Health – Dominican Today

Public Health receives 5,000 vaccinations against monkeypox

The Vice Minister of Public Health, Dr. Eladio Pérez, reported this Wednesday that the country has received 5,000 doses of a vaccine against monkeypox that will soon be available to the most vulnerable population.

According to Pérez, the vaccine is called “Jynneos”, belonging to the “Bavarian Nordic” brand, it is of a “fairly known and tolerable technology, with very low adverse effects”, and only those over 18 years of age may be inoculated.

“We have been able to access an emergency stock that the World Health Organization has for cases of seismic smallpox. They are already in the country. Several months ago it was announced that vaccines had been purchased, they arrived and will be available to the vulnerable population, ”he assured, adding that the State investment for the acquisition of the medicine was more than 32 million pesos. The vaccine will be applied in two different doses and initially, the Ramón de Lara Hospital and all health personnel “who will face the disease if more cases occur, will begin to be immunized since they must be duly protected.”

In addition to this, the representative of the Health Administration indicated that the medicine is stored at temperatures above 50 degrees and can take up to five years to expire.

 

2 years 9 months ago

Health, Local

PAHO/WHO | Pan American Health Organization

PAHO Director meets the President of the Government of Spain, Pedro Sánchez

PAHO Director meets the President of the Government of Spain, Pedro Sánchez

Cristina Mitchell

8 Feb 2023

PAHO Director meets the President of the Government of Spain, Pedro Sánchez

Cristina Mitchell

8 Feb 2023

2 years 9 months ago

Health – Dominican Today

Organization demands that the Senate include abortion in the reform of the Penal Code

The Committee for Unity and Women’s Rights (Cudem) made its strongest claim to the Senate on Tuesday to include the right to abortion in the bill to reform the Penal Code, which has been widely debated in the country.

For the feminist organization, it is an “obligation” of this legislative body to assume its commitment to the protection of women’s rights and to resist pressure from the “more retrograde” interests of political party structures “kneeling” before “powers that be” of a religious nature. The entity stated in a note that the Senate should not continue to ignore the social claims of thousands of women, particularly poor women, who demand three exemptions from abortion penalties across the country.

She went on to say that, like many other institutions and spaces for social and community struggle, the defense of women’s rights is the bedrock of critical social transformations in today’s Dominican society. Cudem described as “unacceptable” the “dogmatic” and “anti-humanist” thought, in the strict sense of the concept, which means the defense and protection of human life of beings born “alive and viable,” as established by international recognition of human rights. She reiterated her call to legislators to remove all conditioning factors and pressures, as well as to accept social and political responsibility by siding with those who, “with our work and efforts,” bear the essential burden of families, which are women.

“It is the responsibility of congressmen and women to legislate in favor of women’s rights so that women can be free to make decisions about our lives and our bodies when a pregnancy poses risks, is not viable, or is the result of rape or incest,” Cudem said.

2 years 9 months ago

Health, Local

Medical News, Health News Latest, Medical News Today - Medical Dialogues |

DME Gujarat Releases Round 4 Results For BSc Nursing Course

Gujarat: The Director of Medical Education (DME Gujarat) has released the results of round 4 for the BSc Nursing course. The list of candidates who need to report to the help centre, the final rank list, the Axis Bank-approved branches for payment of tuition fees, and the list of help centres have also been released.

Per the notice, every candidate should pay the fee and report to the help centre only after taking the latest copy of the allotment letter. Reporting and depositing original certificates and confirmation of admission at the authorized help centre (10:00 am to 4:00 pm) can be done from 8.2.2023 from 10:00 am to 10.2.2023 up to 4:00 pm.

To view the results, click on the link below –

https://medicaldialogues.in/pdf_upload/allotment-201045.pdf

The list of candidates who requires reporting and the final rank list has also been released. The detailed lists are enclosed in the notice below.

There are  75 branches of Axis Bank across Gujarat for the payment of tuition fees. The braches in the following places – Ahmadabad, Amreli, Anand, Arvalli, Banaskantha, Bharuch, Bhavnagar, Botad, Dahod, Devbhumi Dwarka, Gandhinagar, Gir Somnath, Jamnagar, Junagadh, Kheda, Kutch, Mahisagar, Mehsana, Morbi, Navsar, Panchmahal, Patan, Porbandar, Rajkot, Rajpipla, Sabarkantha, Surat, Surendranagar, Tapi, Vadodara, Valsad. The detailed list is enclosed in the notice below.

