global health tribune - november 2013
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Healthcare newspaper of Palm Beach countyTRANSCRIPT
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Shaving, Waxing, orLaser Hair Removal…Which is Right for YOU?
'One-Stop' RadiationTreatment MightOffer Breast CancerCare Alternative
ONCOLOGY NEWSHEALTHCARE NEWS
Cancer diversity has'huge implications'
Exercise May Help Breast CancerSurvivors Battle Bone Loss
What is Structural Chiropractic?
A team at theInstitute ofCancerResearch,London, havedeveloped anew techniquefor measuringthe diversitywithin acancer.
Teen SavesLives bySpeaking toElephants
Importedspices carrysalmonella,insects,excrementand hair,FDA says
CanDizziness Be a Sign of aStroke? Is there an afterlife? Science can prove there is,
quantum physicist claimsJohn Hall, The Independent
LONDON: It's a questionpondered by philosophers,scientists and the devoutsince the dawn of time: Isthere an afterlife?While the religious wouldargue that life on earth is amere warm up for an eternity
spent in heaven or hell, andmany scientists woulddismiss the concept for lackof proof — one expert claimshe has definitive evidence toconfirm once and for all thatthere is indeed life afterdeath.The answer, Professor RobertLanza says, lies in quantum
physics — specifically thetheory of biocentrism. Thescientist, from Wake ForestUniversity School ofMedicine in North Carolina,says the evidence lies in theidea that the concept of deathis a mere figment of ourconsciousness.
continued on page 2
www.GlobalHealthTribune.comPage 2 November 2013MEDICAL NEWS
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Global Health Tribune is a newspaper published everymonth in Palm Beach County. Copyright 2013, all rightsreserved by SEA Publications, Inc. Contents may not bereproduced without the written consent of the publisher. Thepublisher reserves the right to refuse advertising. Thepublisher does not accept responsibility for advertisementerrors beyond the cost of the advertisement itself. Allsubmitted materials are subject to editing.
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Professor Lanza says biocentrismexplains that the universe onlyexists because of an individual'sconsciousness of it — essentiallylife and biology are central toreality, which in turn creates theuniverse; the universe itself doesnot create life. The same appliesto the concepts of space andtime, which Professor Lanzadescribes as "simply tools of themind".
In a message posted on thescientist's website, he explainsthat with this theory in mind, theconcept of death as we know it is"cannot exist in any real sense"as there are no true boundariesby which to define it. Essentially,the idea of dying is somethingwe have long been taught toaccept, but in reality it just existsin our minds.
Professor Lanza says biocentrismis similar to the idea of paralleluniverses — a concepthypothesised by theoreticalphysicists. In much the sameway as everything that couldpossibly happen is speculated tobe occurring all at once acrossmultiple universes, he says thatonce we begin to question ourpreconceived concepts of timeand consciousness, thealternatives are huge and couldalter the way we think about theworld in a way not seen since the15th century's "flat earth" debate.
He goes on to use the so-calleddouble-slit experiment as proofthat the behaviour of a particlecan be altered by a person'sperception of it. In theexperiment, when scientistswatch a particle pass through amulti-holed barrier, the particleacts like a bullet travellingthrough a single slit. When thearticle is not watched, however,the particle moves through theholes like a wave.
Scientists argue that the double-slit experiment proves thatparticles can act as two separateentities at the same time,challenging long-establishedideas of time and perception.
In terms of how this affects lifeafter death, Professor Lanzaexplains that, when we die, ourlife becomes a "perennial flowerthat returns to bloom in themultiverse". He added: "Life isan adventure that transcends ourordinary linear way of thinking.When we die, we do so not in therandom billiard-ball-matrix butin the inescapable-life-matrix."
Is there an afterlife?continued from cover page
Cancer diversity has 'huge implications'By James GallagherHealth and science reporter,BBC News
Ateam at the Institute ofCancer Research,London, have developed
a new technique for measuringthe diversity within a cancer.
They showed "extraordinary"differences between cancerouscells and say new targeted drugsmay fail as they may be unableto kill all the mutated tissue.
Experts said the findings wouldhave "profound implications" fortreatments.
A tumour starts as a single cell,which acquires mutations andeventually dividesuncontrollably. But that is not theend of the process.
Cancerous cells continue tomutate and become moreaggressive, move round the bodyand resist drugs.
This process is chaotic andresults in a "diverse" tumourcontaining cancerous cells thathave mutated in different ways.
"This has huge implications formedicine," researcher Prof MelGreaves told the BBC.
His team at the Institute ofCancer Research investigated
cancer diversity in five childrenwith leukaemia. They comparedmutations in individualcancerous cells with a knowndatabase of mutations.
Their results, published in thejournal Genome Research,showed patients had betweentwo and 10 genetically distinctleukaemias.
Prof Greaves said: "Every patienthas a completely new tree anddoesn't have one cancer, theyhave multiple cancers.
"This is really a technicaladvance to get at thisextraordinary complex diversity,it helps explain why we havesuch difficulty with advanceddiseases."
Tree of cancerScientists compare cancerdiversity to a tree. The initialmutations - the trunk - will be
common to all cancer cells. Butthen the tumour branches out.
It means a treatment that targetsone "branch" or sub-clone of thecancer might slow the disease,but they will never stop it.
Prof Charles Swanton, whoresearches diversity at theUniversity College LondonCancer Institute, told the BBC:"We call it pruning the branchesnot cutting down the tree,targeted therapies will removesome of the sub-clones, butchopping down the tree is hard todo."
The study investigated leukaemiaas it is less diverse than othertypes of cancer. Other tumourssuch as melanoma could feasiblybe made of hundreds ofbranches.
Prof Greaves says oneimplication of the research is that
therapies need to be developedwhich target the trunk of thetumour and that current targetedtherapies being researched maynot tackle advanced cancers.
Another idea he suggests isfocusing on the cancer'ssurroundings as well.
"If it is diversifying like speciesin a habitat, why not target thehabitat - the blood vesselssupplying oxygen orinflammation. There's a lot ofinterest in that," he said.
The research also emphasises theimportance of catching cancersearly before they have becometoo diverse to treat.
Prof Charles Swanton argues:"The bottom line is we need tounderstand cancer diversity tolimit further adaptations, reducethe pace of evolution andprolong the activity of drugs."
Prof Chris Bunce, the researchdirector at Leukaemia andLymphoma Research,commented: "We are beginningto understand how unique andcomplex each patient's cancer isand the profound implicationsthat this can have on the successof treatment.
