30 March 2012

Supreme Court Justices Meet to Vote on Health Care

WASHINGTON (AP) — While the rest of us have to wait until June, the justices of the Supreme Court will know the likely outcome of the historic health care case by the time they go home this weekend.

After months of anticipation, thousands of pages of briefs and more than six hours of arguments, the justices will vote on the fate of the President's health care overhaul in under an hour Friday morning. They will meet in a wood-paneled conference room on the court's main floor. No one else will be present.

In the weeks after this meeting, individual votes can change. Even who wins can change, as the justices read each other's draft opinions and dissents.

But Friday's vote, which each justice probably will record and many will keep for posterity, will be followed soon after by the assignment of a single justice to write a majority opinion, or in a case this complex, perhaps two or more justices to tackle different issues. That's where the hard work begins, with the clock ticking toward the end of the court's work in early summer.

The Friday conference also is not a debate, there will be plenty of time for the back-and-forth in dueling opinions that could follow.

It will be the first time the justices gather as a group to discuss the case. Even they do not always know what the others are thinking when they enter the conference room adjacent to the Chief Justice's office.

By custom, they shake hands. Then the Chief Justice will take his seat at the head of a rectangular table. The longest serving judge among them, will be at the other end. The other seven justices also sit according to seniority, the four most junior on one side across from the other three.

No one's vote counts more than the others', but because they speak in order of seniority, it will become clear fairly quickly what will become of the health care overhaul.

That's because the Chief Justice speaks first, followed by the next two most senior judges. If the three men hold a common view, the health care overhaul probably is history. If they don't, it probably survives.

If the Chief Justice is in the majority, he will assign the main opinion, and in a case of this importance, he may well write it himself, several former law clerks said. If the Chief Justice is a dissenter, the senior justice in the majority assigns the opinion.

The court won't issue its ruling in a case until drafts of majority opinions and any dissents have circulated among the justices, changes have been suggested and either accepted or rejected.

No one will know precisely when decisions on particular cases will be coming, until perhaps the Chief Justice ends a court session in late June by announcing the next meeting will be the last until October. Then it's a safe bet that whatever hasn't been decided will be on the last day. And decisions in the biggest cases very often aren't announced until that last day of the term.

Supreme Court opinions rarely find their way to the public before they are read in the marble courtroom, although the court inadvertently posted opinions and orders on its website about a half hour too soon in December.

The last apparent security breach occurred more than 30 years ago when a reporter for ABC News, informed viewers that the court planned to issue a particular opinion the following day. The Chief Justice accused an employee in the printing shop of tipping the reporter and had the employee transferred to a different job.

Sometimes, though, the justices themselves manage to let people know something big is coming.

On May 17, 1954, the attorney general, secretary of state and Nina Warren, wife of the chief justice, were in the courtroom when Earl Warren read the historic, unanimous opinion in Brown v. Board of Education outlawing school segregation.