Also Read:BFUHS Announces Walk-in Counseling Schedule For BSc Nursing

47 help centres have been allotted for the BSc Nursing courses for admission across Gujarat. These help centres are in the following districts – Ahmedabad, Amreli, Anand, Arvalli, Banaskantha, Bhavnagar, Chhotaudepur, Dahod, Dang, Gandhinagar, Gir Somnath, Jamnagar, Junagadh, Kachchh, Kheda, Mahisagar, Mehsana, Narmada, Navsari, Panchmahal, Patan, Porbandar, Rajkot, Sabarkantha, Surat, Surendranagar, Tapi, Vadodara, Valsad. The detailed list is enclosed in the notice below.

Candidates who have taken admission to courses other than BSc Nursing, i.e. Physiotherapy, GNM, ANM, Orthotics and Prosthetics, Occupational Therapy, B.Optometry and Audiology in any Government or Independent Institutions have given consent were not allowed to participate.

BSc Nursing is a 4 years professional undergraduate course. Those who have passed class 12 from Gujarat Board or its equivalent in science stream with Biology, Chemistry, Physics and English with minimum eligible marks are eligible for BSc Nursing admission. The candidates must be of 17 years of age by 31st December 2022.

The medical education department plays a pivotal role in developing medical and paramedical personnel to cater to the state's health needs. The department also has a role to play in establishing and maintaining well-equipped teaching institutions, which are the premier referral centres from peripheral hospitals.

To view the notices, click on the links below -

https://medicaldialogues.in/pdf_upload/axis-bank-202223-1-201046.pdf

https://medicaldialogues.in/pdf_upload/hp-202223-201047.pdf

https://medicaldialogues.in/pdf_upload/paraclosurer4-201048.pdf

https://medicaldialogues.in/pdf_upload/requiredreportingr4-1-201049.pdf

Also Read:NEET MDS Registration window To Reopen

2 years 9 months ago

State News,News,Gujarat,Medical Education,Nursing education News,Latest Medical Education News

STAT

STAT+: New funding for scientist David Sabatini draws divided reactions

Billionaire New York hedge fund manager Bill Ackman built a record of going against the grain and taking whatever flack or controversy came his way.

True to form, Ackman announced last week that he and an anonymous donor had pledged $25 million over five years toward a new research lab for David Sabatini, a former star scientist from MIT and Whitehead Institute, whose career imploded in 2021 amid allegations of workplace misconduct and sexual harassment.

Continue to STAT+ to read the full story…

2 years 9 months ago

In the Lab, scientists, STAT+

Health

Fantastic new technology for people with vision loss

Today’s technology not only makes life easier for everyone, but in the case of people with vision loss, it allows them to do even the simplest of things others might not have to think about. With modern technology, people with vision loss can do...

Today’s technology not only makes life easier for everyone, but in the case of people with vision loss, it allows them to do even the simplest of things others might not have to think about. With modern technology, people with vision loss can do...

2 years 9 months ago

Health

How common is male infertility?

Infertility is a disease of the reproductive system and it makes a person unable to have children. It can affect a man, a woman, or both. Male infertility means that a man has a problem with his reproductive system and cannot cause a pregnancy with...

Infertility is a disease of the reproductive system and it makes a person unable to have children. It can affect a man, a woman, or both. Male infertility means that a man has a problem with his reproductive system and cannot cause a pregnancy with...

2 years 9 months ago

Kaiser Health News

Un arma secreta para prevenir la próxima pandemia: los murciélagos frugívoros

Más de cuatro docenas de murciélagos frugívoros de Jamaica destinados a un laboratorio en Bozeman, Montana, se convertirán en parte de un experimento con un objetivo ambicioso: predecir la próxima pandemia mundial.

Los murciélagos en todo el mundo son vectores primarios para la transmisión de virus de animales a humanos. Generalmente esos virus son inofensivos para los murciélagos, pero pueden ser mortales para los humanos.

Por ejemplo, en China, los murciélagos de herradura se citan como una causa probable del brote de covid-19. Y los investigadores creen que la presión ejercida sobre los murciélagos por el cambio climático y la invasión del desarrollo humano han aumentado la frecuencia con la que los virus saltan de estos animales a las personas, causando lo que se conoce como enfermedades zoonóticas.

