Cingles Info

Strategies Allow for Drug-Free Organ Transplants in Some, Just One Pill a
Week For Others, Report Researchers at International Congress of The
Transplantation Society
MIAMI, Aug. 26 /PRNewswire/ -- Results of three studies presented today at
the International Congress of The Transplantation Society provide
encouraging evidence that a patient's immune system can be fooled into
accepting a transplanted organ without the need for anti-rejection drugs.
According to one study conducted in India, patients are off the
immunosuppressive drug cyclosporine three months after undergoing living
donor kidney transplantation and an elaborate set of treatments that
included a separate surgical procedure to infuse crushed donor kidney tissue
into their thymus. In another study conducted at the University of
Pittsburgh, a more simple strategy,
but one just as bold, has some patients who received transplants of the
small bowel, one of the must vulnerable organs to rejection, requiring just
one anti-rejection pill once a week instead of the
usual two or three pills two times a day. While in some patients the
researchers had to back off when rejection occurred, they do plan to
continue weaning the patients who so far are doing well, perhaps having them
completely off the anti-rejection drug tacrolimus after one year.
The Pittsburgh team's encounters with rejection and the results of a third
study from Stanford University are a reminder of the formidable challenge of
achieving tolerance, defined as the permanent acceptance of the transplanted
organ without immunosuppressive drugs. Two kidney transplant patients who
were weaned off all drugs within a year of their transplants and who were
drug-free for about five months have since experienced mild rejection
necessitating their going back to low doses of drugs. But the rejection now
treated, their doctors at Stanford are beginning to taper their drugs and
are weaning a third patient in the study as well. At this point, the
numbers are too small to draw conclusions about their results, they say.
Rejection is a common occurrence following transplantation. It merely
signals some degree of activity by immune system cells trying to fight the
presence of the donor organ. Usually an adjustment of doses and drugs can
reverse such episodes, which can vary from mild to serious, and in most
patients, close monitoring of drug levels
keeps rejection at bay. But the drugs that are used to prevent rejection
can have many unpleasant side effects. In addition, they place patients at
risk for developing tumors or serious infections that may be difficult to
treat or be fatal. The drugs also provide no guarantees that the more
insidious, chronic form of rejection will not occur months or years after
transplantation.
More time will be required to determine if any of the patients in these
studies will develop true tolerance. But the results, while preliminary,
show there is promise for patients who must endure a
life-long regimen of immunosuppressive drugs and the attendant side effects
and risks.
At the congress, being held at the Westin Diplomat Resort and Spa in
Hollywood, Fla., Dr. H.L. Trivedi, director of the Institute of Kidney
Diseases and Research Center at Civil Hospital Campus in Ahmedabad, India,
included in his report initial results of 26 patients, each who received an
infusion of their donor's kidney
tissue into the thymus 19 days before the whole organ was transplanted.
The idea behind the procedure is to allow developing T cells being educated
in the thymus to receive a direct and complete introduction to the donor
tissue so that when the cells are mature and circulating in the body they
will be tolerant and less likely to reject the transplanted organ. "It is
expected that these thymocytes will develop anergy to the donor antigens,"
explained Dr. Trivedi.
Ten days before the transplants, the patients also received infusions of
stem cells from their donor's bone marrow into their blood stream and their
own bone marrow. According to Dr. Trivedi, after three months, the patients
were weaned off the drug cyclosporine, but it has been only four months
since the first patient underwent this procedure.
In an earlier arm of the study with longer follow-up, 32 patients who
received living donor kidney transplants following infusions of donor bone
marrow-derived stem cells into their blood stream, bone marrow, liver and
thymus were successfully weaned off cyclosporine one year after the
transplant. The 32 are part of a group of 43 patients who underwent the
multi-step procedure that is based on the same premise as the newer
approach -- to educate the cells to be tolerant of the foreign cells of the
donor. All 43, including those off cyclosporine, have been free of
rejection, and once the 11 remaining patients reach their one-year
anniversary, they too will be taken off
the drug but will remain on low doses of less powerful immunosuppressives,
said Dr. Trivedi.
Patients who underwent routine living donor kidney transplantation without
any special pre-treatment could not be weaned off cyclosporine, and weaning
had to be discontinued in 16 percent of patients who received infusions of
donor bone marrow stem cells into their marrow and blood stream but not the
thymus.
In the Stanford study, weeks before four patients were scheduled for living
donor kidney transplants, their donors, who were not tissue-matched to the
recipients, received doses of a growth factor to boost the number of stem
cells in the blood. (A similar growth factor was used in the Indian study as
well.) The bone marrow was then removed
and saved for infusion into the patients about 11 days after their
transplants. Before receiving the bone marrow, however, patients were
exposed to 10 treatments of irradiation, beginning the day after
transplantation, that was targeted at locations in the body where large
numbers of T cells reside -- the lymph nodes, spleen and thymus. A drug
that depletes immune system T cells, rabbit anti-
thymocyte globulin, was also given after surgery.
According to Dr. Samuel Strober, professor of immunology and rheumatology at
Stanford University School of Medicine, the protocol resulted in
chimerism -- the coexistence of donor and recipient cells -- in three of the
four patients for a period of two to three months, and in two, tests
determined their immune systems were
indifferent to the donor organ. Weaning of all immunosuppressive drugs had
been completed by 12 months in these two patients, but after being off the
drugs for about five months, researchers noted
signs of rejection, which in both cases was treated successfully, and the
patients were returned to low doses of anti-rejection drugs. One patient is
near to complete drug withdrawal and the fourth was never weaned due to an
early rejection.
Importantly, added Dr. Strober, the donor stem-cell infusions did not cause
the potentially life-threatening complication of graft versus host disease,
whereby donor cells attack the recipient's tissues, in any of the patients.
T cell depletion also played an important part in the University of
Pittsburgh study involving 96 recipients of intestine, multivisceral (small
bowel, liver, pancreas, stomach and duodenum), liver,
pancreas, kidney and kidney/pancreas transplants. But instead of receiving
rabbit anti-thymocyte globulin during surgery and at intervals the following
days, patients received a one-time dose just hours before transplantation.
The research team believes that the T cells, those on the front lines of an
immune system attack, need to
be reduced before, not after the introduction of the "enemy," the
transplanted organ. The day after transplantation the team then
administered lower-than- usual doses of tacrolimus, with no other
immunosuppressive agents, not even prednisone, given.
The "new" strategy is actually based on practice and clinical experience of
40 years ago, said Dr. Thomas E. Starzl, professor of surgery at the
University of Pittsburgh's Thomas E. Starzl Transplantation Institute. To
most, it may seem "counterintuitive," he added, because current dogma is to
give patients high doses of immunosuppression as soon as the organ is
transplanted. But under too much immunosuppression, the initial immune
reaction against the donor organ is eliminated, and that prevents a process
called clonal deletion, whereby the activated T cells directed against the
graft
are selectively removed. Without this process, the ensuing steps in the
development of tolerance cannot occur, he explained.
Results presented today by Dr. Kareem Abu-Elmagd, associate professor of
surgery at the University of Pittsburgh's Starzl Institute, involved 22
recipients of small intestine, liver/small bowel and multivisceral
transplants. Results with other organs are being reported at other times
during the congress, which runs through Friday. Seventeen of the 22
patients also received intestinal grafts
that had been irradiated prior to transplantation and donor bone marrow.
Twelve met criteria for weaning off tacrolimus, and at some point after 90
days, the team started the process in a step-wise
fashion, with reductions in the number of doses made every two weeks.
Nine of the 12 patients have been free of rejection since weaning was
initiated, including a recipient of an isolated small bowel that had not
been irradiated, who has been on a once-a-week dose for five months.
Because of close monitoring for immune activation, the researchers were able
to identify four patients in whom rejection would have likely occurred.
Further weaning was delayed in these patients. Three other patients, all
recipients of isolated small bowels, developed rejection that required their
doses be increased and other
agents be administered. One included a patient who had been taking
tacrolimus once every two weeks when the rejection developed. Another of
the three patients, whose rejection occurred at a twice-a-week dose, is now
back to being weaned.
According to the researchers, having their patients take one pill two or
three times a week for up to a year is a reasonable goal before complete
withdrawal would be considered.
Held every two years, the International Congress of The Transplantation
Society is recognized as the field's most important international scientific
meeting. More than 1,600 abstracts covering
basic and clinical science are being presented, and nearly 3,000 surgeons,
physicians and researchers from 71 countries are in attendance. Co-chairs
of the congress are Drs. Camillo Ricordi of the Diabetes Research Institute
at the University of Miami and Domingo Casadei of the Instituto de
Nefrologia in Buenos Aires.
SOURCE International Congress of The Transplantation Society cO:
International Congress of The Transplantation Society;
University of Pittsburgh; Thomas E. Starzl Transplantation Institute;
Stanford University School of Medicine; Institute of Kidney Diseases
and Research Center ST: Florida, Pennsylvania, California, India SU: TDS
SVY
http://www.prnewswire.com