29 March 2012

Cases of Cancers Linked With Obesity Increase

Story first appeared in the Wall Street Journal.
Several cancers linked to obesity and a sedentary lifestyle rose every year from 1999 through 2008, even as improved screening and a sharp decline in the number of smokers have helped push down the rate of new cancer diagnoses overall across the U.S., according to a report released Wednesday.
Rates of cancers of the kidney, pancreas, lower esophagus and uterus increased annually through 2008, the latest data available, according to the Annual Report to the Nation on the Status of Cancer. Rates of breast cancer in women at least 50 years old declined 1.3% annually from 1999 to 2005 but rose slightly between 2005 and 2008.
The data add to a growing body of evidence that obesity raises the risk of these and some other cancers. As many as one-third of common cancers in industrialized nations are linked to excess weight and lack of physical activity, according to the International Agency for Research on Cancer. Obesity rates leveled off in the U.S. a decade ago, but an estimated 68.8% of adults remain overweight or obese, according to the CDC, and cancers can take years to develop.
Obesity-related cancers include common ones, such as breast and colorectal cancer, as well as less common ones, such as pancreatic cancer. Excess weight can also decrease the chance of survival once a patient is diagnosed.
The report, published online Wednesday in the journal Cancer, is by researchers from the CDC, the North American Association of Central Cancer Registries, the National Cancer Institute, and the American Cancer Society.
The evidence of a causal link with cancer, while not yet definitive, is far clearer with excess weight and lack of physical activity than with specific foods or nutrients.
The rising rates contrast with the progress made in recent years against major killers such as lung cancer, scientists say. While tobacco use has plummeted since the 1960s, obesity rates have soared.
Overall, rates of new cancer diagnosis have been declining slightly since the mid-1990s. They fell 0.6% annually among men between 1998 and 2008. But the declines aren't uniform. Among women, rates fell 0.5% annually between 1998 and 2006 and then leveled off between 2006 and 2008.
A review of more than 7,000 studies found evidence of a link between excess weight and several cancers, according to the report. While the precise link isn't understood, fat cells can encourage the body to produce more substances such as insulin or hormones that can stimulate tumor growth, scientists say. Obese postmenopausal women may have higher levels of free estrogens and androgens, a risk factor for breast, ovarian and uterine cancers. Adenocarcinoma, in the lower esophagus, develops mostly in people who suffer from chronic stomach-acid reflux, often triggered by excess weight.
Not all of the obesity-related cancers are on the rise. Rates of colorectal cancer declined 2.6% yearly between 1999 and 2008, thanks in large part to widespread screening.  Whether the rise in obesity-related cancers will continue is unknown.

28 March 2012

Virginia Man Gets A New Face In Baltimore

Story first appeared in The Baltimore Sun.

When the patient opened his eyes after a marathon 36-hour surgery to give him a new face, he immediately wanted a mirror.

A natural reaction for a man who had been practically living as a recluse since a 1997 gun accident took off his nose, chin, lips and teeth, said doctors from the University of Maryland who had just performed the world's most extensive face transplant on the 37-year-old from Hillsville, Va.

There were up to 150 doctors, nurses and other professionals from the Maryland medical system who had a direct hand in caring for the patient.  So many hands in the surgery does leave room for possible error, which could lead to a Baltimore Medical Malpractice Lawyer stepping in.
Just six days after his surgery, he was saying some words, shaving and brushing his teeth. He's also beginning to get some feeling back in his face.

The patient received donor skin from his scalp to his neck, as well as a new jaw, teeth, tongue and the underlying muscle and tissue. In addition to matching his blood type, doctors had to match his skin color and bone structure to a donor.

Unemployed and living with his parents before he came to Maryland in 2005, the patient had undergone a dozen surgeries, but none that could restore him to functioning membership in society.

Maryland had been working for the past decade on face transplant methods, improving the way tissue, muscle, skin and bone are woven onto a recipient and increasing the odds of acceptance by a recipient.

The Department of Defense's Office of Naval Research funded the work with eight grants totaling $13 million. It supports research that could aid returning service members injured by explosives. At some point, injured veterans could undergo transplants at Maryland.

The hospital provided no details about the gun accident, but during Tuesday's news conference at Maryland, doctors and university officials recounted the patient’s transformation through a series of photos.

Doctors showed before and after pictures that included a photo from his high school prom; a post-injury photo where he appeared to have no chin and a mangled nose; and a post-surgery photo that made him appear close to normal, if swollen, after surgery.

The patient’s facial features appear to be a blend of his own and those of his donor, whose family he has not met.  The donor was not named by the Living Legacy Foundation of Maryland, which works in the state to supply recipients with needed organs. The same donor provided five life-saving organs to five other recipients, four of whom also had surgeries at Maryland.

Drivers who check "organ donor "on their licenses do not consent to face transplants. A family must give special permission.

Around the world, 22 people have received face transplants since the first was performed in France seven years ago. While Maryland is a large transplant center, this was its first face transplant.

