled nursing care, Alzheimer’s disease and dementia care, and hospice. Healthcare professionals from around the world consult with the Jewish Home in an effort to improve eldercare in their home countries. The Jewish Home is a nonprofit organization that relies upon donations from individuals, corporations and foundations to continue its remarkable work. Further information regarding the Home can be found online at http://www.jha.org/ or by calling 818-757-4407.

Los Angeles Jewish Home for the Aging

CONTACT: Jim Yeager, +1-818-597-8453, [email protected], for LosAngeles Jewish Home for the Aging

Web site: http://www.jha.org/hospice.htm

Web site: http://www.jha.org/

DEAR DR. GOTT: You mentioned gangrene of the bowel in your column. I had never heard of this until recently. A friend of mine had a colonoscopy last September and had no problems detected. However, in November, she had a severe pain on a Sunday night, was sent to the emergency room of the hospital and had her colon removed the next day. Gangrene had started to occur. Up to this point, she had never had any bowel problems, so it has been hard to understand why this problem happened so suddenly. My question is, could something have happened during the colonoscopy that she wasn’t told about that might have caused this to happen?

DEAR READER: One of the most serious consequences – fortunately rare – of colonoscopy is bowel perforation. During the procedure, the instrument sometimes pokes a hole in the colon that can lead to serious infection, resulting in gangrene if not treated.

Symptoms ordinarily appear in a matter of hours but may be masked for several days. A two-month wait would be virtually impossible. Therefore, I doubt that the colonoscopy caused the gangrene your friend experienced.

Bowel gangrene is more often the consequence of colon ischemia, arterial blockage of colonic segments leading to death of intestinal tissue. In the elderly, sudden or recurring abdominal discomfort must include bowel gangrene as a possible cause. For this reason, emergency scanning studies are necessary for diagnosis and to define the extent of the problem before surgery, the only life-saving cure.

Abdominal pain in children is commonly caused by appendicitis. However, in adults, there are many other causes, ranging from gallbladder disease and peptic ulcer to bowel ischemia and cancer.

I believe that your friend had appropriate treatment for her colonic problem, which was not related to her colon study two months before.

Ear buzzing

DEAR DR. GOTT: I am in serious need of your help. I am a 24-year- old female and I am having trouble with my right ear. Every time there is a moderately loud noise, my ear starts buzzing. The buzzing is getting worse each day, and now, whenever I laugh or even talk loudly, I have to plug my ear. Even the water hitting my cheek in the shower makes it buzz. I have seen two ear specialists and have had several hearing tests only to reveal that I have perfect hearing.

One doctor told me it could possibly be a tumor but not likely. The buzzing seems to be getting worse and more frequent, and I am worried about permanent damage.

Any suggestions?

DEAR READER: You are suffering from an unusual form of tinnitus (ear noise).

I recommend that you be examined by another ear-nose-and-throat specialist to discover the cause of your tinnitus. Additional opinions in situations such as these are generally extremely valuable.

(Dr. Gott is a practicing physician and the author of the new book “Dr. Gott’s No Flour, No Sugar Diet.” Quill Driver Books, www.quilldriver-books.com; 800-605-7176. Readers can write to Dr. Gott in care of United Media, 200 Madison Ave., Fourth Floor, New York, N.Y. 10016.)

(c) 2006 Bismarck Tribune. Provided by ProQuest Information and Learning. All rights Reserved.

PITTSBURGH, Nov. 8 /PRNewswire/ — UPMC Health Plan’s Medicaid program, UPMC for You, ranked among the top-10 Medicaid health plans in the United States for the third consecutive year, according to a recent review by the National Committee for Quality Assurance (NCQA) and U.S. News & World Report.

Data from NCQA, a national organization that reviews and ranks health plans on quality and preventive health measures, also showed that for the third consecutive year UPMC for You is the top Medical Assistance health plan in Pennsylvania. Rankings appear in the November 6, 2006, issue of U.S. News & World Report.

UPMC for You’s No. 8 national ranking is based on NCQA’s review of preventive health and quality data. Among the parameters NCQA measures are immunization rates, breast cancer screening, customer service, and quality of care.

UPMC for You received five stars (the highest ranking) for two categories, “Access to Care,” and “Prevention.”

“UPMC for You now has a track record of ranking among the best preventive health programs in the country,” said Diane P. Holder, president of UPMC Health Plan. “The recent NCQA report is an indication that UPMC for You and its network providers have succeeded year after year in providing care at the highest quality level.”

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS, the tool NCQA uses to measure and report on the performance of the nation’s health plans.

About UPMC Health Plan

UPMC Health Plan, the second-largest health insurer in Western Pennsylvania, is owned by the University of Pittsburgh Medical Center (UPMC), one of the nation’s top-ranked health systems. As part of an integrated health care delivery system, UPMC Health Plan partners with UPMC and community network providers to improve clinical outcomes as well as the health of the greater community. According to the U.S. News & World Report/NCQA’s listing of “America’s Best Health Plans,” UPMC Health Plan is the top-ranked health plan in Pennsylvania and one of the top 10 health plans in the nation. The Health Plan is also the highest-ranked managed care company in the nation for breast cancer screening for the third consecutive year. The integrated partner companies of the UPMC Insurance Services Division – which includes UPMC Health Plan, Work Partners, EAP Solutions, UPMC for You (Medical Assistance), and Community Care Behavioral Health – offer a full range of group health insurance, Medicare, Children’s Health Insurance Program, Medical Assistance, behavioral health, employee assistance, and workers’ compensation products and services to over 900,000 members. Our local provider network includes UPMC as well as community providers, totaling more than 80 hospitals and more than 7,000 physicians in a 28-county region.

UPMC Health Plan

CONTACT: Michael Taylor of UPMC Health Plan, +1-412-454-7534

Web site: http://www.upmchealthplan.com/

PITTSBURGH, Nov. 8 /PRNewswire/ — MED3OOO, Inc., a national healthcare management and technology company, has entered into a multi-year network management contract with Valley Care, an Independent Practice Association (IPA) based in Santa Paula, California. MED3OOO will provide a full range of operational support and technology to the IPA to further broaden the Group’s success.

Valley Care’s network includes over 200+ physician members and provides healthcare services to 10,000 patients in and around northern Ventura County, California.

“Valley Care is committed to helping our network of physicians improve the care and outcomes of our patient population,” said Michael Swartout, M.D., Chief Medical Director of Valley Care IPA. “MED3OOO’s expertise in IPA network management will enhance our operational processes to coordinate the delivery of care with our health plans and provide the reporting capabilities which are critical to staying competitive and delivering quality medical services.”

“We are pleased to be selected as a business partner with Valley Care IPA,” commented Lynn Stratton, Vice President of Network Services at MED3OOO. “With increasing healthcare costs, lower reimbursements, and greater regulatory requirements, physician networks are turning to organizations that can implement technology and processes which not only improve business, but also enhance patient care and population health, while managing growth and payer demands. At MED3OOO, we are committed to helping provider networks to excel in managing and growing networks using our advanced technology tools which include population health management through our M3/IQ(TM) advanced data warehouse technology.”

About MED3OOO

MED3OOO, a leader in healthcare management and technology, advances the performance of group medical practices and physician networks. Focused on the provision of Evidence-Based Management and Evidence-Based Medicine, MED3OOO empowers over 7,000 physician, hospital, and health system clients across the United States. For more information, please contact Karla Sartori, MED3OOO Corporate Marketing Manager, at 412-937-8887 or [email protected].

About Valley Care IPA

Valley Care IPA is comprised of 200+ primary care and specialty physicians who have cared for area residents of the Ventura and Santa Paula and Fillmore communities since 1994. Valley Care IPA physicians are dedicated to providing healthcare of the highest quality, delivered with care and compassion. The IPA is proud to have been recognized by PacifiCare in its Quality Index. The IPA has received numerous Best Practice Awards. At Valley Care IPA, quality care is a priority of all the providers. For more information, please visit http://www.vcipa.com/.

   CONTACT:    Karla Sartori   412-937-8887 ext. 325   [email protected]   http://www.med3000.com/   

This release was issued through eReleases(TM). For more information, visit http://www.ereleases.com/.

MED3OOO, Inc.

CONTACT: Karla Sartori of MED3OOO, +1-412-937-8887 ext. 325, [email protected]

Web Site: http://www.med3000.com/http://www.vcipa.com/

By Kim, M J; Rolland, Y; Cepeda, O; Gammack, J K; Morley, J E

Abstract

Most persons with diabetes mellitus are over the age of 60 years. Males develop diabetes more commonly than females. Older diabetics tend to have both impaired insulin release as well as insulin resistance. In older persons diabetes mellitus is associated with decreased functional status and cognitive dysfunction. In general, older persons with diabetes are inclined to be underdiagnosed and undertreated. Managing diabetes in older persons requires special considerations because of their differences in pathophysiology of diabetes and strong association with functional, cognitive impairments and comorbidities. The use of strict therapeutic diets is not recommended in older persons. Treatment of hypertension and hyperglycemia can improve outcomes in older persons. The interdisciplinary team approach is important for care of older diabetic persons.

Keywords: Metformin, falls, insulin adeponectin euglycemia

Introduction

I was eating bad stuff. Lots of sugar and carbs, junk food all the time. It makes you very irritated.

(Singer Avril Lavigne)

In 600 BC, Susruta, the Aryuvedic physician noticed that certain individuals had honey urine (‘madhumeha’) that was strongly attracting to ants. He also noted that there were two types of persons with honey urine, one being younger, thin people and the other older, fatter people. Thus, the concept that older persons had a different form of diabetes mellitus compared to younger persons has existed since the beginning of recorded medicine.

The prevalence of diabetes mellitus is rapidly increasing. In 2000, 2.8% of the world-wide population had diabetes, with an expected increase to 4.4% (or 366 million persons) by 2030. The majority of diabetics in developed countries are over 60 years of age. By the year 2030 there are expected to be almost twice as many older persons with diabetes in developing countries compared to the more developed ones [1]. The largest number of diabetics live in India, China and the United States.

From 1980 to 2004 the prevalence of diabetes mellitus in the United States has doubled. Diabetes mellitus is more common in men than women (Figure 1). At 65-74 years of age, 20.5% of men living in the United States are diabetic, and in the 75+ age group 17.3% are diabetic. Diabetes is undiagnosed in large numbers of the population and this occurs more often in men than women. In the 60-74 year age group 41.5% of men with diabetes were undiagnosed and in the 75+ age group 34.5% were not diagnosed [2]. In nursing homes the prevalence of diabetes is approximately 30%, with the diagnosis being made in approximately one-third of those with diabetes. Although there is evidence that optimal glycemic control can reduce the rate of occurrence of the secondary complications of diabetes, as in younger persons, the majority of older persons with diabetes did not achieve American Diabetes Association (ADA) recommendations for glycemic control.

There are many similarities between diabetes mellitus and the aging process. Diabetes appears to accelerate aging by about a decade. Thus, both diabetes and aging at the biochemical level lead to a decline in DNA unwinding rate, increased collagen cross- linking, increased capillary basement membrane thickening and a decline in the Na+K+ ATPase activity [3]. Clinically, persons with diabetes have twice the prevalence of cataracts of the general population, accelerated atherosclerosis, cognitive decline and a decreased functional status.

Pathogenesis of diabetes mellitus in older persons

Older persons have their own characteristics for the pathogenesis of diabetes. Older diabetics tend to have both impaired insulin release as well as insulin resistance. Older persons with diabetes have a decrease in insulin-mediated glucose disposal, as well as a decrease in non-insulin mediated glucose uptake into organs such as the brain [4]. However, they tend to have little change in fasting hepatic glucose output, unlike classic type II diabetics. Older persons with diabetes often tend to be less obese than younger or middle-aged diabetics [5,6]. Older persons also tend to have more evidence of pancreatic islet cell dysfunction to produce insulin, compared to middle-aged Type II diabetics. Clinically, this results in older diabetics often presenting with a mixed hyperosmolar/ ketoacidotic coma. However, the mechanism for the decline in islet cell function with aging is still uncertain. Because of these differences in the pathophysiology of diabetes in the older person, we have suggested that the classic diabetes in an older person should be considered a type 1 (Table I) [7]. In the New Mexico Aging Process study, we showed that persons who reach 70 years of age, with no evidence of glucose intolerance are very unlikely to develop diabetes mellitus over the next 14 years [8].

Figure 1. Prevalence of diabetes mellitus in the USA.

The reason for insulin resistance occurring with aging appears to be due to accumulation of lipid within muscle [9]. This can either be due to a mitochondrial defect resulting in decreased utilization of intramuscular lipid or hyperlipidemia leading to myosteatosis. Increased intracellular lipid leads to altered phosphorylation of the insulin receptor substrate resulting in decreased activity of the glucose transporters.

Adiponectin is a fat cell hormone belonging to the tumor necrosis factor superfamily [10]. It enhances insulin sensitivity and decreases triglycerides. In animal models it reverses insulin resistance. In the elderly, levels of adiponectin are higher in lean compared to obese subjects and in women [11]. Insulin resistance was negatively correlated with adiponectin levels and positively correlated with leptin levels. Its potential role in diabetes of older men has yet to be determined.