I have never been interested in IV drugs nor ever addicted to
anything other than tobacco.
After moving to the Seattle area I have met 3 ladies in the methadone
program, one of them a very close friend. she had been in this
program for 14 years and finally decided to taper herself off of
methadone and be free of it. She did this entirely on her own,
successfully, without help from the program which is important to
note as I will continue to explain.
Anyhow, she did very well and everyone was very proud of her. They
say that methadone doesn't leave any long term effects after
discontinuing it but I question that. I think it took her about a
year at least to recover from it. After all 14 years is a very long
time.
Another woman has been on the program for 22 years. She was kicked
off of the program for failing to show up to pick up her dosing
without a good verifiable excuse. If people do not show up for their
regular appointments (which I think is twice a week) and without a
verifiable excuse, I think that it is automatically presummed that
they are using illicit drugs so they are suspendewd from the program
for 30 days or more and would have to start all over again. In this
womans case, she claimed that she could not get a ride to the
facility (whether true or not I don't know) but she immediately began
injecting heroin because she is addicted to the methadone and would
have to go through a simiolar withdrawal.
The third woman has been on the program at least 12 years, probably
14 by now, but she continues to abuse drugs of all sorts.
All three of these women have told me that there is no reasonable
system in place to get them off of the methadone. I KNOW this to be
true because I was very very close to the person who tapered herself
off of methadone. The methadone program did not help her at all with
this, evidently they just don't see that as a priority in the local
methadone program.
This was verified by all three of these women who all stated that
getting off of methadone is not part of the program. This may seem
hard to believe, I'm sure there is some written provision somewhere
in the program that describes getting off of the methadone but in
real practice it certainly does NOT seem like a principle objective
of the program.
It seems to me that this is an ideal set up for the big drug
companies who supply the methadone and I imagine that they have a
very strong influence (a controlling influence) in how these programs
are administered. It seems to me that it is a big money making
machine and the longer they can keep clients on the methadone the
more money they will make. there is no financial incentive for them
to provide a system to get people off of methadone. Also as with
many government agencies there is no real incentive (in practice) to
actually solve the problems, but rather these agencies tend to nurse
the problems along indefinately. If they solved the problems there
would eventually be no need for the agencies in some cases so they
would, in effect, eliminate their jobs by solving the problems. This
may be inadvertent but I have seen this happen so much in government
programs that I think it is a rule of bureaucracy. The problems are
just nursed along without ever being solved. In this case restoring
people's lives so they can go on without addiction and without
methadone.
My very dear friend who took it upon herself to get off of methadone
after 14 years and did it successfully, under difficult circumstances
by the way, is a real exception as far as I can see.
There are a couple of other perceptions I had: In the methadone
program some people apparently have no desire to stop using drugs or
get off of methadone and live drug free. It did not seem that there
was a strong program in place to bring people to that end- that is
getting off of methadone and live drug free. Maybe the system is
satisfied simply to reduce crime rates by providing methadone to
addicts.
In any case, maybe this system needs a good ewxamination.
Dennis near Seattle

Lisa,
People can become whatever they want to be online, it usually
doesn't have a thing to do with who they really are in person. Usually
the people who act out the most in groups like this are the ones with
the largest insecurities. They don't feel good about themselves, they
don't like themselves, so they go bully who ever they can to make
themselves feel better. Any time anyone sets out to harm others on
purpose it will always come back to them tenfold. It's a little kid
game to make themselves feel better at the expense of others. They
whine about not feeling like anyone here was very supportive of them,
but how could anyone be with the attitudes they brought with them?
This group and the people in it were nothing more than an experiment
to them. It was nothing but an immature game, played by immature
people. When this guy puts you down more than likely he's doing it
because he's jealous. He can't have much of a life if he has this much
time on his hands to be able to write these things about you. They
probably all came from dysfunctional families and were abused as kids.
Instead of learning from it and growing beyond it they abuse others.
Think about it, what kind of mentality does it take to go into a
support group knowing most of the people in it are sick with
intentions of abusing them for laughs? How much sense does it take to
go into a group in attack mode when they have no idea who they are
attacking? When my kids were growing up I always told them not to pick
on other kids in school, just because a kid looks like a nerd his
father could be the national president of the local outlaw bikers.
These people are the equivalent of school yard bullies, only it's
fairly pitiful considering their ages.
Online these people are considered trolls. When you let them know
they are getting to you, you are supplying them with the negative
energy they feed on. If you don't feed the trolls they'll go find
someone else who will. If you keep posting things about them upsetting
you they are never going to go away. If it bothers you that much turn
them in for abuse. One thing a troll can't handle is a person who is
secure in themselves. So, it's pretty much about jealousy. Misery
loves company, they are so miserable with themselves that they spread
it around to others. Just don't feed the trolls.
Vickie

Dear Dana I have been gone from Iowa for 27 yr but the winters used to be quite
harsh and snowy as any of those states up there get, my cousin said the last few
have not been so bad though I am marooned in Ar. till I get the transplant or
maybe Tennesee that is where the hospital is seeeeeeeee ya...Michael

As with many things in my life right now, I'm confused as to why you wrote that
to me??? Did I ask what it mean't somewhere? Please help!!
Del
"K. Maxwell." <paintedbones@...
Del ESLD is end stage Liver diesease
SPONSORED LINKS
Hepatitis c

Hi Everyone,
We (Tampa Bay Hepatitis & Liver Disease Support Group, Inc) will be hosting a
booth this weekend at the Harborview Center in Clearwater (300 Cleveland St.-
Downtown). It will be the Full Throttle Expo/Motorcycle Show. Full Throttle was
kind enough to donate a vendor's booth to us, so we can continue with our
mission of awareness and education. We need volunteers to be at the booth to
hand out pamphlets, talk to people, and just basically to be a smiling face.
There's also a lot to do and see there; motorcycle shows, live music, food, fun,
Miss Full Throttle contest :-), vendors, celebrities, etc. Times are Sat. 10 AM
- 9 PM, and Sun. 10 AM - 6 PM. You can volunteer for any time slots you would
like: 1 hour, 2 hours, etc. Please call Cindy or Debbie to volunteer.
Cindy 727-535-1498
Debbie (at The Chance Center) 727-384-1030
Thank you in advance!
Cindy

--
Whats with all the repetes?????????????????????????????????

my first year here. And it was not just a few inches. Try a 3 to 4
feet each. Tehee! It was fun for awhile. But after a few winters,
shoveling that driveway got too much. Hire a plow now! Oops!
That's not a two way street either! Oh well, growing older has it's
good points and bad. But would never be a teenager again! I used to
wear shorts on Christmas in Texas. Don't do that here!! Dana
humid here but the winters are nice, one year I was in San Antonio
for christmas and it was 83 on christmas day that sure felt
wierd...Michael
Texas is that way. Everytime I go there I can't stand it. So I
transfered with my company to NJ, but cost of living to high so I
bought a house up in Mt. Pocono, Pa and comuted till HepC put me on
permanent disability. I love the mountains and the change of
seasons, but when my daughter grauduates High School I plan on moving
SW. Would like to got to Colorado. Dry there. The humidity kills my
joints. But Christmas is great with all the snow and lights and
looking over the Mountain. I even get to see bear cut through my
yard!!
as far as having them go to the doctor and having all STD Test Done
and shown results to my before intimacy. Aids really frightens me!!
Wished I had of none about Hep and all that in my early days. Funny
what growing up does. No longer as invinsible as we were before.
Even safe sex/condoms is difficult because your not sure if they are
going to be faithful!!!
here we have a bass tourney that draws names like Bill Dance and such
I personally wish the corps of engineers had left it alone because
they flooded out some of the finest crystal on the planet but that is
the breaks I suppose as far as catching the women goes I am much more
restrained in this area than previously as Hep c is not something I
want to even take a chance on spreading to another .....and there are
things out there I do not want to take a chance on catching either
who knows what will become the next AIDs? I better shut up I am
scaring myself LOL Lake Ouachita is 22 miles long and one of the
cleanest in the country, I love it but so much of the time it is too
hot to enjoy it ,well here I am rambling on lol ...Michael
Oklahoma and Arkansas allot. Almost all my family is down there. I
was just in Texas in June. But was not a great visit. It was over
my deseased fathers Estate.
catch many fish there! But bet you catch allot of women! Tehee!
Dana
the lake here you can see the bottom at 14 feet too but stay out of
the white river it is white with fertilizer LOL Michael
healing water and hot springs? I am on the top of a mountain and
have well water, of wich I was told was very good for you, till it
was tested. High in Iron and Acid.
that is the same source as what the mountain valley co. sells for
1.00 a quart in the stores so I dont reeeeealy boil water. Some
people pay 16.00 just to bathe in this water so I doubt it needs
boiled, maybe that is why I stay here. The healing water is what they
call it but it seems to have little effect on HCV....Hmmm maybe I
need to switch to a hot spring...it is only 1/2 block anyway too. See
ya...Michael
use something a little stronger that plastic unless you are using
microwave. Then you have to make sure it is microwavable plastic.
And of cours, after you boil so much water in an iron pan, it begins
to rust, then, if you use the teflon coated ones, the teflon begins
to wear out, and of course, then you have that rust problem again!
They tell me to buy drinking water from the store. Just seems silly
to have to buy water, dirt, rocks........... Dana
have to put the water in some other kind of pot? I have a garbage can
almost full of....used plastic ones LOL Michael
are in. Now, if you could just get that boiling water thing down.
Tehee! Dana

Okay, I volunteer to help you guys out with the
collection. Now first: I need to know if you are both
up for this Challenge? Hum! I am not a Scorpio but an
Aries and I do not know what Nancy is Except that she
likes to howl at the moon! Tehee.
Then: If you both are serious we need to arrange a
time and make sure that Nancy gets there soon so she
can keep that Pickup!
I will be happy to take all collections. I will give
you my bank addy and and you can deposit all funds
there in the name of Michael and Nancy's Challange.
But Nancy Dear, I really do want a report on that
shower.
I know that your profile says flirting. I think
Michael needs to add that to his. I will really miss
all this if you two guys get together and the mystery
is solved.
Oh, and if the check to you is late Nancy,
well.......maybe I took a trip!! Tehee

What are the winters like there? No shoveling? Hmm!
See you have more time for that oil change thing!!
Dana

A fun video, Kelly's Lot.
http://www.sonicbids.com/epk/epk.asp?epk_id=22942
Kelly's website:
http://www.hepcaware.org <http://www.hepcaware.org/