Doctors there have been working to perfect the protocol to prevent rejection of any transplant.  Normally, patients are given a daily three-drug cocktail for the rest of their lives to keep them from rejecting their transplants.

Starting five years ago, the center's doctors began using two drugs for many kidney and pancreas transplant patients and they're trying them on the patient, the first time for a face-transplant patient, surgeons said. The drugs suppress the immune system and make a patient more vulnerable to infection, so a smaller amount can reduce that side effect. Eventually, doctors hope to reduce the dosage of the two drugs.

Doctors felt confident using the new drug regimen on the patient after years of lab work at Maryland.  The research supported the change as long as they also transplanted high amounts of "vascularized" bone marrow, which came inside the jaw transplanted into his face. The bones and attached vessels give the marrow a ready place to live and steady supply of blood, and that seems to offer some continuous protection from rejection, though researchers aren't entirely sure why.

27 March 2012

Massachusetts Law Didn't Hurt Businesses After All

Story first appeared in the Detroit Free Press.

Massachusetts was a forerunner to the federal government's health care overhaul, adopting comprehensive changes that took effect in 2007, three years before the Affordable Care Act.

The state law did not hurt businesses as many feared, according to a recent report from the state. It is conducted annually by the Blue Cross Blue Shield of Massachusetts Foundation.

Some highlights:

* Employers keep coverage: Some 91% of Massachusetts workers are employed by firms with health coverage, a figure that has held steady since 2006.

* Workers like their health plans: More than seven of every 10 workers rated their health plans as very good or excellent, and rated both the quality of their care and satisfaction with it higher than in pre-revision years.

* Small businesses are not hurt by public plans: Employer-sponsored coverage remains steady at small businesses, with more than 70% retaining coverage for employees between 2006 and 2010.

* Premiums are rising: Monthly insurance premiums for people with workplace coverage continue to rise in Massachusetts at rates higher than those nationwide. That's partly because the state did not have as many cost-savings programs as the new federal law requires, according to health policy experts. Federal health officials hope to achieve many savings by restructuring the federal Medicare program into a high-quality, cost-saving plan, an option Massachusetts does not have.

By 2009, the average annual employee contribution to premiums for Massachusetts plans was $1,321 for an individual and $4,088 for a family, compared with $957 for a single person and $3,474 for a family nationwide, according to the foundation's report.

Out-of-pocket costs also have risen in Massachusetts, with 3% to 4% of workers enrolled in high-deductibles plans in 2011, compared with 1% in 2006.

Overall it's hard to determine how much of the increases are because of Massachusetts state law alone, or whether it is part of a larger national trend toward growing out-of-pocket costs for consumers and workers.

05 March 2012

Stylist Advice for Scalp: Common Scalp Conditions and Treatment Suggestions

First appeared in Huffington Post
As a hairstylist, I see a lot of scalps. It's usually the first thing I inspect during a consultation. I've learned over the years that most people pay very little attention to their scalp. It's usually hiding under their hair and not a concern until they experience symptoms. Scalp conditions vary from simple (like dry, flaky scalp or scalp acne) to serious (an irregular mole, a rash). A Ringworm Cure is also available. Here are a few scalp problems I have come across:

Dry Scalp feels tight and dry combined with tiny white flakes you may notice on top of the head, around the hairline and on the back of the neck. The usual cause is dry winter weather, or a possible summer sunburn. Try shampoos and conditioners that are dry-scalp specific. Always use warm to cool water and rinse well. Hot water and residue of products left behind promote dry flaking. Use minimal heat when styling, and always wear a cap in the sun to prevent sunburn.

Dandruff is excessive rapid buildup of dead skin flaking and shedding from the scalp. You may experience redness, itching and oily larger scale flaking. It's not dangerous or contagious -- just annoying. You might try dandruff shampoos containing zinc (such as Head and Shoulders), coal tar (T/Gel) or selenium sulfide (Selsun Blue). Always consult a physician if your dandruff doesn't clear up after a few shampoos. There are several options to Stop Dandruff available.