Table I. Differences in the pathophysiology of diabetes mellitus in the young, middle-aged and old.

Cytokines, such as tumor necrosis alpha, have been implicated in the production of insulin resistance. Aging is often associated with elevated cytokines due to visceral obesity and a low level inflammatory state. The role of cytokines in the modulation of insulin resistance in older men requires further exploration.

The metabolic syndrome (insulin resistance syndrome) which was originally described by Camus in 1966 [12], is associated with an increased risk of diabetes and is extremely common in older persons. Its prevalence is almost one-fourth of adult Americans [13]. The metabolic syndrome consists of hyperinsulinemia, hypertension, glucose intolerance, hyperuricemia, altered clotting abnormalities (such as an elevated plasminogen activating inhibitor 1), lipid abnormalities (including increased triglycerides, decreased high density lipoprotein lipase and increased small dense low density lipoprotein), myosteatosis, nonalcoholic steatotic hepatitis and possibly cognitive dysfunction. It is caused by an interaction of decreased exercise and overeating with a genetic milieu that promotes its development [14]. It is not surprising that the metabolic syndrome predicts future diabetics, since glucose intolerance is a component of the metabolic syndrome. To date, the most accepted pathophysiology of the metabolic syndrome is insulin resistance. It is unclear, however, whether in older persons with metabolic syndrome the insulin resistance is primary cause or secondary result of coexisting illness.

Reasons for maintenance of euglycemia in older diabetics

The major reasons for maintenance of euglycemia in older persons with diabetes are listed in Table II. There is evidence that age interacts with diabetes to accelerate the rate at which secondary complications, such as retinopathy, neuropathy and nephropathy, occur [15]. Progression rate of retinopathy in older persons has been shown to be directly related to their HbA^sub 1^C level [16]. Persons with diabetes are more likely to develop infection, including recurrence of tuberculosis [17]. Osmotic diuresis from elevated glucose levels leads to nocturia with interference of sleep, increased incontinence and dehydration. Dehydration is particularly likely to occur in older persons because of their impaired thirst drive [18].

Diabetics are more likely to complain of pain than other persons with chronic diseases [19]. Infusion of glucose into healthy young men decreased both the pain threshold and the maximal pain tolerated [20]. Older male diabetics could tolerate less pain than age- matched non-diabetics. Glucose appears to decrease pain-tolerance by inhibiting the ability of beta-endorphin to down-regulate perceived pain.

Table II. Reasons for the maintenance of euglycemia in older persons.

Diabetes, besides being associated with an increased incidence of vascular ulcers, is also associated with a higher incidence of pressure ulcers [20]. In diabetics, these ulcers tend to heal slower.

Postprandial hypotension is associated with an increase in falls, syncope, stroke, myocardial infarction and death [21]. It is stimulated by carbohydrate which releases the vasodilatory peptide, calcitonin gene related peptide [22]. Postprandial hypotension is more common in persons with diabetes mellitus.

Aretaeus, the Cappadocian (~AD80) stated that diabetes is a disease ofthe stomach. Diabetes, especially when poorly controlled, delays stomach emptying [23]. This can interact with the delayed stomach emptying already seen in older persons [24]. Poor glycemic control compared to good control is associated with a marked increase in gastrointestinal symptoms including dysphagia, heartburn, nausea, postprandial fullness, diarrhea, constipation and fecal incontinence.

Zinc deficiency occurs in approximately 10% of older diabetics [25,26]. Diabetes is associated with impaired zinc absorption. In addition, glucose infusion results in hyperzincuria. Zinc deficiency has been associated with decreased phytohemoglutinin T cell proliferation, increased lipid peroxidation, decreased zinc serum thymic factor, decreased antioxidant activity, decreased wound healing and decreased testosterone levels [27].

Impaired cognition, functional decline and diabetes

A systematic literature review found that diabetes, hypertension, stroke and arthritis were the conditions most likely to be associated with subsequent functional decline [28]. The Manitoba Longitudinal Study on Aging showed in a 12-year follow-up study of 3,573 individuals 65 to 84 years of age that not having diabetes was one of the factors that predicted maintaining functional independence [29]. Numerous other studies from around the world have shown that diabetes is a strong predictor of disability [5,6,30, 31,32]. In the third National Health and Nutrition Examination Survey (NHANES III), disability was found to be present in 39% of diabetic men and 63% of diabetic women [30]. In men, but not women, stroke was an important predictor of disability.

The All Wales Research in Elderly Diabetes (AWARE) study compared 400 diabetics over the age of 65 years with an age-matched cohort of nondiabetics [33]. This study found that diabetics had a greater disability on the Barthel Index and were more likely to use a walking aid. This study also found that diabetics were less likely to read, use the telephone, go out socially, write letters or garden than were non-diabetics.

Lower body disability and impaired mobility are particularly common in older person with diabetes [34]. A community based study found that persons with diabetes mellitus were more likely to have injurious falls than non-diabetics [6]. Maurer et al. [35] found in a nursing home that the fall rate in persons with diabetes was 78% and only 30% in those without. Multiple factors besides lower body disability, such as visual impairment, orthostatic hypotension, postprandial hypotension and cognitive impairment appear to play a role in the increased fall risk seen in older diabetics. It should be recognized that autonomic abnormalities, such as orthostatic hypotension, are among the earliest manifestations of diabetes [36].

Animal studies have demonstrated that hyperglycemia, as well as hypoglycemia, is associated with poor memory [37]. Numerous community based studies have found that Type II diabetes mellitus is associated with cognitive impairment [38,39,40]. In older women, Gregg et al. [41] reported a 2-fold increase in cognitive impairment when followed for 6 years. Improvement of glucose control in older diabetics has been demonstrated to result in improvement in cognitive function [42,43]. Type 2 diabetes is associated with an increased risk in developing vascular dementia [44].

The possible reasons for diabetes and poor diabetic control being associated with cognitive impairment are listed in Table III. Diabetics, besides having an increased likelihood of developing vascular dementia, also appear to be more likely to develop Alzheimer’s disease [45]. Depression is more common in persons with diabetes than in those without diabetes [46]. Depression is a key factor in worsening diabetic control, decreased treatment compliance, hospitalization and subsequent death in persons with diabetes [15,47].

Hyperinsulinemia has been associated with poor cognitive function and insulin administered directly into the hippocampus in mice produces poor memory [49 and unpublished observations). Hypertriglyceridemia has been associated with delirium. Elevated triglycrides in persons with Type II diabetes are associated with poor performance on the digit symbol substitution test, digit span backward test and reaction time [48]. In a second study, elevated triglycerides were associated with poor retrieval from semantic memory in Type II diabetics [49]. Finally, reducing hypertrigylceridemia with gemfibrozil improved cerebral blood flow and function on the cognitive capacity screening examination [50]. Our unpublished studies in mice have shown that triglycerides injected into the brain can impair memory and in vitro triglycerides impair long term potentiation. Lowering hypertriglyceridemia with gemfibrozil in mice improves memory and reduces oxidative damage.

Table III. Potential causes of poor cognition in older persons with diabetes mellitus.

Leptin enhances long term potentiation and improves memory [51]. Hypertriglyceridemia impairs the ability of leptin to cross the blood brain barrier and enter the brain [52]. Thus, impaired ability of leptin to enter the brain may provide another mechanism by which hypertriglyceridemia impairs memory.

Overall, the recognition of the role of hyperglycemia and hypertriglyceridemia in impaired cognition and functional impairment represents a key reason for maintenance of good diabetic control.

Diabetes and hypertension

The United Kingdom Prospective Diabetes Study (UKDPS) demonstrated that lowering blood pressure to below 150/85 mm Hg found a decrease in microvascular disease, heart failure, and mortality in the well controlled group [53]. Treatment of hypertension appeared to be more effective than treating glucose in improving outcomes. There was no difference between those subjects receiving atenolol compared to those receiving captopril. Because of the entry age cut off of 65 years, this study cannot be applied to persons over 75 years of age.

The ALLHAT/The Antihypertensive and LipidLowering Treatment to Prevent Heart Attack Trial) followed 33,357 patients with a mean age of 67 years [54]. Type 2 diabetes was present in 36%. Chlorthalidone reduced heart failure to a greater degree than did amlodipine and was more effective than lisinopril in reducing blood pressure and preventing cardiovascular events. Persons with diabetes had similar results as those without diabetes.

Numerous studies have investigated the effects of angiotensin converting enzyme inhibitors and angiotensin receptor blockers in older persons with diabetes and hypertension [55,56,57]. They appear effective at reducing cardiovascular endpoints and microalbuminuria. The available data does not support that they are more effective than other antihypertensive medications. Both ramipril and losartan appear to lower the risk of diabetes occurring in persons over 55 years of age [56,58]. The reason for this is not apparent, though there is some evidence that these drugs may enhance skeletal muscle function and thus lower insulin resistance.

Diabetes and hypogonadism

It is now well recognized that late onset hypogonadism is a very common condition [59]. Diabetes mellitus is associated with an increased prevalence of hypogonadotrophic hypogonadism [60,61]. The reasons for this are uncertain, but the above mentioned zinc deficiency may be one of the causes. In addition, adipokines, such as leptin and tumor necrosis factor alpha, may play a role. Increased insulin levels decrease sex hormone binding globulin levels, leading to a decrease in total testosterone. Testosterone replacement therapy may have beneficial effects on insulin sensitivity in older diabetic men with late onset hypogonadism. A reduction in fat mass in response to testosterone replacement therapy leads to decreased circulating free fatty acids, possibly resulting in an improvement of insulin sensitivity. Until recently, however, the available data on testosterone replacement therapy for enhancing insulin sensitivity in older men with diabetes does not yet exist.

Diabetes and Nutrition

We have to lament that our mode of cure is so contrary to the inclinations of the efficacy of the [diet] regimen, and the impropriety of deviation, yet they commonly trespass, concealing what they feel as a transgression on themselves. They express a regret that a medicine could not be discovered however nauseous or distasteful, which would suppress the necessity of any restriction of diet.

(John Rolo, 1798)

Two studies have shown that at least in older persons in nursing homes, a regular diet and even ingestion of concentrated sweets makes little difference to glycemie control [62,63]. This has led to both the American Diabetic Association and the American Dietetic Association to no longer recommend the use of therapeutic diabetic diets in nursing homes [64,65]. The major reason to avoid diabetic diets in older persons is that they can interact with the anorexia of aging and lead to inappropriate weight loss and malnutrition.

Recent studies have strongly suggested that the hyperglycemia and hyperlipidemia following ingestion of a meal are more strongly related to future atherosclerotic cardiac disease than are fasting glucose levels [66]. The mechanism (s) of this effect include oxidative stress, tissue glycation, endothelial dysfunction, activation of coagulation and toxic effects of triglycerides and free fatty acids. The area of the hyperglycemic excursion following a meal can be limited by adding high fiber foods or polyunsaturated fatty acids to the meal.

Diabetics have an increase in gut wall permeability [67] which can lead to increased translocation of bacteria from the gut into the portal vein and thoracic duct. This leads to an increase in circulating endotoxins, such as lipopolysacarides, with activation of monocytes. Monocyte activation results in increased circulating cytokines, e.g. tumor necro\sis factor a. Elevated cytokines can result in anorexia, muscle loss (sarcopenia), functional decline and immune dysfunction. The use of prebiotics, e.g. oligofructosaccharides, may result in a decrease in cytokine production by altering the intestinal bacterial milieu.

Homocysteine levels are often elevated in older diabetics and are associated with accelerated atherosclerosis, osteopenia and Alzheimer’s disease [68]. One cause of high homocysteine levels is vitamin B12 deficiency, which occurs more commonly in diabetics. The diagnosis can be made by the combination of a low or borderline low vitamin Bi2 level and an elevated methylmalonic acid level. High dose folate will lower the levels in some other patients.

A number of other nutritional issues need to be considered in the older diabetic. These include (i) zinc replacement in older persons with vascular or pressure ulcers, (ii) high doses of vitamin C and E can interfere with the glucose oxidation reaction used to measure blood glucose levels, (iii) low magnesium levels, that occur with osmotic diuresis, may lead to increased levels of systolic hypertension, (iv) hypovitaminosis D is common in medical patients with diabetes [69] and there is an increased incidence of hip fracture in older diabetics [70], (v) high copper levels may accelerate atherosclerosis and (vi) the role of chromium together with nicotinic acid (glucose tolerance factor) in diabetics is uncertain, but appears minor [71].

Lifestyle interventions and diabetes

A number of studies have demonstrated that in middle-aged persons lifestyle modifications (diet and exercise) can reduce the progression of impaired glucose tolerance to Type II diabetes by approximately 50% [72,73,74]. This is in keeping with a large epidemiological study of 42,000 males aged 40 to 75 years where it was demonstrated that a ‘western’ style pattern (refined grains, red meat, French fries, high-fat dairy products and sweets/desserts) and low physical activity were associated with an increase in risk for Type 2 diabetes [75]. Moderate alcohol consumption, at least 5 drinks/week was protective against developing Type II diabetes. In the intervention studies lifestyle modification was more protective than metformin or acarbose [76]. In persons over 60 years of age metformin was no better than placebo.

