A secret weapon in preventing the next pandemic: Fruit bats
More than four dozen Jamaican fruit bats destined for a lab in Bozeman, Montana, are set to become part of an experiment with an ambitious goal: predicting the next global pandemic.
More than four dozen Jamaican fruit bats destined for a lab in Bozeman, Montana, are set to become part of an experiment with an ambitious goal: predicting the next global pandemic.
2 years 4 months ago
Decisions by CVS and Optum Panicked Thousands of Their Sickest Patients
NEW YORK — The fear started when a few patients saw their nurses and dietitians posting job searches on LinkedIn.
Word spread to Facebook groups, and patients started calling Coram CVS, a major U.S. supplier of the compounded IV nutrients on which they rely for survival. To their dismay, CVS Health confirmed the rumors on June 1: It was closing 36 of the 71 branches of its Coram home infusion business and laying off about 2,000 nurses, dietitians, pharmacists, and other employees.
Many of the patients left in the lurch have life-threatening digestive disorders that render them unable to eat or drink. They depend on parenteral nutrition, or PN — in which amino acids, sugars, fats, vitamins, and electrolytes are pumped, in most cases, through a specialized catheter directly into a large vein near the heart.
The day after CVS’ move, another big supplier, Optum Rx, announced its own consolidation. Suddenly, thousands would be without their highly complex, shortage-plagued, essential drugs and nutrients.
“With this kind of disruption, patients can’t get through on the phones. They panic,” said Cynthia Reddick, a senior nutritionist who was let go in the CVS restructuring.
“It was very difficult. Many emails, many phone calls, acting as a liaison between my doctor and the company,” said Elizabeth Fisher Smith, a 32-year-old public health instructor in New York City, whose Coram branch closed. A rare medical disorder has forced her to rely on PN for survival since 2017. “In the end, I got my supplies, but it added to my mental burden. And I’m someone who has worked in health care nearly my entire adult life.”
CVS had abandoned most of its less lucrative market in home parenteral nutrition, or HPN, and “acute care” drugs like IV antibiotics. Instead, it would focus on high-dollar, specialty intravenous medications like Remicade, which is used for arthritis and other autoimmune conditions.
Home and outpatient infusions are a growing business in the United States, as new drugs for chronic illness enable patients, health care providers, and insurers to bypass in-person treatment. Even the wellness industry is cashing in, with spa storefronts and home hydration services.
But while reimbursement for expensive new drugs has drawn the interest of big corporations and private equity, the industry is strained by a lack of nurses and pharmacists. And the less profitable parts of the business — as well as the vulnerable patients they serve — are at serious risk.
This includes the 30,000-plus Americans who rely for survival on parenteral nutrition, which has 72 ingredients. Among those patients are premature infants and post-surgery patients with digestive problems, and people with short or damaged bowels, often the result of genetic defects.
While some specialty infusion drugs are billed through pharmacy benefit managers that typically pay suppliers in a few weeks, medical plans that cover HPN, IV antibiotics, and some other infusion drugs can take 90 days to pay, said Dan Manchise, president of Mann Medical Consultants, a home care consulting company.
In the 2010s, CVS bought Coram, and Optum bought up smaller home infusion companies, both with the hope that consolidation and scale would offer more negotiating power with insurers and manufacturers, leading to a more stable market. But the level of patient care required was too high for them to make money, industry officials said.
“With the margins seen in the industry,” Manchise said, “if you’ve taken on expensive patients and you don’t get paid, you’re dead.”
In September, CVS announced its purchase of Signify Health, a high-tech company that sends out home health workers to evaluate billing rates for “high-priority” Medicare Advantage patients, according to an analyst’s report. In other words, as CVS shed one group of patients whose care yields low margins, it was spending $8 billion to seek more profitable ones.
CVS “pivots when necessary,” spokesperson Mike DeAngelis told KHN. “We decided to focus more resources on patients who receive infusion services for specialty medications” that “continue to see sustained growth.” Optum declined to discuss its move, but a spokesperson said the company was “steadfastly committed to serving the needs” of more than 2,000 HPN patients.
DeAngelis said CVS worked with its HPN patients to “seamlessly transition their care” to new companies.
However, several Coram patients interviewed about the transition indicated it was hardly smooth. Other HPN businesses were strained by the new demand for services, and frightening disruptions occurred.
Smith had to convince her new supplier that she still needed two IV pumps — one for HPN, the other for hydration. Without two, she’d rely partly on “gravity” infusion, in which the IV bag hangs from a pole that must move with the patient, making it impossible for her to keep her job.
“They just blatantly told her they weren’t giving her a pump because it was more expensive, she didn’t need it, and that’s why Coram went out of business,” Smith said.
Many patients who were hospitalized at the time of the switch — several inpatient stays a year are not unusual for HPN patients — had to remain in the hospital until they could find new suppliers. Such hospitalizations typically cost at least $3,000 a day.
“The biggest problem was getting people out of the hospital until other companies had ramped up,” said Dr. David Seres, a professor of medicine at the Institute of Human Nutrition at Columbia University Medical Center. Even over a few days, he said, “there was a lot of emotional hardship and fear over losing long-term relationships.”
To address HPN patients’ nutritional needs, a team of physicians, nurses, and dietitians must work with their supplier, Seres said. The companies conduct weekly bloodwork and adjust the contents of the HPN bags, all under sterile conditions because these patients are at risk of blood infections, which can be grave.
As for Coram, “it’s pretty obvious they had to trim down business that was not making money,” Reddick said, adding that it was noteworthy both Coram and Optum Rx “pivoted the same way to focus on higher-dollar, higher-reimbursement, high-margin populations.”
“I get it, from the business perspective,” Smith said. “At the same time, they left a lot of patients in a not great situation.”
***
Smith shares a postage-stamp Queens apartment with her husband, Matt; his enormous flight simulator (he’s an amateur pilot); cabinets and fridges full of medical supplies; and two large, friendly dogs, Caspian and Gretl. On a recent morning, she went about her routine: detaching the bag of milky IV fluid that had pumped all night through a central line implanted in her chest, flushing the line with saline, injecting medications into another saline bag, and then hooking it through a paperback-sized pump into her central line.
Smith has a connective tissue disorder called Ehlers-Danlos syndrome, which can cause many health problems. As a child, Smith had frequent issues such as a torn Achilles tendon and shoulder dislocations. In her 20s, while working as an EMT, she developed severe gut blockages and became progressively less able to digest food. In 2017, she went on HPN and takes nothing by mouth except for an occasional sip of liquid or bite of soft food, in hopes of preventing the total atrophy of her intestines. HPN enabled her to commute to George Washington University in Washington, D.C., where in 2020 she completed a master’s in public health.
On days when she teaches at LaGuardia Community College — she had 35 students this semester — Smith is up at 6 a.m. to tend to her medical care, leaves the house at 9:15 for class, comes home in the afternoon for a bag of IV hydration, then returns for a late afternoon or evening class. In the evening she gets more hydration, then hooks up the HPN bag for the night. On rare occasions she skips the HPN, “but then I regret it,” she said. The next day she’ll have headaches and feel dizzy, sometimes losing her train of thought in class.
Smith describes a “love-hate relationship” with HPN. She hates being dependent on it, the sour smell of the stuff when it spills, and the mountains of unrecyclable garbage from the 120 pounds of supplies couriered to her apartment weekly. She worries about blood clots and infections. She finds the smell of food disconcerting; Matt tries not to cook when she’s home. Other HPN patients speak of sudden cravings for pasta or Frosted Mini-Wheats.
Yet HPN “has given me my life back,” Smith said.
She is a zealous self-caretaker, but some dangers are beyond her control. IV feeding over time is associated with liver damage. The assemblage of HPN bags by compounding pharmacists is risky. If the ingredients aren’t mixed in the right order, they can crystallize and kill a patient, said Seres, Smith’s doctor.
He and other doctors would like to transition patients to food, but this isn’t always possible. Some eventually seek drastic treatments such as bowel lengthening or even transplants of the entire digestive tract.
“When they run out of options, they could die,” said Dr. Ryan Hurt, a Mayo Clinic physician and president of the American Society for Parenteral and Enteral Nutrition.
***
And then there are the shortages.
In 2017, Hurricane Maria crippled dozens of labs and factories making IV components in Puerto Rico; next came the covid-19 emergency, which shifted vital supplies to gravely ill hospital patients.