"This study significantlyadvances our understanding ofhow cancers start and evolve."
New CDC Vital Signs: Colorectal cancer testing needs to increase among adults
Colorectal cancer is thesecond leading cancerkiller among men and
women in the United States, afterlung cancer. About 1 in 3 adults isnot getting screened for colorectalcancer as recommended by theU.S. Preventive services TaskForce (USPSTF), according to anew Vital Signs report: ColorectalCancer Screening Test Use -2012, released on november.Colorectal cancer screeningsaves lives, but only if people gettested. Adults aged 50 to 75years should get tested with oneor a combination of thesescreening tests:Fecal occult blood test (FOBT)or fecal immunochemical test(FIT) done at home every year,Flexible sigmoidoscopy, doneevery five years, with FOBT/FITdone every three years,
Colonoscopy done every 10years.Colorectal cancer screening canincrease if doctors, nurses, andhealth systems:Offer all recommended testsoptions with advice about eachtest.Match patients with the test theyare most likely to complete.Work with public health officialsto get more people tested usingpatient navigators to help peoplethrough procedures likecolonoscopy.Make it easier for people to getFOBT/ FIT kits in places otherthan a doctor’s office, like givingthem out at flu shot clinics ormailing them to their homes.They can speak with their healthcare provider about the testingoptions and get the test that theyprefer. Through the Affordable
Care Act, more Americans willhave access to health coverageand preventive services likecolorectal cancer screening tests.The tests will be available at nocost. Visit Healthcare.gov or call1-800-318-2596 (TTY/TDD 1-855-889-4325) to learn more.Open enrollment in theMarketplace began October 1and ends March 31, 2014. Forthose enrolled by December 15,
2013, coverage starts as early asJanuary 1, 2014.CDC provides funding to 25 statesand 4 tribes across the UnitedStates for five years to increasecolorectal cancer screening ratesamong men and women aged 50years and older through organizedscreening methods. Contact alocal health department to find outabout a colorectal cancerscreening near you.
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Twist and Shout…Is that your Ankle Talking?
Page 3November 2013www.GlobalHealthTribune.comTHE FORGOTTEN FOOT
Arthur Hansen DPM, M.S.
WEST OFFICE:3347 SR 7, Suite 204Wellington, FL 33449
EAST OFFICE:2326 South Congress Ave.
Suite 1-A West Palm Beach, FL 33406
We have all done it.You know, twistedor turned an ankle.Some of us were
stepping off of a curb, somebeing the ‘weekend warrior’ andothers simply wearing thoseheels that were just a bit toohigh; but we’ve all done it. Yourankle got really swollen, red andbruised, and luckily for most ofus, after a few weeks we wereback to normal. However,sometimes a twisted ankledoesn’t go back to normal. Thatcontinual pain, clicking, and/orswelling that lasts several weeksafter twisting your ankle can bean indication of a more seriousinjury.
Ankle sprains are very commonafflicting approximately 25,000people each day. The ankle isheld in place largely by threeligaments. These ligaments areelastic in nature stretching withnormal movements of the ankleand then returning to theirnormal size. When the ligamentsare forced to stretch outside theirnormal range, for example withsevere twisting, it is considered asprain. This causes varyinglevels of swelling, redness,bruising and pain. The ligamentscan be slightly sprained orcompletely torn.
When diagnosing an anklesprain, your doctor will take adetailed history, palpate differentareas of the ankle, determine anylimitations of range of motion,and order an x-ray to rule out anyfracture or bone chip.
Treatment for ankle sprainsdepends on the severity; howeverRest, Ice, Compression, andElevation comprise the backboneof medical recommendations.Non-steroidal anti-inflammatorymedications are usuallyprescribed as well as varying
levels of weight bearing.Physical therapy is also used toincrease strength in the stretchedligaments, increase range ofmotion of the ankle and todecrease pain. This conservativetreatment regimen is adequate toallow most sprains to heal.
However, if an ankle spraincontinues to be painful and swellafter the initial injury andtreatment, a more serious injurymay have occurred. Such
injuries could include instabilityof the ankle and fractures orbone chips that were not seen onthe initial x-ray. Advanceddiagnostic procedures such asMRI’s and CT scans are valuabletools utilized in diagnosingchronic pain and swellingfollowing an ankle sprain.
Sometimes these complicationsfollowing an ankle sprain requiresurgical intervention, includingbut not limited to; arthroscopic
surgery or repair of the tornligaments to regain stabilityabout the ankle joint.
Stretching and proper shoe gearare important preventivemeasures in keeping those anklesprains at bay. As is being wellaware of the terrain you arewalking or running on.
Long-term complications fromankle sprains are usuallypreventable if the diagnosis ismade early and the treatmentplan is initiated as soon aspossible right after the injury. Ifyour pain and swelling continuesafter an ankle sprain, it is best tohave it evaluated by a doctor.
If you are experiencing anyproblems with your feet, call ouroffice at 561-433-5577 toschedule an appointment today.
Page 4 November 2013 www.GlobalHealthTribune.comHEALTHCARE NEWS
Teen Saves Lives bySpeaking to ElephantsBy Ellen's Good News
Here's a language you never got theoption to learn in school! A 14-year-old girl from India knows
how to speak to elephants, a skill thatcomes in handy more often than you'dthink.Last June, a herd of 11 elephants fromnearby forests entered a residential area inthe city of Rourkela. Before the wildanimals could wreak havoc on the townand its residents, authorities got hold ofteenage girl Nirmala Toppo, becauseunbelievably, she seems to have the abilityto communicate with elephants.Nirmala rushed from her village on theOdisha-Jharkhand border to a footballfield in the city where the elephants weretemporarily being held."First I pray and then talk to the herd," theteen recently told BBC. "They understandwhat I say. I tell them this is not yourhome. You should return where youbelong."The elephants started walking with her. Infact, they walked with her for miles,speaking to them the whole way as sheguided them back to the forest.Elephants in the area's nearby forests
frequently invade villages and towns,destroying homes and trampling people.The more their habitat is encroached byhumans for activities like mining andcutting down trees, the more likely theyare to wander out of the forest.Nirmala, who is known as "Lady Tarzan,"speaks to the pachyderms in her localtribal dialect of Mundaari. She explainsthat because tribal people and theelephants (among other wild animals)have cohabited in the same area for ages,the elephants understand their language.Not only does this story show a braveyoung girl using her skills to help bothhumans and animals, it proves that it'spossible for two very different species toshare a bond and communicate with eachother.