Exercise is recommended for all older persons with diabetes. An exercise program should consist of endurance, resistance, balance, postural and flexibility exercises.

Medications and diabetes

In general, the same drugs as are used for the management of older as well as younger diabetics with some caveats (Table IV). A particularly important point is to recognize that in older persons loss of muscle mass can lead to severe renal failure occurring in the presence of a normal creatinine – the so-called ‘concealed renal failure’ [77]. This can lead to increased adverse drug reactions to water soluble drugs such as oral hypoglycemic agents, digoxin and angiotensin converting enzyme inhibitors.

Table IV. Medications used for the treatment of diabetes mellitus in older men.

The United Kingdom Prospective Diabetes Study demonstrated that it is very difficult to maintain intensive control of diabetes, as demonstrated by an increase in HbA^sub 1^C from approximately 6 to 8 over twelve years [78]. However, it should be pointed out that increases in the conventional care group were even higher. In middle- aged diabetics who were obese, metformin proved to be the most effective drug at improving outcomes. However, metformin tends to become less effective in older diabetics and the development of renal dysfunction with aging and disease such as congestive heart failure increase the risk of lactic acidosis occurring. In the United States metformin is not recommended for persons over 80 years of age. Metformin also can cause anorexia and weight loss [79] which can accelerate the development of protein energy undernutrition, a common problem in older persons [80].

Sulfonylurea drugs are still commonly used in older persons. Chlorpropramide should not be used over the age of 65 years as it has a prolonged half-life and is associated with a high incidence of hyponatremia. Similarly glybenclamide is not recommended in persons over 70 years of age. Glyburide, glipizide, and glimeperide all can be used safely in older persons. There does not appear to be a major difference between the drugs, with an equivalent prevalence of hypoglycemia occurring when they obtain the same degree of hypoglycemia. In some very old individuals, tolbutamide once a day may be sufficient to maintain euglycemia. Repaglinide, a meglitinide, and nateglinide, a D-phenylalanine derivative, have very short half-lives and therefore, need to be given multiple times a day making them less useful in older persons. There is no difference in hypoglycemic episodes between these agents and sulfonylureas.

Thiazolidinediones work by activating the PPARγ (peroxisome proliferator-activated receptor). These drugs enhance peripheral tissue sensitivity to insulin. Troglitizone was withdrawn because of a high level of liver failure associated with its use. At present pioglitasone and rosiglitasone are available. They are excellent monotherapy drugs in the old-old (> 80 years of age). These drugs are associated with occasional liver dysfunction, water retention and occasionally overt heart failure.

The alpha-1 glucosidase inhibitors, acarbose and miglitol, are drugs which tend to smooth out the glycemic excursion following a meal. This appears to be due to both delayed carbohydrate digestion and absorption as well as due to an increase in glucagonlike peptide- 1 [81]. These drugs are about half as effective as sulfonylureas at lowering the HbA^sub 1^C [82]. They are associated with abdominal pain, flatulence and diarrhoea. Acarbose has been demonstrated to decrease cardiovascular events in people with impaired glucose tolerance [83].

Glucagon-like peptide-1 (GLP-1) is a peptide that is produced by the duodenum and stimulates insulin production, inhibits hepatic glucose production, delays gastric emptying and produces anorexia. Recently, a frog skin homolog, GLP-1 receptor agonist, exendin-4, has been approved in the United States for treatment of Type 2 diabetes. It lowers Hb A^sub 1^C by approximately 1 in persons who are not controlled on sulfonylureas and/or metformin [84]. It is uncertain whether it will have a place in the management of the older diabetic.

Because of the problems with polypharmacy in older persons, it makes sense to move to insulin earlier, rather than later, when glycemic control cannot be easily obtained with oral agents. Of course, this approach depends on the ability of the older person or the caretaker to monitor blood glucose and administer insulin. Intermediate acting (NPH) and short-acting regular insulin remain the mainstay of the management of the older diabetic. Long acting drugs such as glargine insulin increase the risk for hypoglycemia when the older person doesn’t eat or food is delayed. Rapid acting insulins require administration 3 times a day and in the nursing home they are often given at a routine time and lead to hypoglycemia when the meal is delivered late.

Of the drugs under development, dipeptidyl peptidase (DPP) IV inhibitors appear to have the most promise for older diabetics. This enzyme is a member of a family of serine peptidases [85]. DPP inhibitors increase the release of insulin by stabilizing circulating concentrations of the gut incretin hormones via GLP-1 and glucose-dependent insulinotropic peptide (GIP). Efficacy of this drug-type has been demonstrated in humans [86].

The interdisciplinary team

The goals of diabetic management programs for the older people should be to optimize glycemic control for minimizing metabolic decompensation and long term complications and improve quality of life. Accordingly, managing diabetes in older persons requires an interdisciplinary team. Use of a team of health professionals has been shown to improve diabetic care over a single provider [87]. For the team to be optimally effective, physician extenders need to have the ability to make changes in medication dosage.

A number of studies have demonstrated that short-term educational programs can not only improve knowledge, but produce modest improvements in glycated hemoglobin, blood pressure and perceived quality of life [88,89,90,91,92,93]. Frequent followup and self- monitoring of blood glucose are key components to success. Older persons were shown to have low participation in self-monitoring of blood glucose in two studies [87,94].

Conclusion

In older persons the diagnosis of diabetes mellitus requires a fasting glucose of greater than 126 mg/dl (7 mmol/L) or a postprandial glucose greater than 200 mg/dL(11.1 mmol/L). Older diabetics have multiple problems due to the interaction of the aging process with the disease. This means that they are best treated within an interdisciplinary team. Both blood pressure and glucose should be carefully controlled, while minimizing hypoglycemia and orthostatic hypotension.

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63. Coulston AM, Mandelbaum D, Reaven GM. Dietary management of nursing home residents with non-insulin-dependent diabetes mellitus. Am J Clin Nutr 1990;51:67-71.

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74. van Dam RM, Willett WC, Rimm EB, Stampfer MJ, Hu FB. Dietary fat and meat intake in relation to risk of type 2 diabetes in men. Diabetes Care 2002;25:417-424.

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M. J. KIM, Y. ROLLAND, O. CEPEDA, J. K. GAMMACK, & J. E. MORLEY

Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, Musouri, USA

Correspondence: John E. Morley, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis Missouri 63104, USA. Tel: 1 314 977 8462. Fax: 1 314 771 8575. E-mail: [email protected]

Copyright Taylor & Francis Ltd. Sep 2006

(c) 2006 Aging Male. Provided by ProQuest Information and Learning. All rights Reserved.

FOXBORO, Mass., Nov. 7 /PRNewswire/ — BL Healthcare, is about to release a system that will allow closer monitoring of physiological parameters of chronic illness by the healthcare provider by accepting data transmitted by wireless medical devices in the home such as weight scales, blood pressure devices or glucose meters. Data is immediately made available to both the patient as well as the healthcare providers, wherever they may be. Anyone with a television and either a telephone line or an internet connection will be able to do so simply and without a computer.

BL Healthcare’s TVx system will enable patients to hold 2-way videoconferences with doctors and nurses or family members right from their home using their own Television as the display. An inbuilt video camera and a remote control with a microphone allow patients to videoconference with healthcare professionals or caregivers.

TVx System also enables video-based patient education, such as movies or video clips, to be made available on demand. This functionality provides patient education in the home in a visual form that shows the patients how to live with and manage their disease. These videos can be customized for each individual patient by the healthcare providers.

The TV – based display allows the patient to review information on-demand and answer interactive queries from the doctors and nurses. This system helps overcome barriers such as lack of literacy or discomfort with computers.

Patients suffering from chronic conditions such as diabetes, CHF, COPD, asthma and hypertension benefit from such remote monitoring.

“We have been testing BL Healthcare’s television based solution in a usability study for over a year. Both patients as well as the nurses find the system easy to use,” says Richard Jacovini, President of Homecare Network, Jefferson Health Systems. “We are in the process of implementing an organization wide remote care management program using BL Healthcare’s solutions,” continues Mr. Jacovini.

BL Healthcare remote care management products are characterized by reliability, simplicity and flexibility and are designed to empower providers, patients and caregivers to improve care, compliance and outcomes while reducing costs.

“If you know how to use a remote control to navigate your television screen, you know how to use the system,” says Michael Mathur, President and CEO of BL Healthcare.

A number of Health Plans are evaluating using these types of technology solutions for not only the chronically ill but also for ‘at risk’ and healthy people. BL Healthcare’s solutions provide a simple way for them to stay connected and communicate with their members.

About BL Healthcare

BL Healthcare, is a Massachusetts-based health care technology company (http://www.blhealthcare.com/ ) that develops, installs and supports remote health management solutions. The Company’s services link patients, providers, and caregivers for the monitoring and management of wellness and disease states at distributed points of healthcare access, particularly in the patient’s home.

For further information, please contact Doug Kinner at (508) 543 4150 — [email protected]

BL Healthcare

CONTACT: Doug Kinner of BL Healthcare, +1-508-543-4150,[email protected]

Web site: http://www.blhealthcare.com/

NEW YORK, Nov. 7 /PRNewswire/ — Paul Weathersbee, Ph.D., director of Ferring Pharmaceutical’s Medical Science Services, received a “Family Building Award” last night at the American Fertility Association’s (AFA) annual benefit, The Kokopelli Ball, at Pier 60 at Chelsea Piers in New York City. The AFA Family Building Award honorees are recognized for their commitment and determination to help those with reproductive difficulties. They are honored for using their expertise and dedication to patient care to help couples build families.

In 2003, Dr. Weathersbee joined Ferring Pharmaceuticals to provide scientific support for Ferring’s family of fertility treatments such as BRAVELLE(R) (urofollitropin for injection, purified), MENOPUR(R) (menotropins for injection, USP), REPRONEX(R) (menotropins for injection, USP) and NOVAREL(R) (chorionic gonadotropin for injection, USP). Dr. Weathersbee also oversees a group of regionally based Medical Science Liaisons (MSL’s) who provide clinical support to physicians about Ferring’s fertility treatments.

“The American Fertility Association is honored to present our 2006 Family Building Award to Dr. Weathersbee for his ongoing commitment to the reproductive community,” said Pamela Madsen, executive director of the AFA. “Dr. Weathersbee’s outstanding contributions in developing the first media products specifically designed for the in vitro fertilization (IVF) laboratory as well as his continuing efforts have helped educate professionals about advances in the fertility field.”

“I am honored to receive the AFA’s Family Building Award and to be recognized as a contributor to those who are going through the journey to parenthood,” said Dr. Weathersbee. “Ferring shares AFA’s commitment and desire to be patient-focused by providing educational resources and ongoing support for those couples trying to build a family.”

About Paul Weathersbee, Ph.D.

Paul Weathersbee, Ph.D. received his doctoral degree from the University of Illinois in 1978. He then completed a National Institutes of Health- sponsored post-doctoral position at the University of Washington with the Alcoholism and Drug Abuse Institute. His research led to the development of some of the first data on fetal alcohol syndrome (FAS) in a non-human primate model. In his first academic position at the University of California (UC) Irvine in the Department of Obstetrics and Gynecology, he served as the Reproductive and Endocrine Laboratory director. At UC Irvine, he also implemented trans-abdominal ovarian monitoring into the Division of Reproductive Endocrinology’s practice and was the chief sonographer. Dr. Weathersbee then joined Irvine Scientific where he was instrumental in developing the first commercially available culture media designed specifically for IVF. These products included Human Tubal Fluid (HTF) and Synthetic Serum Substitute (SSS).

In May 2003, Dr. Weathersbee brought his considerable expertise in the field to Ferring Pharmaceuticals as director of medical affairs after serving as the associate director of medical affairs at Organon and director of medical affairs at Serono. At Ferring, he oversees the field medical support of the sales team through a group of regionally based Medical Science Liaisons.

About Ferring Pharmaceuticals

Ferring Pharmaceuticals, part of the Ferring Group, a privately owned, international pharmaceutical company, markets BRAVELLE(R), MENOPUR(R), REPRONEX(R) and NOVAREL(R) in the U.S. to infertility specialists and their patients. Ferring also offers the Q*CAP(TM), the first and only needle-free reconstitution device, for use with its fertility treatments.

Ferring’s line of orthopaedic and urology products includes EUFLEXXA(TM), hyaluronic acid for pain from osteoarthritis in the knee. Other products include ACTHREL(R) (corticorelin ovine triflutate for injection) for the differential diagnosis of Cushing’s syndrome and DESMOPRESSIN ACETATE in injectable and rhinal tube forms for the treatment of diabetes insipidus and primary nocturnal enuresis.

The Ferring Group specializes in the research, development and commercialization of compounds in general and pediatric endocrinology, urology, gastroenterology, obstetrics/gynecology and infertility. For more information, call 888-337-7464 or visit http://www.ferringusa.com/ or http://www.ferringfertility.com/.

