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Overview of Chronic Kidney Disease

Chronic Kidney Disease is one of the most common and widespread diseases in the world. In the US, it affects over 25 million adults, while many more are at risk of developing CKD because of family history or having faced other kidney problems. Chronic diseases refer to those which develop over a longer period of time and it is only when significant damage has been done that they start to show symptoms. CKD is no different.

Before going into the causes and symptoms of this disease, let’s first look into how our kidneys function so we better understand the science behind the disease as well.

Function of the kidneys

Kidneys are one of the vital organs of the body and are located right beneath the ribcage, towards the back. They are connected with the bladder by way of thin tubes called ‘ureters’. The main role that our kidneys play in the body is that of cleaning the blood. They filter the blood by removing waste products and excess fluids, sending them out of the body through urine. It is the ureters that take the waste products from the kidneys to the bladder and subsequently, out of the body. The kidneys perform this function because of millions of nephrons, which are the kidneys’ very own filters.

Dysfunction in the kidneys and their filtering centers (the nephrons) increases the amount of waste products in the blood because they are not being filtered and excreted at the same optimal rate that a healthy kidney should do.

Causes and symptoms of CKD

The main causes of chronic kidney disease are hypertension and diabetes. In diabetes, the blood sugar level goes beyond the safe limit putting vital organs at risk, kidneys being one of them. In hypertension, the blood pressure against the blood vessel walls increases considerably. Kidney failure is one of the leading outcomes of hypertension, in addition to heart attacks and strokes. Both hypertension and diabetes, leading to chronic kidney disease, point towards unhealthy lifestyle manifested in poor eating habits mainly. But it is not the only cause in all the cases. Often, factors like family history and some birth defects such as solitary kidney also lead to slow progression of kidney disease.

Some of the common and apparent symptoms of chronic kidney disease include persistent tiredness, significantly weakened eyesight, loss of appetite, swelling in feet and ankles mainly, trouble in sleeping, and notable increase in the number of times you need to urinate in a day. High blood pressure as a cause of kidney disease often results in internal bleeding in the eyes as well. If unchecked for dangerously long time, it can result in brain damage as well.

Treatment methods

CKD, in most of the cases, ends up in chronic kidney/renal failure. Although the ultimate solution is kidney transplant, there are various reasons why it cannot be done immediately. The short term solution is putting the patient on dialysis, which performs the function of the kidneys; cleansing the blood. Depending on the condition of the patient, its frequency can be anywhere between once and thrice a week.

If there is any other disease or infection in the body, it is difficult to conduct transplant because the donor kidney has chances of being rejected by the body. In order for the kidney to be accepted in the body, immune system has to be suppressed, which is not possible in the presence of an infection. It is only when the body has been cleared of all kinds of infections and other deficiencies that immune system can be suppressed by means of immunosuppressant medicines and the foreign kidney be accepted by the body’s own defense mechanism.

Nursing Homes for Alzheimer’s Afflicted Patients

No matter how close you are to your loved one, eventually most people suffering from Alzheimer’s disease do require the additional care provided at a nursing home. This is because the disease worsens with time, requiring 24/7 surveillance. Nursing homes ensure that the people suffering from Alzheimer’s or other forms of dementia are secure and in good, well treatable environment.

It may feel like being stabbed by a thousand knives at once having to leave behind an Alzheimer patient in a nursing home, but it is the only appropriate solution for the advanced stage of the disease. Knowing that you are making the right decision for your loved one. Below are some suggestions on how to find the appropriate nursing home for Alzheimer’s afflicted patients.

Types of Nursing Homes

With the progress of the disease, there are increase physical and mental challenges individual caregivers have to tackle (at home) with each passing day. Therefore, the nursing homes are a safe haven where the patient will obtain the proper healthcare and treatment. There are two basic types of nursing homes available for people suffering from Alzheimer’s:

Basic Care: This type of care covers personal care such as dressing, bathing, using toilets, laundry, eating and simply moving around the place.

Professional Care: The professional care requires the services of skilled professionals such as nurses, occupational and physical therapist who will monitor the health condition of the afflicted individual. The professional healthcare specialist will provide treatments.

Services Provided at Nursing Homes

Even though the services at different nursing homes vary, you will commonly discover the following facilities being provided:

Emergency services round the clock for critical situations
Lodging and boarding services
All sorts of personal care along with supervision
Fun filled activities to keep the patient engaged

What should you look for in a nursing home facility for people suffering from Alzheimer disease?

Fees and Insurance

The fee structure for nursing homes is quite high for long-term care facilities, but you must analyze the differences in the levels of services offered on different packages. Find out about billing structures, acceptance of medical insurance coverage and the exact services that are a part of the quoted fees.