Exercise May Help EaseDepression in Teens: Study
Teens can suffer from depressionlike everyone else, but a small newstudy hints that exercise might help
ease the condition.The British study included three boys and10 girls with depression who wereenrolled in trainer-led workouts threetimes a week for 12 weeks. The teenswere also encouraged to exercise 30minutes a day on the other days.According to the researchers, theworkouts were linked to significant boostsin mood, with depression severity cut by63 percent. Eighty-three percent of theteens who completed the exercise programwere no longer as depressed by the end ofthe study, which was slated forpresentation at the Society forNeuroscience annual meeting in SanDiego."Exercise has so many advantages as atherapy: It is non-drug, has few sideeffects and has countless other healthbenefits. But it has never been tested inyouth as treatment for depression," studyauthor Robin Callister, of the Universityof Newcastle, said in a Society forNeuroscience news release."Evidence that exercise can lift mood inyoung people is a huge step forward intreatment of this delicate population," sheadded. "We are now conducting a largertrial to further evaluate the effects ofexercise in depression and are hopeful thatit could be used as a treatment in addition
to other treatments for depression withoutpotential problems."Two experts in the United States said thefindings made sense."It is no surprise that exercise reducesdepression, regardless of age," said MarkSolms, co-chair of theNeuropsychoanalysis Association in NewYork City. "It is well established thatvigorous and protracted exercise raisesendorphin levels, and that endorphins[brain chemicals linked to lowered stress]reduce the mental pain of depression noless than they reduce physical pain."Victor Fornari is director of the division ofchild and adolescent psychiatry at NorthShore-LIJ Health System in New HydePark, N.Y. He noted that depression is a"serious medical condition associated withsuffering" and also a major contributor tosuicides among young people."Although the evidence suggests that themost effective treatment to date foradolescents with depression is acombination of cognitive behavioraltherapy in conjunction with antidepressantmedication, exercise may also be valuablein the recovery of depression," Fornarisaid. "In addition to being associated witha healthy lifestyle, regular exercise mayhave positive benefit in terms ofpsychological relief, as it does with somedepressed adults."Still, the study is very small and expertsnoted that findings presented at medicalmeetings are typically consideredpreliminary until published in a peer-reviewed journal.Fornari agreed that "further studies areneeded in order to determine the role ofexercise in the recovery from depressionduring adolescence."And Solms pointed out another potentialhurdle when using exercise as treatmentfor depression: "The only problem is thatit is very difficult to motivate depressedpeople to exercise," he said.
Page 5November 2013www.GlobalHealthTribune.comHEALTHCARE NEWS
HAIR REMOVAL NEWSShaving, Waxing, or Laser Hair Removal… Which is Right for YOU?
By Dr. R. Sabates CLS, CME
Many women stick toshaving because it’sthe most familiaroption. However,
shaving often leads to razor burn(those often painful red bumps),cuts, or even ingrown hairs -none of which are attractive.
In breaking down the differentmethods, they used the timespent on a particular method, thepain factor using a scale between1 and 10 (being the mostpainful), side effects, and overallcost. The following includessome of their data whichincludes the predetermined costover twenty years.
Shaving The least painful as it scored atwo. However, there were oftenpainful side effects, such as razorburn, cuts, and ingrown hairs.Overall, this method was theleast expensive at $3,456.00.
WaxingOften painful and uncomfortable– this method was given aneight! Side effects includebruising, water blisters, rednessfor up to a week, and theoccasional scarring. This wasalso the highest priced method at$15,600.00.
LaserThis showed a mediumdiscomfort level and was given afive. Side effects are minimum.It was slightly more expensivethan buying your razors at thelocal store, at a cost of $5,405.00.That amount included fourtreatments using a medical laser,plus annual touch-ups, again overa twenty year span.
The bottom line is for the priceand time spent, the clear winneris laser hair removal.
The next question… Which laserhair removal system is best foryou?
There are home units sold on TVthat claim permanent hair removaland medical lasers that can onlybe used by a doctor. The morecommonly advertised home unitsare NO! NO! and TRIA Laser.
No! No! is not a laser, butinstead a heated blade that singesthe hair root and can give thesame results as waxing.
Medical lasers are made bynumerous manufacturers andbasically use only threewavelengths, each with its ownpros and cons. All are equally aseffective in permanent hairreduction. Studies show up to95% of treated hair does notreturn.
The 755nm Alex laser is best forskin types 1-3. However, it canoccasionally causehypopigmentation. The 810nmDiode has been approved for allskin types, but works best for skintypes 1-4. Finally, the 1064nmYAG is best for skin types 4-6.The YAG can be more painful anddoes require an anesthetic.
Something else that separates thelasers is speed of treatment. Byfar the fastest hair removal laseris the LightSheer DUET 810nm.It has a larger hand piece thatalso contains a vacuum systemwhich reduces discomfort andthere is no need for an anesthetic.
The most amazing part is thattreatments that once took twohours can now be done in only 45minutes. This is so convenientfor a patient and it also reducesthe cost of the treatments.
For more information on laserhair removal or where to findthe right laser for you, call 561-753- 3336 or visitwww.tropicalaser.com.
Totalbeauty.com recently did a survey onthe three most often used hair removalprocesses; shaving, waxing and usinglaser hair removal treatments. Theybroke it down by the pain factor, as wellas time and money spent from one year totwenty years.
TRIA is a low power diodelaser. This home unit can beeffective only in certain typesof patients. It works best ondark coarse hair on lightskinned patients, type 1-3, andis now approved for the face.The best studies reveal that itcan permanently clear 30-40 %of hair in specially chosenpatients.
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Page 6 November 2013 www.GlobalHealthTribune.comPRACTICE TRENDS
PALM BEACH PRIMARY CARE ASSOCIATES, INC.
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Shekhar Sharma M.D.Ebonee Johnson A.R.N.P.
Shekhar V. Sharma, M.D.Board Certified in Internal Medicine
What is Prediabetes?
Prediabetes is a prelude totype 2 diabetes mellitus.What that means is yourblood glucose is higher
than normal, but not at the126mg level to be diagnosed astype 2 diabetes mellitus.Therefore, if your blood sugarlevel is from 100mg to 125mg,you are considered to haveimpaired blood sugar levels orprediabetes. This condition doesput you at risk for developingtype 2 diabetes.