Prices for vital HPN ingredients can fluctuate unpredictably as companies making them come and go. For example, in recent years the cost of the sodium acetate used as an electrolyte in a bag of HPN ballooned from $2 to $25, then briefly to $300, said Michael Rigas, a co-founder of the home infusion pharmacy KabaFusion.
“There may be 50 different companies involved in producing everything in an HPN bag,” Rigas said. “They’re all doing their own thing — expanding, contracting, looking for ways to make money.” This leaves patients struggling to deal with various shortages from saline and IV bags to special tubing and vitamins.
“In the last five years I’ve seen more things out of stock or on shortage than the previous 35 years combined,” said Rigas.
The sudden retrenchment of CVS and Optum Rx made things worse. Another, infuriating source of worry: the steady rise of IV spas and concierge services, staffed by moonlighting or burned-out hospital nurses, offering IV vitamins and hydration to well-off people who enjoy the rush of infusions to relieve symptoms of a cold, morning sickness, a hangover, or just a case of the blahs.
In January, infusion professionals urged FDA Commissioner Robert Califf to examine spa and concierge services’ use of IV products as an “emerging contributing factor” to shortages.
The FDA, however, has little authority over IV spas. The Federal Trade Commission has cracked down on some spa operations — for unsubstantiated health claims rather than resource misuse.
Bracha Banayan’s concierge service, called IVDRIPS, started in 2017 in New York City and now employs 90 people, including 60 registered nurses, in four states, she said. They visit about 5,000 patrons each year, providing IV hydration and vitamins in sessions of an hour or two for up to $600 a visit. The goal is “to hydrate and be healthy” with a “boost that makes us feel better,” Banayan said.
Although experts don’t recommend IV hydration outside of medical settings, the market has exploded, Banayan said: “Every med spa is like, ‘We want to bring in IV services.’ Every single paramedic I know is opening an IV center.”
Matt Smith, Elizabeth’s husband, isn’t surprised. Educated as a lawyer, he is a paramedic who trains others at Columbia University Irving Medical Center. “You give someone a choice of go up to some rich person’s apartment and start an IV on them, or carry a 500-pound person living in squalor down from their apartment,” he said. “There’s one that’s going to be very hard on your body and one very easy on your body.”
The very existence of IV spa companies can feel like an insult.
“These people are using resources that are literally a matter of life or death to us,” Elizabeth Smith said.
Shortages in HPN supplies have caused serious health problems including organ failure, severe blisters, rashes, and brain damage.
For five months last year, Rylee Cornwell, 18 and living in Spokane, Washington, could rarely procure lipids for her HPN treatment. She grew dizzy or fainted when she tried to stand, so she mostly slept. Eventually she moved to Phoenix, where the Mayo Clinic has many Ehlers-Danlos patients and supplies are easier to access.
Mike Sherels was a University of Minnesota Gophers football coach when an allergic reaction caused him to lose most of his intestines. At times he’s had to rely on an ethanol solution that damages the ports on his central line, a potentially deadly problem “since you can only have so many central access sites put into your body during your life,” he said.
When Faith Johnson, a 22-year-old Las Vegas student, was unable to get IV multivitamins, she tried crushing vitamin pills and swallowing the powder, but couldn’t keep the substance down and became malnourished. She has been hospitalized five times this past year.
Dread stalks Matt Smith, who daily fears that Elizabeth will call to say she has a headache, which could mean a minor allergic or viral issue — or a bloodstream infection that will land her in the hospital.
Even more worrying, he said: “What happens if all these companies stop doing it? What is the alternative? I don’t know what the economics of HPN are. All I know is the stuff either comes or it doesn’t.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
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This story can be republished for free (details).
2 years 4 months ago
Health Care Costs, Health Industry, Pharmaceuticals
A Secret Weapon in Preventing the Next Pandemic: Fruit Bats
More than four dozen Jamaican fruit bats destined for a lab in Bozeman, Montana, are set to become part of an experiment with an ambitious goal: predicting the next global pandemic.
Bats worldwide are primary vectors for virus transmission from animals to humans. Those viruses often are harmless to bats but can be deadly to humans. Horseshoe bats in China, for example, are cited as a likely cause of the covid-19 outbreak. And researchers believe pressure put on bats by climate change and encroachment from human development have increased the frequency of viruses jumping from bats to people, causing what are known as zoonotic diseases.
“Spillover events are the result of a cascade of stressors — bat habitat is cleared, climate becomes more extreme, bats move into human areas to find food,” said Raina Plowright, a disease ecologist and co-author of a recent paper in the journal Nature and another in Ecology Letters on the role of ecological changes in disease.
That’s why Montana State University immunologist Agnieszka Rynda-Apple plans to bring the Jamaican fruit bats to Bozeman this winter to start a breeding colony and accelerate her lab’s work as part of a team of 70 researchers in seven countries. The group, called BatOneHealth — founded by Plowright — hopes to find ways to predict where the next deadly virus might make the leap from bats to people.
“We’re collaborating on the question of why bats are such a fantastic vector,” said Rynda-Apple. “We’re trying to understand what is it about their immune systems that makes them retain the virus, and what is the situation in which they shed the virus.”
To study the role of nutritional stress, researchers create different diets for them, she said, “and infect them with the influenza virus and then study how much virus they are shedding, the length of the viral shedding, and their antiviral response.”
While she and her colleagues have already been doing these kinds of experiments, breeding bats will allow them to expand the research.
It’s a painstaking effort to thoroughly understand how environmental change contributes to nutritional stress and to better predict spillover. “If we can really understand all the pieces of the puzzle, that gives us tools to go back in and think about eco-counter measures that we can put in place that will break the cycle of spillovers,” said Andrew Hoegh, an assistant professor of statistics at MSU who is creating models for possible spillover scenarios.
The small team of researchers at MSU works with a researcher at the National Institutes of Health’s Rocky Mountain Laboratories in Hamilton, Montana.
The recent papers published in Nature and Ecology Letters focus on the Hendra virus in Australia, which is where Plowright was born. Hendra is a respiratory virus that causes flu-like symptoms and spreads from bats to horses, and then can be passed on to people who treat the horses. It is deadly, with a mortality rate of 75% in horses. Of the seven people known to have been infected, four died.
The question that propelled Plowright’s work is why Hendra began to show up in horses and people in the 1990s, even though bats have likely hosted the virus for eons. The research demonstrates that the reason is environmental change.
Plowright began her bat research in 2006. In samples taken from Australian bats called flying foxes, she and her colleagues rarely detected the virus. After Tropical Cyclone Larry off the coast of the Northern Territory wiped out the bats’ food source in 2005-06, hundreds of thousands of the animals simply disappeared. However, they found one small population of weak and starving bats loaded with the Hendra virus. That led Plowright to focus on nutritional stress as a key player in spillover.
She and her collaborators scoured 25 years of data on habitat loss, spillover, and climate and discovered a link between the loss of food sources caused by environmental change and high viral loads in food-stressed bats.
In the year after an El Niño climate pattern, with its high temperatures — occurring every few years — many eucalyptus trees don’t produce the flowers with nectar the bats need. And human encroachment on other habitats, from farms to urban development, has eliminated alternative food sources. And so the bats tend to move into urban areas with substandard fig, mango, and other trees, and, stressed, shed virus. When the bats excrete urine and feces, horses inhale it while sniffing the ground.
The researchers hope their work with Hendra-infected bats will illustrate a universal principle: how the destruction and alteration of nature can increase the likelihood that deadly pathogens will spill over from wild animals to humans.
The three most likely sources of spillover are bats, mammals, and arthropods, especially ticks. Some 60% of emerging infectious diseases that infect humans come from animals, and about two-thirds of those come from wild animals.
The idea that deforestation and human encroachment into wild land fuels pandemics is not new. For example, experts believe that HIV, which causes AIDS, first infected humans when people ate chimpanzees in central Africa. A Malaysian outbreak in late 1998 and early 1999 of the bat-borne Nipah virus spread from bats to pigs. The pigs amplified it, and it spread to humans, infecting 276 people and killing 106 in that outbreak. Now emerging is the connection to stress brought on by environmental changes.
One critical piece of this complex puzzle is bat immune systems. The Jamaican fruit bats kept at MSU will help researchers learn more about the effects of nutritional stress on their viral load.