About the American Fertility Association (AFA)

The American Fertility Association is a national organization headquartered in New York City that provides education, support and advocacy for women and men facing decisions related to family building, reproductive health, preventive health and menopause. The mission of the AFA is to serve as a lifetime resource that helps people make informed choices about their reproductive health through advocacy, education, awareness building and research funding. For more information, call 1-888-917-3777.

Ferring Pharmaceuticals

CONTACT: Andrea Preston of Kovak-Likly Communications for FerringPharmaceuticals, +1-203-762-8833, [email protected]

Web site: http://www.ferringfertility.com/http://www.ferringusa.com/

By Peter Popham

High in the Italian Alps above the Venetian coast is a village where people do not fall ill. They eat red meat, they drink wine and grappa, many of them smoke, but the crippling, much-feared diseases of civilisation pass them by. They have high cholesterol because of their diet, but it doesn’t lead to heart attacks. Hypertension is almost unknown. Very few suffer from diabetes. Cancer is rare. Genetic disease is unheard of.

The village is called Stoccareddo, and it is Italy’s Shangri-La. Yet no one ever goes there because it is the end of the road. For about 800 years, since a couple of Danes, or so it is believed, pitched their tents on this high outcrop nearly 1,000 metres (3,000ft) above Venice (which on a clear day you can see), the people of Stoccareddo have kept themselves to themselves. And how: 97 per cent of the population bears the same surname, Bau. Endogamy – marrying with-penine passes in Tuscany or Umbria, in the community – is still nearly universal. “Only a Bau can understand a Bau,” goes the local saying. “The entire village throughout its history,” says one scientist who is studying them, “fits on a single family tree. It’s one huge family.”

Stoccareddo has suddenly become famous because, while in the rest of the world we are obsessed with the ills of civilisation, Stoccareddo doesn’t have them. Three years ago scientists trying to learn more about the genetic causes of rare diseases stumbled on the place.

For them its value was that it was a genetic island, which made it an ideal test bed for research into DNA. But quickly they discovered this other remarkable fact, that the people are incredibly healthy. They eat, they drink, the pensioners play cards in the local bar (and knock back pros-ecco at tea time), the children play football in the street, women take down washing and smoke and gossip. It is all intensely normal. Except for this extraordinary, blessed fact: the people go on and on. “Horses die, not Baus,” the locals say.

I pulled into the village piazza on a sunny October afternoon. It was not what I had expected. Stoccareddo, I had understood, was high up and far away, immensely remote and hard to get to. I had in mind the sort of villages you find in remote Appenine passes in Tuscany or Umbria, all grave grey stone covered in orange lichen and aged crones bent at the waist. Stoccareddo wasn’t like that at all. For one thing it wasn’t remote: Gallio, the neighbouring large village of which it is an administrative frazione, is 10 minutes away by car. Asiago, a tourist town that draws thousands of people from the plains escaping the heat of summer or coming up to ski, is only a few kilometres further on. We are talking high plateau here, not vertiginous mountain passes. Under the autumn sun, with the foliage on the slopes beginning to turn, the area is blindingly beautiful.

Stoccareddo, however, is not. Don’t go expecting the picturesque, which in Italian villages tends to go with dwindling populations, no new babies in decades, and Brits and Germans lining up at the offices of the im-mobiliaristi waving their chequebooks. Stoccareddo is not moribund like those pretty villages we covet: it is energetic and prosperous, teeming with children, and rather ugly.

I got out of the car and introduced myself to three old men sitting on a bench on the promontory that looks across to the mountains. Fortunato Bau, 68, beaming and ruddy-faced, took me in hand. Like hundreds of Italian villages, Stoccareddo does not offer enough work to keep its population busy. For generations they have been going away to work, especially as miners.

Fortunato went to France as a young man, stayed eight years and came back with enough capital to set himself up in the building trade. He’s been making money ever since, and is now the owner of a large slab of housing at the bottom of the village. He’s pretty typical of the village which, with a population of 390, has nine little firms specialising in making roofs and three factories, two turning out trousers and one flower vases. “They’re not lazy people,” said Fortunato’s son Wimer, 32, a village councillor, “they roll up their sleeves.”

Most of the village houses are modern, hulking, imitation chalets, all recently built or modernised. In the evening the village street is lined with newish cars. Stoccareddo is not, therefore, a case of Tibetan-type isolation, a la Lost Horizon. But until a couple of decades ago it was far more isolated than it appears today. Until then it was not possible to drive by car to Gallio and the only way out of the village was down “4,444 steps”, I was told, to the nearest railway station. “We’d come back from where we were working in November,” said Fortunato, “and stay at home until March, by which time our money had run out. Then we would set off again.” But more than physical remoteness, the key factor in the village’s genetic health would seem to be its cultural isolation and homogeneity: the men might spend months working far away, but they would invariably marry a local woman, and raise their families in the village.

Even today, with the outside world so temptingly close, most marriages are within the community. Which raises a ticklish question: isn’t all that intermarriage supposed to be a bad thing, genetically speaking? Think Romanoffs, think haemophilia and chinless wonders …

“Those are royals, and different rules apply,” said Uros Hladnik, one of the geneticists who is studying the village population. “They always had expensive health care, there was not the selection of healthy mates. If the in-breeding started a long time in the past, as it did in Stoccareddo, all the bad genes must have been flushed out. Today there is not a single case of genetic disease to be found among the Baus.”

Dr Hladnik works for the Baschirotto Institute for Rare Diseases (Bird), whose tireless work is the reason Stoccareddo is becoming so famous.

And with him we descend from the mountains to the plains, and from the calm joy of being disease-free to the complicated and desperate hell of rare genetic illness.

In 1970, Anna Baschirotto, a teacher of Italian literature, gave birth to a son, Mauro. Within a year it transpired that the baby was incurably ill, but no doctor could tell her why. The symptoms were terrifying: the disease retarded his growth, gave him incessant skin, nail and hair problems and weakened his immune system, making him vulnerable to every infection. Ms Baschirotto and her husband, Guiseppe, wrestled with the illness for 15 years, and with the paucity of resources, the weakness of diagnosis and the scarcity of medicines available for such rare conditions. At the age of 16, Mauro died. “It was a real Calvary,” Ms Baschirotto says. “He was very sweet and very intelligent. No one knew his illness was genetic until 10 years after his death.” Today it is identified as Apeced syndrome. Still there is no cure. The bereaved couple’s life was transformed by the experience, and after his death they set up a foundation to bring to others afflicted with rare conditions the sort of help they so dramatically lacked. Bird operates inside Italy’s national health system, though it also is in need of private funding.

“For 15 years we struggled against his disease,” Ms Baschirotto said, “and when he died we decided to devote ourselves to helping others in the same situation.” The couple raised money and bought an old convent outside Vicenza which is now their headquarters.

Here they offer speedy diagnosis, outpatient care and therapy and the chance for victims of incredibly rare conditions to come together and discover that they are not alone in the world. They host, for example, groups of children with Lesch-Nyhan disease, which produces the symptoms of acute gout in the legs, and gives the children the compulsion to bite and hurt themselves and others, meaning their hands must be permanently restrained. Or sufferers from the equally terrible Prader-Willi syndrome, which stunts growth, enfeebles muscular development, and makes the victims constantly and insatiably hungry.

The sufferers are also seeking cures but the common factor in these diseases, apart from their cruelty and complexity, is that because they are so rare no pharmaceutical company is interested in devoting millions to curing them.

“It was a forgotten area of medicine,” Ms Baschirotto said. “Not much work had been done on rare diseases, it was not interesting for the pharmaceutical world. There was no profit in producing the medicines – it was only good for the patients themselves. But we have a different mission from the pharmaceutical companies. I don’t criticise their mission, which is profit, but ours is different.” The Baschirottos set about trying to do what the commercial world would not, filling the old convent with laboratories and hiring a staff of high-powered geneticists to conduct cutting-edge research.

It was the compassionate work of her institute that brought Ms Baschirotto to the Alta Valsugana region, where Stoccareddo is located. “A little girl called Angela, who lived in Asiago, near Stoccareddo, died of genetic disease two-and-a-half years ago,” she remembered. “We got to know the area and we got to know Stoccareddo and we learnt about its unique genetic inheritance.” It is not unusual for villages in this region, the Valsugana, to be dominated by a single surname. “There are others round about,” said Don Giampaolo, Stoccareddo’s priest. “In the village of Zaibena there are many Marinis; in Asiago there are 2,000 Rigonis out of a total population of 6,000; in Sasso the dominant name is Rossi.” But nowhere is the domination so complete as in Stoccareddo.

“We came here,” said Ms Baschirotto, “because it is a genetic island and we thought it could be useful at the genetic level for our work into the prevention of genetic disease. There are genetic lessons to be learnt here that can be of value not just to us and our patients but to all humanity. A local doctor introduced us and helped us to get the villagers’ trust.”

They took blood and other medical samples from the whole village – and slowly the stunning picture of a village free from disease was revealed. A village, for example, with a classically heavy, over- rich, over-meaty diet, but with none of the associated problems. Far more men in the village have high cholesterol than the Italian average, 38 per cent as opposed to 21 per cent. But while 23 per cent of Italian males have problematically low levels of HDL, the “good” cholesterol that helps prevent heart disease, only 5.4 per cent of Stoccareddo have this problem. Hypertension is a problem for 33 per cent of Italian men and 31 per cent of Italian women; the figures for Stoccareddo are 6.5 and 5.5 per cent respectively. “We found many villagers with high cholesterol,” says Dr Hladnik, “but a very low incidence of the problems connected with high cholesterol. Something is protecting them from the complications that normally result from high cholesterol. It’s our job to find out what.” Meanwhile the Baus are sitting back and basking in their new fame: rarely in my experience has journalistic nosiness been accorded such a joyous welcome. Fortunato actually invited me to stay the night. When the idea was shot down by his wife Teonilda (another Bau, needless to say), he poured me an afternoon campari soda and belted out one of the village songs.

(c) 2006 Independent, The; London (UK). Provided by ProQuest Information and Learning. All rights Reserved.

By Katie McDevitt, The Tribune, Mesa, Ariz.

Nov. 5–Bicycle officer Heather Penner stopped suddenly while patrolling a Tempe parking lot.

“Smell that?” she asked.

A faint odor lingered in the night air but quickly floated off with a breeze.

Penner pointed her head and sniffed frantically toward the sky. Her eyes darted about the rows of parked cars. In seconds, her gaze stopped on a sedan parked in the corner with its windows partially open.

She parked her bike and walked up to the car, where two young women had just lit up a marijuana pipe.

“I never do this,” one woman said to Penner. “I can’t believe I got caught.”

State Capitol police Sgt. Bob Gerome, who was working as Penner’s partner, chuckled as a paddy wagon drove off with the women loaded in the back.

“You were like a bloodhound,” he said in amazement.

Penner laughed, and the two officers rode off to find the next crime.

It’s not hard to understand why patrolling the streets on a bicycles has its advantages. The officers can see, smell and hear what police in cruisers cannot. They can sneak up quietly on criminals and aggressively corner them with their bicycles. And if an offender runs, they can hunt him down more quickly than officers on foot.

They’re fit and they’re tough. But at the same time, they’re friendly faces on Mill Avenue who will provide directions to people who are lost and recommend parking spaces.

Recently, the Tempe bike team taught a two-day, 20-hour bicycle certification class in which eight officers navigated through cones, popped up stairs and tackled sandy off-road trails so they could learn what it takes to become a bicycle cop. The Tribune came along.

WELCOME TO BIKE SCHOOL

Officer Anthony Miller is a strong, stocky man built like a football player. He has already attended bike school once but couldn’t pass. So he decided to try again.

“You can’t expect to show up and just do it,” Miller said. “You have to be in bike shape and doing the cones. You have to practice it.”

A Show Low officer, two state Capitol police officers and five Tempe officers arrived quietly to the bike trailer about 5 p.m. on the first day of class. The bike trailer is north of the Mill Avenue bridge, a small area where the bike unit meets before heading out to the streets.

Among the group were two of Mill Avenue’s mounted officers.

“When it rains, they can’t go on the horse,” said bike team Sgt. Mike Powell. “So we want to have everyone crosstrained.”

After basic bicycle education, the class rode near Tempe Town Lake to practice skills essential for the 10-hour shift that bike cops work. They learned to dismount the moving bike, ride with their arms around each other and stay on the bike despite being pushed.

Finally, the group embarked on a 15-mile flat ride where they stopped only for pushups and sit-ups.

Many officers agree the bicycle unit is one of the hardest working groups in the department. In fact, the 10 officers on the bike team combined arrest at least 100 people each week.

After a long day of riding ended, the fatigued group still had one final task: practicing tactics.

“When you talk with someone, use your bike like a car,” said officer Mike Hayes, a three-year bike veteran. The bicycle should be positioned between the officer and the suspect, Hayes told the class at the end of the night. “It’s easier to chase someone down on a bike than to get into a foot pursuit,” he said.

The officers left their first day of training aching and weary. But that didn’t stop them from returning the next day for another round of pedaling.

PASSING THE CLASS

“If you fall in front of a crowd once, I guarantee you won’t do it again,” said Sgt. Mike Powell to the class.