How do you know if you havethis dangerous condition?
Unfortunately, there are usuallyno symptoms associated withthis diagnosis. In my practice, Isee a tremendous number of
patients with impaired bloodsugar levels that fall below thediabetes level and the worst partis that they have no idea theyeven have this condition. WhenI ask a patient that hasprediabetes what symptoms theyhave, they always say the samething – they don’t have any.
So, how do you go aboutfinding out if you haveprediabetes?
There are a few different ways todetermine if you haveprediabetes; a GlycatedHemoglobin Test (A1C), FastingPlasma Glucose (Fasting BloodSugar Test), or an Oral GlucoseTolerance Test. My preference isthe Fasting Blood Sugar Test.This test is usually performed inthe morning and in order to takethis test, you need to fast andtherefore cannot eat or drinkanything except for water afterMidnight.
I am writing this article to stressthe importance of taking this test.Not only is this conditiondangerous, but it can be just asdangerous as diabetes mellitus –both of which need to be treated.
What are the complications ofthis condition?
Stroke, heart disease, frequentyeast infections, and generally
higher levels of cholesterol in theblood. Sadly, approximately75,000,000 Americans with thiscondition go undiagnosed whichputs them at a high risk for futurecomplications. I insist that thiscondition be treated aggressivelybefore it transforms itself intodiabetes mellitus, which itusually does.I would recommend you alsocheck your hemoglobin A1Clevels. As you can see from thechart, a prediabetic hemoglobinrange is between 5.7% and 6.5%.Full-blown diabetes mellitus isdiagnosed with a level at orabove 6.5%.
As I mentioned in a previousarticle, a waistline that exceeds40” for a male and 35” for afemale should be a matter ofconcern because that could leadto prediabetes.
Recent studies have shown thatother conditions associated withprediabetes are hearingimpairment, yellowing of thetoenails, and erectiledysfunction.
What can I do to preventgetting prediabetes?
Since the progression from
prediabetes to type 2 diabetes isnot etched in stone, you can dosome things that may help toprevent getting the disease. Youcan start by making somelifestyle changes, which includefollowing a restrictive sugar-freeand low carbohydrate diet. Ihighly recommend exercising atleast 30 minutes a day which willhelp to burn the sugar and reduceits levels. I also suggest losingthose extra pounds andmaintaining a healthy weight. Iam a firm believer in the phrase,“An ounce of prevention is wortha pound of cure.” No punintended!
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DIABETESDIABETES DIABETES
PREDIABETES PREDIABETES
FPGFasting Blood Sugar Oral Glucose Tolerance Test
OGTTA1C
NORMAL NORMAL NORMAL
≥ 200 mg/dl< 200 mg/dl
≥ 140 mg/dl< 140 mg/dl
≥ 126 mg/dl< 126 mg/dl
≥ 100 mg/dl< 100 mg/dl
≥ 6.5%< 6.5%
≥ 5.7%< 5.7%
PREDIABETES
Page 7November 2013www.GlobalHealthTribune.comHEALTHCARE NEWS
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Imported spices carry salmonella, insects,excrement and hair, FDA says
Doctors in China grownew face on girl's chest
The U.S. Food and DrugAdministration saysthat almost 7 percent ofimported spices over a
three-year period werecontaminated with salmonella.
In a report released by the FDAsays testing of imported spicesbetween 2007 and 2010 showedthat spices were twice as likelyas other inspected foods to becontaminated with the pathogen.More than 80 different types ofsalmonella were detected.
The study looked at spicesimported from several countries,with many of the shipmentscoming from India, Mexico,Thailand and Vietnam.
The agency decided to study theissue as several spice-relatedoutbreaks have caused illnessesaround the globe. In 2009 and2010, black pepper and redpepper from India, Vietnam andChina used in salami causedhundreds of illnesses. The FDAsays there have been 14 knownoutbreaks around the world since1973, causing almost 2,000illnesses, many of which were inchildren.
The FDA, which monitors foodand drug safety for Americanconsumers, says that during thethree-year period, 749 shipmentsof spice were refused entry intothe United States because of
salmonella contamination, while238 other shipments were deniedbecause of the presence of whatthe FDA calls "filth" — insects,excrement, hair or othermaterials.
The agency said some of thespices that were foundcontaminated at the border werelater cooked or treated toeliminate possible pathogens, somuch of the salmonella waslikely gone by the time the spiceswere eaten. The agency alsonoted that the amount of spicegenerally eaten at a meal issmall, meaning people have lessof a chance of getting sick from acontaminated spice than acontaminated fruit or vegetable,for example.
Still, the agency has targetedspices because their route to adiner's plate is so circuitous andthe potential for contaminationcomes at many different points.Most all of the spices eaten in theUnited States are imported, and
most come from small farms in avariety of countries that havedifferent levels of food safetyoversight.
The report says spices areproduced by a wide variety ofagricultural practices, including"on very small farms where farmanimals are used to plow, cropsare harvested by hand, and spicesare dried in open air." All ofthese practices have potential foranimal, bird or humancontamination. Off the farm,spices from the small farms areoften combined, sold toexchanges or packingcompanies, or stored for years,increasing the chances that theyare temporarily in uncleancircumstances.
Michael Taylor, FDA's deputycommissioner for foods, says theagency is "not recommendingthat consumers stay away fromspices," though the chances ofsomeone getting sick can bereduced by adding spices to foodbefore it is cooked.
Taylor says that new food safetyrules that aim to make importedand domestic food safer on farmsand in processing facilitiesshould help reduce spicecontamination. Those rulesinclude regulations that willrequire food importers to betterunderstand where the food theybring into the country has been.
BEIJING: A 17-year-old girl inChina has received a pioneeringface transplant after doctors grewtissue grafted from her leg on herchest.
Xu Jianmei had the eight-hoursurgery in the city of Fuzhou, inFujian province, in the southeastof China, earlier on November.
The teenager was severelydisfigured in a fire when she wasjust five years old. She lost herchin, eyelids and a large part ofher right ear.
Xu's parents were unable toafford her plastic surgery, but lastyear, doctors proposed growing anew face on her chest usingtissue grafted from her leg, state-run Xinhua news agencyreported.
"First, we took a piece of bloodvessel fascia from her thigh andimplanted it in her chest. Thenwe inserted a skin expander
beneath the part of skin wherethe blood vessel fascia wasplanted, so that the part couldexpand and produce enough skinfor her new face," JiangChenghong, Xu's surgeon, said.