Vincent Munster, chief of the virus ecology unit of Rocky Mountain Laboratories and a member of BatOneHealth, is also looking at different species of bats to better understand the ecology of spillover. “There are 1,400 different bat species and there are very significant differences between bats who harbor coronaviruses and bats who harbor Ebola virus,” said Munster. “And bats who live with hundreds of thousands together versus bats who are relatively solitary.”
Meanwhile, Plowright’s husband, Gary Tabor, is president of the Center for Large Landscape Conservation, a nonprofit that applies ecology of disease research to protect wildlife habitat — in part, to assure that wildlife is adequately nourished and to guard against virus spillover.
“Habitat fragmentation is a planetary health issue that is not being sufficiently addressed, given the world continues to experience unprecedented levels of land clearing,” said Tabor.
As the ability to predict outbreaks improves, other strategies become possible. Models that can predict where the Hendra virus could spill over could lead to vaccination for horses in those areas.
Another possible solution is the set of “eco-counter measures” Hoegh referred to — such as large-scale planting of flowering eucalyptus trees so flying foxes won’t be forced to seek nectar in developed areas.
“Right now, the world is focused on how we can stop the next pandemic,” said Plowright. “Unfortunately, preserving or restoring nature is rarely part of the discussion.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
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This story can be republished for free (details).
2 years 4 months ago
Public Health, States, COVID-19, Environmental Health, Montana
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
Cigna expects revenue gains from launches of Humira biosimilars
US: Cigna Corp expects its pharmacy benefit management unit to earn more from the second half of 2023 as makers of cheaper versions of AbbVie Inc's arthritis drug Humira will boost aftermarket discounts to gain access to patients.
Amgen Inc launched a biosimilar version of Humira called Amjevita in the United States on Tuesday, and at least seven others are expected to roll out in July.
Pharmacy benefit managers (PBMs) act as intermediaries between drugmakers and insurers. They get after-market discounts from drugmakers to add treatments to the lists they recommend to insurers and companies offering coverage for employees.
PBMs typically pass on most of the discounts, called rebates, to their clients and retain some in fees.
Cigna's PBM unit has both Humira and Amgen's Amjevita on its list of covered drugs.
Chief Executive David Cordani said in a conference call to discuss Cigna's fourth-quarter earnings that he anticipates "value creation from the increased availability of biosimilars building in the second half of 2023 and ramping in 2024 and beyond."
Those gains will help partially offset the anticipated cost this year of setting up its contract to manage Centene Corp's annual pharmacy spend of around $40 billion.
Cigna's insurance arm, meanwhile, faces a possible shift towards less profitable government-backed health programs due to chances of the U.S. economy's "fragility" pressuring enrollment in corporate plans, Cordani said.
The company forecast a medical care ratio - the ratio of the amount paid out for medical services versus revenue brought in - of 81.5% to 82.5% for 2023. The midpoint is marginally higher than last year's 81.7% and a Wall Street estimate of 81.9%.
Its annual profit forecast of at least $24.60 per share was marginally below expectations of $24.84 per share.
Read also: AbbVie raises sales outlook of Skyrizi, Rinvoq to USD 17.5 billion in 2025
2 years 4 months ago
News,Industry,Pharma News,Latest Industry News
PAHO/WHO | Pan American Health Organization
Dr. Jarbas Barbosa elected as WHO Regional Director for the Americas
Dr. Jarbas Barbosa elected as WHO Regional Director for the Americas
Cristina Mitchell
6 Feb 2023
Dr. Jarbas Barbosa elected as WHO Regional Director for the Americas
Cristina Mitchell
6 Feb 2023
2 years 4 months ago
Medscape Medical News Headlines
Omit Digital Rectal Exam in Prostate Cancer Surveillance?
The routine use of MRI during active surveillance for prostate cancer obviates the need for another exam that some patients find uncomfortable, an expert panel agreed. Medscape Medical News
The routine use of MRI during active surveillance for prostate cancer obviates the need for another exam that some patients find uncomfortable, an expert panel agreed. Medscape Medical News
2 years 4 months ago
Urology, News
Acne incidence associated with age, BMI in children, adolescents
Among children and adolescents with acne, prescription systemic medications were more likely to be used by those with a higher BMI than those with a low or normal BMI, according to a study.“Little is known about acne incidence in preadolescents and its potential association with BMI,” Katinna E.
Rodriguez Baisi, MD, of Ponce Health Sciences University in Ponce, Puerto Rico, and colleagues wrote.The population-based retrospective cohort study included 643 children and adolescents aged 7 to 12 years who had an initial acne diagnosis between 2010 and 2018.For each case, the group
2 years 4 months ago
STAT+: Pharmalittle: AbbVie to lift $2B cap on deals as Humira rivals appear; India to spend $80M to bolster regulatory system
Good morning, everyone, and welcome to another working week. We hope the weekend respite was relaxing and invigorating, because that oh-so-familiar routine of online meetings, conferences and deadlines has predictably returned. But what can you do? The world, such as it is, keeps spinning.
So to give it a nudge in a useful direction, we are firing up the coffee kettle to brew another cup of stimulation. Our choice today is maple bourbon. As always, you are invited to join us. Meanwhile, here is the latest menu of tidbits to help you start your journey. We hope your day is productive and meaningful. And of course, do keep in touch. We are searching for new pen pals …
Now that its blockbuster immune-disease therapy Humira is facing lower-priced competition, AbbVie is turning to a pair of next-generation successors to replenish the billions of dollars in sales that will be lost, The Wall Street Journal writes. The company is also betting on four drug approvals by the end of next year. In addition, AbbVie is lifting a self-imposed $2 billion limit on the size of deals it would do to add more products. AbbVie is counting most on persuading doctors that two newer immune drugs, Skyrizi and Rinvoq, are more effective than Humira and can pass peak Humira sales in four years.
2 years 4 months ago
Pharma, Pharmalot, Pharmaceuticals, STAT+
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
FNB Pediatric Hemato-Oncology: Admissions, Medical Colleges, fees, eligibility criteria
FNB Paediatric Haemato-Oncology or Fellow of National Board in Paediatric
Haemato-Oncology also known as FNB in Paediatric Haemato-Oncology is a doctoral
fellowship program for doctors in India that is done by them after completion
of their postgraduate medical degree course. The duration of the FNB course is
for 2 years.
FNB Paediatric Haemato-Oncology or Fellow of National Board in Paediatric
Haemato-Oncology also known as FNB in Paediatric Haemato-Oncology is a doctoral
fellowship program for doctors in India that is done by them after completion
of their postgraduate medical degree course. The duration of the FNB course is
for 2 years.
FNB Paediatric Haemato-Oncology encompasses a broad array of
disorders of children and adolescents with Primary immunodeficiency disorders,
solid tumours, hematological cancers, and non-malignant disorders of the blood
and blood-forming tissues.
The course is a full-time course pursued at various accredited
institutes/hospitals across the country, the top institutions include Sir Ganga
Ram Hospital, Rajiv Gandhi Cancer
Institute, Research Centre, New Delhi, and more.
Candidates can get admission to 2 years FNB
course after successfully qualifying for the FET (Fellowship Entrance Test)
examination which NBEMS conducts. FET is conducted annually as per the
prescribed schedule. The merit-based counselling for admissions to the FNB
Programme after the conduct of FET is administered by NBEMS.
The fee for pursuing FNB Paediatric Haemato-Oncology varies from
accredited institute/hospital to hospital and is Rs.1,25,000 per year.
After completion of their respective course, doctors can join the
job market. Candidates can take reputed jobs at positions as research fellows,
Senior residents, Consultants, etc. with an approximate average salary range of
Rs. 22 lakhs to Rs. 46 lakhs per year.
The Nomenclature of the FNB qualification awarded by the National Board
of Examinations in Medical Sciences is “Fellow of National Board”. The FNB
qualifications are recognized qualifications in terms of the Gazette
notification dated 10th August 2016.
What is FNB in Paediatric
Haemato-Oncology?
FNB in Paediatric Haemato-Oncology is a two-year doctoral fellowship
program that candidates can pursue after completing a postgraduate degree.
The main goal of the Paediatric
Haemato-Oncology fellowship is to provide the clinical experience and
educational opportunities necessary to build a solid foundation of medical
knowledge, critical thinking abilities, literature review, diagnostic acumen and technical skills.
