Santo Domingo.- The Centers for Diagnostics and Advanced Medicine and Medical Conferences and Telemedicine (CEDIMAT) has become the first hospital in Santo Domingo to receive the prestigious Stroke Centers of Latin America certification from the WSO/SIECV.

This certification verifies that CEDIMAT adheres to international standards for managing and caring for patients with vascular events, as explained by Drs. Francisco Méndez, emergency manager, and Luis Eduardo Suazo, neurosurgeon and coordinator of the Neurosurgery service and stroke unit at CEDIMAT.

CEDIMAT was the pioneer in applying thrombolysis and mechanical thrombectomy treatments for patients with ischemic vascular conditions, crucial interventions that can be life-saving. This certification places CEDIMAT at the top of the quality scale, ensuring superior care for stroke patients compared to 90% of other countries. Thrombolysis, effective within the first 4 to 5 hours of an ischemic event, and thrombectomy, which can reverse mobility loss within the first 24 hours, are key treatments provided by the trained emergency staff at CEDIMAT.

The certification was granted after a thorough evaluation by the Certification Program of the Stroke Centers of Latin America and the Caribbean, involving representatives from the World Stroke Organization, the Ibero-American Society of Cerebrovascular Diseases, the Certification Program Coordinator, and local delegations.

WASHINGTON — President Joe Biden on Tuesday proposed a new rule to address excessive heat in the workplace, warning — as tens of millions of people in the U.S. are under heat advisories — that high temperatures are the country’s leading weather-related killer.

If finalized, the measure would protect an estimated 36 million U.S. workers from injuries related to heat exposure on the job — establishing the first major federal safety standard of its kind. Those affected by excessive heat in the workplace include farmworkers, delivery and construction workers, landscapers and indoor workers in warehouses, factories and kitchens.

Biden highlighted the proposed rule as one of five steps his Democratic administration is taking to address extreme weather as Hurricane Beryl is already ripping through the Caribbean in an ominous sign for the summer.

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When, in April, the federal government began requiring some cows to be tested for a strain of avian flu before their herds could be moved across state lines, it seemed like an obvious step to try to track and slow the virus that had started spreading among U.S. dairy cattle.

But Joe Armstrong, a veterinarian at the University of Minnesota extension school, feared the U.S. Department of Agriculture rule could lead to potential problems for his colleagues, who were in effect being deputized to implement it.

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SELF-CARE DOES not have to cost anything. It is just doing things you enjoy and many of the things we enjoy or feel fulfilled from cost nothing. Stepping outside and taking a deep breath, for example, might be the greatest act of self-care. Even if...

Corporate Communications Specialist at the Queen Elizabeth Hospital Shane Sealy told Barbados TODAY that operations had resumed as usual yesterday evening as there had been “very, very minor damage” at the Martindales Road facility and most had already been addressed.

“Once the national shutdown was discontinued and the all-clear was given, we resumed normal services and visiting hours from six o’clock. Meanwhile, our clinics will open as normal (today) as well as our pharmacies,” he said.

Sealy also advised those patients whose surgeries or appointments were postponed due to the passage of the weather system to contact the hospital’s Patient Advice and Liaison Service at 536-4800 to be rescheduled.

“We are getting things back on track and we want them to reach out to us so we could let them know what to do,” he added.

The post All services resume at QEH appeared first on Barbados Today.

I trained as a physician and have asked patients the very same question thousands of times, so I think hard about how to quantify the sum of the sore hips, the prickly thighs, and the numbing, itchy pain near my left shoulder blade. I pause and then, mostly arbitrarily, choose a number. “Three or four?” I venture, knowing the real answer is long, complicated, and not measurable in this one-dimensional way.

Pain is a squirrely thing. It’s sometimes burning, sometimes drilling, sometimes a deep-in-the-muscles clenching ache. Mine can depend on my mood or how much attention I afford it and can recede nearly entirely if I’m engrossed in a film or a task. Pain can also be disabling enough to cancel vacations, or so overwhelming that it leads people to opioid addiction. Even 10+ pain can be bearable when it’s endured for good reason, like giving birth to a child. But what’s the purpose of the pains I have now, the lingering effects of a head injury?