After making sure that the tissuemaking up a new face can bekept alive, it can be transplantedto the patient's face.
Doctors believe that the woundsleft by the surgery would healover the next several weeks.
"With her new face, she will beable to express herself in a moreprecise way. She will even beable to blush when her emotionschange but it may take a longtime," said Jiang.
A similar operation wasconducted by Chinese doctors inlate September, when a man inFujian received a new nose thatwas grown on his forehead usingtissue taken from his ribs.
Page 8 November 2013 www.GlobalHealthTribune.comAROUND TOWN
Halloween SoiréeSome of the top medical
professionals in Palm BeachCounty were barely recognizable at
the annual Halloween Soiree held at thehome of Drs. Arthur and Lori Hansen.The event draws such a large crowd everyyear and the costumes were justincredible. Thanks to Dr. Arthur and Lori Hansen,Dr. Raj Bansal, Dr. Urmila Mistry, andDr. and Mrs. Daniel Ghiragossian forhosting and putting together anotherenjoyable event.
Page 9November 2013www.GlobalHealthTribune.com
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Page 11November 2013www.GlobalHealthTribune.comONCOLOGY NEWS
NOVEMBER 2013
NOVEMBER 2013
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'One-Stop' Radiation Treatment MightOffer Breast Cancer Care Alternative
Some women with earlybreast cancer mightbenefit from a "one-and-done" treatment, in
which they receive a single doseof targeted radiation therapyduring the surgery that removestheir tumor.A pair of new studies found thatthis procedure works about aswell as current protocols thatrequire six weeks of dailyradiation therapy followingsurgery.The new procedure usesminiature devices that deliverradiation directly to the site ofthe tumor, while the site remainsexposed by surgery followinglumpectomy."It's right in front of thesurgeon's and the radiationoncologist's eyes, so we can putthe beam precisely where it isneeded," said study co-author Dr.Michael Baum, emeritusprofessor of surgery and aprincipal research associate at theUniversity College LondonMedical School. "We can formthe cavity to the shape of thebeam. It's elegant and deadsimple."The procedure also appears safer,in terms of radiation exposure.Fewer women who receivedtargeted therapy died duringBaum's study, an occurrence theychalked up to the patients' morelimited exposure to radiation.In Baum's trial, women receivedone dose of radiation therapy for20 to 45 minutes followingsurgery. About 15 percent of the
patients had tumor complicationsthat required them to return forthe standard weeks of radiationtherapy. However, radiationtreatment was completed for therest of the women, and withcancer recurrence ratescomparable to standardtreatment."You can say 80 percent or moreof these women will completetheir therapy at the time ofsurgery," Baum said.This therapy could prove anadvantage for women who live inremote areas without easy accessto a radiation therapy center,Baum said.He said these women often haveto undergo a full mastectomyeven if they are eligible forbreast-saving cancer surgery,simply because they can't make itto the follow-up radiationtherapy sessions that will preventtheir cancer from recurring."I think this will be a boon forAmerican women, even thoughyou are a wealthy country,"
Baum said. "Even for thewealthiest country in the world,there are many women living inrural areas who don't have theoption of traveling two or threehours a day back and forth to aradiotherapy center. This will cutdown on the number ofmastectomies."However, only certain womenwith early-stage breast cancerwill be able to benefit, noted Dr.Stephanie Bernik, chief ofsurgical oncology at Lenox HillHospital, in New York City.Women best suited for theprocedure are over age 45, willhave small, single tumors, andthe cancer will not have spreadto their lymph nodes, she said."In certain carefully selectedwomen you can do this, but itdoes not apply to all womenacross the board," Bernik said."We have to be careful not toapply this to every cancer patientwho comes through the door."Baum's study was publishedonline Nov. 11 in The Lancet.
Exercise May Help Breast CancerSurvivors Battle Bone LossAerobics and strength-trainingexercises may help reducebone loss and the risk offractures in breast cancersurvivors, a new studysuggests.Bone loss is a serious problemfor breast cancer survivors.Treatments such as aromataseinhibitors block the productionof estrogen, a hormone thatfuels the growth of manybreast cancers. Estrogen,however, is needed for boneformation.The researchers also saidchemotherapy can triggerearly menopause, resulting inlow estrogen levels and boneloss.This 12-month study includedbreast cancer survivors whohad recently completedtreatment. About half of themtook part in anaerobic/resistance exerciseprogram three times a week ata fitness center. The otherwomen were assigned to acontrol group and givenrecommendations of 30minutes of moderate-intensityexercise most days of theweek.By the end of the study, the
women in the intervention grouphad more physical endurance,greater muscle mass and lowerfat mass than those in the controlgroup, according to the study,which was presented Thursday atthe annual meeting of theAmerican Institute for CancerResearch, in Bethesda, Md.Research presented at meetingsshould be viewed as preliminaryuntil published in a peer-reviewed medical journal."Women who are completingcancer therapy should be gettinga strong prescription for healthpromotion, which includesaerobic-resistance exercise,"study author M. Tish Knobf, aprofessor at the Yale School ofMedicine, said in an institutenews release. "Routine exerciseimproves muscle strength,balance, quality of life, mood,functional ability andcardiovascular status, and mayminimize the risk of bone loss."Another study presented at thesame meeting found that manysurvivors of breast cancer andother cancers are at risk for lowlevels of vitamin D, and manywill need to take vitamin Dsupplements. The vitamin helpspromote bone health.
By Dennis ThompsonHealthDay Reporter
By HealthDay
Page 12 November 2013 www.GlobalHealthTribune.comAROUND TOWN
Palm BeachGastroenterologyConsultants, LLC
Call Us Today If You Suffer From Any Of The Following:
At Palm Beach Surgery Center we provide a safe and friendly environment, with a highly qualified and dedicated staff. A variety of procedures such as colonoscopy, endoscopy, gastroplications, ERCP, Liver Biopsy, 24 PH Monitoring/BRAVO can be done at our facility thus avoiding the need for hospitalization.
www.wellingtongastroenterology.com
WELLINGTON1157 South State Road 7Wellington, Florida 33414
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Digestive Diseases StatsDysphagiaGallstonesGastroesophagealJaundiceLactose IntoleranceLiver DiseaseNervous Stomach
Abdominal PainBleedingChest PainCirrhosis of the LiverColitisConstipationDiarrhea
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We are conducting a clinical researchstudy of an investigational medicine.If you meet the following criteria, youmay be interested in participating in this clinical trial.