The field of Pediatric Haematology-Oncology encompasses a broad array of
disorders of children and adolescents with Primary immunodeficiency disorders, solid tumours, hematological
cancers, and non-malignant disorders of the blood and blood-forming tissues.
The National Board of Examinations (NBE) has released a curriculum for
FNB Paediatric Haemato-Oncology.
The curriculum governs the education and training of FNB Paediatric
Haemato-Oncology.
Course Highlights
Here are some of the
course highlights of FNB Paediatric Haemato-Oncology
Name of Course
FNB Paediatric Haemato-Oncology
Level
Fellowship
Duration of Course
Two years
Course Mode
Full Time
Minimum Academic Requirement
Candidates must have a postgraduate medical Degree in DNB/MD Paediatrics obtained from any
college/university recognized by the Medical Council of India (Now NMC)/NBE. The
feeder qualification mentioned here is as of 2022. For any further changes to
the prerequisite requirement please refer to the NBE website
Admission Process / Entrance Process / Entrance Modalities
Entrance Exam (FET)
Merit-based counselling administered by NBEMS
Course Fees
Rs.1,25,000 per year
Average Salary
Rs. 22 lakhs to Rs.46 lakhs per year
Eligibility Criteria
The eligibility criteria for FNB in Paediatric Haemato-Oncology are defined as the set of rules or minimum prerequisites that aspirants must meet to be eligible for admission, which includes:
Name of Fellowship course
Course Type
Prior Eligibility Requirement
Paediatric Haemato-Oncology
FNB
DNB/MD
Paediatrics
Note:
· The feeder qualification for FNB Paediatric Haemato-Oncology is defined
by the NBE and is subject to changes in the NBE.
· The feeder qualification mentioned here is as of 2022.
· For any changes,
please refer to the NBE website.
· There is no upper age limit for training in NBEMS Fellowship courses.
Admission Process
The admission process contains a few steps to be followed for the candidates
for admission to FNB. Candidates can view the complete admission process for
FNB Paediatric Haemato-Oncology mentioned below:
- FET is a
qualifying-cum-ranking examination for admission to Fellow of National Board
(FNB)/Fellow of National Board - Post Doctoral (FNB-PD) courses. - The
selection of a student will be through an MCQ-based examination namely
Fellowship Entrance Test. - A student
can apply for the fellowship courses for which his/her broad or super speciality
qualification/ equivalent qualification is eligible, at the time of online
submission of the application form. - The total
duration of the question paper will be 105 minutes (Part A - 45 minutes and
Part B - 60 minutes). - QUALIFYING
CRITERIA: Students who obtain a minimum of 50th Percentile in their respective
question paper/speciality shall be declared as “Qualified”. - NBEMS
shall declare a speciality-wise merit list i.e., there will be a separate merit
list for each fellowship course. There shall not be any equating/scaling and
normalization. The merit shall be generated strictly based on marks obtained by
the student and the application of the prescribed tie-breaking criteria. - The
admission to Fellowship courses in the accredited hospitals shall be undertaken
solely based on merit-based counselling conducted by NBEMS. - Documents
required to be produced at the time of counselling: MBBS Degree Certificate and
MD/MS/DNB/DM/MCh/DrNB Degree Certificate/Provisional Pass Certificate of
eligible Post Graduate Medical Qualification issued.
Fees Structure
The fee structure for FNB Paediatric Haemato-Oncology varies from
accredited institute/hospital to hospital. The fee is generally less for
Government Institutes and more for private institutes. The average fee
structure for FNB Paediatric Haemato-Oncology is Rs.1,25,000 per year.
Colleges offering FNB Paediatric Haemato-Oncology
Various accredited institutes/hospitals across
India offer courses for pursuing FNB Paediatric Haemato-Oncology.
As per the National Board of Examinations website,
the following accredited institutes/hospitals are offering (FNB Paediatric
Haemato-Oncology) courses for the academic year 2022-23.
Hospital/Institute
Speciality
No. of Accredited Seat(s) (Broad/Super/Fellowship)
Apollo Hospital 21, Greams lane, Off Greams Rd, Thousand Lights,
Chennai. Tamil Nadu-600006
Paediatric Hemato-Oncology
2
Bai Jerbai Wadia Hospital for Children Institute of Child Health and
Research Centre, Acharya Donde Marg, Parel, Mumbai Maharashtra-400012
Paediatric Hemato-Oncology
3
Fortis Memorial Research Institute Sector-44, Opposite HUDA CITY
Centre Metro Station, Gurgaon, Haryana-122002
Paediatric Hemato-Oncology
1
Gandhi Memorial and Associated Hospital (King George`s Medical
University) Chowk, Lucknow Uttar Pradesh-226003
Paediatric Hemato-Oncology
1
Guru Teg Bahadur Hospital, Dilshad Garden, Delhi-110095
Paediatric Hemato-Oncology
1
Indo-American Cancer Institute and Research Centre Road No.14, Banjara
Hills, Hyderabad Telangana-500034
Paediatric Hemato-Oncology
2
Indraprastha Apollo Hospital Delhi-Mathura Road, Sarita Vihar, New
Delhi Delhi-110076
Paediatric Hemato-Oncology
2
Institute of Child Health and Hospital for Children Tamil Salai,
Egmore Chennai Tamil Nadu-600008
Paediatric Hemato-Oncology
1
Malabar Cancer Centre Moozhikkara P O, Kodiyeri, Thalassery, Kannur
Kerala-670103
Paediatric Hemato-Oncology
1
Medanta The Medicity Sector-38, Gurgaon Haryana-122001
Paediatric Hemato-Oncology
1
MVR Cancer Centre and Research Institute CP7/504 VELLALASSERI REC
(NIT) VIA CALICUT Kerala-673601
Paediatric Hemato-Oncology
1
Narayana Hrudayalaya Hospital (NH-Narayana Health City, Bangalore)
#258/A, Bommasandra Industrial Area, Anekal Taluk, Bangalore Karnataka-560099
Paediatric Hemato-Oncology
2
Rainbow Children`s Hospital 22, Rd#10, Banjara Hills, Hyderabad-500034
Telangana-500034
Paediatric Hemato-Oncology
1
Rajiv Gandhi Cancer Institute and Research Centre Sec-5, Rohini, New
Delhi Delhi-110085
Paediatric Hemato-Oncology
2
Sir Ganga Ram Hospital Rajinder Nagar, New Delhi Delhi-110060
Paediatric Hemato-Oncology
2
Sri Shankara Cancer Hospital and Research centre Shankara Math
Premises, 1st cross, Shankarapuram, Basavanagudi, Bangalore Karnataka-560004
Paediatric Hemato-Oncology
2
St. Johns Medical College Hospital Sarjapur Road, Koramangala
Bangalore Karnataka-560034
Paediatric Hemato-Oncology
3
Tata Medical Center 14 Major Arterial Road (E-W), Newtown, Rajarhat,
Kolkata West Bengal-700160
Paediatric Hemato-Oncology
3
The Gujarat Cancer and Research Institute M.P.Shah Cancer Hospital,
New Civil Hospital Campus, Asarwa Gujarat-380016
Paediatric Hemato-Oncology
2
Syllabus
FNB in Paediatric Haemato-Oncology is a two years specialization course
that provides training in the stream of Paediatric Haemato-Oncology.
The course content for FNB Paediatric Haemato-Oncology is given in the
NBE Curriculum released by the National Board of Examinations, which can be
assessed through the link mentioned below:
FNB Paediatric Hemato-Oncology: Check out NBE released Curriculum
Haematology
• Physiology of Hemostasis and Hematopoiesis
• Classification & Diagnosis of Anemia during Childhood
• Anemia During the Neonatal Period
• Erythroblastosis Fetalis
• Iron-Deficiency Anemia
Megaloblastic Anemia
• Hematologic Manifestations of Systemic Illness
• Bone Marrow Failure syndromes including Acquired Marrow failure
• Hemolytic Anemia due to Membrane & Enzyme Defects
• Hemoglobinopathies…. Sickle Cell Disease/ Thalassemia
• Extracorpuscular Hemolytic Disease (AIHA etc)
• Polycythemia
• Disorders of White Blood Cell
• Disorders of Platelets
• Hemostatic Disorders
• Thrombotic Disorders
• Lymphadenopathy and Splenomegaly
• Porphyrias
• Diagnostic Methodologies in Pediatric Hematology
• Various National Health Programme in Anemia
Transfusion Medicine
• Indications for transfusion of various components
• Methods of preparation of components
• Cryopreservation of Stem Cells
• Transfusion Reactions
• Transfusion Transmitted Diseases
Oncology
• Main Objective: To understand the epidemiology, molecular and cellular biology of various tumours.
