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Internal Medicine

Consistent poverty linked to higher mortality rates – Healio

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Poverty should be considered a major risk factor for death in the United States, according to the results of research published in JAMA Internal Medicine.

The United States consistently has a poverty rate much higher than similarly wealthy countries, which presents an enormous challenge to population health, given that considerable research demonstrates that being in poverty is bad for ones health, David Brady, PhD, a professor of public policy at University of California, Riverside, and colleagues wrote.

Although previous research has offered valuable contributions on income and mortality, the researchers wrote that the quantity of mortality connected with U.S. poverty is unknown. So, they conducted a cohort study to estimate the associations between mortality and poverty and quantify the proportion of deaths linked to poverty.

Brady and colleagues evaluated the Panel Study of Income Dynamics 1997 to 2019 data merged with the Cross-National Equivalent File, ultimately including 18,995 respondents aged 15 years or older. The survey observed mortality from surviving family members and validated with the National Death Index. When it came to measuring socioeconomic status, the higher quality household income measure included all income sources and taxes and was adjusted for household size.

Brady and colleagues found that poverty was linked to a greater mortality hazard of 1.42 (95% CI, 1.26-1.6). Consistently being in poverty referred to as cumulative poverty was linked to a greater mortality hazard of 1.71 (95% CI, 1.45-2.02).

Current poverty was associated with 6.5% of deaths (95% CI, 4.1-9) among those aged 15 years or older in 2019. Among that same demographic, cumulative poverty was linked to 10.5% of deaths (95% CI, 6.9-14.4).

Current poverty was connected to higher mortality than major causes like stroke, accidents and lower respiratory diseases, according to the researchers. It was also linked to higher mortality than far more visible causes, they wrote. For instance, current poverty mortality was responsible for 2.6 times as many deaths as drug overdose, 3.9 times as many deaths as suicide, 4.7 times as many deaths as firearms and 10 times as many homicides.

However, cumulative poverty was linked to approximately 60% greater mortality than current poverty and higher mortality than obesity and dementia. The researchers wrote that the only causes or risks with greater mortality than cumulative poverty were cancer, smoking and heart disease.

Because the U.S. consistently has high poverty rates, these estimates can contribute to understanding why the U.S. has comparatively lower life expectancy, Brady and colleagues wrote. Because certain ethnic and racial minority groups are far more likely to be in poverty, our estimates can improve understanding of ethnic and racial inequalities in life expectancy.

Brady and colleagues additionally noted that disparities in survival between those in poverty and those not in poverty begin to emerge at around 40 years of age. The gap peaks around 70 years of age, they wrote, and then begins to converge again.

The mortality associated with poverty is also associated with enormous economic costs, the researchers wrote. Therefore, benefit-cost calculations of poverty-reducing social policies should incorporate the benefits of lower mortality.

Brady and colleagues also noted that poverty likely aggravated the mortality impact of COVID-19, which occurred after our analyses ended in 2019.

Therefore, one limitation of this study is that our estimates may be conservative about the number of deaths associated with poverty, they wrote. Ultimately, we propose that poverty should be considered a major risk factor for death in the U.S.

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Consistent poverty linked to higher mortality rates - Healio

Internal Medicine

Poor performance in non-lame Standardbreds often involves several … – Horsetalk

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Poor performance in Standardbred racehorses without lameness issues often involves multiple problems, researchers in Italy report.

Chiara Lo Feudo and her fellow researchers, writing in the Journal of Veterinary Internal Medicine, said poor performance is a common and complex condition of racehorses, usually associated with subclinical disorders.

In addition to musculoskeletal conditions, medical disorders are common, and their identification can be challenging for veterinarians.

In fact, poorly performing horses are mostly normal on physical examination, and the identification of underlying medical diseases often requires dynamic tests. Multiple disorders can affect horses at the same time, and it can be difficult to determine the contribution of each to impaired racing performance.

The study team, with the University of Milan, set out to describe the prevalence and distribution of medical disorders diagnosed in a population of poorly performing Standardbred trotters and their associations with fitness variables measured during a standardized treadmill test.

In addition, the associations between simultaneously encountered diseases was evaluated, and the contribution of each disorder on changes in fitness-related variables in a multifactorial setting was determined.

The medical records of Standardbred trotters referred for poor performance to the Equine Sports Medicine Unit of the Veterinary Teaching Hospital at the University of Milan between 2002 and 2021 were reviewed.

All of the 259 non-lame horses identified were in full training upon admission. The age of the horses varied from 2 to 9years. They were made up of 93 females, 146 stallions and 20 geldings.

All underwent a standard diagnostic evaluation for poor performance, with identification of subclinical causes.

The diagnostic protocol included a resting examination, plasma lactate concentration, a treadmill test with continuous heart monitoring and assessment of fitness variables, creatine kinase activity, a treadmill endoscopy, postexercise tracheobronchoscopy, bronchoalveolar lavage, and gastroscopy.

The prevalence of different disorders was evaluated, including cardiac arrhythmias, exertional myopathies, dynamic upper airway obstructions, exercise-induced pulmonary hemorrhage (bleeding from the lungs), moderate equine asthma and gastric ulcers.