Seborrheic Dermatitis looks and feels like an advanced version of typical dandruff. You'll likely experience redness and itching, with larger areas of thick crusty white/yellowish oily flaking and possible hair loss. I highly suggest treatment by a dermatologist. A daily at-home treatment of a five-minute scalp massage to loosen skin followed by an over-the-counter medicated shampoo containing resorcin, selenium, salicylic acid, coal tar or zinc can be helpful, in my experience. Always remember to rinse well and use clean brushes and combs to prevent infection.

Psoriasis is often itchy, dry and painful. It can be identified by red patches of raised thick, dry silvery-pinkish scales of dead, dry skin. Your doctor can easily diagnose and prescribe treatments in the form of lotions, creams and shampoos, and sometimes prescribe pills, injections and phototherapy. In my experience, organic topical oils such as Argon oil and coconut oil can help ease the symptoms and provide comfort to an itchy scalp. There are several methods for Psoriasis Treatment.

Moles can be very dangerous. I always observe and report moles that appear to grow in size, change in color, itch, feel rough in texture or bleed. They may need to be removed, so I also advise any client with a mole to seek the consultation of a dermatologist.

Staph infection may result from head trauma or a simple scratch to the scalp. Staph can be contagious and if not handled promptly and specifically treated, can cause organ failure or death. Pay attention to unusual itching, pain or tenderness, lumps, lesions or nodules that are tender, painful, scabby or oozing with pussy liquid. Address these symptoms with your doctor immediately.

Treatment usually consists of antibiotics given orally, topically or through an IV. Use a medicated shampoo such as Hibiclens in addition to a few drops of tea tree oil at the site several times per day. Be extra hygienic by repeatedly washing your hands so as not to reinfect the area. As a precautionary measure, throw out old hair brushes, combs and styling tools.

Scalp Ringworm (tinea capitis) is a common fungal infection of the scalp and hair that appears as scaly spots and patches of broken hair on the head in circular patterns. Scalp Ringworm is most commonly seen in children and treated by a physician with anti-fungals in pill form accompanied by anti-fungal shampoos and creams. It is also contagious and transferred through infected objects. So wash hands consistently, and throw out anything that may have been contaminated. Ringworm Treatment for Humans is possible.

Never hesitate to ask your hair stylist to routinely inspect your scalp. It may serve you well to check your scalp regularly -- and an early diagnosis could end up saving your life.

700 Neglected Cats Part of Massive Operation

First appeared in Tampa Bay Times
Inside a trailer, cats cringed and yowled in crates stacked four high.

A Tampa woman hunkered on Thursday over a squirmy brown cat with bright blue eyes and dirty white paws.

"It's all right, bubba," Lori Piper said, stroking the cat's head. "Shh. Shh. Shh."

A vet from Naples listened to Blue Eyes' heart. Discovered missing teeth and a skin rash on her back. Shaved a small patch of fur and stuck her with a needle for a blood sample. Her hands explored the cat's abdomen.

"This one's possibly pregnant," she said.

This is a rescue operation of a rescue operation.

For the past four days, the American Society for the Prevention of Cruelty to Animals has plucked nearly 700 cats from a Madison County pine forest where a man named Craig Grant lived and ran a sanctuary. It is the largest cat rescue ever undertaken by the ASPCA. Caboodle Ranch was shut down Monday following a five-month undercover investigation by People for the Ethical Treatment of Animals. 

The cats, with more coming every day, are being housed in an abandoned warehouse west of Jacksonville. They are divided into isolation units based on their medical problems. Cats with ringworm, feline AIDS and leukemia in one area. Cats with upper respiratory ailments and eye infections in another. Feral cats in yet another. A Ringworm Treatment for Cats is essential.

One hundred and twenty-five volunteers and veterinarians are working round-the-clock to treat animals that had for years depended on Grant, and an occasional helper, for their sustenance and care.