“Estos eventos indirectos son el resultado de una cascada de factores estresantes: el hábitat de los murciélagos cambia, el clima se vuelve más extremo, los murciélagos se trasladan a áreas humanas para encontrar comida”, dijo Raina Plowright, ecologista de enfermedades y coautora de un artículo reciente en la revista Nature y otro en Ecology Letters sobre el papel de los cambios ecológicos en las enfermedades.

Es por eso que Agnieszka Rynda-Apple, inmunóloga de la Universidad Estatal de Montana (MSU), planea traer murciélagos frugívoros (o de la fruta) de Jamaica a Bozeman este invierno para iniciar una colonia de reproducción y acelerar el trabajo de su laboratorio como parte de un equipo de 70 investigadores en siete países.

El grupo, llamado BatOneHealth, fundado por Plowright, espera encontrar formas de predecir dónde el póximo virus mortal podría dar el salto de los murciélagos a las personas. “Estamos colaborando para responder a la pregunta de por qué los murciélagos son un vector tan fantástico”, dijo Rynda-Apple.

“Estamos tratando de entender qué es lo que hace que sus sistemas inmunológicos retengan el virus y cuál es la situación en la que lo eliminan”, agregó.

Para estudiar el papel del estrés nutricional, explicó que los investigadores crean diferentes dietas para estos mamíferos, “los infectan con el virus de la influenza y luego estudian cuánto virus están eliminando, la duración de la eliminación viral y su respuesta antiviral”.

Si bien Rynda Apple y sus colegas ya han estado haciendo este tipo de experimentos, la cría de murciélagos les permitirá ampliar la investigación. Es un esfuerzo arduo comprender a fondo cómo el cambio ambiental contribuye al estrés nutricional, y predecir mejor el efecto indirecto.

“Si realmente podemos entender todas las piezas del rompecabezas, eso nos dará herramientas para volver atrás y pensar en medidas contra-ecológicas que podemos poner en práctica para romper el ciclo de los efectos indirectos”, dijo Andrew Hoegh, profesor asistente de estadísticas en MSU que está creando modelos para posibles escenarios indirectos.

El pequeño equipo de investigadores de la MSU trabaja con un investigador del Rocky Mountain Laboratories de los Institutos Nacionales de Salud en Hamilton, Montana.

Los artículos recientes publicados en Nature y Ecology Letters se centran en el virus Hendra en Australia, que es donde nació Plowright.

Hendra es un virus respiratorio que causa síntomas similares a los de la gripe y se propaga de los murciélagos a los caballos, y luego puede transmitirse a las personas que tratan a los caballos. Es mortal, con una tasa de mortalidad del 75% en caballos. De las siete personas que hasta el momento se sabe que contrajeron esta infección, cuatro murieron.

La pregunta que impulsó el trabajo de Plowright es por qué Hendra comenzó a aparecer en caballos y personas en la década de 1990, a pesar de que los murciélagos probablemente han albergado al virus por millones de años.

La investigación demuestra que la razón es el cambio ambiental. Plowright comenzó su investigación sobre murciélagos en 2006. En muestras tomadas de murciélagos australianos llamados zorros voladores, ella y sus colegas rara vez detectaron el virus.

Después de que el ciclón tropical Larry frente a la costa del Territorio del Norte australiano acabara con la fuente de alimento de los murciélagos en 2005-06, cientos de miles de animales simplemente desaparecieron. Sin embargo, encontraron una pequeña población de murciélagos débiles y hambrientos cargados con el virus Hendra.

Eso llevó a Plowright a centrarse en el estrés nutricional como un factor clave en el efecto indirecto. El equipo analizó 25 años de datos sobre la pérdida de hábitat, el derrame y el clima, y descubrieron un vínculo entre la pérdida de fuentes de alimento causada por el cambio ambiental y las altas cargas virales en murciélagos estresados por la comida.

En el año posterior a un patrón climático de El Niño, con sus altas temperaturas, que ocurren cada pocos años, muchos árboles de eucalipto no producen las flores con el néctar que necesitan los murciélagos. Y la invasión humana de otros hábitats, desde las granjas hasta el desarrollo urbano, ha eliminado las fuentes alternativas de alimentos. Entonces, los murciélagos tienden a mudarse a áreas urbanas con higueras, mangos y otros árboles deficientes y, estresados, propagan los virus.