Moderate equine asthma and gastric ulcers were the most common disorders identified, followed by bleeding from the lungs, dynamic upper airway obstructions, cardiac arrhythmias, and exertional myopathies diseases that affect the muscles that control voluntary movement.

Hemosiderin scores were positively correlated with levels of neutrophils, eosinophils, and mast cells in lavage fluid. Increased creatine kinase activity was linked with neutrophilia in lavage fluid, dynamic upper airway obstructions, premature complexes (when the lower chambers of the heart contract before they should), and gastric disease affecting the upper squamous portion of the stomach.

Treadmill velocity at a plasma lactate concentration of 4mmol/L and at a heart rate of 200 beats per minute was negatively affected by neutrophilia in lavage fluid, multiple dynamic upper airway obstructions, exertional myopathies, and squamous gastric disease.

The multifactorial nature of poor performance was confirmed, the researchers said, with moderate equine asthma, dynamic upper airway obstructions, myopathies and equine gastric ulcer syndrome representing the main diseases involved in fitness impairment.

Two or more disorders were simultaneously observed in almost 90% of the horses.

The most commonly diagnosed disorders were gastric ulcer syndrome and moderate equine asthma, followed by bleeding in the lungs, equine glandular gastric disease and dynamic upper airway obstructions.

All disorders, except for premature complexes, were associated with one or more fitness variables.

The greatest impairment of fitness was related to the diagnosis of exertional myopathies, severe and multiple dynamic upper airway obstructions, neutrophilic inflammation of the lower airway, and severe grades of squamous gastric disease.

A definitive diagnosis was reached for 254 of 255 horses, which suggests that the diagnostic protocol performed in our study was comprehensive enough to evaluate the most common subclinical non-orthopedic causes of racing poor performance.

Gastric ulcers were diagnosed in almost all horses, with severe squamous gastric disease (grade 3 or 4) detected in 87% of the horses, whereas the prevalence of glandular gastric disease was approximately 58%.

Respiratory diseases represented an equally common cause of poor performance among the study horses. A diagnosis of mild to moderate asthma was made in 97% of the horses, with the majority of them affected by a mixed inflammatory form.

The authors noted that mild to moderate asthma is universally recognized as one of the most common causes of impaired athletic capacity in horses.

Based on endoscopy, around 60% of the horses had blood in the trachea, but only 17% were positive for exercise-induced pulmonary hemorrhage (EIPH) based on their total hemosiderin score and could therefore be considered bleeders.

Clinically relevant premature complexes were detected in 18% of the horses during treadmill exercise.

Finally, post-exercise creatine-kinase activity was higher than normal in 11% of the horses, whereas clinical myopathies (observed during hospitalization or inferred by history) affected 17% of the horses.

Exertional rhabdomyolysis is reported to have a prevalence of 6% among Standardbred racehorses, which may be higher in our study because of the inclusion of only poorly performing horses.

The researchers said the horses in the study came from different training centers over a period of 20years. Therefore, different training techniques may have influenced the results.

Finally, because our study was performed retrospectively and only included poorly performing Standardbred racehorses, future studies should verify whether or not the identified associations are found in a mixed population, including a control group of well-performing horses.

The study team comprised Lo Feudo, Luca Stucchi, Bianca Conturba, Giovanni Stancari, Enrica Zucca and Francesco Ferrucci, all with the University of Milan.

Lo Feudo, CM, Stucchi, L, Conturba, B, Stancari, G, Zucca, E, Ferrucci, F. Medical causes of poor performance and their associations with fitness in Standardbred racehorses. J Vet Intern Med. 2023; 1- 14. doi:10.1111/jvim.16734

The study, published under a Creative Commons License, can be read here.

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Poor performance in non-lame Standardbreds often involves several ... - Horsetalk

Internal Medicine

Q&A: What impact did ID experts have on the COVID-19 pandemic? – Healio

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Throughout the COVID-19 pandemic, infectious disease experts made contributions to help control the outbreak and improve public understanding of the new disease.

Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security, and colleagues wrote in a recent paper that these efforts went well beyond their usual responsibilities and often led to hours of additional work without additional compensation.

We spoke with Adalja about the impacts infectious disease (ID) experts had and what they mean for the future for both ID experts and potential pandemics.

Healio: What prompted this paper?

Adalja: The prompt for this paper which is a distillation of a larger report was the tremendous ID expertise the nation relied upon throughout the pandemic. This expertise was not just in-hospital treatment of patients but extended far outside hospital walls into communities and added much resiliency to communities and organizations. Often, this work was voluntary and uncompensated but so vital.

Healio: What were some of the most notable contributions the ID workforce made to the COVID-19 response?

Adalja: The ID workforce helped reopen schools, gyms and workplaces. Some ID physicians even helped sports teams, entertainment venues, consulted on movie filming and provided expert forecasting to financial firms.

Healio: What were the impacts of these contributions?

Adalja: Its hard to quantify the impact, but it was core to resiliency and recovery of many communities and organizations.