By Thursday, dozens of cats still waited in staging areas to see teams of veterinarians inside the triage trailer.

Lori Piper looked at the vet and turned to the rows of cats waiting to be treated:

"Tell me when you are ready for the next one," she said.

• • •

Caboodle Ranch opened about eight years ago after Grant bought property and started accepting cats at his "no-kill sanctuary" in the woods.

In an interview last year with the Times, he acknowledged his affinity for cats grew at a time when he was lonely. His son had moved out and gotten married. He started with 11 cats. Soon property managers were paying him $30 to remove cats. His unusual setup in the woods, featuring a small cat village with a post office, a town hall and a Walmart, attracted national attention. Inside Edition, The Colbert Report and Animal Planet featured him. Donations trickled in. He told the Times he received $150,000 in 2010 alone.  He wasn’t interested in How to Get Rid of Ringworm in Cats.

People from all over the country brought him their cats for a fee. But combining hundreds of felines on 5 acres in the woods resulted in many of them getting sick.

Five months ago, an undercover PETA investigator volunteered at Caboodle Ranch. She took video of cats with swollen eyes that could barely breathe or lift their heads. According to PETA, the helper volunteered to take some of the sick animals to the vet, but Grant refused. PETA helps with Ringworm Treatment for Dogs as well.

Grant was arrested Monday and charged with animal cruelty and scheming to defraud. His bond was set at $250,000.

In a statement he posted on his website this week, he said he was out on bail but not being allowed back on his property.

"I feel very sick and in a daze right now. My happiness, my life and the lives of my 600 babies are being destroyed."

He claimed all the cats in photos and video taken by PETA were being treated.

"I either take them to the vets or call to describe symptoms and am told what to do," he wrote. "I do not have the heart to put cats to sleep … I feel my heart does most of their healing. Night after night I am in the sick ward and work until I can't stand up anymore. Sometimes grabbing a roll of paper towels for a pillow to sleep on the floor with them at the end of the day."

• • •

Inside the "dipping room" where the cats are taken after they've seen a vet, an orange tabby decided it had had enough. The cat backed into the corner of its crate and hissed.

Francisca Rapier, an animal protection investigator from Spokane, Wash., tried to grab the cat with a white towel, but it twisted out of her hands. Connie Brooks, who once ran the Tampa Bay SPCA and is now president of the Bay Area Disaster Animal Response Team, grabbed a net.

The cat caught its mouth on its collar and started tumbling around the cage, hissing wildly. Rapier got her by the scruff and pulled her out, took the cat over to a big gray tub of yellow liquid.

"She's all right," Brooks said, as Rapier and two others dipped the cat into the tub of lime solution, which kills ringworm. Droplets of yellow liquid was splattered up and down their arms.  This is also a way to Get Rid of Ringworm in Dogs.

Jenn Miler-Most from Pinellas Park, who runs her own organizing business, approached the next cat, a short-hair gray.

"You're going to love it," she said. "You're going to feel like a new woman."

• • •

In front of a row of outdoor kennels, Tim Rickey, senior director of field investigations and response for the ASPCA, stood by as volunteers assembled more cages donated by PetSmart Charities.

"Almost all the cats have some type of upper respiratory (illness)," he said.

One had to be euthanized. Some had to go to emergency vet clinics for treatment. Though some appeared to be recovering, many huddled in their cages, wheezing and listless. A dark mottled cat cried loudly above the others. An orange cat with mucus dripping from its nose sneezed over and over.

The animals will stay at the Jacksonville facility until either Grant agrees to relinquish them or they are awarded to the ASPCA, a process that could take up to 60 days. Hopefully none of them needing more Ringworm Treatment.

For now, the cats are evidence. Once they are healthy, they will be put up for adoption.

As Rickey spoke, he got a phone call. "I have to take this," he said.

Then he was on the phone, planning ASPCA's next operation: to help animals stranded by the deadly tornadoes in the Midwest. This has been a lesson for them all in Ringworm Treatment for Pets.