Me!! Come visit ME!!! Pam will be in Georgia this weekend, too!
EARTH TO ALFIE...ITS THE BUD-SHOOTOUT AT DAYTONA GIRLFRIEND..WANNA GO..GOT A
DATE FOR ME..CAN GET YOU A NICE YEHAAAAAAAAAAAAAA TOO!!
ALFIE..WE'RE TALKING FIRST RACE OF THE SEASON..WE'RE TALKING FIREWORKS..WE'RE
TALKING LOADS AND LOADS OF.....................EVERYTHING...MEN ESPECIALLY!!
if'n you want to come..bring that southern accent gurl

The check is in the mail! ROFLMAO

Here I am Dear...it's nice to know I'm missed :-) (lost my tease and funny
bone for a bit but I found it...behind the couch and...I'm Baaaack! :-)
(Hey Hon, have you heard any more on the progress of that gas money
collection? LOL)
Love,
Nancy

« MedMira Rapid Test | Main
January 17, 2006
Conclusions About Milk Thistle
A May 2005 review of clinical studies which casts doubt on milk thistle's value
has recently been re-released into the press. Alternatively, an extensive amount
of research supports the continued usage of this herb at higher dosages.
Researchers of the Cochrane Review examined 13 randomized, clinical trials
assessing the impact of silymarin (the extract of milk thistle) on liver
disease. It is important to note that a current search of silymarin clinical
studies on Medline.com results in 846 entries. According to the National
Institutes of Health and hundreds of in-vitro studies, silymarin demonstrates a
marked hepato-protective effect. In addition to concluding that milk thistle is
perfectly safe, the researchers in this Cochrane Collection Review also concede
that studies using higher dosages are required to accurately determine
silymarin's effect on liver function.
Those concerned with optimal liver protection should look for the following
characteristics in a quality milk thistle product:
* A high dosage
* A delivery system which enhances absorption
* Use of the most beneficial constituent of silymarin
Medical researchers concur that silybin, which comprises 50 percent of
silymarin, is responsible for the majority of milk thistle's liver-protective
qualities. While the standard dose of silymarin is 420 mg per day, higher
dosages of the more specific form, silybin, demonstrate correspondingly higher
levels of liver protection. Furthermore, when silybin is in a phytosome complex,
liver cells can absorb 8 to 10 times more than a standard preparation. The daily
recommended dosage of UltraThistle provides 1,080 mg of silybin phytosome, far
exceeding the levels of bio-available milk thistle used in this scientific
review. For more information on UltraThistle, visit www.UltraThistle.com.
The article below urges researchers to conduct studies with higher dosages of
milk thistle extract.
Milk Thistle Does Not Lower Mortality in Liver Diseases, Best Studies Find
By Lise Stevens, Contributing Writer
Health Behavior News Service
Milk thistle, a widely used alternative medicine, is not proven effective in
lowering mortality in alcoholic or hepatitis B or C liver disease, according to
a systematic review of current evidence.
While some studies found that liver-related mortality may be significantly
reduced in patients treated with milk thistle, these findings were not
duplicated in the higher quality clinical trials.
However, milk thistle was found safe to use with no serious side effects and
with participants perceiving improvement in symptoms - although no more than
with placebo.
Dr. Andrea Rambaldi, visiting researcher at the of the Centre for Clinical
Intervention Research at Copenhagen University Hospital, led a team that
reviewed 13 randomized clinical trials involving 915 patients who were treated
with milk thistle or its extracts.
Participants had acute or chronic alcoholic liver cirrhosis, liver fibrosis,
hepatitis and/or steatosis, and viral-induced liver disease (hepatitis B and/or
hepatitis C). Patients with rarer specific forms of liver disease were excluded.
All the trials compared the efficacy of milk thistle or any milk thistle
constituent versus placebo or no intervention in patients with liver disease.
"There is no evidence supporting or refuting milk thistle for alcoholic and/or
hepatitis B or C virus liver diseases," the authors found.
The review appears in the most recent issue of The Cochrane Library, a
publication of The Cochrane Collaboration, an international organization that
evaluates medical research. Systematic reviews draw evidence-based conclusions
about medical practice after considering both the content and quality of
existing medical trials on a topic.
According to the Centers for Disease Control and Prevention, 170 million people
worldwide are infected with hepatitis C, and 2 billion are infected with
hepatitis B. While a vaccine exists to prevent hepatitis B, there is no vaccine
for hepatitis C.
Although the virus can be cleared in a handful of patients, many strains are
resistant to treatment. Drug therapies that focus on long-term suppression of
the virus are expensive, and many patients develop a resistance. The current
gold standard treatment, which combines injections of interferon and ribavirin,
has serious side effects and is hard for patients to tolerate.
With lack of effective treatment for liver disease, researchers have been
looking for alternative therapies that curb symptoms with minimum adverse
effects on patients.
Milk thistle and its extracts have been used since the time of ancient Greece
for medicinal purposes, are currently widely used in Europe for liver disease,
and are readily available in the United States at alternative medicine outlets
and outdoor markets.
G. Thomas Strickland, M.D., Ph.D., professor at the University of Maryland
School of Medicine, has been studying the role of silymarin, an extract of milk
thistle, in preventing complications of chronic hepatitis virus infection.
Strickland says that the exact mechanism of action of silymarin is unclear.
A problem with current trials, according to Dr. Strickland, is that the dose of
silymarin administered, typically 140 mg three times daily, is too low. "I would
certainly double it," he says, "especially since at the current dose we're not
seeing any improvement in acute viral or chronic hepatitis, and we've shown that
silymarin is totally safe."
" The problem is, there is no cure for viral hepatitis except bed rest and diet,
and treatments like silymarin are worth pursuing," Strickland says, calling for
more research funding.
" We should consider doing randomized clinical trials with higher doses of
silymarin," Dr. Rambaldi concurs.
According to the National Center for Complementary and Alternative Medicine , a
part of the National Institutes of Health, studies in laboratory animals suggest
that silymarin may benefit the liver by promoting the growth of certain types of
liver cells, demonstrating a protective effect, fighting oxidation (a chemical
process that damages cells) and inhibiting inflammation.
In their review, Dr. Rambaldi and colleagues conclude, "Milk thistle could
potentially affect alcoholic and/or hepatitis B or C virus liver diseases.
Therefore, large-scale randomized clinical trials on milk thistle for alcoholic
and/or hepatitis B or C liver diseases versus placebo may be needed."
- Rambaldi A, Jacobs BP, Iaquinto G, Gluud C. Milk thistle for alcoholic and/or
hepatitis B or C virus liver diseases. The Cochrane Database of Systematic
Reviews 2005, Issue 2.
Posted by Editors at January 17, 2006 04:37 PM
http://hepatitis-central.com/mt/archives/2006/01/conclusions_abo.html

Penis artist's work shocks father
~Bayla~
SVRnWaiting
'C' It! Treat It! Beat It!
May 10th
Hepatitis C Awareness Day
Be Smart...Get Tested!

I haven't seen anything from Nancy all day is she OK? I surely hope
so! see ya...Michael

Hi Bayla, please have a Super Safe ride and enjoyment on your jaunt. E-mail mail
me upon your safe return.AL.
Bayla <bgumins@...
St.Augustine on Friday..anyone want a ride?
~Bayla~
SVRnWaiting
'C' It! Treat It! Beat It!
May 10th
Hepatitis C Awareness Day
Be Smart...Get Tested!

excellent idea Alfie..she really needs letters to deliver to the big guys (for
lack of a better word at 7am) so that she can push through more $$ for Georgia
State $$ for us? heck if you think I can remember what she told me. Its on the
board in a post that PAM put out...on that Georgia board y'all are on..and this
board..and the FloridaSupport board..I think it needs to have something to do
with HELP US STUPID STATE we can't all afford to treat this dragon
Bayla
'C' It! Treat It! Defeat It!

Thank you. I have been waiting on the Pegasys since May and finding out that my
year of hell with Pegintron didn't work. Yeah!!!

Yea Dana I was born and raised in Iowa I have done my quota of snow shoveling
for this life LOL see ya...Michael