The concept of reducing these shades of pain to a single number dates to the 1970s. But the zero-to-10 scale is ubiquitous today because of what was called a “pain revolution” in the ’90s, when intense new attention to addressing pain — primarily with opioids — was framed as progress. Doctors today have a fuller understanding of treating pain, as well as the terrible consequences of prescribing opioids so readily. What they are learning only now is how to better measure pain and treat its many forms.

About 30 years ago, physicians who championed the use of opioids gave robust new life to what had been a niche specialty: pain management. They started pushing the idea that pain should be measured at every appointment as a “fifth vital sign.” The American Pain Society went as far as copyrighting the phrase. But unlike the other vital signs — blood pressure, temperature, heart rate, and breathing rate — pain had no objective scale. How to measure the unmeasurable? The society encouraged doctors and nurses to use the zero-to-10 rating system. Around that time, the FDA approved OxyContin, a slow-release opioid painkiller made by Purdue Pharma. The drugmaker itself encouraged doctors to routinely record and treat pain, and aggressively marketed opioids as an obvious solution.

To be fair, in an era when pain was too often ignored or undertreated, the zero-to-10 rating system could be regarded as an advance. Morphine pumps were not available for those cancer patients I saw in the ’80s, even those in agonizing pain from cancer in their bones; doctors regarded pain as an inevitable part of disease. In the emergency room where I practiced in the early ’90s, prescribing even a few opioid pills was a hassle: It required asking the head nurse to unlock a special prescription pad and making a copy for the state agency that tracked prescribing patterns. Regulators (rightly) worried that handing out narcotics would lead to addiction. As a result, some patients in need of relief likely went without.

After pain doctors and opioid manufacturers campaigned for broader use of opioids — claiming that newer forms were not addictive, or much less so than previous incarnations — prescribing the drugs became far easier and were promoted for all kinds of pain, whether from knee arthritis or back problems. As a young doctor joining the “pain revolution,” I probably asked patients thousands of times to rate their pain on a scale of zero to 10 and wrote many scripts each week for pain medication, as monitoring “the fifth vital sign” quickly became routine in the medical system. In time, a zero-to-10 pain measurement became a necessary box to fill in electronic medical records. The Joint Commission on the Accreditation of Healthcare Organizations made regularly assessing pain a prerequisite for medical centers receiving federal health care dollars. Medical groups added treatment of pain to their list of patient rights, and satisfaction with pain treatment became a component of post-visit patient surveys. (A poor showing could mean lower reimbursement from some insurers.)

But this approach to pain management had clear drawbacks. Studies accumulated showing that measuring patients’ pain didn’t result in better pain control. Doctors showed little interest in or didn’t know how to respond to the recorded answer. And patients’ satisfaction with their doctors’ discussion of pain didn’t necessarily mean they got adequate treatment. At the same time, the drugs were fueling the growing opioid epidemic. Research showed that an estimated 3% to 19% of people who received a prescription for pain medication from a doctor developed an addiction.

Doctors who wanted to treat pain had few other options, though. “We had a good sense that these drugs weren’t the only way to manage pain,” Linda Porter, director of the National Institutes of Health’s Office of Pain Policy and Planning, told me. “But we didn’t have a good understanding of the complexity or alternatives.” The enthusiasm for narcotics left many varietals of pain underexplored and undertreated for years. Only in 2018, a year when nearly 50,000 Americans died of an overdose, did Congress start funding a program — the Early Phase Pain Investigation Clinical Network, or EPPIC-Net — designed to explore types of pain and find better solutions. The network connects specialists at 12 academic specialized clinical centers and is meant to jump-start new research in the field and find bespoke solutions for different kinds of pain.

A zero-to-10 scale may make sense in certain situations, such as when a nurse uses it to adjust a medication dose for a patient hospitalized after surgery or an accident. And researchers and pain specialists have tried to create better rating tools — dozens, in fact, none of which was adequate to capture pain’s complexity, a European panel of experts concluded. The Veterans Health Administration, for instance, created one that had supplemental questions and visual prompts: A rating of 5 correlated with a frown and a pain level that “interrupts some activities.” The survey took much longer to administer and produced results that were no better than the zero-to-10 system. By the 2010s, many medical organizations, including the American Medical Association and the American Academy of Family Physicians, were rejecting not just the zero-to-10 scale but the entire notion that pain could be meaningfully self-reported numerically by a patient.