Chemotherapy
• Main objective: To know the mechanism of action, indications,
toxicities and management of chemotherapeutic agents used in patients with malignancies.
i. Principles of chemotherapy
a) Principles of combination chemotherapy
b) Principles of drug resistance
c) Specific agents
ii. Immunologic Abnormalities
Main Objective: To know the management of infections in immunocompromised patients.
Bacterial Prophylaxis
Fungal Prophylaxis
Viral Prophylaxis
Treatment of infection in immunocompromised patients
Early Warning Signs of Cancer in Children/ Models for Early Diagnosis
Procedures in Pediatric Oncology: Practical Guidelines
iii. Cancer
• Etiopathogenesis of cancer
• Epidemiology of cancer
o Age-related incidence
o Race-related incidence
o Genetic factors
o Chemical-related factors
o Environmental factors
o Immunologic factors
• Tumor molecular and cellular biology factors
• Oncogenesis and cell growth regulation factors
o Lymphoproliferative Disorders
o Myelodysplastic Syndromes
o Myeloproliferative Disorders
o Leukemias
o Histiocytosis Syndromes
o Hodgkin's Disease
o Non-Hodgkin Lymphoma
o Central Nervous System Malignancies
o Neuroblastoma
o Wilms' Tumor
o Rhabdomyosarcoma & Other Soft Tissue Sarcomas
o Malignant Bone Tumors and Osteosarcoma
o Retinoblastoma
o Germ Cell Tumors
o Primary Hepatic Tumors
o Gonadal/ Germ cell tumors
o Rare Tumors
o Tumors in adolescents and young adult
o HLH
o Hematopoietic Stem Cell Transplantation
iv. Rationale, principles, and procedures of Hematopoietic stem cell
transplant
• Oncological, haematological, Immunological, metabolic, and autoimmune diseases which are correctable with the transplant procedure
• Rationale for transplant for a given disease or disease status, such
as for high-risk malignant disease
• Urgency of the workup of a patient with a diagnosis of severe aplastic anaemia, and the identification of a suitable histocompatible sibling
donor
so that transplant procedure can be undertaken as soon as possible before multiple transfusions are given
• Pre-transplant evaluation process (to evaluate organ function) to determine the suitability of an individual patient to undergo a transplant procedure
• Methods in which transplant recipients are conditioned for the
transplant procedure, as well as the rationale for the specific transplant conditioning regimen and design of the conditioning regimen
• Sources of hematopoietic stem/progenitor cells available for the
procedure of stem cell transplant, as well as the rationale for the selection of a particular source of stem cell product
• Process of acquisition and procurement of stem cells, as well as the rationale and the procedures utilized for the processing of the stem
cells before the transplant procedure
• Immunosuppressive therapy for the prevention of graft versus host disease, graft rejection the mode of administration of these agents, as
well as their respective benefits and side effects
• Acute, delayed, and chronic complications associated with the
transplant procedure and management of these complications, i.e. acute and chronic GvHD, veno-occlusive disease, immunodeficiency, infections, bleeding complications, acute organ failure, delayed organ dysfunctions including
growth and development, endocrine functions, and effect on neurocognitive function
• Management of patients undergoing hematopoietic stem cell transplant and immunocompromised patients' hematological and immunological recovery, prevention of management of graft versus host disease, effects of chronic GVHD and other late effects of procedure of transplantation.
Clinical and histopathological changes with GVHD and use of drugs and procedures appropriate for the treatment of CGvHD.
• Implementation of all the guidelines for the care of immunocompromised patients including limiting environmental exposures to microorganisms by proper isolation measures, maintenance of the patients in a proper air-handled environment, and administration of prophylactic antimicrobial therapy.
• The knowledge of the Stem cell procurement process, which includes the evaluation of the patient for suitability for the procedure, the consenting process for the procedure, collection of the product (Bone Marrow
harvest under general anaesthesia or collection of the peripheral blood stem
cells by apheresis procedure) and evaluation of the product collected
v. Gene Therapy
vi. Monoclonal Antibodies in Pediatric Hematology and Oncology
vii. Biological Response Modifiers
viii. Management of Oncologic Emergencies
ix. Supportive Care of Patients with Cancer
x. Nutritional Assessment and Intervention
xi. Palliative and Supportive Care
xii. Evaluation, Investigations & Management of Late Effects of
Childhood Cancer
xiii. Psycho-Social Aspects of Managing Oncologic Patients
xiv. Childhood Cancer in Low-Income and Middle-Income Countries in the Twenty-First Century
xv. Cancer Registries and the Descriptive Epidemiology of Pediatric
Cancer in Low-and Middle-Income Countries
xvi. The Role of International Organizations on Collaboration for Global
Pediatric Cancer Control
xvii. The Role of Twinning Programs and Telemedicine in Pediatric
Oncology
xviii. Paediatric Radiotherapy
xix. Central Venous Catheters
xx. Management of Fever in the Child with Cancer
xxi. Acute Pain Management in the Inpatient Setting
xxii. Palliative Care
xxiii. Chemotherapy Basics
xxiv. Guide to Procedures
xxv. Treatment of Chemotherapy Extravasations
xxvi. Biostatistics, Research Methodology and Clinical Epidemiology
xxvii. Ethics
xxviii. Medico-legal aspects relevant to the discipline
xxix. Health Policy issues as may apply to the discipline
Career Options
After completing FNB Paediatric Haemato-Oncology, candidates will get
employment opportunities in Government and the Private sector.
In the Government sector, candidates have various options to choose from
which include Junior research fellow, Teaching at academic medical centres, and
Consultants.
While in the Private sector, the options are Fellow (Paediatric
Haemato-Oncology), Junior research fellow, Senior Research fellow (Paediatric
Haemato-Oncology), and Consultants.
Frequently Asked
Questions (FAQs) –FNB Paediatric Haemato-Oncology Course /FNB in Paediatric
Haemato-Oncology Course
- Question: What is the complete full form of FNB?
Answer: The full form of FNB is Fellow of National board.
- Question: What is FNB Paediatric Haemato-Oncology?
Answer: FNB in Paediatric Haemato-Oncology or Fellow of National Board in Paediatric Haemato-Oncology is a doctoral fellowship program for doctors in India that is done by them
after completion of their postgraduate medical degree course.
- Question: What is the duration of FNB in Paediatric Haemato-Oncology?
Answer: FNB in Paediatric Haemato-Oncology is a fellowship program
of two years.
- Question: What is the eligibility of FNB in Paediatric
Haemato-Oncology?
Answer: The candidate should have a DNB or MD (Paediatrics) degree obtained from
any college/university recognized by the Medical Council of India (Now
NMC)/NBE. The prerequisite requirements mentioned here are as of 2022. For any
further changes, please refer to the NBE website.
- Question: What is the scope of FNB Paediatric
Haemato-Oncology?
Answer: FNB Paediatric Haemato-Oncology offers candidates various
employment opportunities and career prospects.
- Question: What is the average salary for an FNB Paediatric
Haemato-Oncology candidate?
Answer: The FNB Paediatric Haemato-Oncology candidate’s average salary
is between Rs.22 lakhs to Rs. 46 lakhs per annum depending on the experience.
- Question: Can you teach after completing FNB Paediatric Haemato-Oncology
Course?
Answer: Yes, the
candidate can teach in a medical college/hospital after completing the
fellowship.
2 years 4 months ago
News,Health news,NBE News,Medical Education,Medical Colleges News,Medical Courses News,Medical Universities News,Medical Admission News,Latest Medical Education News,Medical Courses
Health – Demerara Waves Online News- Guyana
Medical Scientific Council to be established- Pres. Ali
President Irfaan Ali on Saturday evening announced that his administration would soon set up a National Medical Scientific Council to harness Guyana’s best experts in the field of human medicine. He said that proposed body would be tasked with bringing Guyana’s “best talent” to investigate the best in medical science development that could be applied ...
President Irfaan Ali on Saturday evening announced that his administration would soon set up a National Medical Scientific Council to harness Guyana’s best experts in the field of human medicine. He said that proposed body would be tasked with bringing Guyana’s “best talent” to investigate the best in medical science development that could be applied ...