Thank-you, this helps to clarify matters & qualify same.When credibility is at
stake, it may be important to have back-up! AL.
Allan W Anger Jr <allananger@...
Hepatitis!
Having Hepatitis means many things change, and a lot of them are invisible.
Unlike having cancer or being hurt in an accident, most people do not understand
even a little about HCV and its effects, and of those that think they know, many
are actually misinformed.
In the spirit of informing those who wish to understand ... These are the things
that I would like you to understand about me before you judge me...
Please understand that being sick doesn't mean I'm not still a human being. I
have to spend most of my day in considerable pain and exhaustion, and if you
visit I probably don't seem like much fun to be with, but I'm still me stuck
inside this body. I still worry about life and work and my family and friends,
and most of the time I'd still like to hear you talk about yours too.
Please understand the difference between "happy" and "healthy". When you've got
the flu you probably feel miserable with it, but I've been sick for years. I
can't be miserable all the time; in fact I work hard at not being miserable. So
if you're talking to me and I sound happy, it means I'm happy. That's all. It
doesn't mean that I'm not in a lot of pain, or extremely tired, or that I'm
getting better, or any of those things. Please, don't say, "Oh, you're sounding
better!". I am not sounding better, I am sounding happy. If you want to comment
on that, you're welcome.
Please understand that being able to stand up for ten minutes, doesn't
necessarily mean that I can stand up for twenty minutes, or an hour. And, just
because I managed to stand up for thirty minutes yesterday doesn't mean that I
can do the same today. With a lot of diseases you're either paralyzed, or you
can move. With this one it gets more confusing.
Please repeat the above paragraph substituting, "sitting", "walking",
"thinking", "being sociable" and so on ... it applies to everything. That's what
Hepatitis does to you.
Please understand that HCV or HBV is variable. It's quite possible (for me, it's
common) that one day I am able to walk to the park and back, while the next day
I'll have trouble getting to the kitchen. Please don't attack me when I'm ill by
saying, "But you did it before!" if you want me to do something then ask if I
can. In a similar vein, I may need to cancel an invitation at the last minute,
if this happens please do not take it personally.
Please understand that "getting out and doing things" does not make me feel
better. Telling me that I need a treadmill, or that I just need to loose (or
gain)weight, get this exercise machine, join this gym, try these classes... may
frustrate me to tears, and is not correct... if I was capable of doing these
things, don't you know that I would? I am working with my doctor and physical
therapist and am already doing the exercise and diet that I am supposed to do.
Another statement that hurts is, "You just need to push yourself more, exercise
harder". Obviously HCV deals directly with muscles, and because our muscles
don't repair themselves the way your muscles do, this does far more damage than
good and could result in
recovery time in days or weeks or months from a single activity.
Also, Hepatitis may cause secondary depression (wouldn't you get depressed if
you were hurting and exhausted for years on end!?) but it is not created by
depression. Please understand that if I say I have to sit down/lie down/take
these pills now, that I do have to do it right now - it can't be put off or
forgotten just because I'm out for the day (or whatever). Hepatitis does not
forgive.
If you want to suggest a cure to me, don't. It's not because I don't appreciate
the thought, and it's not because I don't want to get well. It's because I have
had almost every single one of my friends suggest one at one point or another.
At first I tried them all, but then I realized that I was using up so much
energy trying things that I was making myself sicker, not better. If there were
something that cured, or even helped, all people with hepatitis then we'd know
about it. This is not a drug-company conspiracy; there is worldwide networking
(both on and off the Internet) between people with Hepatitis if something worked
we would KNOW. If after reading that, you still want to suggest a cure, then do
it, but don't expect me to rush out and try
it. I'll take what you said and discuss it with my doctor.
In many ways I depend on you - people who are not sick - I need you to visit me
when I am too sick to go out... Sometimes I need your help me with the shopping,
cooking or cleaning. I may need you to take me to the doctor, or to the physical
therapist. I need you on a different level too ... you're my link to the outside
world... if you don't come to visit me at home and/or whenever I'm hospitalized,
then I might not get to see you...and as much as it's possible,
I need you to understand me...
By Bek Oberin

SPONSORED LINKS
Hepatitis c treatment Hepatitis c Hepatitis c virus Hepatitis c
information Hepatitis disease Hepatitis c support

Michael,
I never knew what snow was till I moved up here! 17 snow storms my first year
here. And it was not just a few inches. Try a 3 to 4 feet each. Tehee! It
was fun for awhile. But after a few winters, shoveling that driveway got too
much. Hire a plow now! Oops! That's not a two way street either! Oh well,
growing older has it's good points and bad. But would never be a teenager
again! I used to wear shorts on Christmas in Texas. Don't do that here!!
Dana
nevernilla wrote:Yea Dana. it gets entirely too damn hot and humid here but the
winters are nice, one year I was in San Antonio for christmas and it was 83 on
christmas day that sure felt wierd...Michael

Michael,
I look so forward to being a grandmother and getting even with my daughter for
what my mother did to get even with me!! Tehee! Just no more Children.
Grandchildren you can send home. Dana
nevernilla wrote:Oh yes I takes me calcium every day dear Nancy. I was sitting
on a park bench this morning and two elderly gentlemen were sitting on the next
one and one said " hey did I show you the pictures of my grandkids?" And the
otherone goes"no you didn't and I'd like to thank you for that" LOL it was
really a hoot made me glad I nave no grandkids to show off too C-ya...Michael

Yea Dana. it gets entirely too damn hot and humid here but the winters are nice,
one year I was in San Antonio for christmas and it was 83 on christmas day that
sure felt wierd...Michael

I just Wonder what will happen if one of you want to run and neither of you
can??
Dana
nevernilla wrote:I do not frighten easily lass for I am Irish, and I hate
running LOLOL...Michael, PS I have a bad leg I cant run LOL

I must agree with you! Dana
Nancy wrote:One would have to have a job before being a Cyberslacker tho, yes?
The rest
of us are just engaged in
"constructive, positive resources for stress relief...For example, teens
worried about approaching a member of the opposite sex may find the Web a
more congenial space for tension-free conversation. And online support
groups have for years been key in helping otherwise isolated individuals
cope with sometimes overwhelming issues. According to Davis, "this
highlights what the Internet does best--provides information and a medium
for like-minded individuals to interact."
Constructive, Positive...I like it! :-)
Love,
Nancy

Okay all of you were talking so bad yesturday that you blew my modem!! Well I
am up and running and my computer is old, soooooo it asked me if you could just
tone it down a little? Or was that me? Tehee! Anyways, think maybe Nancy
should go see Michael. What do you drive Nancy?? Tehee. He has lots of Bars!!
Dana
Nancy wrote:Thank the Heavens...for I have bad ankles and can't run either.
LOL
(The visual of "Walk Chasing" you is Killing me here! Didn't Carol Burnett
and Tim Conway do a skit like that? Or was that...OMG this time travel is
burning out my RAM here!...Arte Johnson and Whatsherface on Laugh-In?)
ROTFLMAO!!!
Must be time for my meds! LOL
Love,
Nancy

Michael,
What do you do, rent out your shower? And I did not ask about the Bars, Nancy
did. I just said I understood the Bars. But it is nice to know they are strong!
Tehee!
Dana
nevernilla wrote:why through a major exercise in Geometry and a bit of algebra
thrown in...no really I filled it with tourists and the bars on the walls are
strong enough to do suspension on LOL...Michael

Michael,
It sounds beautiful there, but it must get humid and hot too. Texas is that
way. Everytime I go there I can't stand it. So I transfered with my company to
NJ, but cost of living to high so I bought a house up in Mt. Pocono, Pa and
comuted till HepC put me on permanent disability. I love the mountains and the
change of seasons, but when my daughter grauduates High School I plan on moving
SW. Would like to got to Colorado. Dry there. The humidity kills my joints.
But Christmas is great with all the snow and lights and looking over the
Mountain. I even get to see bear cut through my yard!!
As far as picking up people, I very much understand that. I go as far as having
them go to the doctor and having all STD Test Done and shown results to my
before intimacy. Aids really frightens me!! Wished I had of none about Hep and
all that in my early days. Funny what growing up does. No longer as invinsible
as we were before. Even safe sex/condoms is difficult because your not sure if
they are going to be faithful!!!
Oh well, enough of that! Dana
nevernilla wrote:Dear Dana sorry but they catch alot of fish here we have a
bass tourney that draws names like Bill Dance and such I personally wish the
corps of engineers had left it alone because they flooded out some of the finest
crystal on the planet but that is the breaks I suppose as far as catching the
women goes I am much more restrained in this area than previously as Hep c is
not something I want to even take a chance on spreading to another .....and
there are things out there I do not want to take a chance on catching either who
knows what will become the next AIDs? I better shut up I am scaring myself LOL
Lake Ouachita is 22 miles long and one of the cleanest in the country, I love it
but so much of the time it is too hot to enjoy it ,well here I am rambling on
lol ...Michael

Cyberslackers I love it !!!!!

Health - Reuters
Internet Addiction May Be Form of Stress Management
Mon Aug 26, 1:55 PM ET
By E. J. Mundell
CHICAGO (Reuters Health) - When the going gets tough, many
stressed-out Web surfers go "cyberslacking," according to the results of a new
study.
Researchers say that a small minority of Internet users may spend
hours online in a compulsive effort to avoid life's anxieties.
"Procrastination, low productivity, social withdrawal and
relationship difficulties" were common among those spending an unhealthy amount
of time on the Web, report researchers led by graduate student Richard Davis of
York University in Toronto, Ontario.
He presented the findings here Saturday at the annual meeting of the
American Psychological Association.
Experts estimate that only about 2% to 3% of all Web users fall into
the category of "Internet addicts"--individuals who typically neglect family and
friends, lie about how much time they spend online, and mold their daily lives
to fit their Internet use.
In their study, Davis and his colleagues sought to determine the
psychological role of Web use among individuals at high risk for addiction. He
had 60 undergraduate students complete standard questionnaires measuring their
amount of daily Web use, perceived stress, and personal coping styles.
The Canadian researchers found that individuals with online habits
suggestive of "problematic Internet use" were more apt to rely on "avoidant
coping"--reacting to life's stressors by simply turning to a distractor.
Furthermore, individuals in danger of Internet addiction also tended
to be nonassertive when faced with problems. For example, "if their boss has
reprimanded them, instead of dealing with it head-on they will do it in
non-assertive ways" such as complaining to others or simply avoiding thinking
about the incident, Davis explained. Excessive, unhealthy Internet use appeared
to combine nonassertive coping with avoidance--something Davis described as
"withdrawal coping."
Excessive Internet use was also strongly linked to procrastination,
suggesting that the Web is fast becoming a more interactive ( news - external
web site) alternative to video games or bad TV. In the workplace, especially,
this type of online procrastination is commonly known as "cyberslacking,"
resulting in "significant losses in productivity," according to the researchers.
In fact, one 2001 study found 50% of Web surfers admitting that they spent about
half of their online time avoiding more productive activities.
And just what are hardcore Web users doing during all those hours
online? "We know that the number-one thing people are looking at is online
pornography," Davis said. "That's a big distractor. Also engaging in online
gaming (gambling), and chat rooms." While some addicts may be focusing on just
one "distractor"--pornography or online casinos, for example--others may split
their time between these activities, chatting and more generalized surfing,
Davis noted.
The researchers found no differences between men and women when it
came to the percentage of individuals showing signs of problematic Internet use,
or their underlying psychology. Women are increasingly making up a larger
percentage of Web users, Davis pointed out. "For young females, it used to be
that young teenage girls used to come home and go to their telephone and talk
all night to their friends. Now they are coming home and instant-messaging in a
big way."
But the Internet can also offer constructive, positive resources for
stress relief, he said. For example, teens worried about approaching a member of
the opposite sex may find the Web a more congenial space for tension-free
conversation. And online support groups have for years been key in helping
otherwise isolated individuals cope with sometimes overwhelming issues.
According to Davis, "this highlights what the Internet does best--provides
information and a medium for like-minded individuals to interact."