It hurts, and people laugh, but “you get up and ride away,” said officer Kevin Kelch. “Then you can go around the corner and feel your pain.”

Many of the officers in the bike class had minor falls during training. Past classes had hospital trips and fainting episodes.

As the second day of class began, mumbles of sore backs and aching rear ends echoed throughout the group. After some stretches, the class embarked on an off-road trip through Papago Park. The riders flicked their gears and pedaled hard over gravel and hills covered in sand.

When the ride was over, the officers went back to the bike trailer for a quick drink of water before heading out to one of the most challenging parts of the class — the stairs.

To pass the class, each person had to learn to ride up two steps. The group began by practicing on a curb.

For some, popping up the stairs came easy. But other officers smacked the steps and came to a halt or fell to the side.

“Speed it up,” Hayes said to one officer who approached the stairs slowly and couldn’t make it. Hayes stood by to catch anyone who fell.

The officers were straightfaced and serious during the stairs part of the training. But by the end of the lesson, their demeanor changed. The group lined up single-file and rode up and down stairs comfortably.

The veteran cyclists flew down flights of stairs and performed tricks nearby, while curious onlookers watched the show.

“I wasn’t the greatest bike rider,” officer Tom Blank said. “But when they show you step by step how to do it, it’s pretty easy.”

Blank, who normally works in a patrol car, is a tall and quiet man who attended the class to get certified to work overtime hours on a bicycle. But he still had to pass the test.

THE OBSTACLE COURSE

Gusts of cold air blew from under a freeway overpass as the class prepared to take its final test near Tempe Town Lake.

Two minutes, 30 seconds was the time limit to weave through tightly placed cones, perform tactical maneuvers, hop a curb, dismount the bike and pull together everything learned.

“Usually, all of them pass,” Kelch said. “We’ll work with them for the whole two days if they can’t pass it.”

The words were comforting to the group, but it didn’t stop the nervousness. If the officers pass the obstacle course, they are certified to work on a bicycle. But to join the bike team, they must go through a selection process.

“I just want to get past the keyhole part because that’s the biggest part I’ve had trouble with,” Blank said while watching another officer wind through the course.

The keyhole is named after a particular arrangement of cones.

As the officers stood around waiting for their turn, a loud “Whoo hoo” rang out through the crowd.

Officer Anthony Miller, who failed the test last time around, finished the course in just more than two minutes. He smiled as he rode his bike up the hill toward the rest of the group.

At the end of the class, all eight officers passed. They filed into the bike trailer about 10 p.m., where they were rewarded with hot hamburgers on the grill.

The officers then changed into their uniforms and headed to Mill Avenue to put to work what they’d learned.

“It was intense,” officer Kyle Swesey said. “And there were a lot of guys pushing us.”

—–

Copyright (c) 2006, The Tribune, Mesa, Ariz.

Distributed by McClatchy-Tribune Business News.

For reprints, email [email protected], call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

DETROIT, Nov. 2 /PRNewswire/ — Detroit Receiving announced the launch of its Senior Education Series today. The Series is designed to help seniors and their families make informed health care decisions about issues related to aging. Speaking at the event was Governor Jennifer M. Granholm. The governor, along with hospital leadership, kicked-off the series, which is offered through the hospital’s Rosa Parks Geriatric Center. Following the launch, a group of senior citizens participated in the first seminar of the series called “Aging Successfully,” at the hospital.

(Photo: http://www.newscom.com/cgi-bin/prnh/20061102/CLTH548 )

“The DMC and Rosa Parks Geriatric Center are providing an invaluable service by providing access to health care,” Granholm said. “We want to make access to affordable health care universal and have an economic plan to make that a priority because health care matters to all people.”

“We are pleased to have such visible support for an important outreach program,” said Iris Taylor, Ph.D., president of Detroit Receiving Hospital. “We’re honored to have Governor Granholm here to speak and look forward to expanding our services for seniors, and adults of all ages.”

The Rosa Parks Geriatric Center at Detroit Receiving Hospital is dedicated to servicing the health needs of adults 60 and older. The Center team is comprised of geriatric specialty physicians, nurse practitioners, social workers and pharmacists. Each team member is experienced in caring for older adults, and is committed to understanding the patient’s needs. Through a multidisciplinary approach, the Center provides comprehensive primary care, as well as care for those conditions common to many seniors, such as high blood pressure and diabetes. In addition to primary care, the Center provides access to specialties in cardiology, psychiatry, and rehabilitation, as well as diagnostic services.

The Rosa Parks Geriatric Center is part of the Detroit Medical Center’s Geriatric Center of excellence, which is designed to provide comprehensive services to the growing population of seniors in the Metro area. The Geriatric Center of excellence improves senior health care through education, research, clinical programs and community partnerships.

For more information on these services or to schedule an appointment, please call the Senior Health Line at 1-888-264-0102.

Detroit Receiving Hospital, Michigan’s first Level I Trauma Center, is an adult specialty hospital offering expertise in emergency medicine, complex trauma, critical care, neuroscience and gerontology. As the region’s leader in emergency medicine, Receiving’s emergency department treats more than 85,000 patients annually, and nearly 60 percent of Michigan’s emergency physicians are trained at Receiving. Receiving also features the state’s largest burn center, Michigan’s first hospital-based 24/7 hyperbaric oxygen therapy program, and Metro Detroit’s first certified primary stroke center.

Detroit Receiving Hospital is one of nine hospitals operated by the Detroit Medical Center (DMC). The DMC is proud to be the Official Healthcare Services Provider of the Detroit Tigers, Detroit Red Wings, Detroit Pistons and Detroit Shock.

Photo: NewsCom: http://www.newscom.com/cgi-bin/prnh/20061102/CLTH548AP Archive: http://photoarchive.ap.org/PRN Photo Desk, [email protected]

Detroit Receiving Hospital

CONTACT: Bree Glenn, Public Relations and Marketing Manager of DetroitReceiving Hospital, +1-313-966-9611, or [email protected]

Web site: http://www.dmc.org/

PITTSBURGH, Nov. 2 /PRNewswire/ — Highmark Inc. today announced the insurer’s newest tool to help employers manage costs while encouraging appropriate care. Through a special unit of nurses, registered dietitians and exercise physiologists, Blues on Call Plus offers tailored programs that meet group customers’ unique needs.

“This program is designed to help our group customers address the health care needs of all employees,” said Michael Dubroff, D.O., Highmark’s vice president for Health Excellence Partners, the Highmark unit that oversees the new program. “Blues on Call Plus addresses the range of health care services with an increased emphasis on wellness and preventive care to help prevent diseases before they become chronic conditions such as diabetes and heart disease.”

The new program, which groups may purchase beginning in January, has four components that target members at different health stages. All components stress wellness and preventive care as the keys to a healthier lifestyle. Highmark also provides a medical director and physician consultant to help resolve health-related conditions that impact productivity.

Health Promotion Outreach targets those at risk of developing a chronic condition by helping them identify programs and services that reverse, stop or slow their chances of that disease. Based on information provided through personal wellness profiles, Health Coaches reach out to employees — identifying programs based on their specific health care needs. Tailored outreach services are also available for eight targeted health conditions, including depression and obesity. Condition management programs help members with chronic conditions such as diabetes or congestive heart failure better manage their condition.

Blues on Call Plus also includes a complex case and utilization management component for members with high cost or specific diagnosis. Nurse specialists guide members to appropriate, timely health care services while ensuring members have access to appropriate support and services after hospital discharge.

“The goal with Blues on Call Plus is to take care of the whole person by encouraging employees to live a healthy lifestyle while addressing any behavioral risk factors and chronic conditions,” said Dubroff. “Keeping members healthy, present and productive at work benefits both the employer and employee.”

The insurer is currently launching the program with its own employees and several employer groups. Highmark will charge groups that purchase Blues on Call Plus an additional fee, which it hopes will be offset by improvements in member health status and a reduction in those who develop chronic conditions. The insurer will provide employers with performance scorecards on a regular basis highlighting the numbers of interventions performed and the types and quantities of interactions with the group’s employees.

About Highmark

As one of the leading health insurers in Pennsylvania, Highmark Inc.’s mission is to provide access to affordable, quality health care enabling individuals to live longer, healthier lives. Based in Pittsburgh, Highmark serves 4.6 million people through the company’s health care benefits business.

Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. For more information about Highmark visit http://www.highmark.com/. .

Highmark Inc.

CONTACT: Denise Grabner, +1-412-544-7488, [email protected], or Leilyn Perri, +1-717-302-4243, [email protected], both of Highmark Inc.

Web site: http://www.highmark.com/

INDIANAPOLIS, Nov. 2 /PRNewswire/ — For the nearly 107 million Americans with high cholesterol, monitoring levels just got easier. Starting today, the CardioChek(R) handheld meter is available over the counter at all CVS/pharmacy stores (nearly 6,200 locations) throughout the United States. CardioChek measures cholesterol and related whole blood indicators of cardiovascular risk in just two minutes.

The CardioChek meter retails at $99.99. A package of three PTS Panels(TM) Total Cholesterol Test Strips or HDL Test Strips sells for $12.99, and must be purchased separately. The products are FDA cleared.

About the CardioChek system

The CardioChek system is a hand-held analyzer used with PTS Panels Test Strips. The system monitors key health indicators related to heart disease, diabetes and other chronic conditions. Home users simply insert a color-coded test strip and accompanying MEMo chip(TM) into the meter; add a small amount of blood (about 15 micro liters); and test results are displayed within two minutes.

The CardioChek analyzer stores up to thirty results in memory for future comparison. It can be programmed in one of six languages: English, Spanish, French, German, Italian, and Portuguese.

The system is manufactured by Polymer Technology Systems Inc., an Indianapolis-based company that delivers point-of-care diagnostics to the global health care market. “As the price of health insurance and health care continues to escalate, consumers are looking for ways to monitor their health at home. The CardioChek monitor is an easy and simple way to monitor your cholesterol levels at home,” says Bob Huffstodt, PTS CEO. “Having tested millions of people worldwide in doctors’ offices and at health fairs with our professional system, we are very excited to now make our consumer version available to consumers at CVS/pharmacy.”

About CVS/pharmacy

CVS/pharmacy, a wholly-owned subsidiary of CVS Corporation, is America’s largest retail pharmacy. CVS is committed to serving the healthcare needs of all customers by being the easiest pharmacy for customers to use, both in its stores and online at CVS.com. General information about CVS is available at http://www.cvs.com/pressroom , as well as http://investor.cvs.com/ .

About Polymer Technology Systems Inc. (PTS)

Polymer Technology Systems Inc. is a global company headquartered in Indianapolis, Ind., with sales offices in Africa, Australia, Europe, Latin America, the Middle East, and the Pacific Rim. PTS developed and markets point-of-care diagnostic products including the CardioChek and CardioChek PA handheld analyzers. PTS has developed PTS Panels Test Strips kits for home use with the CardioChek to measure Total Cholesterol, HDL Cholesterol, and Triglycerides. PTS also offers tests for direct LDL cholesterol, Creatinine, Ketone, Glucose, Lipid panel, and other combination test strips for professional use with the CardioChek PA. For more information visit http://www.cardiochek.com/ .

Polymer Technology Systems Inc.

CONTACT: Rae Hostetler of Hostetler Public Relations, +1-317-733-8700,[email protected] , for Polymer Technology Systems Inc.

Web site: http://www.cvs.com/pressroomhttp://investor.cvs.com/http://www.cardiochek.com/

BOSTON, Nov. 2 /PRNewswire/ — Surface Logix Inc. announced today that the Company’s lead clinical candidate, SLx-2101, has been selected as one of the top ten most promising cardiovascular drugs in development, offering significant potential for strategic partnering. SLx-2101 is an oral selective, fast-onset, long-acting (48 hour) PDE-5 inhibitor designed specifically to expand the therapeutic potential of PDE-5 inhibition beyond erectile dysfunction into larger cardiovascular markets. The selection was made by an independent committee assembled by Windhover Information, a leading provider of business information products and services to senior executives in the pharmaceutical, biotechnology, and medical device industries.

“Selected companies have been screened using a strict set of judging criteria for the top ten award, and represent what our committee considered the most attractive cardiovascular licensing opportunities the industry has to offer,” stated Roger Longman of Windhover Information.

“It is an honor to be chosen by this respected group of industry professionals, and we welcome the independent validation of SLx-2101,” said Jim Mahoney, Surface Logix President and Chief Executive Officer. “We are currently investigating SLx-2101 in Phase II clinical trials and believe it will fulfill the original promise of PDE5 inhibition in cardiovascular disease including hypertension and Raynaud’s disease.”

The selection committee was led by Marc Wortman, PhD, contributing writer to Windhover’s In Vivo and Start Up, and Ed Saltzman, president of Defined Health, a leading business development strategy consulting firm. Drawing on the analytic resources of both organizations, the group evaluated hundreds of compounds currently in development for the treatment of cardiovascular disease prior to selecting SLx-2101 among the top ten most attractive.