• Age 18 – 79 inclusive• At least 28 stools over a 7-day period• Moderate to severe Pain in your abdomen associated with:
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Participants receive study related care, diagnostic tests, and study medication at no cost. Payment for time and travel to the study centermay be provided
For more information about the research study, please contact:
Congratulations to Dr.Jonathan Chung on thegrand opening of his new
state-of-the-art structuralchiropractic center located at 420South State Road 7, Suite, 170 inRoyal Palm Beach.
Keystone Chiropractic focuseson correcting the structure ofyour spine and not just providingpain relief.
Call 561-247-0044 for your freeconsultation today.
Grand Opening ofKeystone Chiropractic
Your Keystone Chiropractic team - Dr. Jonathan Chung and Brittany Dobbs
Adrienne Rieley, Dr. Shane Zack, and Dr. JonathanChung.
Dr. Chung reviews a structural chiropractic casestudy with Dr. Natalia Tsar
Dear Deborah is a monthly advice column written by Deborah Lynn witha common sense approach to dating. If you have any questions or
comments, please forward them to:[email protected] as we would love to help.
only have a baby shower for yourfirst child. However, times havechanged and certain things thatwere taboo in the past are nowacceptable.
DEAR DEBORAH:My husband recently lost his job.Even though I work part-time, ithas been a huge burden on ourfinances. He is too embarrassed totell our family and friends becauseof his massive ego. Without hisincome, there is no way that I canafford to buy our familiesChristmas presents this year. Theproblem is that I gave him myword that I would not tell anyone.Since we always exchange giftswith our families, I am not surehow to handle this situationwithout going back on my word tomy husband.- I Promised
Dear I Promised:First, I am very sorry to hear thatyour husband lost his job. A jobloss can put a huge strain on amarriage and you do not want toadd to that by going against hiswishes. Since you cannot afford topurchase gifts than why not makethem? You can either do this onyour own or call your familymembers and suggest that you allcreate items with your own handsthis year. Not only will thesehandmade gifts come from yourheart, but each item will be one-of-a-kind and cherished for a lifetime.
DEAR DEBORAH:I just scheduled a date with awoman I met online and our firstmeeting just so happens to fallon her birthday. Since we’veonly spoken a handful of times,do I need to buy her a birthdaygift?- Birthday Date
Dear Birthday Date: I do feel that you need toacknowledge her birthday andthat can be done in the form of abirthday card and/or flowers.It’s a sweet gesture and one thatshe will truly appreciate.
DEAR DEBORAH:My sister is having her thirdchild. She already has twochildren that are both in middleschool. This child was anunexpected surprise and she hadalready given all of her babystuff away. Would it beappropriate to have a babyshower and have her registeragain for all new items? - A Pleasant Surprise
Dear A Pleasant Surprise: Absolutely! There is nothingwrong with celebrating theupcoming birth of a second orthird child by having a babyshower for necessities. In thepast, people felt that you could
Dear Deborah
Page 13November 2013www.GlobalHealthTribune.com
Dr. Jonathan Chung is a Doctor of
Chiropractic who focuses on
Structural Correction and is
primarily concerned with Structural
Shifts of the spine. He graduated
from the University of Central
Florida with a B.S. in Microbiology
and Molecular Biology. Dr. Chung
then went on and received his
doctorate from Life University's
College of Chiropractic. Dr. Chung
is certified in pediatrics from the
International Chiropractic Pediatric
Association, and is a Structural
Chiropractic Researcher who has
been published in scientific peer-
reviewed journals.
HEALTHCARE NEWS
KEYSTONE CHIROPRACTIC
Keystone Chiropractic is focused on structural correction of the spine. We use state of the arttechnology and techniques to restore full function of the spine and nervous system to allow the
innate recuperative capacity of the body to work optimally.
Royal Palm Beachoffice now open!
KEYSTONE CHIROPRACTIC
420 State Road 7 Suite #170
Royal Palm Beach, FL 33411
Call Dr. Jonathan Chung at(561) 247-0044
CALL FOR A COMPLIMENTARY CONSULTATIONWhere a Consultation is a Conversation,
not a Commitmentmention this ad and receive a gift certificate
applicable to your structural exam
WHEN THE SPINE SHIFTS• Arm Pain• Carpal Tunnel (Wrist)• Canal Stenosis
• degenerated Joints• digestive disorders
• disc Herniation• dizziness (Vertigo)
• dowager’s Hump• Fatigue
• Fibromyalgia• Headaches• Hearing Issues• Itchiness• Low Back Pain
• mid Back Pain• migraine Headaches• muscle Spasm
• muscle Tension• Neck Pain
• Numbness/Tingling• Pinched Nerve
• Poor Posture• Rotator Cuff
• Shoulder Pain• Sinus Conditions• Spinal decay
• Strength Issues• Thoracic Outlet Syndrome
• TmJ Issues• Upper Back Pain
they think about what’s known as“Traditional Chiropractic”.Traditional chiropractors usemanipulations with a goal ofdecreasing pain, reducing spasm,and increasing range of motionusually after an accident or a fall.Most of them are good at whatthey do in providing relief painrelief.
A chiropractor that focuses onStructural Correction looks at thebody from an engineeringperspective. The human spine isa fantastic work of engineeringwhen all of the veretebrae are intheir proper place. However, thelife we live opens us up toaccidents, falls, sports injuries,and chronic sitting that placestremendous stress on ourstructure. When this happens, ashift in the head and neck canoccur and distort the body’snormal alignment.
Think of it like this: if your bodywas a house, your spine is yourfoundation. If your foundationwas built unevenly, you wouldexpect to see several problemsstart to happen in the house frombroken dry wall, to loose floorboards. In that way, we seesecondary conditions likeheadaches, back pain, discdegeneration, and paresthesia area result of long term structuralproblems. In order to truly fixthese problems, we can’t focuson the secondary problems, wehave to go in and fix thefoundation.
For many people, the foundationfor their Structural problemsactually starts in the head andneck. When the head and neckshift and lock out of place likefound in Atlas DisplacementComplex, then the shoulders andhips will actually shift out ofplace to compensate. Your wholebody will go where your headand neck go.
The main reason we even payattention to the mechanics ofthe spine is because it isintimately tied to the functionof the central nervous system.When your spine shifts, it leadsto signals being misfired intothe brainstem. When thebrainstem doesn’t workproperly, it’s like the electricalsystem of your house
malfunctioning. Nothing elseworks right.