Facilities and Level of Care

Taking a deep look at the facilities is also extremely crucial. Your quest for the best nursing home should not end until you have discovered an Alzheimer’s care facility that will completely provide all the services that you think that your loved one will require. Level of care should never be compromised upon. Knowing the visiting schedule is also important.

Assessment and Admission Requirement

Find out if there is a designated waiting period before the admission of the patient. Find out how the care plans of individuals are devised—are they the same or are they customized? How often an assessment is conducted to determine the services that a particular resident requires?

Atmosphere

Visit the nursing home prior to the admission and meet other patients. Looking at their condition will let you know whether the rights of the residents are violated or not. If you can manage to talk to volunteers and staff, it would help in shaping an opinion.

Medical breakthroughs That are Changing the World

Diseases, especially those that affect one’s physical abilities to get around and prevent us from living our lives in a normal fashion can have a dramatic effect on their entire well-being. In fact, some illnesses hamper the ability of people to manage just the basic things in life, such as eating by themselves and walking without assistance of any kind. Fortunately, there have been some major medical breakthroughs in recent times. By allowing them to live their life to the fullest, these medical breakthroughs are changing the game for many. What are these medical breakthroughs?

Pill Cam Colon

Imagine a pill that you can swallow with a camera that can view the entire colon, without sedation or radiation. This is not science fiction. This is a scientific fact. The Israeli company Given Imaging has developed such a device that has been successfully tested and is currently being used for potential colon cancer patients.

BrainGate’s Brain Sensor

In mid-2015, BrainGate, a technology company, implanted a brain sensor into the brain of a woman who had been paralyzed for the past fifteen years. After the brain sensor was implanted, the woman was able to drink coffee without any assistance. So how does this brain technology work? BrainGate’s cognitive apparatus records electrical signals after mining the neurons of brain activity. Once this is done, the sensor translates the signals into movement commands.

Diagnosis of Cancer via Dogs

This may sound a little absurd, but research has proven dogs can naturally diagnose cancer. Recently, four dogs including two German shepherds, an Australian shepherd, and a Labrador retriever were tested by a group of German scientists. In order to identify the presence of lung cancer in the surveyed individuals, each dog was made to sniff the breath of over two hundred patients.

The success to failure ratio was 71:29. Furthermore, the dogs were asked to identify the presence of breast cancer, colon cancer and bladder cancer in the surveyed individuals. Once again, the dogs had an over 70% success ratio. Therefore, there was enough evidence for the German scientists to conclude that dogs can naturally diagnose cancer.

Cardiac Output Monitor

Another invention from Israel that is used for the prevention of sepsis, a blood infection that is responsible for one in four hospital deaths and is listed as one of the top 10 causes of death in the United States.

Cheetah Medical uses sensors to monitor the movement of blood from the heart to the body’s organs which enables medical professionals to more efficiently diagnose and treat patients.

Technology for Migraine Pain

Today, technology is putting forth new ways of relieving headaches including severe headaches such as migraines. For many people, drugs do not do the job. Therefore, there is a growing need for alternative ways.

Fortunately, the FDA has taken the demands of migraine patients into consideration and has approved two migraine gadgets: Cefaly and SpringTMS. Cefaly is worn across the forehead for about twenty minutes each day while SpringTMS is a gadget held at the back of the head where the pain exists. Both these gadgets significantly relieve migraine pain.

There you have it—the three major medical breakthroughs that are changing the lives of many people. However, there are many other medical breakthroughs that are helping people to overcome their diseases.

The Four Most Lethal Diseases Caused by Mosquitoes

Although they are tiny, mosquitoes can be very pestilential creatures. We are all cognizant of the dangers of the Zika virus and the issues they are having on our human population, but there here are additional mosquito-borne illnesses in addition to Zika. Some of them are more lethal than the others. Below is a list of the most lethal diseases that mosquitoes can carry?

Zika Virus

Primarily caused by Aedes mosquitoes, Zika virus is a disease first identified in 1947 in Uganda. A mild illness, Zika virus may cause viral fever. Furthermore, an infected person may suffer from headache, aches, and skin rashes. Unfortunately, there is no precautionary antidote for this disease so the only way you can protect yourself from Zika virus is staying clear of mosquito bites. Pregnant women and infants are most affected by this disease.