The evaluation which ranked SLx-2101 among this top echelon measured a number of factors including:

   -- Unmet medical need   -- Market potential   -- Multi-level partnering opportunities (biotech and pharma)   -- Potential for new opportunities beyond initial indications   -- Diversity of indications   -- History of the molecule and drug   -- Strong science   -- Strong company   

As a selected company, Surface Logix has been invited to present data on SLx-2101 at Windhover’s Therapeutic Alliances Cardiovascular Conference in Chicago on November 16th, immediately following the American Heart Association (AHA) Conference.

About SLx-2101

SLx-2101 was designed using Surface Logix’s proprietary chemistry platform, the Pharmacomer Technology Platform to have a combination of potency, selectivity, tissue distribution and half-life which optimizes its potential for once daily utility in the vascular tissues involved in major cardiovascular diseases. The clinical experience of SLx-2101 to date establishes the PK range of the PDE5 inhibitor as well as demonstrating efficacy in established models of endothelial function (peripheral arterial tone and erectile function). Additional Phase II studies in cardiovascular indications are scheduled for Q4, 2006.

About Surface Logix Inc.

Surface Logix Inc. uses its expertise in biophysical chemistry to create new small molecule drugs that are optimized to meet the challenges of human physiology. The company is advancing multiple internal programs focused primarily on cardiovascular, metabolic, inflammatory and fibrotic diseases. For more information, please visit http://www.surfacelogix.com/.

   Contact:   Warwick Tong   Senior Vice President, Commercial Development   [email protected]   617.746.8500    Media:   Kari Watson   MacDougall Biomedical Communications Inc.   [email protected]   508.647.0209  

Surface Logix Inc.

CONTACT: Warwick Tong, Senior Vice President, Commercial Development of+1-617-746-8500, [email protected]; or Media: Kari Watson of MacDougallBiomedical Communications Inc., +1-508-647-0209, [email protected]

Web site: http://www.surfacelogix.com/

WESTWOOD, N.J., Nov. 1 /PRNewswire/ — Hackensack University Medical Center (HUMC) has entered into a Memorandum of Understanding with Pascack Valley Hospital (PVH) to acquire the hospital from Well Care Group, Inc. The acquisition is expected to be completed in early 2007.

Under the terms of the agreement HUMC’s clinical and financial resources would support PVH’s existing programs, and help establish new services while also enhancing the overall technology and equipment at the hospital and its affiliates. HUMC also is committed to enhancing the availability of full-time physicians and to establishing additional specialty care services in areas such as radiology, anesthesia, and in the emergency room.

“This is an opportunity for Hackensack University Medical Center to provide expanded quality of care to a community where Pascack Valley Hospital has done an extraordinary job in building a dedicated patient base,” stated John Ferguson, President and CEO, Hackensack University Medical Center. “It also is an opportunity that allows HUMC to continue its growth in key service areas of patient care such as oncology, cardiac services, and women’s and children’s services.”

“The merger is a natural progression for Pascack Valley and Hackensack University Medical Center, considering that we share many physicians and services already,” stated Donald M. Genaro, Chairman of the Board of Directors at Pascack Valley Hospital.

“This is a win for all involved — especially for Pascack patients and their families — providing benefits to the community now and for generations to come.”

“While it is true that this merger will benefit both hospitals, the ultimate beneficiary of this acquisition is each of the communities served by HUMC, PVH and our affiliates,” added Joseph Simunovich, Chairman of the HUMC Board of Governors. “The union will result in enhanced clinical offerings that will, in turn, provide high-quality, cost-effective health care to all patients served by these hospitals.”

Once the merger is complete, PVH will be renamed “Pascack Valley Hospital, an Affiliate of Hackensack University Medical Center.” Physicians on the medical staff of PVH will maintain their same privileges at HUMC going forward.

Hackensack University Medical Center, a 781-bed teaching and research hospital affiliated with The University of Medicine and Dentistry of New Jersey-New Jersey Medical School, is the largest provider of inpatient and outpatient services in the state of New Jersey and the fourth largest hospital in the nation based on admissions.

Pascack Valley Hospital (PVH) is a full-service, 291-bed non-profit medical center and the flagship of an integrated network of healthcare services and physicians known as the Well Care Group, Inc., which provides a full spectrum of the most advanced, technically-specialized healthcare services available today.

Hackensack University Medical Center (HUMC)

CONTACT: Tony Bawidamann of MWW Group, +1-201-231-6035,[email protected], for Hackensack University Medical Center (HUMC)

PITTSBURGH, Nov. 1 /PRNewswire/ — Two hundred and eighty eight mental health advocates from all areas of the state of Pennsylvania have sent a petition to Governor Rendell. Their concerns stem from increased difficulty in obtaining care for persons with severe mental illness since the governor’s office began downsizing psychiatric state hospital beds. The petition is included below as well as the signatures of the three Pittsburgh-area psychiatrists who spearheaded the petition drive. The two hundred and eighty- eight co-signers represent leading mental health advocates across the state – persons with mental illness, family members, physicians, psychiatrists, therapists, nurses, consumer advocates, business leaders and citizens. For a complete list of signers or for more information please contact Dr. Suzanne Vogel-Scibilia, Medical Director, Beaver County Psychiatric Services, 724-775-9152 or at Email: [email protected].

   The following petition has been sent to Governor Rendell:    Petition:   

We wish to express our strong opposition to any further downsizing or closing of state psychiatric hospitals in Pennsylvania. We represent a broad geographic and vocational spectrum of 288 state citizens, clients, family members and professionals, who are concerned and affected by the cutting of such services, and we fear the consequences for our communities. We feel that our concerns have not been addressed adequately by Governor Rendell’s staff at OMHSAS.

The recent closing of Harrisburg State Hospital highlights this concern. Nine months after the technical closure in January of 2006, over 24 clients still remain on the hospital grounds without a specific date of transfer. For the clients returned to the community, the funds for increased community services and programs offer inadequate assistance given the huge service deficits currently present in many Pennsylvania counties. This has long been known as a significant problem throughout our state. The National Alliance on Mental Illness (http://www.nami.org/grades) gave Pennsylvania’s 2006 mental health care system a D+ grade in a scientifically designed nation-wide evaluation.

As has been shown for over 40 years nationwide, the idea that some of the chronic mentally ill can be treated humanely and effectively without a long term treatment facility is wishful thinking. Scientific studies have shown that as state hospital beds decrease, the number of persons with mental illness imprisoned increases proportionally. Judge Michael J. Barrasse, Lackawanna County Court of Common Pleas (Phone 570-963-6452), has publicly expressed concern about the impact on the Pennsylvania’s prisons and justice system if the number of state hospital beds decline without a change in Pennsylvania’s current psychiatric service system. Persons with mental illness deserve better than to be placed in jails because of inadequate psychiatric state hospital capacity or viable outpatient community placements, and taxpayers should not be forced to assume the triple financial burden of increased inmates, more critically ill medical patients and expanding numbers of homeless.

Due to current comments from OMHSAS of Pennsylvania to community providers, many advocates believe the next hospital to close may be Mayview State Hospital. The Pittsburgh area has already begun to feel the damaging effects of reduced bed availability as this facility is down-sized. Our sickest clients can not obtain admission, spaces on acute inpatient psychiatric wards are less available to the community at large, increased numbers of inadequately-treated mentally ill patients are ending up homeless, dropping out of treatment or warehoused in jail; while pre-trial mentally ill jail inmates are waiting excessively for a forensic evaluation and treatment. These consequences escalate costs to local communities on many levels.

Pennsylvanians do not have a comprehensive, state-wide, written plan delineating the process of state hospital closures. We all agree that people with severe and persistent mental illness recover best when treated in the community; but the extreme current shortage of state hospital beds robs individuals with severe disease of the only safety net to prevent harm and jeopardizes recovery when the illness prevents living in our communities. Given the current services needs for consumers in Pennsylvania, the current state hospital system provides a necessary resource for safe care to individuals with severe and persistent mental illness who have failed to respond to treatment by other less restrictive means.

We call on Governor Rendell to speak directly to the voters of Pennsylvania, not to state whether any current plans exist or do not exist, but rather to make a firm and sincere campaign promise prior to this election to not close or down-size further state hospital beds in Pennsylvania. We ask this because of current inadequacies in community resources and the lack of a state-wide comprehensive plan for closure and placement. We await Governor Rendell’s response.

    Signed:     Suzanne Vogel-Scibilia MD      Medical Director, Beaver County Psychiatric Services, Beaver, PA 15009    David Ness MD      Psychiatrist, Western Psychiatric Institute and Clinic, Pittsburgh, PA    Christine Martone MD      Psychiatrist, Allegheny County Jail, Pittsburgh, PA  

Beaver County Psychiatric Services

CONTACT: Dr. Suzanne Vogel-Scibilia, Medical Director of Beaver CountyPsychiatric Services, +1-724-775-9152, or [email protected]

Given Imaging Ltd. (NASDAQ: GIVN) today announced new capsule endoscopy reimbursement policies for PillCam(TM) ESO and PillCam(TM) SB.

Esophageal Capsule Endoscopy

First Coast Service Options, Inc., administrator of Florida and Connecticut Medicare, has updated its capsule endoscopy guidelines becoming the first third-party payor to designate PillCam ESO to be medically reasonable and necessary as a diagnostic tool for patients who are unable to undergo conventional endoscopy or are diagnosed with portal hypertension and require immediate evaluation of esophageal varices. The updated guidelines are effective October 30, 2006. First Coast Service Options provides benefits to over 3 million beneficiaries. For more information visit the Centers for Medicare and Medicaid website at: http://www.cms.hhs.gov/mcd/viewlcd.asp?lcd_id=13831&lcd_version=8&show=all#19.

Mark Gilreath, senior vice president of global marketing at Given Imaging, said, “We applaud First Coast Service for their commitment to delivering the best care to their patients and are pleased that they recognized the value that PillCam ESO holds for helping those patients who cannot undergo conventional endoscopy or are at risk for varices. We anticipate that other payors will recognize this value to help them deliver the best patient care.”

Small Bowel Capsule Endoscopy

Spain’s National Health Service has included capsule endoscopy for the small bowel in its portfolio of health services. Effective immediately, individuals with symptoms of persistent obscure gastrointestinal bleeding of presumed small bowel origin following negative upper and lower endoscopies may undergo the PillCam SB procedure at hospitals and clinics that offer it.

About Given Imaging Ltd.

Given Imaging is redefining gastrointestinal diagnosis by developing, producing and marketing innovative, patient-friendly products for detecting gastrointestinal disorders. The company’s technology platform is the PillCam(TM) Platform, featuring the PillCam video capsule, a disposable, miniature video camera contained in a capsule, which is ingested by the patient, a sensor array, data recorder and RAPID(R) software. Given Imaging has three commercially available capsules: the PillCam SB video capsule to visualize the entire small intestine which is currently marketed in the United States and in more than 50 other countries; the PillCam ESO video capsule to visualize the esophagus; and the Agile(TM) patency capsule to determine the free passage of the PillCam capsule in the GI tract. The PillCam COLON video capsule to visualize the colon has been cleared for marketing in the European Union, and multi-center clinical trials are underway in Europe and the U.S. A capsule to visualize the stomach is under development. More than 400,000 patients worldwide have benefited from the PillCam capsule endoscopy procedure. Given Imaging’s headquarters, manufacturing and R&D facilities are located in Yoqneam, Israel; it has direct sales and marketing operations in the United States, Germany and France, and local offices in Japan, Spain and Australia. For more information, visit http://www.givenimaging.com.

This press release contains forward-looking statements within the meaning of the “safe harbor” provisions of the U.S. Private Securities Litigation Reform Act of 1995. These forward-looking statements include, but are not limited to, projections about our business and our future revenues, expenses and profitability. Forward-looking statements may be, but are not necessarily, identified by the use of forward-looking terminology such as “may,””anticipates,””estimates,””expects,””intends,””plans,””believes,” and words and terms of similar substance. Forward-looking statements involve known and unknown risks, uncertainties and other factors which may cause the actual events, results, performance, circumstances or achievements of the Company to be materially different from any future events, results, performance, circumstances or achievements expressed or implied by such forward-looking statements. Factors that could cause actual events, results, performance, circumstances or achievements to differ from such forward-looking statements include, but are not limited to, the following: (1) satisfactory results of clinical trials with PillCam Colon (2) changes in regulatory environment, (3) our success in implementing our sales, marketing and manufacturing plans, (4) protection and validity of patents and other intellectual property rights, (5) the impact of currency exchange rates, (6) the effect of competition by other companies, (7) the outcome of future litigation, including patent litigation with Olympus Corporation, (8) the reimbursement policies for our product from healthcare payors, (9) quarterly variations in operating results, (10) the impact of the newly adopted SFAS 123R for expensing option-based payments, (11) the possibility of armed conflict or civil or military unrest in Israel, and (12) other risks and factors disclosed in our filings with the U.S. Securities and Exchange Commission, including, but not limited to, risks and factors identified under such headings as “Risk Factors”, “Cautionary Language Regarding Forward-Looking Statements” and “Operating Results and Financial Review and Prospects” in the Company’s Annual Report on Form 20-F for the year ended December 31, 2005. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release. Except for the Company’s ongoing obligations to disclose material information under the applicable securities laws, it undertakes no obligation to release publicly any revisions to any forward-looking statements, to report events or to report the occurrence of unanticipated events.