How do we fix a StructuralProblem? First we have toidentify the problem. Achiropractor that focuses oncorrection should have tools likea precision X-ray frameincluding head clamps toreduce motion and filters toreduce radiation. You’ll also seescanning devices that helpmeasure the function of thecentral nervous system. And ofcourse, we use NUCCA Tablesthat are designed to bring acorrection to the spine ratherthan a manipulation to increasejoint motion to decrease pain.While this type of chiropracticisn’t for everyone, it’s great forpeople who are looking toachieve lasting results instead ofa temporary patch to pain.
By Jonathan Chung, DC
Whenever Iintroduce myselfas a chiropractorthat focuses on
Structural Correction, mostpeople are curious to learn thatthere are different kinds ofchiropractic care. When mostpeople think about chiropractic,
What is Structural Chiropractic?
Page 14 November 2013 www.GlobalHealthTribune.comHEALTHCARE NEWS
What is Select Specialty Hospital?By Mike Corvaia
When people askme, what is SelectSpecialty Hospital,my response is
always the same. SelectSpecialty Hospital is the mostunique hospital in all of PalmBeach County.
How so, you might ask?
First off, Select SpecialtyHospital provides acute care likeany other major hospital in thearea, but the key difference is thatSelect Specialty does not have anemergency room. We often seepatients who have been admittedthough an ER and have beenstabilized, yet who are not readyto be discharged from acute care.The vast majority of our patientsare referred to us directly fromthe intensive care unit or ICU.Select Specialty Hospital is not ashort term acute care hospital, orSTACH, even though ourlicensure is the same. Instead, weare considered a long term acutecare hospital or LTACH. Inessence, we see the same patientsthat require acute care but we aredesigned to treat those medicallycomplex patients for a few weeksrather than a few days.
So, you’re like a rehabhospital?
No, we are not a rehab hospital,but we do provide extensiverehab with a full staff ofphysical, occupational, andspeech therapy specialists whichare available to every patient.
Well, then you’re like a skillednursing facility, right?
We are actually much more thanthat. Physicians and casemanagers alike are continuallyimpressed with the varyinglevels of acuity we handle here atour facilities. Select SpecialtyHospital is an acute carehospital, and any patientrequiring critical care nursing,intensive respiratory services,and rehabilitation therapy wouldbenefit greatly from our hospital.
A typical patient at SelectSpecialty is one who requiresacute medical care for theirdisease or illness, and who is notmedically stable enough to allowtransfer to a lower level of care,such as a skilled nursing facility,rehab hospital, nursing home, orin-home care.
Make no mistake, our goal at
Select Specialty is to get you oryour loved one to your desireddestination: a stable, healthierlevel of care. We help to fulfillthat goal in a clean, safeenvironment that is fully staffedwith professional healthcareproviders at every level. AtSelect Specialty, we only employhighly trained critical careRegistered Nurses. Our nurse topatient ratio is better than what isoffered at most hospitals and atevery level of lower care such asa skilled nursing facility orrehab, where the ratio is 1:15 ormore. Our ICU is staffed with a2:1 ratio for the sickest patient(s)we admit to our hospital. Wehave physicians in our facilityaround the clock. Respiratorytherapy is available 24 hours of
every day, and pharmacists arepresent seven days a week. Ourstaff features specialistphysicians available for consult,whose areas of medicine includepulmonary, nephrology,cardiology and infectiousdisease, ear-nose and throat,neurology, internal medicine, andpain management. Our staff alsoincludes general and traumasurgeons, as well as a designatedwound care team. In addition tothe more than 150 physicians onstaff at Select Specialty, we alsooffer CT scan, a full rehab gym,an operating room fortracheostomy placement,percutaneous endoscopicgastrostomy or (PEG) placement,complex wound caredebridement and skin grafts to
name just a few procedures, aswell as an intensive care unit.
We encourage you to tour ourfacilities in person, so feel free tocome by for a visit. We arecentrally located in Lake Worth,just minutes from Palms West,St. Mary’s, Palm Beach Gardens,West Palm, and Delray, to namejust a few hospitals within milesof us. Or, if you’d prefer to seeus right now, log on toselectmedical.com, click thelocation icon and type in “LakeWorth, FL” to take a virtual tourof our hospital.
We hope that you and your lovedones won’t require a stay withinany hospital, but should youneed specialized acute care, weat Select Specialty would like toreassure you that we are ahospital with a proven record ofexceptional patient outcomes,with a family of physicians andhealthcare professionals thatgenuinely care about yourwellbeing.
Select Specialty Hospital of Palm Beach
3060 Melaleuca Lane, Lake Worth, FL
561-357-7200 (Main line)www.selectmedical.com
Page 15November 2013www.GlobalHealthTribune.comAROUND TOWN
Advanced Medical, P.A.Internal Medicine & Family Practice
“If you ever need to be hospitalized, we will be with you from the office to the hospital and at your bedside”.
Palomino Park III • 3347 State Road 7 Suite 206 • Wellington, FL 33449
Phone: 561.434.1935 • Fax: 561.434.3169
Ishan Gunawardene, MDDiplomate of American Board
of Internal Medicine
Chief, Dept of Medicine Wellington Regional Medical Center
Heart / Chest Pain
Breathing Problems
Well Woman Check-ups
Pain Control
Over Weight
Blood Drawing
EKG / Echo Blood Pressure
Blood Sugar
Se Habla Español
Can Dizziness Be a Sign of a Stroke?By Ishan Gunawardene, M.D.
Dizziness can be such afrustrating symptom for manypatients and one of the mostcommon reasons why elderly
adults visit their physician. Dizziness is awidely used term which can describeeverything from feeling a bit faint orlightheaded to feeling unsteady.
Since it is more prevalent in the elderly,this sensation can lead to a greater risk ofloss of balance, falling, back and hipfractures, as well as many other injuries.More than 30% of people over the age of65 will experience that dizzy sensation,while people over 85 have an even higherrate at over 50%. Although generallycaused by a benign inner orcardiovascular disorder, it may beassociated with lifetime consequences,such as stroke and death.
Dizziness is a term that is used to describea feeling or sensation and is classified intofour categories; vertigo, presyncope,disequilibrium, or lightheadedness.