Dengue fever

Without a shadow of a doubt, dengue fever is one of the most lethal illnesses caused by mosquitoes. People living in tropical and subtropical climates are the ones most prone to this disease. Similar to the Zika virus, dengue fever is primarily caused by Aedes mosquitoes. By multiplying in our body’s cells, dengue mosquitoes cause rashes, joints pain, headache, and high fever. However, these conditions are just the initial symptoms of the disease. Dengue can also cause nausea, vomiting, bleeding and even death. Generally, infected people take acetaminophen to treat dengue fever. However, to date, there are no specific medications or treatments for this ailment.

Malaria

Caused by female Anopheles, malaria occurs when a human is bit by a mosquito and Plasmodium vivax is transferred into the bloodstream. Malaria can travel from the bloodstream into the liver and disrupt the normal functioning of the liver. Malaria can also cause headaches, fever, sweating, severe-flu and chills. Although this illness has been virtually eliminated in the United States, it continues to haunt the people in Africa and South America.

West Nile

West Nile was first discovered in 1999. Caused by culex mosquitoes, West Nile primarily affects birds and animals. However, there are also cases of humans being affected by this disease. In fact, many human fatalities caused by West Nile have been reported to date. West Nile is a lethal disease, as it can damage brain tissues and cause coma, convulsions, and even death.

What is the SHIN-NY?

Many New Yorkers are asking about SHIN-NY and sPRL. Here are some helpful answers to your questions.

What is the SHIN-NY?

The Statewide Health Information Network of New York (SHIN-NY) is a secure information network that enables the exchange of patient data in New York State. The SHIN-NY is a “network of networks” comprised of nine independent Regional Health Information Organizations (RHIOs). It is governed by the New York State Department of Health and coordinated by the New York eHealth Collaborative (NYeC). By participating in a local RHIO, healthcare providers can access clinical data for patients who have provided consent. Once a provider connects to a RHIO, they are automatically connected to the SHIN-NY.

What is required to participate in a RHIO?

To become a member of a RHIO, a provider needs to sign a “participation agreement.” A healthcare provider can obtain access through a clinical viewer or portal. While there is no cost to receive basic RHIO services, there may be a cost to connect to a RHIO if a custom interface is required. Providers should contact their RHIO for additional participant information.

What does it mean to connect to the SHIN-NY?

The SHIN-NY is the interconnected network of RHIOs. By connecting to a RHIO, the provider is also connected into the SHIN-NY network. The plan is to make exchange of data statewide by October.

What is a Qualified Entity or QE?

A “Qualified Entity” is similar to a RHIO. The term Qualified Entity is a specific legal term established by the Department of Health to define entities that are certified (“qualified”) to provide clinical record exchange services as part of the SHIN-NY. All RHIOs must pass a certification test before they may be interconnected with other RHIOs to ensure they meet stringent security, privacy, and technology standards.

What is Statewide Patient Record Lookup (sPRL), and how does it work?

sPRL acts like a secure search engine to search for a patient’s data, similar to a “Googling” function, When a healthcare provider enters basic demographic information for a specific patient who has provided their consent, sPRL will return all the records it finds for that patient from each RHIO region. Here’s how it works. When a provider uploads a patient record to the RHIO, the patient’s name is included in the RHIO’s patient index. All RHIO patient indexes are combined into a Master Patient Index for the SHIN-NY as a whole. When a provider looks up a consented patient’s records, the RHIO’s patient index is matched against the statewide Master Patient Index to see what records reside in other RHIOs. When matches between indexes occur, the records show up in the search. Essentially, sPRL allows a healthcare provider to search records across New York State for a particular patient’s information.

How is sPRL different from the existing local Patient Record Lookup (PRL) that a RHIO offers? What is the additional value?

sPRL allows participating providers to retrieve their patient’s clinical records across the entire statewide network as long as the patient has consented to make his or her records available. While this functionality has already been available within individual RHIOs’ networks, sPRL lets providers search for records across the whole state. So, for example, a family practitioner in Brooklyn can look up her patient’s health records from a provider who treated her in Binghamton.

When will sPRL be available to providers?

To ensure a smooth process, the RHIOs will be starting the interconnection process in groups of three beginning July 7th, 2015. This “onboarding” will continue through the end of September. As RHIOs become fully interconnected, their records will be available to the other interconnected RHIOs. (Of note: if a patient’s records reside in a RHIO that is not yet interconnected, an sPRL search will not show those records yet.) By October, all RHIOs will be interconnected, and providers will have access to all the RHIOs’ records regardless of which RHIO the provider participates in.

Medicare Favors Cheaper Opioids Over Ones with Abuse-Deterrent Properties

Medicare Part D plan coverage for abuse-deterrent, brand name opioids has declined from 2012 to 2015.