 For further information contact:  Fern Lazar/David Carey Lazar Partners Ltd. 1-(866) GIVEN-IR Contact via http://www.marketwire.com/mw/emailprcntct?id=28FCB11536F87128/ Contact via http://www.marketwire.com/mw/emailprcntct?id=9DF7BCEA4071D706  

SOURCE: Given Imaging

CLEVELAND, Oct. 31 /PRNewswire/ — Cleveland Clinic has launched Real World Connect(TM), an innovative web portal that will make available a wealth of educational resources online.

Developed by Cleveland Clinic’s Office of Civic Education Initiatives, Real World Connect(TM) will provide online learning opportunities in the areas of math, science, health and wellness, the arts and innovation.

“Making available this broad array of educational resources online will strengthen lesson plans, enhance materials available for school projects and research papers, and improve the access to current health information,” said Rosalind Strickland, Senior Director of Cleveland Clinic’s Office of Civic Education Initiatives. “These resources have the potential to benefit countless students, educators and home schoolers.”

The online resources available at Real World Connect(TM) can be accessed by visiting http://www.clevelandclinic.org/RealWorldConnect. The resources include:

    - Worldwide Classroom - a curriculum of state-of-the-art distance      learning courses.    - Infotrac - a nationally recognized database of health information      resources.    - My Health Librarian - a personalized service that provides answers to      health questions.    - Earl's Virtual Garage - a narrated, minds-on educational playground for      children of all ages.    - Online X-Ray Library - a student-created database of authentic medical      images.    - Virtual eXpressions Exhibition - an online collection of award-winning      student art and the scientific research that inspired it.   

In September, Cleveland Clinic and StarBak Communications, the leading provider of integrated network video solutions, agreed to collaborate to enhance learning opportunities available to Cleveland-area schools through state-of-the-art distance learning programs.

StarBak is providing its Integrated Network Video (INV) platform to facilitate video streaming and archiving in order that Cleveland Clinic’s video archive and distance learning programs be more accessible to regional students in a variety of formats. The technology is improving the Clinic’s ability to offer Real World Connect(TM).

Similarly, last May Cleveland Clinic launched a new digital-learning initiative in collaboration with Cleveland Municipal School District and the OneCommunity network to bring creative educational experiences to students throughout Cleveland. As part of its continued commitment to Cleveland Schools, Cleveland Clinic is using the new digital classroom capabilities to provide distance-learning curriculums, including live surgery broadcasts, to students and teachers. Those who view the broadcasts are able to participate in interactive discussions with Cleveland Clinic researchers and clinicians, directly from their classrooms.

Approximately 105 Cleveland Municipal schools now have access to Cleveland Clinic’s distance-learning programs, an accomplishment made possible by the connectivity of OneCommunity, a Cleveland-based broadband network, and the Clinic’s financial support. In addition to remote field trips, the Clinic is developing lessons to maximize the benefit of its resources and medical expertise for teachers and students in kindergarten through grade 12.

The Clinic’s Office of Civic Education Initiatives was established to fulfill the Cleveland Clinic’s commitment to promote education throughout Northeast Ohio. In partnership with area schools, local businesses, and fellow nonprofit organizations, the Office creates innovative programs designed to enhance children’s learning in the areas of math, science, health and wellness, the arts, and innovation. Programs include summer science and nursing internships, an interdisciplinary program for art and science and several health education programs for elementary school students, including Spotlight on Learning, which incorporates health education with theatre.

Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and hospital care with research and education. Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Approximately 1,500 full-time salaried physicians at Cleveland Clinic and Cleveland Clinic Florida represent more than 100 medical specialties and subspecialties. In 2005, there were 2.9 million outpatient visits to Cleveland Clinic. Patients came for treatment from every state and from more than 80 countries. There were nearly 54,000 hospital admissions to Cleveland Clinic in 2005. For more information, visit http://www.clevelandclinic.org/.

Cleveland Clinic

CONTACT: Raquel Santiago of Cleveland Clinic, +1-216-444-4235

Web site: http://www.clevelandclinic.org/RealWorldConnecthttp://www.clevelandclinic.org/

Abraxis BioScience, Inc. (NASDAQ:ABBI), an integrated, global biopharmaceutical company today announced the launch of the Abraxis Patient Access Program (APAP), a comprehensive patient assistance program for cancer patients being treated with ABRAXANE® (paclitaxel protein-bound particles for injectable suspension) (albumin-bound). Through APAP, financially eligible cancer patients in need of treatment with ABRAXANE will receive access to the drug at no cost. This new program, which replaces the previous ABRAXANE patient assistance programs, makes it possible for financially eligible cancer patients to receive assistance in all instances where ABRAXANE has been prescribed.

“Through our new patient assistance program, we will be able to provide eligible cancer patients with ABRAXANE at no cost,” said Patrick Soon-Shiong, chairman and chief executive officer of Abraxis BioScience. “Since its launch in 2005, over 20,000 patients with cancer have received ABRAXANE. With nearly 1.4 million people in the United States estimated to be diagnosed with cancer in 2006, it is important for patients to be able to receive the best possible treatment. We are committed to ensuring there are no cost barriers for cancer patients who may benefit from treatment with ABRAXANE.”

Access to this program is available through the Abraxis Resource Center (ARC of Support), a comprehensive program that provides a broad range of services caring for patients being treated with ABRAXANE. This new program offers two distinct access points for cancer patients:

ABRAXANE at no cost to eligible uninsured patients with a household adjusted gross income of less than $75,000 per year.

Replacement of ABRAXANE at no cost for physicians treating an eligible insured patient, who requires additional financial support following a denied insurance claim.

“Since the FDA approval of ABRAXANE in January 2005, we have provided reimbursement and product information support for physicians and their patients. Our dedication to this endeavor has not wavered. With the launch of this new program, we are now able to provide expanded reimbursement support to more cancer patients,” said Carlo Montagner, president of Abraxis Oncology, a division of Abraxis BioScience.

Physicians who wish to enroll a patient in the program should call the ARC of Support at 1-800-564-0216, option three. For more information about ABRAXANE and the services provided by ARC of Support including APAP, please visit www.abraxane.com.

About Breast Cancer

According to the American Cancer Society, breast cancer is the most common cancer among women, other than skin cancer, and is the second leading cause of cancer death in women in the United States. The risk of having breast cancer for a woman sometime during her life is about one in eight. In 2006 alone, an estimated 213,000 new cases of breast cancer are expected to occur in women, and an estimated 41,000 women are expected to die from the disease.

About ABRAXANE®

The U.S. Food and Drug Administration approved ABRAXANE® for Injectable Suspension (paclitaxel protein-bound particles for injectable suspension) (albumin-bound) in January 2005 for the treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within six months of adjuvant chemotherapy. Prior therapy should have included an anthracycline unless clinically contraindicated. For the full prescribing information for ABRAXANE® please visit www.abraxane.com.

About Abraxis BioScience, Inc.

Abraxis BioScience, Inc. is an integrated global biopharmaceutical company dedicated to meeting the needs of critically ill patients. The company develops, manufactures and markets one of the broadest portfolios of injectable products and leverages revolutionary technology such as its nab™ platform to discover and deliver breakthrough therapeutics that transform the treatment of cancer and other life-threatening diseases. The first FDA approved product to use this nab platform, ABRAXANE®, was launched in 2005 for the treatment of metastatic breast cancer. Abraxis trades on the NASDAQ Stock Market under the symbol ABBI. For more information about the company and its products, please visit www.abraxisbio.com.

RICHMOND, Va., Oct. 30 /PRNewswire/ — The Anthem HealthKeepers Plus plans of HealthKeepers, Inc., Peninsula Health Care, Inc. and Priority Health Care, Inc. (the affiliated HMOs of Anthem Blue Cross and Blue Shield in Virginia) offered to Medicaid-eligible Virginians are ranked No. 19 in the nation, according to U.S.News & World Report/National Committee for Quality Assurance’s America’s Best Health Plans 2006. This recognition as one of the nation’s best health plans is the result of outstanding overall performance in clinical care measures, member satisfaction and NCQA accreditation.

“Promoting and providing access to high-quality medical care for our members is an essential part of our mission.” said Tom Byrd, president, Anthem Blue Cross and Blue Shield. “Working in collaboration with hospitals and physicians, we continually look for new and better ways to control and prevent disease and ensure our members are receiving the care they need when they need it. We want to help our members live as healthy and productive lives as possible.”

The national rankings are based on a complex, weighted methodology that combines a health plan’s NCQA Accreditation Standards score and multiple measures of clinical performance and service. These measures are grouped into four categories: access to care, overall member satisfaction, prevention and treatment. A detailed description of the methodology applied by NCQA is available on its Web site at http://www.ncqa.org/.

“This ranking reflects Anthem’s commitment to quality and service,” said Margaret O’Kane, NCQA president. “Not only has Anthem excelled at providing its members with access to high-quality clinical care and measuring its effectiveness, its plans have also received top-notch ratings from its members for service.”

The Proof is in the Program

The Anthem HealthKeepers Plus Outreach program has played an important role in improving the health of Medicaid members by providing education and assistance and empowering them to take personal responsibility for their health. Anthem HealthKeepers Plus Outreach representatives accomplish this by visiting with Virginia Medicaid members face-to-face and educating them on their benefits and more importantly, how to access them. In addition, Anthem HealthKeepers Plus Outreach representatives assist high-risk Medicaid members by coordinating additional care with nurse case managers. Anthem HealthKeepers Plus Outreach representatives play a vital role because they are the front line for Medicaid members who directly benefit from the education they supply.

About NCQA

The National Committee for Quality Assurance (NCQA) is a private, non- profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. NCQA provides health care quality information free of charge through the Web and the media in order to help consumers, employers and others make more informed health care choices. More information can be found at http://www.ncqa.org/.

About U.S.News & World Report

Founded in 1933, the weekly news magazine, U.S.News & World Report, is devoted to investigative journalism and reporting and to analyzing national and international affairs, politics, business, health, science, technology and social trends. Through its annual rankings of America’s Best Colleges, America’s Best Graduate Schools and America’s Best Hospitals, and its News You Can Use Brand, U.S.News has earned a reputation as the leading provider of service news and information that improves the quality of life of its readers. Available online at http://www.usnews.com/, U.S.News, for the second time in a row, was named the most credible newsweekly by the Pew Biennial News Consumption Survey and the most credible news organization in print. “America’s Best Health Plans” is a trademark of U.S.News & World Report.

About Anthem Blue Cross and Blue Shield in Virginia

Anthem Health Plans of Virginia, Inc., d/b/a Anthem Blue Cross and Blue Shield in Virginia is a subsidiary of WellPoint Inc. WellPoint’s mission is to improve the lives of the people it serves and the health of its communities. WellPoint, Inc. is the largest health benefits company in terms of commercial membership in the United States. Through its nationwide networks, the company delivers a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, pharmacy benefit management, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. Headquartered in Indianapolis, Indiana, WellPoint is an independent licensee of the Blue Cross and Blue Shield Association and serves its members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as Blue Cross Blue Shield in 10 New York City metropolitan and surrounding counties and as Blue Cross or Blue Cross Blue Shield in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at http://www.wellpoint.com/.

For more information on Anthem Blue Cross and Blue Shield in Virginia, please visit http://www.anthem.com/ and choose “Virginia.”

* HEDIS is a registered trademark of NCQA.

Anthem Blue Cross and Blue Shield in Virginia

CONTACT: Scott Golden of Anthem Blue Cross and Blue Shield in Virginia,+1-804-354-5252

Web Site: http://www.anthem.com/http://www.ncqa.org/http://www.usnews.com/http://www.wellpoint.com/

MADISON, Wis., Oct. 30 /PRNewswire/ — Navitus Health Solutions LLC announced that the State of Wisconsin Department of Employee Trust Funds (ETF) has renewed its current agreement with the pharmacy benefits provider for a term of four years. As such, Navitus will continue to provide a comprehensive and cost-effective pharmacy benefit program for more than 230,000 state and local employees, retirees and their dependents.

“Navitus performs better than traditional PBM models. It has provided substantial savings to our health care programs,” said Tom Korpady, Administrator of the Division of Insurance Services at the Department of Employee Trust Funds (ETF). “Since 2003, we’ve increased coverage, reduced member copays, and decreased our net drug costs by almost $30 million. We continue to experience long-term savings with our drug spend at five to six percent lower than national averages.”

Navitus’ program offers lower costs on carefully selected medications that are monitored for safety and effectiveness by a team of physicians and pharmacists. The company negotiates discounts and rebates with participating pharmacies and drug manufacturers on covered medications and then passes along 100 percent of the savings to its members and customers.

“Navitus is committed to providing its members and customers with the highest-quality prescription benefit services and exceeding current drug savings,” said Allan Zimmerman, president and CEO of Navitus Health Solutions. “Our mission is to deliver innovative, high-quality products and programs to assist the state in lowering its prescription drug costs and improving the quality of care for their members.”