Cuando los murciélagos excretan orina y heces, los caballos las inhalan mientras huelen el suelo. Los investigadores esperan que su trabajo con murciélagos infectados con Hendra ilustre un principio universal: cómo la destrucción y la alteración de la naturaleza pueden aumentar la probabilidad de que los patógenos mortales pasen de los animales salvajes a los humanos.

Las tres fuentes más probables de contagio son los murciélagos, los mamíferos y los artrópodos, especialmente las garrapatas. Alrededor del 60% de las enfermedades infecciosas emergentes que infectan a los humanos provienen de animales, y alrededor de dos tercios de ellas provienen de animales salvajes.

La idea de que la deforestación y la invasión humana de las tierras salvajes alimentan las pandemias no es nueva. Por ejemplo, expertos creen que el VIH, que causa el SIDA, infectó a los humanos por primera vez cuando la gente comía chimpancés en África central. Un brote en Malasia a fines de 1998 y principios de 1999 del virus Nipah transmitido por murciélagos se propagó de murciélagos a cerdos. Los cerdos lo amplificaron y se propagó a los humanos, con un brote que infectó a 276 personas, y mató a 106.

Ahora está emergiendo la conexión con el estrés provocado por los cambios ambientales.

Una pieza crítica de este complejo rompecabezas es el sistema inmunológico de los murciélagos. Los murciélagos frugívoros de Jamaica que vivirán en la MSU ayudarán a los investigadores a obtener más información sobre los efectos del estrés nutricional en su carga viral.

Vincent Munster, jefe de la unidad de ecología de virus de Rocky Mountain Laboratories y miembro de BatOneHealth, también está analizando diferentes especies de murciélagos para comprender mejor la ecología del contagio. “Hay 1,400 especies diferentes de murciélagos y hay diferencias muy significativas entre los que albergan coronavirus y los murciélagos que albergan el virus del Ébola”, dijo Munster. “Y murciélagos que viven cientos de miles juntos versus murciélagos que son relativamente solitarios”.

Mientras tanto, Gary Tabor, esposo de Plowright, es presidente del Center for Large Landscape Conservation, una organización sin fines de lucro que aplica la ecología de la investigación de enfermedades para proteger el hábitat de la vida silvestre, en parte, para garantizar que la vida silvestre esté adecuadamente alimentada y protegerse contra la propagación de virus.

“La fragmentación del hábitat es un problema de salud planetaria que no se está abordando lo suficiente, dado que el mundo continúa experimentando niveles sin precedentes de deforestación”, dijo Tabor.

A medida que mejore la capacidad de predecir brotes, otras estrategias se vuelven posibles. Los modelos que pueden predecir dónde podría extenderse el virus Hendra podrían conducir a la vacunación de los caballos en esas áreas. Otra posible solución es el conjunto de “contramedidas ecológicas” a las que se refirió Hoegh, como la plantación a gran escala de eucaliptos en flor para que los murciélagos zorros voladores no se vean obligados a buscar néctar en áreas desarrolladas.

“En este momento, el mundo está enfocado en cómo podemos detener la próxima pandemia”, dijo Plowright. “Desafortunadamente, preservar o restaurar la naturaleza rara vez es parte de la discusión”.

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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2 years 9 months ago

Noticias En Español, Public Health, States, COVID-19, Environmental Health, Montana

PAHO/WHO | Pan American Health Organization

Member states discuss pandemic treaty and other key health issues at 152nd WHO Executive Board

Member states discuss pandemic treaty and other key health issues at 152nd WHO Executive Board

Oscar Reyes

7 Feb 2023

Member states discuss pandemic treaty and other key health issues at 152nd WHO Executive Board

Oscar Reyes

7 Feb 2023

2 years 9 months ago

Health Archives - Barbados Today

A Garden of Hope launched at Walkers Reserve



The Walkers Institute for Regenerative Research Education and Design (WIRRED) hosted the launch of A Garden of Hope at Walkers Reserve on Saturday, January 28. This work is a creative intervention at the Reserve by Annalee Davis in collaboration with Kevin Talma and the Walkers Institute for Regenerative Research Education and Design (WIRRED). 

The name, A Garden of Hope, refers to the 17th-century Hope estate, later amalgamated into a larger Scotland plantation, once owned by Judith Powrey, becoming the foundation of what is now Walkers Reserve. It eventually shifted from sugar cane to a silica sand quarry. 