In the years that opioids had dominated pain remedies, a few drugs — such as gabapentin and pregabalin for neuropathy, and lidocaine patches and creams for musculoskeletal aches — had become available. “There was a growing awareness of the incredible complexity of pain — that you would have to find the right drugs for the right patients,” Rebecca Hommer, EPPIC-Net’s interim director, told me. Researchers are now looking for biomarkers associated with different kinds of pain so that drug studies can use more objective measures to assess the medications’ effect. A better understanding of the neural pathways and neurotransmitters that create different types of pain could also help researchers design drugs to interrupt and tame them.

Any treatments that come out of this research are unlikely to be blockbusters like opioids; by design, they will be useful to fewer people. That also makes them less appealing prospects to drug companies. So EPPIC-Net is helping small drug companies, academics, and even individual doctors design and conduct early-stage trials to test the safety and efficacy of promising pain-taming molecules. That information will be handed over to drug manufacturers for late-stage trials, all with the aim of getting new drugs approved by the FDA more quickly.

The first EPPIC-Net trials are just getting underway. Finding better treatments will be no easy task, because the nervous system is a largely unexplored universe of molecules, cells, and electronic connections that interact in countless ways. The 2021 Nobel Prize in Physiology or Medicine went to scientists who discovered the mechanisms that allow us to feel the most basic sensations: cold and hot. In comparison, pain is a hydra. A simple number might feel definitive. But it’s not helping anyone make the pain go away.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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The agency sent a civil investigative demand requiring Teva to provide information related to the patents listed in the so-called Orange Book, which is maintained by the Food and Drug Administration. The move comes after the FTC late last year began warning Teva and several other companies that they should remove hundreds of “improperly or inaccurately” listed patents or face further action.

The FTC has argued Teva and these other companies listed patents in the Orange Book without properly claiming certain key information, such as a drug substance or method for using a drug. Industry critics say the tactic makes it harder for generic companies to sell lower-cost alternatives to Americans and has been blamed by several congressional lawmakers for keeping prices high.

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CEO of the Queen Elizabeth Hospital (QEH) Neil Clark has assured that patients and staff at the public hospital are safe amid the passage of Hurricane Beryl.

Speaking on CBC a short while ago, he said the QEH had survived the worst of the Category 3 hurricane, with only a few minor leaks reported.

“I’ve walked around last night, I’ve walked around the different departments and units; it feels very calm and the wind has been quite kind to us so far. It’s been a little bit rougher now this morning, it’s picking up a little bit. We’ve had a few minor leaks but no major damage or no major incident at all. We’re keeping the patients safe, we’re keeping the staff safe, we’re feeding everybody and we’re looking after everybody,” he assured.

“So if you’re at home and you’re worried about your patients or your family members who might be staff, please be assured everything is calm and under control at the hospital.”

Clark confirmed that clinics and theatres for elective surgery remain closed today. He said the aim is to have those reopen from tomorrow.

“As soon as we get the all clear, we’ll review the facilities and the aim would be to allow the outpatient clinics and the theatres to recommence tomorrow. But we’ll have to check the facilities. It will be dependent on the all clear time and we’ll be communicating later on today if that’s the plan that we’ll be bringing the patients back in for clinics and theatres on Tuesday,” the hospital CEO said.

According to Clark, a few patients had turned up at the Accident and Emergency Department during the passage of Hurricane Beryl but the department was “quite calm”.

“I’ve have been down to meet the team. It’s a nice change for them to have that calmness, to catch up with the patients who were in the department before the hurricane started and to move through those patients and to prepare us, I suppose, for after the lockdown is [discontinued] and the patients maybe want to come back out. We should be ready to receive any patients as soon as there’s a need to do that,” he said.

The post All at QEH safe, no major damage – hospital CEO appeared first on Barbados Today.

The first presidential debate of 2024 left many Americans and even some traditional Democratic allies wondering about President Biden’s mental fitness for office based on what appeared to be his unclear train of thought at times and his raspy voice on Thursday night.