Vertigo is often described as a falsesensation of which you or yoursurroundings are spinning or moving.This exaggerated motion can last from afew seconds to much longer and can occurfrom a sudden change in your bodyposition, such as quickly bending over(benign positional vertigo). Your innerear which is part of the vestibular systemdetects the imbalance which is processedby the brainstem. There are two types ofVertigo:
Peripheral vertigo involves the part ofyour inner ear that controls balance. Thistype includes benign paroxysmalpositional vertigo (BPPV), Cogan’ssyndrome, Meniere disease, Ototoxicity,and vestibular neuritis.
Central vertigo is due to a problem withinthe brain and generally in the brainstem orthe back part of the brain (cerebellum).
Presyncope refers to a feeling ofimpending faint or loss of consciousness.
Disequilibrium refers to an imbalanceand postural instability or unsteadiness.
Lightheadedness is when you feel thatyou are about to faint or pass-out. Ifdizzy, this feeling often improves whenyou lie down.
There are so many things that can triggerthat dizzy feeling and far too many to listhere. However, they can be as simple as asudden movement, alcohol consumption,low blood pressure, an inner ear infection,certain activities, medications, low bloodsugar or iron, dehydration, to a number ofdiseases.
Ultimately, your physician will obtain atotal medical history and perform acomplete physical examination of whichare both effective in arriving at the properdiagnosis. There are also other tools thatcan be utilized in order to help yourphysician determine the cause of yourdizziness.
If however you start to experience any ofthe following; slurred speech, weaknesson one side of your body, numbness,double vision, or a decreased sense ofconsciousness, seek medical attentionimmediately as most of these can betreated if given prompt attention.
Your brain is a very powerful organ andeven though your brainstem is only a half-inch in diameter, it does control all thebasic activities of your central nervoussystem. Those include yourconsciousness, blood pressure, breathing,and all of your motor control skills. Whenyour brain begins to speak to you in theform of symptoms, you need to listen.
Diabetes Greatly Raises YoungerWomen's Heart Risk: Study
Women under 60 typically havelower heart risks than theirmale peers but diabetes can
change all that, a new study finds.The research showed that women youngerthan 60 who had diabetes were up to fourtimes more likely to develop coronaryheart disease than those without diabetes,putting them at the same risk level as men."We need to work harder to prevent heartdisease in women under 60 who havediabetes," study author Dr. Rita RastogiKalyani, an endocrinologist at the JohnsHopkins University School of Medicine,said in a Hopkins news release.Another expert agreed. "Women less than60 years old with diabetes need to beaggressively screened for heart disease,and prevention is crucial," said Dr.Suzanne Steinbaum, director of women
and heart disease at Lenox Hill Hospital inNew York City. "In this group, perhaps therecommendations of diet and exercise and'watch and wait' is not the best way tomanage the patient," she said.Instead, doctors should make sure that"targets for cholesterol and blood pressureare met with medication [and] lifestyleintervention, as soon as the diagnosis ismade," said Steinbaum.In the study, Kalyani's team analyzed datafrom more than 10,000 Americans whotook part in three large studies. None ofthe participants had a history of heartdisease when they enrolled in the studies.In contrast to the findings for women,diabetes had little or no effect on men'srisk of heart disease, according to thestudy, which was published recently in thejournal Diabetes Care.
Upcoming Medical and Fundraising EventsNovember 10 – December 10, 2013
November 15Epilepsy Foundation of Florida. PalmBeach Zoo, West Palm Beach. Theevent beings at 6:30pm and cost $20.00per adult and $10.00 per child. Foradditional information, contact 561-478-6515.
November 15 – 17Chris Evert & Raymond James ProCelebrity Tennis Classic. DelrayBeach Stadium and Tennis Club, DelrayBeach. Visit the website for a completelisting of events, www.chrisevert.org.
November 16Leukemia & Lymphoma Society’sLight the Night Walk. Sunset CoveAmphitheater, Boca Raton. Visitwww.lightthenight.org to find out howyou can participate.
November 23St. Jude Give thanks. Walk. JohnPrince Park, Lake Worth. Check-inbegins at 8:00am and the walk at9:00am. For additional information, call305-265-1371 or visithttp://fundraising.stjude.org/site/PageServer?pagename=walk_home
Jewels and Jeans 2013 Annual BBQDinner, Casino and Auction. BeachClub, Palm Beach. Event begins at6:00pm and the cost is $175.00 a ticket.For additional information, contact 561-842-3213.
November 25CROS Ministries. End Hunger in PalmBeach. Doing It Green (DIG), DelrayBeach. The cost for the buffet is $35.00and proceeds help to eradicate hunger inPalm Beach County. For additionalinformation, contact 561-233-9009 orwww.crosministries.org.
November 29Paradise Fund: Sixth Annual ParadiseCasino. Flagler Museum, Palm Beach.All ages welcome and proceeds benefitthe Paradise Fund Children’s Relief Fund.For additional information, contact 561-801-0767 or visitwww.paradisefund.com.
December 7Neil S. Hirsch Family Boys & GirlsClub f Wellington. 26TH AnnualWellington Dinner Dance. Wycliffe Golf& Country Club, Wellington. The cost is$225.00 per ticket. For additionalinformation, contact Kevin Murray at561-683-3287 or email [email protected]. You can alsovisit their website at www.bgcpbc.org.
Jewish Adoption and Foster CareOptions (JAFCO). 15th Annual HeroesGala. The Polo Club, Boca Raton. Thecost is $300.00 per ticket and the fundsraised will benefit abused, neglected andspecial needs children. For additionalinformation, contact 561-372-0103.
PCPACOACCOUNTABLE CARE ORGANIZATION
(561) 537-48043347 State Road 7
Suite 206 Wellington, FL 33449
You Are Personally invited to Join a Primary Care Physician-owned and PCP driven ACO, where each member will be an equal owner.
Join this fast growing ACO and take this unique opportunity to be an integral part of the future of healthcare.
We are a 100% transparent and fully primary care physician-owned ACO
BY PRIMARY CARE PHYSICIANSFOR PRIMARY CARE PHYSICIANS
PCP Accountable Care Organization
An All Primary / Internal Medicine ACO
We can help you diagnose successful
strategies to navigate your road to increased revenue.
Coordinated Care ManagementCare
ManagementCost
QualityMetrics
Alignment ofCare
InformationStreamlining
MonitorPatient CareDeficiencies
MedicareEvidence Based
Guidelines
ImprovedPatient
OutcomesReduce HospitalReadmissions