I vote yes but you may not be prepared for a 48/M with that much gas lol ( its a
guy thing ) Michael

Too much it is a 3/4 ton to boot big and heavyLOL...Michael

why through a major exercise in Geometry and a bit of algebra thrown in...no
really I filled it with tourists and the bars on the walls are strong enough to
do suspension on LOL...Michael

Health department has STD screenings
By MICHAEL WALLACE
Published May 9, 2006

Dear Dana sorry but they catch alot of fish here we have a bass tourney that
draws names like Bill Dance and such I personally wish the corps of engineers
had left it alone because they flooded out some of the finest crystal on the
planet but that is the breaks I suppose as far as catching the women goes I am
much more restrained in this area than previously as Hep c is not something I
want to even take a chance on spreading to another .....and there are things out
there I do not want to take a chance on catching either who knows what will
become the next AIDs? I better shut up I am scaring myself LOL Lake Ouachita is
22 miles long and one of the cleanest in the country, I love it but so much of
the time it is too hot to enjoy it ,well here I am rambling on lol ...Michael

FRONTLINE INVESTIGATES THE 25 YEARS OF MISSTEPS THAT MADE HIV/AIDS ONE OF THE
GREATEST PLAGUES IN HISTORY
FRONTLINE presents THE AGE OF AIDS
May 30 and 31, 2006, from 9 to 11 P.M. ET on PBS
www.pbs.org/frontline/aids
On the 25th anniversary of the first diagnosed cases of AIDS, FRONTLINE
examines
one of the worst pandemics the world has ever known in The Age of AIDS, airing
Tuesday and Wednesday, May 30 and 31, 2006, from 9 to 11 P.M. ET on PBS (check
local listings). After a quarter century of political denial and social stigma,
of stunning scientific breakthroughs, bitter policy battles, and inadequate
prevention campaigns, HIV/AIDS continues to spread rapidly throughout much of
the
world, particularly in developing nations. Over 25 years, roughly 70 million
people
have been infected with the virus and 22 million have already died of AIDS.
"It's a very human virus, a very human epidemic. It touches right to the heart
of
our existence," says Dr. Peter Piot, executive director of UNAIDS. "When you
think
of it, that in let's say 25 years, about 70 million people have become infected
with this virus, probably coming from one [transmission] ... it's mind blowing."
And
the crisis continues: over the next decade, an estimated 50 million more people
will contract HIV. "We cannot continue just to treat patients as they become
infected," says Dr. David Ho, AIDS researcher and Time magazine's 1996 Man of
the
Year for his work on the life-prolonging "triple cocktail" treatment for HIV.
"The real solution to this epidemic is to curtail the spread of the virus."
Why humanity has failed to stop the spread of HIV is the central question of
The
Age of AIDS. Over four hours, the series examines one of the most important
scientific and political stories of our time: the story of a mysterious agent
that
invaded the human species and exploited its frailties and compulsions -- sexual
desire and drug addiction, bigotry and greed, political indifference and
bureaucratic
inertia -- to spread itself across the globe.
Filmed around the world in 16 countries, The Age of AIDS features interviews
with
major players in the battle against HIV/AIDS: scientists, including James Curran
of Emory University and formerly with the Centers for Disease Control, Anthony
Fauci of the National Institute for Allergic and Infectious Diseases, and Dr.
Helene Gayle of the Bill and Melinda Gates Foundation; political figures,
including
former President Bill Clinton, U2 front man and AIDS activist Bono, and
evangelist
Franklin Graham; and innovative activists, including Cleve Jones, creator of the
AIDS quilt; Noerine Kaleeba, founder of Africa's first AIDS support
organization;
and Mechai Viravaidya, "the condom king" of Thailand.
In the first night's two-hour broadcast, The Age of AIDS begins with the
medical
and scientific mystery that emerged in 1981 when five gay men in Los Angeles
were
diagnosed with a new disease. The film documents the frantic search by American
and European scientists and epidemiologists to find the source of the deadly
infection as they tracked its spread among gay men, intravenous drug users, and
hemophiliacs, and then into the general population. The trail led them back in
time, from major American and European cities, to Haiti, and finally to the
Congo.
"It has become incontrovertible," says virologist George Shaw, "that the HIV-1
virus that currently infects over 60 million humans arose as a consequence of a
single transmission event from a single chimpanzee in West Central Africa to one
human."
The story then moves from the mysterious virus to the fear, stigma and
political
controversies during the Reagan administration. Attempts to prevent the spread
of
the disease, most prevalent among gay men and intravenous drug users at the
time,
sparked furious public debate. As the film tracks the devastating spread of HIV
around the world, it documents how some countries -- in Europe, Africa and Asia
-- found tools to slow its progress, including needle exchange programs and
massive
condom distribution campaigns.
"Without question, politics has been one of the driving forces in the spread
of
this disease," says Merv Silverman, former president of the American Foundation
for AIDS Research. "AIDS is the most political disease I've ever seen."
The second night of The Age of AIDS begins by exploring the chasm that emerged
between rich and poor following the development of the miraculous "triple
cocktail"
HIV treatment. In the mid-1990s, when doctors discovered the cocktail, it seemed
to signal a new era in which AIDS was no longer a fatal disease. But the high
price of the drugs meant they were unaffordable to patients in developing
nations.
The Age of AIDS tracks the political struggle to lower those prices, in
countries
like Brazil, and documents the South African government's tragic failure to
battle
the epidemic that was overwhelming their country.
"This is a movement and a government that fought for the equality of black
people,"
says South African activist Zachie Achmat. "To find out that the movement does
not care about the lives of poor people and the lives of black people and is
prepared to consign us to the graveyard, was actually quite shocking."
The film also examines the next wave of the AIDS epidemic, in some of the most
populous and strategically important nations in the world, including Russia,
India
and China, and tracks the same pattern of official denial and political
indifference
that characterized the epidemic in so many other countries. Globally, pressure
was building around the political struggle to finance AIDS prevention and
treatment
in the developing world, between the UN-backed Global Fund and the Bush
administration's AIDS initiative, which was heavily influenced by the
president's
evangelical Christian political supporters.
Twenty-five years after the first cases were diagnosed, a scientific solution
to
the AIDS pandemic remains elusive. Despite billions of dollars being poured into
research, most scientists believe a breakthrough on an effective vaccine against
HIV is years, perhaps decades away. "Even if we come up with a cure or vaccine
tomorrow, just think about the time that would be needed to implement all these
measures widely throughout the world," says David Ho, who was a young medical
resident in Los Angeles in 1981 when he saw his first AIDS patient. "So to me
it's clear that I'm not going to see the end of this epidemic. And it's also
pretty
clear that my children won't see the end of this epidemic."
"The story of this pandemic shows how AIDS is a lens that reveals the flaws in
the social fabric of every country it enters," says Renata Simone, series
producer
and reporter for The Age of AIDS. "AIDS always was a preventable pandemic. And
it
still is -- the lessons for the future are here in the history."
The Age of AIDS is a co-production of WGBH/FRONTLINE and Paladin InVision Ltd.
with Silverbridge Productions Ltd. and Channel 4. The Series Producer and
Reporter
is Renata Simone. Part I is produced and directed by William Cran, and is
written
by William Cran & Renata Simone. Part II is produced and directed by Greg
Barker,
and is written by Greg Barker & Renata Simone. FRONTLINE is produced by WGBH
Boston
and is broadcast nationwide on PBS. Funding for FRONTLINE is provided by The
Park
Foundation and through the support of PBS viewers. Additional support for The
Age
of AIDS is provided by the Corporation for Public Broadcasting, the Michael W.
McCarthy Foundation, the Esmond V. Harmsworth Charitable Foundation and the B.W.
Bastian Foundation. FRONTLINE is closed-captioned for deaf and hard-of-hearing
viewers and described for people who are blind or visually impaired by the Media
Access Group at WGBH. FRONTLINE is a registered trademark of WGBH Educational
Foundation. The FRONTLINE executive producer for special projects is Michael
Sullivan. The executive producer for FRONTLINE is David Fanning.