2 years 4 months ago
Health, News
Health – Demerara Waves Online News- Guyana
Diabetics, cancer patients can now get stem cell, immuno-therapy treatment in Guyana
Persons suffering from cancers, diabetes, heart and other non-communicable diseases will now able to receive life-saving immuno-therapy and stem cell treatment in Guyana for the first time, officials said on Saturday.
Those types of regenerative medical treatment, which are now being offered by Woodland’s Hospital in association with the Trinidad-headquartered Fidelity Healthcare Ltd, were launched ...
2 years 4 months ago
Health, News
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
Arthroscopic partial meniscectomy for torn meniscus still too often unnecessarily performed
A surgery for a torn meniscus caused by wear and tear is rarely beneficial, this was already known.
Researchers at Radboud university medical center have found in a new study that there are no smaller groups of patients who do benefit from surgery for a torn meniscus. ‘We should not perform this surgery anymore, but offer a policy focused on prevention, combined with a personal approach with a focus on physiotherapy.’ This saves between 11 and 26 million euros in healthcare costs per year.
For people of middle age or older with a tear in the meniscus, but without a history of acute knee trauma, surgery is rarely useful. Many studies have already shown that an arthroscopic surgery, in which a doctor treats a tear, is no better than physiotherapy or even a sham surgery, in which a doctor only makes incisions in the knee. Tears in the meniscus also often occur in people who have no complaints and are often not the cause of pain. Yet many orthopedic surgeons still operate on a torn meniscus. How come?
‘At the population level, it has been shown that this surgery, a so-called partial meniscectomy, has no effect, but a few people can benefit from it. Many orthopedists say that they still often operate, because they know exactly who a surgery is useful for’, says researcher Gerjon Hannink from Radboudumc. ‘We wanted to know if there are smaller groups of patients who you should actually operate on.’
Surgery unnecessary
‘To find out, we needed a lot of data’, says Stan Wijn, who earned his doctorate on the study. ‘All studies so far were too small to find subgroups. That is why we collected data from four studies on the effect of meniscus surgery, giving us data from 605 patients in total. We reanalyzed the raw data in the larger context. We looked for subgroups for whom surgery could be useful based on 13 factors, including age, BMI, gender, location of the tear, and knee function.’
The researchers found no subgroup, even when they used artificial intelligence to analyze the data. Not one subgroup scored better in terms of knee pain, knee function, or mental well-being. ‘We show with this study that there are no smaller groups of patients who you should actually operate on’, says Wijn. ‘As far as we are concerned, we should hardly perform any surgery on the meniscus. Only in case of very obvious complaints, such as a locked knee or when stretching the knee is no longer possible.’
No more bargaining
What can we offer patients with knee pain? ‘Prevention, combined with a personalized approach focused on physiotherapy’, Hannink answers. ‘We need to consider a degenerative knee more as a chronic condition. A clear guideline is very important in this regard, and orthopedic surgeons must adhere to it. I still hear too often that they operate because "if I don't do it, someone else will." Some patients even go abroad if they can't get surgery in the Netherlands. Dutch health insurance companies should no longer reimburse the procedure if it is performed abroad.’
Maroeska Rovers, professor of Evidence-Based Surgery, adds: ‘For this surgery, we should move toward the principle of "no, unless there is a specific indication for it", such as a locked knee. This saves us 11 to 26 million euros in the Netherlands each year, without sacrificing quality of life. With the Integral Care Agreement, we choose appropriate care. Then we should also choose not to operate and stop bargaining.'
Reference:
S.R.W. Wijn, G. Hannink, H. Østerås, M.A. Risberg, E.M. Roos, K.B. Hare, V.A. van de Graaf, R.W. Poolman, H.-W. Ahn, J.-K. Seon, M. Englund, M.M. Rover Published:January 13, 2023 DOI:https://doi.org/10.1016/j.joca.2023.01.002
2 years 4 months ago
Orthopaedics,Surgery,Orthopaedics News,Surgery News,Top Medical News
Health Archives - Barbados Today
Cancer screening event attracts large crowd
The belief that men do not pay enough attention to their health was dispelled on Saturday morning when Cancer Support Services held a Prostate Specific and Carcinoembryonic Antigen (PSA/CEA) Screening. The hosting of the event was symbolic because it coincided with World Cancer Day.
This session, which took place at their office at Dayrells Road in Christ Church, attracted a large crowd.
Janette Lynton, Executive Director and Founder of Cancer Support Services, was pleased with the turnout. She noted this was their first event for the year. Events are scheduled for every six weeks. She said, “We started at 10 am and so far we have 160 people waiting but we have seen 100 already and it’s just 12 pm and we are finishing at 1 pm.”
Lynton is appreciative of the support provided by corporate Barbados. She stated, “I want to thank all of the persons that came on board with us, Summit Rehab Centre, who sponsored 10 men today and I also want to thank the lab and all of the persons who have donated the water, everything today.”
She confirmed, “We are seeing quite a few younger persons coming out, which is very commendable and we trust that this will continue on that trend.” She emphasised, “Although the person may get a high PSA that does not mean it is cancerous. It can be an infection; it can be so many other different things. But we always recommend that they take the results to their physician and if they don’t have a physician, we would recommend one and we usually follow up with them so that they are not left out there alone.” The procedure involves a blood test and there is nothing to fear. “Early detection is the key,” she assured.
Michael Cobham, who attended the screening, described the experience as a pleasant one. “It was a long wait because there were a lot of people that came out to get tested today but the process itself was very simple.” He advised, “I encourage everyone to come out. I came for my general health. Getting older I want to know more about what is happening to me. This was an opportunity to come and get the test at a discounted price, so I took it.”
Though the recommended age for the test is 35, if there is a strong history of cancer in their family, individuals are encouraged to get screened at an earlier age.
Cancer survivor Ian Carrington was on hand promoting his self–published book An Unexpected Challenge : My Battle with Cancer, which chronicles his experience with the disease. He shared, “Twenty- eight years ago I had a confrontation with cancer and I thought I should share my story, looking at the impact on myself, my family and looking at the methods I used to heal and perhaps more importantly the lessons I learned in the process.”
A cancer diagnosis is not a death sentence. He said , “I subsequently learned there are a lot of people that survive it but a lot of people are not aware of that.” He reinforced that persons should listen to their bodies, if something does not feel quite right they should not hesitate to get the issue checked. His book is available at local bookstores across the island.
Summit Rehab Centre representatives were on site displaying some of the products that they offer. Students from Ross University School of Medicine conducted free blood pressure checks.
A similar exercise will take place in St Lucy in March to capture the northern catchment area. (STT)
The post Cancer screening event attracts large crowd appeared first on Barbados Today.
2 years 4 months ago
A Slider, Health, Local News
Cholera under control in Villa Liberación; more than 2,800 have been vaccinated
Santo Domingo, DR
In Villa Liberación del Almirante in Santo Domingo East, cholera is “under control” after the area became a focus of concentration of the disease. At the same time, the residents of the crowded sector have heeded the call of the health authorities to be immunized against the disease, registering at least 2,804 people who received the dose.
Santo Domingo, DR
In Villa Liberación del Almirante in Santo Domingo East, cholera is “under control” after the area became a focus of concentration of the disease. At the same time, the residents of the crowded sector have heeded the call of the health authorities to be immunized against the disease, registering at least 2,804 people who received the dose.
Of the people inoculated, 1,825 were students of the neighboring schools. In contrast, the rest were inoculated at the Diagnostic Tent, vaccination posts in the Almirante, house-to-house campaigns, and the health area of the district.
Rafael Güichardo, risk manager of this health area, highlighted the municipalities’ receptiveness to oral vaccination at the health posts and house-to-house campaigns.
“They have grasped the message we have for them to get vaccinated, because it is really for their own health,” he said.
Güichardo also highlighted that in the last few days, even though they continue to attend to people in the tent, no people have come with characteristic cholera symptoms such as dehydration, vomiting, and diarrhea.
“Patients come with different pathologies, such as headaches and different pathologies, but we are not really receiving patients with suspected cholera symptoms,” he added.
An average of four people come to the tent every day.
The service remains stable regarding the drinking water supplied by the Santo Domingo Aqueduct and Sewerage Corporation (CAASD) in the water tank in the diagnostic tent located in the Diagnostic and Primary Attention Center of the sector with the assistance of tanker trucks on a daily basis.