While Part D coverage rates for all prescription opioids decreased 10 percentage points during that time, coverage for branded OxyContin, which had received abuse-deterrent labeling, fell even more (28 percentage points), according to a report from Avalere.

There are currently four branded drugs with abuse-deterrent labeling and no generic opioids with abuse-deterrent labeling.

The Opioid Generic Dilemma

“While prescription opioid abuse continues to be a priority for public health experts and lawmakers, coverage for these products by Part D plans is limited and plans are increasingly favoring lower-cost generic products on their formularies,” Caroline Pearson, senior vice president at Avalere, said in a post on Avalere’s website. “Policymakers seeking to limit opioid abuse will have to balance the desire for greater access to abuse-deterrent opioids with the increased costs of such medications to public programs and private payers.”

The Elderly are Most Affected

Prescription opioid abuse among senior citizens has been particularly concerning as misuse of prescription pain relievers among individuals age 65 and older can was estimated in 2013 to have increased threefold from a decade prior, according to data from the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health.

Avalere’s Report

Avalere’s analysis of opioid coverage and utilization management in Part D found that a quarter of plans require prior authorization for OxyContin in 2015. Generic Oxycodone, which has no abuse-deterrent properties, is covered by all Part D plans and faces lower levels of utilization management. In addition, although the FDA decided not to grant Opana ER abuse-deterrent labeling, it still has a higher coverage rate than OxyContin.

The Avalere report surmises that the analysis suggests plans favor covering lower-cost generic alternatives rather than opioids with abuse-deterrent labeling.

“As policymakers continue to consider options to combat opioid abuse, it will be important for them to consider how to ensure patient access, including access to new innovations that might help limit potential abuse, while balancing this imperative with cost challenges,” the report concludes.

Five Signs Which Tell Us It’s Time for Assisted Living

Leaving your loved ones to be taken care of by strangers is certainly a difficult decision to make. It is a bizarre thing for both, the elderly person and the family members. Yet, it is a decision that has to be made. Nurses and doctors in assisted living institutions are educated and caring people. They take care of the elderly on their own and help them stay safe and healthy.

It is difficult to determine the right time to move the elderly. However, time is of the essence when the health of a person is in question. You never know when the elderly might need immediate medical attention and by the time they get it, it is already too late. Let’s learn about some signs that tell us loud and clear that it’s time for assisted living;

Meandering off:

Dementia is one of the most common conditions that emerge in old age. Most elderly people are found meandering from their rooms or wandering off in the corridors. A time comes when this wondering gets to be too much and increases the risk of falling, hurting and accidents occurring.

Medications:

Regular and timely intake of medications is another necessary part of old age. Medicines are all that keep some elderly on their feet. Yet, a time comes when an old person is not taking medications on time or going days without proper eating. When this begins to happen, know that they need assistance.

Decline in Cognitive Behavior:

A time comes in old age when we begin to forget about directions, fail to make any sound decision or even complete a sentence. These are telling signs that a senior is in need of assisted living.

Injuries:

As people grow old, they begin to lose energy in their bones, their sense of balance becomes off and as a result, they become a victim of frequent injuries. It is unsafe for an elderly to live like this alone, without having anyone to look after them.

Driving:

When you begin to see lots of traffic tickets around the house, dents in the car or people complaining about the driving habits of an elderly person, it means that they are unable to get around on their own. This not only poses a threat to the seniors but to the life of others in the area as well.

As soon as you notice any of the above-mentioned signs in your old parents, grandparents or neighbors, provide them with assisted living, pronto.

Researchers Revise New York City Subway Bacteria Study

The New York City subway has been falsely accused of being dirty and unsanitary for decades. This stereotyped conclusion is far from the truth. Although not the place to dine in, as a transportation system, the New York City subway is as clean as any other system in the world and probably cleaner than some European subways, such as the London Metro and the Metro in Rome.

Recent research in June, 2016 confirms the assertion that the subways are respectively ‘cleaner’ than what most people would think.

The Wall Street Journal reported that in an erratum published July 29, 2015, in the journal Cell Systems that researchers who mapped DNA found in the subway system in New York City said they had mistakenly interpreted data that had led to their original claim, which said that they had found bubonic plague and anthrax DNA traces at certain subway stations. The authors of the study have subsequently revised their conclusions.

“Speaking of Science”, a Washington Post blog points out that after the CDC and the New York City Department of Health pushed back the study, authors made the correction. The method of “data collection was just fine – so they’re not retracting their study – but they admit that their interpretations may have been a bit speculative in nature, and that the media’s interpretation of those interpretations got a little out of control.”