The White House responded to these concerns, claiming that the president, who is 81, was fighting a cold, but some doctors said they perceive the health issues go beyond the sniffles — with one noting that "it is an issue of fitness, not of age."

Dr. Brett Osborn, a Florida neurosurgeon who specializes in cognitive function, told Fox News Digital on Friday about his concerns. 

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"President Biden's performance in [Thursday] night’s debate reignited longstanding discussions about his cognitive abilities and his overall leadership capacity," Osborn told Fox News Digital. 

"Throughout the evening, Biden struggled to maintain a coherent narrative, often losing his train of thought mid-sentence, and providing vague, rambling and undecipherable answers to highly critical questions," said Osborn, expressing his professional opinion.

"His frequent pauses, stumbling over words and reliance on notes underscored concerns about his mental acuity," Osborn added. 

These seeming signs of cognitive decline highlight a "growing inability" to manage the complexities required by the job of the presidency, according to the neurosurgeon.

"His difficulty in articulating clear, concise responses and his apparent disorientation during the debate were seen by many – including his own constituents – as very troubling indicators of his overall health and an obvious decline in his cognitive function," Osborn said.

"President Biden lacks the mental sharpness required for the highest office in the land … especially amid [today's] current national and international crises."

The neurosurgeon, who has not treated Biden personally, also mentioned the 46th president has undergone multiple surgeries for brain aneurysms.

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There is a famous saying in neurosurgery, Osborn noted: "When the air hits your brain, you’re never the same." 

The surgeon surmised, "The odds have been stacked against him for years, long before his presidency."

Dr. Marc Siegel, physician, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, also spoke with Fox News Digital about concerns from his end.

"The debate is, in a way, a psychiatric or cognitive stress test," he told Fox News Digital. 

Although Biden was able to respond to questions and seemed to be spatially aware, according to Siegel, the president did display "frequent disorientation" and had "problems with spontaneity or redirecting," the doctor said. 

He has not personally examined Biden.

Siegel described Biden’s speech as "meandering," noting that he ended sentences in different places than intended, and "often mixed up ‘trillions’ and ‘billions’ and ‘millions.’"

Siegel confirmed that a physical illness, even with a cold, can bring out cognitive issues "even more."

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"Even so, it's hard to believe this is all from a cold," Siegel told Fox News Digital. "Either way, we need someone who is sharp despite a cold." 

The NYU Langone physician noted that cognitive issues "wax and wane," so they won’t always present the same way.

While the age of both candidates has been raised as a concern, Siegel countered that what’s important is a president's physical and mental fitness.

"It is an issue of fitness, not of age," he said. "It is an issue of mental acuity, which is especially important if there is a crisis." 

While Biden is 81 (he turns 82 in November), Trump is 78 years old. 

During an appearance on "Fox & Friends" on Friday morning, Siegel also spoke about the possibility of cold medications impacting Biden's performance.

"None of the medications that he would be taking for a cold, except something that might make him drowsy, would be relevant here," he said. 

"And I don't think they would give him something that would make him drowsy before a debate," he said.

He added, "We've been watching this a long time. This is something progressive."

Fox News Digital reached out to the Biden campaign and to the White House press office for comment.

Earlier this year, concerns emerged about Biden’s age and memory after the release of a special counsel’s report. The report described the Democrat’s memory as "hazy," "fuzzy," "faulty," "poor" and having "significant limitations," the Associated Press noted at the time.

The report indicated that Biden could not recall certain milestones in his own life, such as the date his own son Beau died of brain cancer, as Fox News Digital reported at the time. (Beau Biden passed away on May 30, 2015.)

"My memory is fine," Biden responded afterward from the White House. 

The New York Times editorial board and others have called on Biden to step out of the race after his debate performance. 

Vice President Kamala Harris acknowledged that Biden had a "slow start" to the debate, but she defended his performance overall and his record during his time in the White House.

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Said Dr. Siegel in a New York Post opinion piece that ran in the publication on Saturday morning, "This isn't a question of age. Cognition varies widely with age, and it isn't fair to say that executive function is automatically impaired at a certain point in life. But it's a sad medical fact that a person with growing problems of memory and judgment is frequently the last to acknowledge it."