In addition, community members are supplied with kits containing, among other things, hand sanitizers and chlorine.
Residents follow protocols
For their part, the residents stated that they follow the hygiene protocols to avoid future contagions, such is the case of María de los Santos, who confessed to having been vaccinated and also to washing the food properly, as well as to close the garbage bags tightly until the garbage collection trucks come to pick up the garbage.
2 years 4 months ago
Health, Local
Adverse impact of environmental stress, air pollution on cardiovascular health
OVER the years cardiologists and public health experts have emphasised the adverse impact of traditional risk factors like smoking, hypertension, and diabetes on cardiovascular health.
In recent years we are beginning to recognise non-traditional risk factors that have only received scant attention. Environmental stressors like air pollution, smoke, noise pollution, and extreme temperatures have been shown to have many adverse effects on cardiovascular health.
As we tend to the current and emerging crisis from climate change, cardiologists are becoming more attentive to the impact of environmental stresses and pollution on the heart. While intuitively it is easy to predict that air pollution could lead to lung diseases and cancer, what is lost on many is that, of all the catastrophic consequences of air pollution, cardiovascular disease tops the list, ahead of cancer and lung diseases.
Air pollution and the global burden of disease
The Global Burden of Disease (GBD) project estimated that pollution accounted for about nine million deaths worldwide in 2019, with more than 50 per cent of those (an estimated five million deaths) resulting from cardiovascular disease.
Air pollution can be categorised into ambient fine particulate matter (aerodynamic-mass median diameter
2 years 4 months ago
Time to close the cancer care gap
PORT OF SPAIN, Trinidad and Tobago (CARPHA) — Cancer continues to be one of the leading causes of death. No part of the world has been spared the impact of this public health issue.
In the Caribbean cancer is the second-leading cause of death, accounting for a fifth of all deaths.
PORT OF SPAIN, Trinidad and Tobago (CARPHA) — Cancer continues to be one of the leading causes of death. No part of the world has been spared the impact of this public health issue.
In the Caribbean cancer is the second-leading cause of death, accounting for a fifth of all deaths.
In 2020 over 100,000 new cancer cases and over 65,000 cancer deaths in the Caribbean were estimated. Female breast cancer accounted for the most cancer cases in the Caribbean (15 per cent), while lung cancer caused the most cancer deaths (12 per cent). Prostate, colorectal and stomach cancers are also common.
"Up to 50 per cent of cancer cases are preventable, and 27 per cent of cancers relate to alcohol and tobacco use. People can reduce their risk of getting certain types of cancer by adopting healthy lifestyles and practising suitable health-seeking behaviours," stated Dr Joy St John, executive director at the Caribbean Public Health Agency (CARPHA).
Adopting healthier behaviours sucha s those below can help to reduce your risk of cancer:
*The less alcohol you drink, the lower your risk of cancer
*Avoid tobacco products and exposure to second-hand smoke
*Increase physical activity
*Eat foods low in salt, sugar and harmful fats.
Worldwide, cancer is the second-leading cause of death, causing one-sixth of all deaths. In 2020 there were 19.3 million new cancer cases, with breast, lung, prostate, skin and colon cancers being the most common; and there were 10 million cancer deaths in that same year.
CARPHA is engaged in initiatives to address the risk factors associated with increased cancer risks, including poor nutrition and the consumption of harmful substances such as alcohol and tobacco. CARPHA also supports regional efforts to reduce the threats posed to Caribbean people by unhealthy diets, obesogenic food environments, and the harmful use of alcohol.
The IARC Caribbean Cancer Registry Hub (Caribbean Hub), based at CARPHA's headquarters in Trinidad, provides technical support to increase the quality and population coverage of national cancer registries in the Caribbean through guidance, training, networking, and advocacy for the critical role of such registries in cancer surveillance and cancer control. Cancer registration activities in several Caribbean countries are also being strengthened. Better-quality cancer data provide more reliable evidence to support decision-making for cancer prevention and control at the national and regional levels.
As the three-year 2022-2024 World Cancer Day theme 'Close the Care Gap' continues, the focus is on "uniting our voices and taking action" in 2023. This campaign seeks to close the equity gaps in cancer outcomes between people with different social determinants of health such as race/ethnicity, income level, gender, and geographical location through a united approach and taking action. To help address these issues, a whole-of-society approach is needed to close the gap in inequities. This means collectively taking action and committing to health equality so that everyone has the same opportunity to prevent cancer, find it early, and get proper treatment. Primary health care delivered in communities needs to be strengthened; social and economic factors that negatively affect people's health need to be addressed through policy and programmes; and investments in health-care systems and national programmes are needed.
It is important to support and advocate for the collection and dissemination of high-quality data on cancer incidence, mortality, and treatment to ensure evidence-based decision-making for improvements to national cancer control programmes. Additionally, improved cancer outcomes investments can be helped through strategies such as universal health coverage, primary health care, early detection, timely referral mechanisms, effective treatment, and palliative care.
Cancer is a critical public health concern. When we unite, when we collaborate, change is within reach. When we act, there is progress, impact and equity. Let us close the gap.
2 years 4 months ago
New rules would limit sugar in school meals for first time
US agriculture officials on Friday proposed new nutrition standards for school meals, including the first limits on added sugars, with a focus on sweetened foods such as cereals, yoghurt, flavoured milk, and breakfast pastries.
The plan announced by Agriculture Secretary Tom Vilsack also seeks to significantly decrease sodium in the meals served to the nation's schoolkids by 2029, while making the rules for foods made with whole grains more flexible.
The goal is to improve nutrition and align with US dietary guidelines in the programme that serves breakfast to more than 15 million children and lunch to nearly 30 million children every day, Vilsack said.
"School meals happen to be the meals with the highest nutritional value of any meal that children can get outside the home," Vilsack said in an interview.
The first limits on added sugars would be required in the 2025-2026 school year, starting with high-sugar foods, such as sweetened cereals, yoghurt, and flavoured milks.
Under the plan, for instance, an eight-ounce container of chocolate milk would contain no more than 10 grams of sugar. Some popular flavoured milks now contain twice that amount. The plan also limits sugary grain desserts, such as muffins or doughnuts, to no more than twice a week at breakfast.
By the fall of 2027, added sugars in school meals would be limited to less than 10 per cent of the total calories per week for breakfasts and lunches.
The proposal also would reduce sodium in school meals by 30 per cent by the fall of 2029. It would gradually be reduced to align with federal guidelines, which recommend Americans aged 14 and older limit sodium to about 2,300 milligrams a day, with less for younger children.
Levels would drop, for instance, from an average of about 1,280 milligrams of sodium allowed now per lunch for kids in grades nine to 12 to about 935 milligrams. For comparison, a typical turkey sandwich with mustard and cheese might contain 1,500 milligrams of sodium.
Health experts say cutting back on sugar and salt can help decrease the risk of disease in kids, including obesity, diabetes, high blood pressure, and other problems that often continue into adulthood.
The plan, detailed in a 280-page document, drew mixed reactions. Katie Wilson, executive director of the Urban School Food Alliance, said the changes are "necessary to help America's children lead healthier lives".
But Diane Pratt-Heavner, spokeswoman for the School Nutrition Association, a trade group, said school meals are already healthier than they were a decade ago and increased regulations are a burden, especially for small and rural school districts.
"School meal programmes are at a breaking point," she said. "These programmes are simply not equipped to meet additional rules."
Vilsack emphasised that the plan phases changes in over the next six years to allow schools and food manufacturers time to adjust to the new standards. He said in a press conference Friday that the USDA will also fund grants of up to $150,000 to help small and rural schools make the changes.
"Our hope is that many school districts and food providers accelerate the timeline on their own," he said.
Courtney Gaine, president of the Sugar Association, said the proposal ignores the "many functional roles" sugar plays in food beyond sweetness and encourages the use of sugar substitutes, which have not been fully studied in children. Sugar substitutes are allowed under the new standards, Vilsack said.
As part of the plan, agriculture officials are seeking feedback about a proposal that would continue to require that 80 per cent of all grains offered in a week be whole grains. But it would allow schools to serve non-whole grain foods, such as white-flour tortillas, one day a week to vary their menus.
Another option suggests serving unflavoured non-fat and low fat milk to the youngest children and reserving chocolate and other flavoured milks for high school kids.