Time reports that referring “to the bubonic plague and anthrax findings, the researchers write, ‘There is minimal coverage to the backbone genome of these organisms, and there is no strong evidence to suggest these organisms are in fact present, and no evidence of pathogenicity.’”

Attracting and Retaining Physicians in New York State

The Center for Health Workforce Studies reported recently that the in-state retention of new physicians has gradually declined from a high of 54% in 1999 to the lowest since the survey began of 44% in 2012.

This is particularly troubling as demand for physician services continues to outpace physician supply, particularly in ophthalmology, urology, psychiatry, pathology, general internal medicine, general/family medicine, and otolaryngology.

Member Physicians of the Medical Society of the State of New York protest in Albany

There are areas of the state and populations that are already underserved by the current physician supply. The implications of the forecasts for these areas and populations are dire. New York must do more to attract and retain physicians.

New York Must:

• Reduce the overhead burden shouldered by physician practices through meaningful civil justice reform;

• Assure fairness in contracting by leveling the playing field for physicians in their negotiations with health insurers;

• Continue an adequately funded Excess Medical Liability program to assure that physicians will have the coverage needed to protect them from personal financial exposure to escalating medical liability awards;

• Prevent the imposition of costly and burdensome CON requirements on physician offices and equipment purchases;

• Put additional resources toward the Doctors Across New York program to allow for more awardees and modify eligibility to assure a more equitable balance of awards between institutionally based and private practice physicians;

• Create income tax credits for physicians who practice in specialty shortage areas;

• Continue Medicaid reimbursement of primary care rates at Medicare levels beyond 2015;

• Defeat any proposal to directly or indirectly tax medical services, medical devices or products or sites of service; and

• Defeat any proposal to increase the biennial physician registration fee.

New York State currently has the worst malpractice environment and there is legislation that would allow the statute of limitations of malpractice litigation to increase from the current limit of 2.5 years.

This would result in medical liability premiums to increase by nearly 15%. A cost that would subject physicians to an additional financial burden and subsequently cause more physicians to retire early or leave the state. Sometimes called the “Chase Your Doctor out of New York Act”, this bill must be opposed.

Knowing Fibromyalgia Disease and its Causes

Fibromyalgia, also known as fibromyositis, is a disease that cause the patient to experience excruciating and self-migrating pain from head to toe. This means that the pain can migrate to any part of your body each day.

Patients who suffer from this disease wait for an average of five years before their ailment is accurately diagnosed by an MD, after they exclude any chances of it being a different disease. During this lengthy time period required by physicians to rule out other diseases, many patients do not receive any treatments and continue to suffer. A patient may also be at risk of suffering from other overlapping ailments that are equally or more painful.

Symptoms of Fibromyalgia

There are many symptoms of Fibromyalgia. The most common ones include anxiety, decreased energy, depression, chronic pain, spasms or muscle tightness, stiffness in muscles, extreme muscle pain after workouts, Irritable bowel syndrome, facial and jaw tenderness, migraines of tension related headaches, irritable bowel syndrome, moderate to severe fatigue, insomnia or agitated sleep, sensitivity to odor, bright lights, noise, medications, cold and certain foods, a feeling of swelling rather than actual swelling in the feet and hands, difficulty in concentrating, remembering and performing mental tasks that may be very simple (called fiber fog), abdominal pain, nausea, and bloating, numbness in face, arms, legs or feet and Irritable bladder.

Causes of Fibromyalgia

Fibromyalgia’s underlying causes is still a debatable subject. Many researchers have studied this disease extensively and continue to do so in order to find one possible cause for the excruciatingly painful outcomes. However, most researchers believe that the brain’s central processing is to be blamed for its manifestation.

After conducting extensive studies to figure out and understand the basic mechanisms of fibromyalgia, researchers believe that it is actually caused by a disorder of central processing with neurotransmitter abnormalities. The reason why the disease causes such pain is due to unusual or irregular sensory dispensation in the nervous system.

Fibromyalgia treatment

Fibromyalgia requires adapting to new lifestyle, or rather improve it. People who are resistant to change and adjustments are likely to experience a greater amount of discomfort.

When a patient of fibromyalgia adapts and embraces change, they experience improvement in the way they function as well as the quality of their lives. Furthermore, many medications are used to treat fibromyalgia including anti-seizure medicines such as pregabalin and antidepressants such as fluoxetine or amitriptyline. Apart from personal adjustments and medications, doctors believe acupuncture to be an effective treatment of fibromyalgia. In fact, acupuncture is the most recognized treatment for the fibromyalgia. However, a lot of other therapies are conducted as well to help the patient recover.