Press Release Source: Ribapharm Inc.
Ribapharm Files Patent Infringement Lawsuit Against Hoffmann-La Roche, Inc. in
the United States
Monday August 26, 7:00 am ET
COSTA MESA, Calif., Aug. 26 /PRNewswire-FirstCall/ -- Ribapharm Inc. (NYSE: RNA
- News) today announced that it has filed an action in the United States
District Court in Los Angeles against Hoffmann-La Roche, Inc., to enforce its
patents on the use of ribavirin. Earlier this month, the company initiated
patent infringement actions against Roche in the Netherlands and Germany, and
will be filing a counter-action for patent infringement against Roche in
Switzerland where Roche is seeking a declaratory judgment that their marketing
of ribavirin does not infringe Ribapharm's patents.
"Roche has communicated to the financial community their intention to market a
ribavirin product, an action that would be in violation of the patents in place
for ribavirin and in disregard of our intellectual property rights," said
Johnson Y.N. Lau, M.D., President and CEO of Ribapharm. "These legal actions
against Roche, taken together, make clear Ribapharm's resolve to vigorously
enforce and defend our patents."
Ribavirin, a nucleoside analogue, is licensed to Schering-Plough and marketed in
combination with Schering-Plough's interferon alfa-2b product (Rebetron(TM)) and
with pegylated interferon alfa-2b (PEG-Intron® -- Rebetol®) for the treatment of
chronic hepatitis C.
In June 2002, the National Institutes of Health (NIH) convened a Consensus
Conference Panel to examine current management and treatment practices for
hepatitis C. The panel noted that the hepatitis C virus is the leading cause of
chronic liver diseases in the United States, including liver cirrhosis and
hepatocellular carcinoma. In a draft consensus statement, the NIH panel
concluded that the most effective treatment of chronic hepatitis C is with a
combination therapy of pegylated interferon and ribavirin.
Hepatitis C is a viral infection of the liver, caused by the hepatitis C virus,
or HCV. Globally, an estimated 170 million people are chronically infected with
HCV. Hepatitis C currently accounts for an estimated 10,000 deaths in the U.S.
annually.
Ribapharm is a biopharmaceutical company that seeks to discover, develop,
acquire and commercialize innovative products for the treatment of significant
unmet medical needs, principally in the antiviral and anticancer areas.
THE "SAFE HARBOR" STATEMENT UNDER THE PRIVATE SECURITIES LITIGATION REFORM ACT
OF 1995. This press release contains forward-looking statements that involve
risk and uncertainties, including but not limited to, projections of future
sales, operating income, returns on invested assets, regulatory approval
processes, and other risks detailed from time to time in the Company's
Securities and Exchange Commission filings.

Man jailed for alleged assault, drug possession
By CAROLYNN BRIGHT - IR Staff Writer - 05/09/06
A Helena man is accused of attempting to infect his girlfriend with the
hepatitis C virus during an argument Sunday morning.
According to court documents, Lewis and Clark County Sheriff's deputies were
contacted by a man who said a woman was at his home, and that she had been
assaulted by her boyfriend.
When deputies arrived at the scene, the woman alleged that her boyfriend, John
Jerimia Foster, began arguing with her after they left a local bar at about
12:30 a.m.
By the time the couple reached their residence, the argument had become
physical. The woman said Foster pulled her to the ground once inside the house
and began punching her in the head and face.
Then, she told deputies, he tried to kiss her. In response, the woman said she
bit him on the lip, hoping that he would release his hold on her.
Instead, she said, Foster held her tighter and forced her mouth open, allowing
blood from his lip into her mouth.
She told deputies he told her that now she would have hepatitis C, like he did.
Court documents state that deputies were aware that Foster was, in fact,
infected.
The woman said the attack went on for about three hours after she bit Foster.
Finally, she was able to leave the scene in her truck.
She said Foster climbed into the bed of the truck as she was driving away, and
tried to enter the cab. But he jumped out before she reached the residence from
which she called for help.
According to police reports, deputies went to Foster's home after receiving the
911 call about the alleged assault.
Reports state that Foster admitted to arguing with his girlfriend, but said he
didn't hit her.
In addition, he said he received the cut on his lip in a fall.
Foster was subsequently jailed. As deputies took him into custody, they
discovered a marijuana pipe in Foster's pocket, and a baggie which contained
marijuana.
Prosecutors charged Foster with criminal endangerment, a felony, partner/family
member assault, possession of drug paraphernalia, possession of dangerous drugs
and unlawful restraint, all misdemeanors.
http://helenair.com/articles/2006/05/09/helena/a07050906_01.txt

Stealth virus
Health experts are warning about a looming epidemic of hepatitis C. Testing,
treatment and support groups offer hope.
Posted by the Asbury Park Press on 05/9/06
BY SHANNON MULLEN
STAFF WRITER
Imagine discovering you've had a highly infectious, potentially deadly disease
for the past 26 years and didn't know it.
That's what happened to Jeffrey Bier of Ocean Grove six years ago, when a
routine blood test came back positive for hepatitis C, a virus that attacks the
liver. Through a subsequent biopsy, his doctor was able to estimate that Bier
likely contracted the virus when he was about 17.
Bier was incredulous. He felt fine and had no symptoms of liver failure, which
is often the case with hepatitis C. When he learned more about the virus, which
is spread by blood-to-blood transmission, he was devastated.
"When you find out you've been diagnosed with hepatitis C," he said, "you feel
like a dented can. I thought my life was over."
It wasn't. Bier, 49, has been in remission for five years, thanks to nearly a
year of arduous combination drug therapy.
Not everyone with the virus is so fortunate. The American Liver Foundation says
that 10,000 to 12,000 people in the United States die each year from hepatitis
C. Health experts warn that the more than 4 million Americans who are or have
been infected with hepatitis C are merely the vanguard of an epidemic that could
lead to a tripling of the virus' death rate in the next 10 to 20 years.
A hidden threat
There are six distinct hepatitis viruses: A, B, C, D, E and G. Only the first
three are prevalent in the United States.
All hepatitis viruses inflame the liver. That organ, roughly the size of a
football, performs numerous crucial tasks, such as detoxifying harmful
substances, filtering blood, metabolizing alcohol, regulating blood sugar, and
producing vitamins and hormones.
Hepatitis A, which is commonly spread by contaminated food or water, usually
resolves itself without treatment. Similarly, most adults recover from hepatitis
B, which is spread by blood and other bodily fluids, much like HIV/AIDS.
In addition, there are vaccines available to protect against hepatitis A and B.
That's not the case with hepatitis C, considered the most serious of the
hepatitis viruses. It's also the stealthiest. As Bier's case illustrates, it can
take 20 to 30 years before the virus causes serious liver damage.
"The problem with hepatitis C is that a lot of people don't know they have it,"
said Dr. Eric Eschinger, a specialist in gastroenterology and hepatology at
Community Medical Center in Dover Township. It's estimated that 70 percent of
those infected with the virus don't realize they're infected.
Until the early 1990s, there wasn't even a way to detect the hepatitis C virus.
That meant the nation's blood supply couldn't be screened for it, which is why
those who received blood transfusions or organ transplants prior to 1992 are
considered to be at high risk, as are intravenous and intranasal drug users who
share needles and other drug paraphernalia.
If those who are unaware they carry hepatitis C are lucky, a routine blood test
will detect the virus before it has time to cause liver cancer or cirrhosis, an
irreversible scarring of the liver that can necessitate a liver transplant. That
was Bier's good fortune.
Bier said the doctor who performed his biopsy told him he had only five to seven
years to live. Bier refused to believe him, stormed off and got a second opinion
from Dr. Nancy Gornish, an infectious disease specialist at Jersey Shore
University Medical Center in Neptune. Her assessment was far more hopeful.
She started Bier on an intensive combination drug regimen of pegylated
interferon and ribavirin. Her assistant also steered Bier to a support group for
hepatitis C patients. Bier believes his involvement in that group, which is run
by the Monmouth and Ocean County Hepatitis C Coalition, was crucial to his
eventual recovery.
Flu for a year
The drug treatment for hepatitis C is often a debilitating grind that can last
six months to a year.
"Imagine feeling like you're getting the flu, many days of the week, for months
on end," Gornish explained.
Bier said he had "every side effect," including fatigue, depression, skin
rashes, sleeplessness and a metallic taste in his mouth. But he was told this
was a sign that the drugs were working. This went on for 11 months.
During most of that time, Bier, a security guard, was too sick to work, but he
dragged himself to monthly support group meetings. What he found there was a
diverse group of people, about 15 to 25 at any given session.
Some, himself included, had pushed the envelope too far with lifestyles that put
them squarely at risk to contract a disease such as hepatitis, while others had
led quiet, ordinary lives and had no idea how they got sick.
The current president of the group, Phil Ciorciari, 60, of Middletown doesn't
have hepatitis C, but he got involved because he is close to people who have the
disease.
"Everybody gets along," Bier said. "It's an amazing thing."
The group has monthly meetings in Neptune and Brick. In addition to offering
advice and moral support, the group hosts presentations by hepatitis
specialists, nutritionists, alternative medicine practitioners and
pharmaceutical company representatives. Bier found the information sessions
invaluable.
"I'm telling you," he said, "if I didn't get involved in the support group, I
don't think I would have gotten through the medicine."
The combination drug therapy is effective for 40 percent to 50 percent of those
with the most common form of hepatitis C - a marked improvement from just a few
years ago. Fortunately, Bier wound up being a "responder."
He still goes to meetings, though he's in remission. Recently, group members
elected him vice president.
"I'm so grateful to be in remission," Bier explained. "I've got to give back."
http://www.app.com/apps/pbcs.dll/article?AID=/20060509/LIFE11/605090301/1006