A 60-day public comment period on the plan opens February 7.
Shiriki Kumanyika, a community health expert at Drexel University's Dornsife School of Public Health, said if they're done right, some of the changes will be hard for kids to notice: "They'll see things that they like to eat, but those foods will be healthier," she said.
— AP
2 years 4 months ago
Health Archives - Barbados Today
QEH makes progress in clearing surgery backlog
By Anesta Henry
The Queen Elizabeth Hospital (QEH) is continuing to work towards clearing the backlog of people awaiting elective surgeries.
By Anesta Henry
The Queen Elizabeth Hospital (QEH) is continuing to work towards clearing the backlog of people awaiting elective surgeries.
That assurance has come from Minister of State in the Ministry of Health and Wellness with responsibility for the QEH, Dr Sonia Browne, who also told Barbados TODAY she was pleased the healthcare institution was on top of its cataract surgeries.
She congratulated medical personnel and other workers who contributed to clearing up the backlog in those surgeries “in a timely manner”.
“Now, the joint replacement surgeries have started and we are looking to really get that moving swiftly and in a practical way. Right now, the joint replacement surgeries are not going as fast as I would like it but we are getting there,” she said.
“For the other surgeries, one of the delays was the availability of theatres. All of the theatres that are available, I believe, are in use.”
Dr Browne further explained that while the three theatres at the hospital’s Lion’s Eye Care Centre have been out of use, all major ophthalmology surgeries had to be diverted to the main theatres.
She said the hospital’s management was in the process of getting a loan to get the theatres at the Eye Care Centre repaired.
“We are looking to get those back on track and working again on their own to free up some of the other theatres,” the Minister said.
Responding to complaints from patients referred to the hospital for operations, Dr Browne said that while some complaints were valid, some surgeries were delayed due to reasons beyond the QEH’s control.
She said some patients would show up for operations but their test results showed that, for example, their diabetes “is out of whack, their hypertension is out of whack, they may have eaten when they shouldn’t”, leading to scheduled surgeries having to be postponed.
“I promise you that we are looking at all of that and we are trying to work with the doctors and nurses and everybody else to see where we can address that. The issue that we found is a delay in the start time for surgery and I think we have more or less addressed that, so they start on time and the process would flow,” Dr Browne said.
During a press conference in March last year, Minister of Health and Wellness Ian Gooding-Edghill said partnerships were being explored with Cuba to reduce the backlogs, adding there was need for “out-of-the-box commercial thinking”.
He revealed at that time that part of the plan will be to get all 12 operating theatres back into operation to be utilised “day and night” for surgeries. anestahenry@barbadostoday.bb
The post QEH makes progress in clearing surgery backlog appeared first on Barbados Today.
2 years 4 months ago
A Slider, Health, Local News
Four children admitted for diphtheria Robert Reid Cabral
Four children of different ages have been diagnosed with diphtheria at the Robert Reid Cabral Hospital. Diphtheria is a vaccine-preventable disease.
The children come from communities in Barahona and Duvergé.
They are children from two families in two distant communities, implying an active outbreak in both communities.
Four children of different ages have been diagnosed with diphtheria at the Robert Reid Cabral Hospital. Diphtheria is a vaccine-preventable disease.
The children come from communities in Barahona and Duvergé.
They are children from two families in two distant communities, implying an active outbreak in both communities.
The hospital said the children range in age from two months to four years. Diphtheria is a severe bacterial infection that affects the nose and throat mucous membranes.
The disease occurs when vaccination schedules fail. The medical literature states that the condition can be treated with medication, and in advanced stages, it can damage the heart, kidneys, and nervous system. However, this disease can be fatal in children.
Symptoms
Signs and symptoms of diphtheria almost always begin two to five days after contracting the infection and may develop symptoms such as a thick, gray-colored membrane lining the throat and tonsils. When you have the disease, you may have a sore throat, hoarseness, and swollen glands in the neck—shortness of breath or rapid breathing, runny nose, fever, chills, and tiredness.
Background
In 2021, the Ministry of Public Health issued an epidemiological alert due to the occurrence of diphtheria cases in different parts of the country. As of week 14, four have been confirmed.
By week 14 of the year 2021, eight deaths had been reported. In general, when cases occur, children have not been vaccinated or have incomplete doses.
In such situations, authorities urge the population to go to vaccination centers to follow up on the official vaccination schedule. The children admitted coming from Barahona and Pedernales. The provinces of Barahona and Independencia, belonging to the Enriquillo region, have reported several suspected cases of diphtheria and the death of a four-year-old child.
Donation of equipment
In another development, the Ministry of Public Health received a donation of US$160,000 from the Pan American Health Organization. The Government of the United States provided the funds. The donation consists of two waste management kits and two imaging kits.
They will be destined exclusively for mobile hospitals within the Emergency Medical Teams (EMT) program of the Risk Management Directorate.
The donation seeks to contribute to improving preparedness and response capacity.
2 years 4 months ago
Health, Local
New rules to limit sugar in school meals for first time
WASHINGTON, DC, United States (AP) — Agriculture officials on Friday proposed new nutrition standards for US school meals, including the first limits on added sugars, with a focus on sweetened foods such as cereals, yoghurt, flavoured milk and breakfast pastries.
The plan announced by Agriculture Secretary Tom Vilsack also seeks to significantly decrease sodium in the meals served to the nation's schoolkids by 2029, while making the rules for foods made with whole grains more flexible.
The goal is to improve nutrition and align with US dietary guidelines in the programme that serves breakfast to more than 15 million children and lunch to nearly 30 million children every day, Vilsack said.
"School meals happen to be the meals with the highest nutritional value of any meal that children can get outside the home," Vilsack said in an interview.
The first limits on added sugars would be required in the 2025-2026 school year, starting with high-sugar foods such as sweetened cereals, yogurts and flavoured milks. Under the plan, for instance, an eight-ounce container of chocolate milk could contain no more than 10 grams of sugar; some popular flavoured milks now contain twice that amount. The plan also limits sugary grain desserts, such as muffins or doughnuts, to no more than twice a week at breakfast.
By the fall of 2027 added sugars in school meals would be limited to less than 10 per cent of the total calories per week for breakfasts and lunches.
The proposal also would reduce sodium in school meals by 30 per cent by the fall of 2029. They would gradually be reduced to align with federal guidelines, which recommend Americans aged 14 and older limit sodium to about 2,300 milligrams a day, with less for younger children.
Levels would drop, for instance, from an average of about 1,280 milligrams of sodium allowed now per lunch for kids in grades 9 to 12 to about 935 milligrams. For comparison, a typical turkey sandwich with mustard and cheese might contain 1,500 milligrams of sodium.
Health experts say cutting back on sugar and salt can help decrease the risk of disease in kids, including obesity, diabetes, high blood pressure and other problems that often continue into adulthood.
The plan, detailed in a 280-page document, drew mixed reactions.
Katie Wilson, executive director of the Urban School Food Alliance, said the changes are "necessary to help America's children lead healthier lives". But Diane Pratt-Heavner, spokeswoman for the School Nutrition Association, a trade group, said school meals are already healthier than they were a decade ago and that increased regulations are a burden, especially for small and rural school districts.
"School meal programmes are at a breaking point," she said. "These programmes are simply not equipped to meet additional rules."
Vilsack emphasised that the plan phases changes in over the next six years to allow schools and food manufacturers time to adjust to the new standards.
"Our hope is that many school districts and food providers accelerate the timeline on their own," he said.
Courtney Gaine, president of the Sugar Association, said the proposal ignores the "many functional roles" sugar plays in food beyond sweetness, and encourages the use of sugar substitutes which have not been fully studied in children. Sugar substitutes are allowed under the new standards, Vilsack said.
As part of the plan, agriculture officials are seeking feedback about a proposal that would continue to require that 80 per cent of all grains offered in a week must be whole grains. But it would allow schools to serve non-whole grain foods, such as white-flour tortillas, one day a week to vary their menus.
Another option suggests serving unflavoured, non-fat and low-fat milk to the youngest children and reserving chocolate and other flavoured milks for high school kids.
A 60-day public comment period on the plan opens February 7.
Shiriki Kumanyika, a community health expert at Drexel University's Dornsife School of Public Health, said if they're done right some of the changes will be hard for kids to notice: "They'll see things that they like to eat, but those foods will be healthier," she said.
2 years 4 months ago