About the State of Wisconsin Department of Employee Trust Funds

The State of Wisconsin Department of Employee Trust Funds administers retirement and other benefit programs for more than 500,000 Wisconsin Retirement System (WRS) participants and 1,400 employers. The programs cover state and local government employees and retirees. The mission is to develop and deliver quality benefits and services to members while safeguarding the integrity of the Trust.

About Navitus

Navitus Health Solutions LLC is a health management company that specializes in pharmacy benefit administration services. The company’s services include benefit design and consulting, formulary management, pharmacy network management and clinical programs. With offices in Madison and Appleton, the company provides its services to more than 500,000 individuals, including state employees, retirees and their dependents, as well as employees of managed care organizations, self-insured employers, coalitions and union organizations. For more information about Navitus Health Solutions, visit http://www.navitus.com/.

Navitus Health Solutions LLC

CONTACT: Andi Fuentes, [email protected], or Josh Merkin,[email protected], both of Thorp & Company for Navitus Health Solutions LLC,+1-305-446-2700

Web site: http://www.navitus.com/

JACKSONVILLE, Fla., Oct. 30 /PRNewswire/ — To better serve the needs of its customers, Winn-Dixie Stores, Inc. (Pink Sheets: WNDXQ) is partnering with Birmingham, Ala.-based WELLSPOT Medical Clinics, Inc. to open free-standing walk-in medical clinics in three Jacksonville area Winn-Dixie stores in mid- November. Current plans call for additional Winn-Dixie/WELLSPOT walk-in clinics in the Jacksonville area early next year, with the partnership expanding into other Winn-Dixie stores with in-store pharmacies in Florida, Georgia, Alabama, Mississippi and Louisiana through the end of 2007.

   (Logo:  http://www.newscom.com/cgi-bin/prnh/20061030/CLM035LOGO-a)   (Logo:  http://www.newscom.com/cgi-bin/prnh/20061030/CLM035LOGO-b)  

The first three WELLSPOT walk-in clinics will be in the Winn-Dixie stores at 11380 Beach Boulevard at St. Johns Bluff Road, 5207 Normandy Boulevard near Cassat Avenue, and 1436 S.R. 121 near I-10 in MacClenny.

“This business partnership benefits our customers by providing them with quality medical care in a location they already know and trust for their food and pharmacy needs,” said Peter Lynch, president and CEO of Winn-Dixie Stores, Inc. “Establishing WELLSPOT clinics inside Winn-Dixie stores extends our commitment to getting better all the time and serving the needs of our customers by making economical health care more accessible to the neighborhoods and communities we serve.”

Studies show nearly a third of the U.S. population does not have a family physician, fueling a growing trend of establishing walk-in medical clinics in large retail stores like Winn-Dixie. The rising cost of health care has forced many businesses to cut health insurance coverage for their employees, and left many other people without any health insurance coverage.

“WELLSPOT’s services are an answer to the rising cost and extended wait times associated with routine medical care. We offer our patients professional medical care at an affordable price so that they can return to their normal lifestyle,” said James B. Laughlin, III, WELLSPOT’s CEO. “No appointment is necessary and our medical clinics are conveniently located. Most patient visits normally take less than 20 minutes and can include immunizations, prescription services and a variety of diagnostic tests.”

Highly-trained Advanced Registered Nurse Practitioners (ARNP) – all of whom have earned master’s degrees – staff Winn-Dixie/WELLSPOT walk-in clinics. Nurse Practitioners are nationally certified and licensed by the state to diagnose patients and prescribe necessary medication while working in collaboration with a local physician.

WELLSPOT’s cost for basic medical services is generally less than $50 with lab tests costing $10 to $60, depending on the test performed. In addition to routine health care treatment, wellness programs such as weight loss and smoking cessation also are available. WELLSPOT provides multiple payment options for patients; accepting VISA, MasterCard, cash, check and debit cards as well as many insurance plans. WELLSPOT is dedicated to working with the payer community and is currently contracting with insurance providers serving Florida members. WELLSPOT suggests prospective patients confirm insurance acceptance prior to receiving care.

“Our clinics are for busy people and families, as well as local businesses that strive to reduce employee time away from the workplace. We can help companies and individuals reduce their overall medical costs,” said Laughlin. “Our goal is to be the most trusted and highest quality medical care giver for people seeking fast, convenient and cost-effective treatment and prevention of common medical conditions.”

In support of the Jacksonville-area clinic openings, WELLSPOT is currently interviewing ARNP candidates with Family Practice certification. Interested candidates should go to http://www.wellspot.com/ for additional information. They can submit their resume to [email protected] or call (205) 988-9577.

WELLSPOT currently operates eight walk-in clinics in Alabama and Georgia, with plans to expand to 60 walk-in clinics throughout the Southeast by early 2008.

Winn-Dixie Stores, Inc., is one of the nation’s largest food retailers. Founded in 1925, the company is headquartered in Jacksonville, FL. For more information, please visit http://www.winn-dixie.com/.

About WELLSPOT:

WELLSPOT Medical Clinics offers an innovation in health care by focusing on accessibility, time, cost and treatment for most common conditions. Centers are staffed by certified Advanced Registered Nurse Practitioners and Physician Assistants who are licensed to diagnose, treat and prescribe medications when necessary. For complex conditions, our professionals refer patients to a local network of physicians or medical facilities. Additionally, WELLSPOT provides health screenings, DOT and sports physicals, wellness programs, vaccinations and many other health-related services offered to save people time and money.

For more information about WELLSPOT’s professional medical care, wellness services, fees and payment options, go to http://www.wellspot.com/ or call toll-free, (866) 988-9980.

Photo: http://www.newscom.com/cgi-bin/prnh/20061030/CLM035LOGO-ahttp://www.newscom.com/cgi-bin/prnh/20061030/CLM035LOGO-bAP Archive: http://photoarchive.ap.org/PRN Photo Desk, [email protected]

Winn-Dixie Stores, Inc.

CONTACT: Roseanne Flippen of WELLSPOT, +1-205-263-5803, or cell,+1-205-936-1224, or [email protected]; or Terry Derreberry of Winn-DixieStores, Inc., +1-904-783-5852, or cell, +1-904-233-0631, [email protected]; or Patrick McSweeney of St. John & Partners,+1-904-596-2085, or cell, +1-904-923-4871, or [email protected], for Winn-DixieStores, Inc.

Web site: http://www.winn-dixie.com/http://www.wellspot.com/

NEW YORK, Oct. 30 /PRNewswire/ — The National Kidney Foundation (NKF) and Abbott’s Ross Products Division announced today a joint partnership to develop educational programs that focus on nutrition and chronic kidney disease. The new initiative, which is part of NKF’s “Partners in Education Program,” will feature print and online educational programs for both patients and health care professionals. In addition, Abbott will be identified with the NKF’s Kidney Early Evaluation Program (KEEP), a free health screening for those at risk of chronic kidney disease. All educational programs will be developed by the NKF and promoted through its Kidney Learning System. Abbott will promote the new partnership by displaying the NKF’s logo on the product labels of its two nutritional supplements for people with kidney disease, Nepro(TM) and Suplena(TM).

“Malnutrition is common in patients with chronic kidney disease,” says Allan Collins, MD, president of the National Kidney Foundation. “Recent studies have shown that it is an issue even for patients who are not yet receiving dialysis treatment and that those who suffer malnutrition before dialysis have a greater risk of death from cardiovascular disease. Maintaining good nutritional status is critically important for all people with chronic kidney disease.”

“Our company has a longstanding commitment to educating health care professionals and their patients about the important role nutrition plays in health maintenance and disease management,” states Gary McCullough, president of Abbott’s Ross Products Division. “We are pleased to be partners with the National Kidney Foundation for this nationwide initiative that will benefit people living with Chronic Kidney Disease.”

Chronic kidney disease (CKD) is a condition where the kidneys are no longer able to filter toxins from the blood to sustain healthy body function.

About National Kidney Foundation

The National Kidney Foundation is the nation’s largest voluntary agency dedicated to preventing and treating kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases and increasing the availability of all organs for transplantation. To receive free copies of “Nutrition and Chronic Kidney Disease in the Early Stages: Are You Getting What You Need?” and “Nutrition and Dialysis: Are You Getting What You Need?,” contact the National Kidney Foundation at 800-622-9010.

About Abbott

Abbott is committed to ongoing innovation in the area of chronic kidney disease. Abbott produces two nutritional supplements for people with kidney disease: Nepro and Suplena. Nepro is specifically designed and clinically shown to support the nutritional needs and altered metabolism of people on dialysis. Suplena is a low-protein, high-calorie nutritionally complete formula with a vitamin and mineral profile specifically designed for people in earlier stages of chronic kidney disease who are not receiving dialysis. The company also markets oral and IV-form activated vitamin D medications to address the needs of both CKD and dialysis patients.

Abbott is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals and medical products, including nutritionals, devices and diagnostics. The company employs 65,000 people and markets its products in more than 130 countries.

Abbott’s news releases and other information are available on the company’s Web site at http://www.abbott.com/.

National Kidney Foundation

CONTACT: Ellie Schlam of the National Kidney Foundation,+1-212-889-2210, ext. 143, [email protected]; or Keri J. Butler of Abbott,+1-614-624-7543

Web site: http://www.kidney.org/http://www.abbott.com/

A WELLINGTON schoolgirl who twice suffered a bad reaction to the meningococcal B vaccine says she has daily pain and a disfiguring lump on her neck.

Petra McDiarmid, 16, joins an increasing number of people calling for the Health Ministry to come clean about the vaccine’s possible side effects.

Health Minister Pete Hodgson told Parliament this week there had been “no significant adverse events” associated with the immunisation programme.

But within two days of Petra receiving the first of the three- shot vaccine, her arm, shoulder and neck swelled into a painful mass.

Her mother, Johanne Greally, took her to an emergency doctor, who confirmed Petra’s ailments were caused by the vaccine.

Six weeks later the swelling had gone down and Petra agreed to a booster shot, based on the doctor’s advice that her chances of reacting a second time were no greater than for someone who had never had a reaction.

This time the reaction was instantaneous. “My arm felt really heavy all the time and when I tried to pick up things I wouldn’t be able to pull up my shoulder.

“At first it hurt all the time, now it just aches.”

Ms Greally said Petra had also been left with an 8-centimetre lump on her neck, which jeopardised a budding modelling career.

“My beautiful daughter is permanently deformed.”

Health Ministry claims that there had been no significant adverse health events were not true, Ms Greally said. Otago University centre for adverse reaction monitoring director Michael Tatley said Petra’s case would almost certainly have been included in its reporting had it been alerted to her case.

That she had experienced swelling after both doses of the vaccine suggested it was not only the cause, it would put her at the severe end of the reaction scale, he said. Meningococcal B immunisation programme director Jane O’Hallahan said more than one million people had received more than three million doses of the vaccine since July 2004, with 2200 reporting adverse reactions.

That compared with 213 cases and seven deaths from meningococcal B a year before the immunisation programme was introduced.

Accident Compensation Corporation revealed this week it had accepted 33 claims for harm caused by the vaccine, including two for anaphylactic reactions, six for a serious blood disorder, cellulitis, nerve damage, bruising and fractured upper teeth.

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(c) 2006 Dominion Post. Provided by ProQuest Information and Learning. All rights Reserved.

By Daniel Lee, The Indianapolis Star

Oct. 27–Many people over 60 soon will have easier and more affordable access to a vaccine that helps prevent the painful and common condition known as shingles.

Health insurers are adding the vaccine, Zostavax, to their drug coverage after the immunization advisory committee with the U.S. Centers for Disease Control and Prevention recommended the shot for older patients. Shingles, caused by the reactivation of the chickenpox virus, tends to strike people more commonly as they age.

Indianapolis-based WellPoint said Thursday it will begin providing coverage for Zostavax, made by pharmaceutical giant Merck, for those 60 and older whose benefit plans include vaccines. WellPoint operates Anthem Blue Cross and Blue Shield, the largest commercial insurer in Indiana.

Other insurers adding the vaccine include UnitedHealthcare, a national insurer based in Minnesota, and M-Plan, an Indianapolis health maintenance organization.

Most Anthem plans provide coverage for vaccines, typically with a co-pay, said Dr. Randy Howard, medical director for Anthem in Indiana.

Those enrolled in Medicare should check with their Part D prescription-drug benefit plans to see if the vaccine is covered, said Medicare spokesman Bob Herskovitz. Those eligible for Medicare who don’t have the Part D drug benefit may have another chance to sign up for the coverage starting Nov. 15.

WellPoint, for instance, said it already provides coverage for Zostavax for seniors covered by its Part D programs.

Howard said some people who have shingles, which results in clusters of blisters, also develop severe nerve pain that may last for months or years.

A study showed that Zostavax, given in a single injection, reduced the occurrence of shingles by 64 percent in people ages 60 to 69, according to the FDA. The vaccine also has been shown to lessen its severity for those who do get shingles.

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Copyright (c) 2006, The Indianapolis Star

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