Message of hope
A FORMER drug addict and alcoholic is appealing to all helicopter owners in
Ireland and abroad to help him in his hour of need. Johnny Edwards, formerly of
Clontarf and now living in Scotland, requires a helicopter to be on standby to
take him to Edinburgh Royal Infirmary Hospital if a liver becomes available for
a transplant that he desperately needs.
Johnny has opened three drug rehabilitation centres in Scotland through the
organisation 'Walking Free'.
As reported in Northside People last month, he has vowed to help drug addicts
and their families in Ireland.
He has organised a major event called 'Make Addiction History' in the RDS, which
will take place on May 13 and 14.
Johnny says he dearly wants to be present at the RDS. However, he realises that
the call from the hospital in Edinburgh could come at any time.
"I have Hepatitis C and sclerosis with cancer of the liver as a result of the
Hepatitis of the liver," he says.
"I only heard I was infected with Hep C last September. In fact, I walked and
cycled with some friends all the way from Los Angeles to New York while I had
cancer, the Hep C virus and sclerosis.
"We brought a message of help and healing to millions through the media on our
'Walking Free' trip across the States."
According to Johnny, the RDS event will be brimming with hope, with a choir of
former addicts and their families singing fantastic songs of recovery from
addiction.
"Hip Hop dancers will be celebrating freedom from addiction through powerful
dance routines," he says.
"Don Baker is making a special guest appearance and you will have a chance of
hearing many former addicts and their families tell of how their lives have
changed."
The RDS event was organised before Johnny heard he was sick and in need of a
transplant. He now runs the rehabilitation centres in Scotland where Irish
addicts can receive help.
"I have to carry a pager around with me now," says Johnny. "When a liver is
available, I will have to make my way to the hospital.
"I am hoping someone will go on standby for me with a helicopter to fly me out
if necessary."
Johnny reaffirmed his commitment to helping addicts in Ireland and their
families.
"We need hope in Ireland," he says. "Indeed, having these sicknesses puts me in
a unique position to bring hope to many."
Johnny has also written his autobiography, entitled 'Walking Free'. A lot of the
profits will go towards helping others in Ireland.
"We are hoping to raise funds to open a men's rehab centre in Ireland," he says.
Tickets for this weekend's event are available at Liberty Hall box office on
Eden Quay and at the door on the night. They are priced at e11.50 and can also
be purchased at www.centralticketbureau.com
http://www.dublinpeople.com/cms/index.php?option=com_content&task=view&id=1115&I\
temid=52

Pot May Not Shrink Teens' Brains After All
By Neil Osterweil, Senior Associate Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Assistant Professor of Medicine, University of
California, San Francisco
May 08, 2006
Review
ORANGEBURG, N.Y., May 8 - The notion that marijuana induces growing brains to
atrophy didn't hold up when tested by a new MRI technique, researchers have
reported.
Using diffusion tensor imaging to compare the brains of teenagers who reported
smoking marijuana moderately with those who didn't, the investigators found no
evidence that pot damages or changes the growing adolescent brain.
"These data lead to the likely conclusion that cannabis use, in at least
moderate amounts, during adolescence does not appear to be neurotoxic, although
we cannot exclude any adverse effects of heavier amounts than that used by the
current subjects," wrote Lynn E. DeLisi, M.D., of the Nathan S. Kline Institute
for Psychiatric Research, here, and colleagues at New York University.
"These data are preliminary and need replication with larger numbers of
subjects, although they do have implications for refuting the hypothesis that
cannabis alone can cause a psychiatric disturbance such as schizophrenia by
directly producing brain pathology," said Dr. DeLisi and colleagues in the
open-access online publication Harm Reduction Journal.
A controversial report published in the Lancet in 1971 suggested that marijuana
use is associated with cerebral atrophy, but subsequent brain imaging studies
with CT and MRI have not backed it, the authors noted.
"Since cannabis use changes the density of cannabinoid -1 receptors in the
brain, it is possible that this density alteration could be associated with
volume loss as detectable by MRI in cannabinoid receptor-rich brain regions,
such as temporal cortex," they wrote.
To evaluate possible cannabis-induced neurotoxicity in still-developing brains,
the researchers took advantage of the recently developed MRI technique diffusion
tensor imaging, which relies on the diffusion of water (so-called Brownian
motion) to delineate with greater precision the white matter of the brain. The
measures used include apparent diffusion coefficient, which may relate to
fractional anisotropy; decreases in fractional anisotropy are thought to
correlate with white matter damage.
In this preliminary study, the authors performed analyses on MRI scans of the
brains of nine young men and one young woman (mean age 21 years range, 18-27)
who were frequent marijuana users in their teens, and of age- and sex-matched
controls who never used pot.
They used the diffusion tensor imaging technique to look for cerebral atrophy
and white matter integrity. They also measured whole brain volumes, lateral
ventricular volumes, and gray matter volumes of the amygdala-hippocampal
complex, superior temporal gyrus, and entire temporal lobes (excluding the
amygdala-hippocampal complex).
They found that "while differences existed between groups, no pattern consistent
with evidence of cerebral atrophy or loss of white matter integrity was
detected."
Specifically, they found no significant changes in any measured brain structures
in the marijuana users versus controls. However, on a voxel-by-voxel analysis,
they found that there were two regions where the apparent diffusion coefficient
was reduced in cannabis users relative to non-users, and six regions where the
fractional anisotropy was increased among pot users.
"Regions of higher apparent diffusion coefficient, putative evidence of atrophy,
were not present, although regions of significantly lower apparent diffusion
coefficient were," Dr. DeLisi and colleagues wrote.
"While low fractional anisotropy would be indicative of less white matter
integrity, particularly with respect to fiber direction, all fractional
anisotropy differences in this study were higher values in cannabis users than
non-users."
http://www.medpagetoday.com/Neurology/GeneralNeurology/dh/3242

Debbie,
I think first time maybe should wait on 16 college students with them. Might be
a little much. But she could help paint that seat. Guess they should vote on
that? Ya think? Dana
WaitingOnPeg@... wrote:Almost as fun as it would be to watch Nancy,
Michael, and 16 college students, lol
Debbie
To unsubscribe from this group, send an email to:

Dana,
Believe it or not...I have, on occasion, been considered,,,(by only a few,
mind you)...to be....ummmmm..."voracious" (other, more technical sounding
terms have been used but I hate "clinical" tags :-).
For years, I used to think I was just "Healthy" but, eventually I talked to
enough women (who, in my opinion...maybe weren't...LOL) whose "appetites"
were SO much less that I finally had to concede to that possibility.
BUT...I am Very, Very, Gentle ;-)
Love,
Nancy

Nancy,
Making him scream is okay. But what on earth would you do to make him RUN
screaming?? Dana
Nancy wrote:I think it sounds like a great idea...as long as you can collect
enough to
make sure the poor boy can get back home if he runs screaming from the
building at some point here! LOL

Almost as fun as it would be to watch Nancy, Michael, and 16 college students,
lol
Debbie

Yes, and maybe Nancy could go see Michael and that 16 college students shower
with Oil on her. Tehee! Or maybe we are being little pushy. Flirting may just
be fun sometimes! Dana
WaitingOnPeg@... wrote:That does sound fun to get them together.
Debbie
To unsubscribe from this group, send an email to:

I think it sounds like a great idea...as long as you can collect enough to
make sure the poor boy can get back home if he runs screaming from the
building at some point here! LOL

Tehee! I think we should all chip in and send Michael to visit Nancy! What do
you think? Dana
Nancy wrote:Those things do take a lot of gas, don't they? :-)

That does sound fun to get them together.
Debbie

CDC Plans to Recommend Routine HIV Testing for All US Residents Ages 13 - 64
In June or July 2006, the US Centers for Disease Control and Prevention (CDC)
plans to recommend that physicians offer voluntary HIV antibody testing to all
US residents ages 13 to 64 as part of routine medical exams in private
practices, clinics, hospitals, and emergency departments, reports the Wall
Street Journal (May 8, 2006).
CDC also plans to recommend revising current guidelines that require patients to
sign informed-consent forms before receiving an HIV antibody test and removing
or condensing the requirements for pretest counseling, the Journal reports.
Under current testing regulations, many states require individuals to
participate in a 20-minute counseling session before obtaining an HIV antibody
test. In addition, people in some states must sign a separate informed-consent
form, which details the risks and benefits of the test.
Under the revised recommended guidelines, a physician could perform the test
after receiving a person's oral consent. Physicians would discuss the results of
the test privately with patients who test positive and perform a second test to
confirm the results, according to the Journal.
CDC's recommended guidelines are expected to be released in June or July in the
agency's Morbidity and Mortality Weekly Report. CDC estimates that about 25% of
HIV-positive people in the U.S. do not know their status.
Many physicians believe that routine testing could lead to an earlier diagnosis
and earlier treatment. Furthermore, a person unaware of his or her status might
have "unknowingly infected many other people."
Supportive Reactions
"What we want to do is to address barriers to testing in clinical sites," Kevin
Fenton, director of CDC's National Center for HIV, STD, and TB Prevention said
on Friday at a news conference marking the 25th anniversary of the first
diagnosed case of AIDS. He added, "We know that a barrier is the significant
time it takes for pretest counseling.. HIV testing outside clinical settings
will still bear the requirement for pretest counseling."
Timothy Mastro, acting director of CDC's Global AIDS Program, said, "These new
guidelines ... recommend [changing] the nature of HIV testing so that it's not
based on the risk to an individual or the community in which an individual
resides, but [makes routine] testing of all people" ages 13 to 64 (DeNoon, WebMD
Medical News, May 5, 2006). He added that routine testing could reduce the
stigma that is associated with undergoing an HIV antibody test.
Concerned Reactions
Wendy Mariner, Boston University professor of health law, called routine testing
"a double-edged sword," adding, "It's valuable to alert people to availability
of treatment. But critics worry routine testing could slide into testing without
knowledge or consent. That's not what's intended, but it's a legitimate
concern."
In addition, some critics say that loosening informed-consent requirements might
lead to the unfair treatment of some groups, such as women and minorities. For
example, some critics of routine testing say some people might feel forced to
give consent, their consent might not be sought or the test might be given in a
place where privacy is not maintained, according to the Journal.
Both supporters and opponents of routine testing say that access to counseling
and treatment for HIV is crucial to preventing the spread of HIV. According to
Mastro, counseling, coupled with HIV antibody testing, leads to a 68% reduction
in risky behavior that could lead to new HIV cases.
05/08/06
Sources
M Chase. CDC to Urge Routine HIV Tests for a Broad Swath of Americans. Wall
Street Journal. May 8, 2006. A 1.
Kaiser Daily HIV/AIDS Report (online). CDC To Recommend Routine HIV Testing for
U.S. Residents. May 8, 2006.
http://www.hivandhepatitis.com/recent/2006/ad1/050906_a.html