In recent years, under WIRRED’s stewardship, it has been transitioning to a site of permaculture and regeneration. That is where hope returns, through vision, knowledge, and action; an exhausted landscape is being transformed into a healthier ecosystem and a post-plantation site of healing. It is the largest regeneration project in the Caribbean region. WIRRED continues to engage with myriad partners to meet the goals of environmental conservation to increase biodiversity, develop natural habitats and build awareness around reducing the negative effects of climate change. 

In her narrative about the project, Davis says: “This plot highlights the revolutionary and subversive history of plants, acknowledging them as agents of restoration and reparation while insisting on the need for us to remember valuable systems of knowledge that are being erased or forgotten. This living apothecary is intended as a sacred space of healing, regeneration, and contemplation, honouring the traditions of bush medicine and recognising this site as hallowed ground. The plants in the garden have been designed with a focus on well-being for women’s reproductive and post-reproductive health and are also available as a natural first aid kit. 

Guests Marsha Branch and Israel Mapp.

“I hope that visitors who spend time in the Garden of Hope might reflect on the ancestors who came before us, using what was available to them for medicine – plants growing in their environment that they had to learn about to heal themselves and one another. There is also a QR code and some labelling offering information about local plant uses and traditions. This is very much a work in progress, and hopefully, there will be more opportunities to engage with the garden through workshops for those who are interested.” 

The Garden of Hope is one of the first installations under the eARTh programme at Walkers Reserve. There is no earth without ART and as WIRRED continues to steward the regeneration of the Reserve from a sand quarry into a thriving space for connection and reconnection, they hold space for artistic expression and cultural transformation.

WIRRED is thankful to all contributors to the project and acknowledges everyone who has been a part of its evolution including the McNeel family, Island Developments Ltd., the team at Walkers Reserve, Richard White for the construction and maintenance of the cobb beds, and Ireka Jelani Spiritual Baptist elder who blessed the Garden at Saturday’s launch supported by her two children, Subira and Baruti. (PR)

The post A Garden of Hope launched at Walkers Reserve appeared first on Barbados Today.

2 years 9 months ago

Arts & Culture, Body, Environment, Health

Health – Dominican Today

SNS denies reuse of syringes in the Valverde hospital and the entire Public Network

The National Health Service categorically denied that syringes were being reused to administer medications to patients at the Luis L. Bogaert Hospital in Valverde or anywhere else in the Public Health Services Network.

Newton Solano, the health center’s director, confirmed that he uses a process of optimizing supplies and medicines, “as provided for the entire Public Network,” so that it is dispatched based on the number of patients admitted, usually doubling figures to account for unforeseen events. “It is a false complaint; reusing syringes is never permitted, and it is the nurses who remove the sealed syringes from the warehouse and place the medicines on the patients,” Dr. Solano said. He explained that he has established controls to avoid waste of supplies and medicines and that the hospital has a 24-hour pharmacy service for the first time. “As a result, if any input runs out, it is dispatched immediately,” he assured.

The doctor reiterated that the Bogaert Hospital, a Cibao Occidental Regional Health Service (SRSCO) center, has all of the necessary supplies to respond to users who seek health care at that facility. Similarly, he stated that the operating room is at total capacity, that “more surgeries are being performed than ever,” and that it has been strengthened with previously unavailable services such as laparoscopy, urological, and endoscopic surgery. Finally, Ramón Rodrguez, the director of the Western Cibao Regional Health Service, stated that Dr. Solano has proven to be a director committed to management who has made every effort to provide quality services to his patients.

Concerning the other complaints from the Nursing union, the SNS stated that they are being investigated, even though it believes some are unfounded, and that the entity is working hard, hand in hand with a dedicated team, to improve the health of the country, and that changes will be made. 

 

2 years 9 months ago

Health, Local

The Medical News

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 9 months ago

Kaiser Health News

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.

USE OUR CONTENT

This story can be republished for free (details).

2 years 9 months ago

Health Care Costs, Health Industry, Pharmaceuticals

Kaiser Health News

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.

USE OUR CONTENT

This story can be republished for free (details).

2 years 9 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 9 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 9 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 9 months ago

Urology, News

Healio 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 9 months ago

STAT

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.

Continue to STAT+ to read the full story…

2 years 9 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 9 months ago

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