Those things do take a lot of gas, don't they? :-)

Ah, the "Big Hair" band era (never really was my favorite)...The Blues are
my favorite...have a Very hard time controlling my hips to some good blues
(even in public :-)

so if i still lived in colorado and hung out with the elk and deer hunters
and passed on all the meat they wanted to give me over the years but
wouldn't take then i could have albacore in the mail?? LOL dang........
i am always in the wrong state at the wrong time............. oh
well......... onward and upward :-)
Peace and Love,
Pam
Dogs come when they're called. Cats take a message and get back to you. --
Missy Dizick

Tehee! Not sure I should comment on this! But how do you know it will hold 16
college kids? Dana
nevernilla wrote:well Dana my shower would hold 2 people easily (or 16 college
kids) there is more room than in a VW Beetle, with a fold down seat too but I
need to repaint the seat LOL Im not due for an Oil change for 2000 mi I just had
it done yeaserday...Michael

Michael,
Yes, it took me many years to figure out what I felt instead of what everyone
else told me I should feel. I have been told that I do over analyze... But I
guess that is my best way to get in touch with myself and how I feel rather than
how I should feel. Life is funny. So many ups and downs. But in the end, all
the good things seem to come to mind. Dana
nevernilla wrote:
Yes Dana apparently I chose wrong words on this one you sure do seem eloquent
and deep and in touch with your feelings...Michael

Michael,
I am originally from Dallas, Tx. I used to go fishing in Oklahoma and Arkansas
allot. Almost all my family is down there. I was just in Texas in June. But
was not a great visit. It was over my deseased fathers Estate.
I have never been to Hot springs though. Probably don't catch many fish there!
But bet you catch allot of women! Tehee! Dana
nevernilla wrote:well Dana I live in Hot Springs Arkansas in the lake here you
can see the bottom at 14 feet too but stay out of the white river it is white
with fertilizer LOL Michael

Thank you for that it was truly beautiful and very right too Michael

My contribution on this topic... I like to think that I have learned
something from each and every relationship I've been fortunate enough
to experience. Whether it's strength, humility, perseverance or any
number of other things. Like many, I have been in really bad
relationships as well as very good ones and for me - it all points to
one thing... I love men and I love being in a relationship.
Here's a chapter from one of my favorite books that sums it up really
well in my opinion...
LOVE
It is a mystery why we fall in love. It is a mystery how it
happens. It is a mystery when it comes. It is a mystery why some
loves grow and it is a mystery why some loves fail. You can analyze
this mystery and look for reasons and causes, but you will never do
any more than take the life out of the experience.
Love is more than the sum of the interests and attractions and
commonalities that two people share. And just as life itself is a
gift that comes and goes in its time, the coming of love must be
taken as an unfathomable gift that cannot be questioned in its ways.
Too often, when love comes to people, they try to grasp the
love and hold it to them, refusing to see that it is a gift freely
given and a gift that just as freely moves away. When they fall out
of love, or the person they love feels the spirit of love leaving,
they try desperately to reclaim the love that is lost rather than
accepting the gift for what it was.
They want answers where there are no answers. They want to know what
is wrong with them, or they try to get their lover to change,
thinking that if some small thing were different love would bloom
again. They blame their circumstances. They blame each other. They
try anything to give meaning to what has happened. But there is no
meaning beyond the love itself, and until they accept its own
mysterious ways they live in a sea of misery.
You need to treat what love brings you with kindness. If you
find yourself in love with someone who does not love you, be gentle
with yourself. There is nothing wrong with you. Love just didn't
choose to rest in the other person's heart.
If you find someone else in love with you toward whom you
feel no love, feel honored that love came and called at your door,
but gently refuse the gift you cannot return. Do not take advantage,
do not cause pain. How you deal with love is how love will deal with
you, and all our hearts feel the same pains and joys, even if our
lives and ways are different.
If you fall in love with another who falls in love with you,
and then love chooses to leave, do not try to reclaim it or to assess
blame. Let it go. There is a reason and there is a meaning. You
will know it in time, but time itself will choose the moment.
Remember this and keep it in your heart. You don't choose
love. Love chooses you. All you can really do is accept it for all
its mystery when it comes into your life. Feel the way it fills you
to overflowing, then reach out and give it away. Give it back to the
person who brought it to you. Give it to others who seem poor in
spirit. Give it to the world around you in any way you can.
Love has it own time, its own season, and its own reasons for
coming and going. You cannot bribe it or coerce it or reason it into
staying. If it chooses to leave, from your heart or from the heart
of your lover, there is nothing you can do and nothing you should
do. Be glad that it came to live for a moment in your life. If you
keep your heart open, it will surely come again.
From `Simple Truths' by Kent Nerburn

Factors That Predict a Rapid Virological Response at Week 4 and a Sustained
Virological Response at Week 24
Approximately one third of hepatitis C virus (HCV) genotype 1 patients achieved
a sustained virological response (SVR) after 24 weeks of treatment with
peginterferon alfa-2a (Pegasys) plus ribavirin in a randomized, multinational
trial.
In the present study, researchers aimed to identify factors associated with a
rapid virological response (RVR) at week 4 (HCV RNA <50 IU/mL) and a SVR (HCV
RNA <50 IU/mL at the end of follow-up) in these patients.
Stepwise multiple logistic regression analysis was used to explore the
prognostic factors for a RVR and SVR in genotype 1 patients treated for 24
weeks.
Results
Fifty-one of 216 (24%) genotype 1 patients in the 24-week treatment
groups had a RVR.
SVR rates were considerably higher in patients without a RVR (89% vs.
19%, respectively) were more likely to achieve a RVR than those with HCV RNA
greater than 600,000 IU/mL.
HCV subtype (1b vs. 1a) was also independently associated with.
RVR and baseline HCV RNA less than 200,000 IU/mL were significant and
independent predictors of SVR in patients treated for 24 weeks.
In conclusion, the authors write, "Patients infected with HCV genotype 1 and
treated with peginterferon alfa-2a plus ribavirin sustained a RVR 24% of the
time. This portends an 89% probability of a SVR after 24 weeks of treatment."
05/09/06
Reference
D M Jensen, T R Morgan, P Marcellin and others. Early identification of HCV
genotype 1 patients responding to 24 weeks peginterferon alfa-2a (40
kd)/ribavirin therapy. Hepatology 43(5): 954-960.
http://www.hivandhepatitis.com/hep_c/news/2006/050906_b.html

well Dana I live in Hot Springs Arkansas in the lake here you can see the bottom
at 14 feet too but stay out of the white river it is white with fertilizer LOL
Michael

Computerized Drug Ordering Reduces Chemotherapy Errors
By Neil Osterweil, Senior Associate Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Assistant Professor of Medicine, University of
California, San Francisco
May 08, 2006
Also covered by: Forbes
Review
BALTIMORE, May 8 - For children being treated with chemotherapy, a computerized
drug-ordering system can greatly reduce dosing errors, researchers here
reported.
Using the system reduced the likelihood that a child would get the wrong daily
chemotherapy dose by 74%, and virtually eliminated the risk of dose calculation
errors, wrote Christopher U. Lehmann, M.D., of Johns Hopkins, and colleagues, in
the May issue of the Archives of Pediatric & Adolescent Medicine.
The researchers also published a study in the May 8 issue of Pediatric Critical
Care Medicine showing that a web-based infusion calculator reduced the number of
orders containing errors by 83%.
"Our findings reveal that using a Web-based calculator makes it less likely to
order and give a child the wrong dose or commit other errors, such as omitting
patient information, weight parameters or infusion rates," said Dr. Lehman. "Our
calculator stops ordering errors before they can even reach the pharmacy, let
alone the patient."
The computerized ordering system was developed out of a hospital initiative to
reduce chemotherapy errors. It drew on the expertise of a multidisciplinary team
consisting of pediatric oncologists, nurses, and physician assistants, as well
as pharmacists and information systems experts.
The team adapted a military technique called failure-modes and effects analysis
to see whether it could devise a system that would take some of the bugs out of
conventional drug ordering.
The chemotherapy-ordering system, which the hospital has been using for three
years, uses calculators that automatically adjust dosage according to the
patient age and weight, thereby reducing the risk of calculation errors.
The system, described in the Archives study, also helps to reduce errors that
arise from clinicians' stereotypically illegible handwriting by forcing
providers to use a drop-down menu for drug selection.
To determine whether the system was having its desired effect, Dr. Lehmann and
colleagues compared 1,259 handwritten orders with 1,116 electronic orders, and
found that after the implementation of the computerized system the relative risk
that chemotherapy orders would contain dosing errors was 0.26 (95% confidence
interval, 0.11-0.61).
In addition, after computerization the relative risk of incorrect dosing
calculations decreased dramatically, to 0.09 (95% CI, 0.03-0.34), and there were
significant declines in the risk that there would be missing cumulative dose
calculations (0.32, 95% CI, 0.14-0.77), and incomplete nursing checklists (0.51;
95% CI, 0.33-0.80).
The investigators estimated that the computerized system could prevent 17 or 18
errors for every 100 orders.
"Most of these errors may have been caught by pharmacists or nurses before they
could have hurt a patient, but we wanted to prevent providers from making errors
in the first place because some of them may reach the patient," Dr. Lehmann
said.
They also found, however, that "there was no difference in the likelihood of
improper dosing on treatment plans and a higher likelihood of not matching
medication orders