Healio: What recommendations does the paper suggest to help fortify the ID workforce for future pandemics, and why is it important to do so?

Adalja: The recommendations are to recognize the enormous value that ID physicians provide to communities by making the specialty attractive to training physicians. ID is not a highly compensated subspeciality paradoxically because it is a cognitive specialty and not one that is procedure based. The extra training, for example, an internal medicine physician undergoes to become an ID physician will actually lower their salary. The formula that the government and other payers employ undervalues mental effort and must change. Loan repayment programs can also play a role.

Healio: Do you think the U.S. is in better shape for the next pandemic than it was before COVID-19?

Adalja: Although I think the pandemic opened peoples eyes to how calamitous and deadly a pandemic could be in the 21st century, complacency is already setting in. This is just not a priority for political leaders whose time horizon is just the next election. The missteps that occurred in the early mpox response illustrate this. However, there is hope that the public will demand competence in this field from governments because the pandemics toll was magnified by government failures at all levels.

Healio: What is the main take away from this paper?

Adalja: ID physicians are on all the front lines protecting individuals and society from the threat of infectious diseases. The modern human way of life is one in which an individual benefits from much that ID physicians do, even if they have never seen one for medical care.

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Q&A: What impact did ID experts have on the COVID-19 pandemic? - Healio

Internal Medicine

Nagasaki University Presented Results Of a Specified Clinical Trial On The Use of L. lactis strain Plasma For Patients With COVID-19 – Yahoo Finance

TOKYO, May 11, 2023--(BUSINESS WIRE)--Nagasaki University presented the results of a specified clinical trial on patients with COVID-19 using Lactococcus. lactis strain Plasma*1 (L.lactis Plasma, a postbiotic), researched and developed by Kirin Holdings Company, Limited (Kirin Holdings). The results of this research was presented at the 63rd Annual Scientific Meeting of the Japanese Respiratory Society on Sunday, April 30. Nagasaki University and Kirin Holdings have jointly filed a patent application for the findings of this specified clinical trial.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20230510005547/en/

Specified Clinical Research Contents (Graphic: Business Wire)

1 Lactococcus lactis subsp. lactis JCM 5805 is owned by the RIKEN BioResource Research Center (https://web.brc.riken.jp/en/)

Since December 2019, COVID-19 infections have repeatedly caused pandemics, infecting 676.57 million people worldwide and killing 6.88 million (as of March 10, 2023). With the emergence of Omicron variants, the number of cases in Japan has increased, and the COVID-19 has become a more familiar infectious disease. Although SARS-CoV-2 vaccines have introduced widely and patients with mild illnesses account for a large proportion of the affected population, only a limited number of drugs are available in patients with mild illnesses who are not at risk of developing severe illnesses, and treatment is mainly based on symptomatic therapy.*2 Therefore, there is eagerly awaited for an easily accessible, safe, and effective treatment for COVID-19 in the community.

L. lactis strain Plasma was discovered by Kirin in 2010 as a lactic acid bacteria that activates plasmacytoid dendritic cells (pDC), which are a leader of the immune system. Previous basic studies showed that L.lactis Plasma stimulated pDC to have a first-line defense to viral infectious diseases. Previous clinical studies have also shown that L.lactis Plasma stimulated pDC and suppress the onset of an illness from influenza virus, rotavirus, and dengue. These scientific evidence of its immune function brought L. lactis Plasma registered as the first*4 Food with Functional Claims in Japan on August 2020.

Story continues

Based on the results of Kirin Holdings research on L. lactis Plasma, Nagasaki University, as a research institute with significant achievements in the field of infectious diseases, interested in L. lactis strain Plasma which may effect in relieving symptoms in patientis with COVID-19, and has decided to conduct a specified clinical trial from December 2021.

Since December 2021, Kirin Holdings has been engaged in a specific clinical research project led by Dr. Kazuko Yamamoto, a lecturer at the Department of Respiratory Medicine, Nagasaki University Hospital (currently a professor and chair at the Division of Infectious Diseases, Respiratory and Gastroenterological Medicine (First Department of Internal Medicine), University of the Ryukyus Graduate School of Medicine). This is a multicenter, double-blinded, randomized controlled trial conducted at Nagasaki University Hospital as a core facility. The efficacy and safety of 14 days oral intake of 4 hard capsules containing L. lactis Plasma (400 billion L. lactis Plasma in total) or 4 hard capsules without L. lactis Plasma (placebo) was to be evaluated*5 by having 50 patients with COVID-19 in each group.

2 Approach to Pharmacotherapy for COVID-19 Version 15.1- the Japanese Association for Infectious Diseases3 Secrets of Immunity - Kirin's L. lactis strain Plasma Research https://health.kirin.co.jp/en/about/about.html 4 The first brand in Japan to be registered with the Consumer Affairs Agency as a food with a functional claims for immune function.5 Yamamoto K, et al. BMJ Open 2022;12:e061172

1, Change in subjective symptom overall score (primary endpoint)

The results of an overall score analysis of seven subjective symptoms (Cough, Shortness of breath, fatigue, Headaches, Anosmia and Dysgeusia, Anorexia, and Chest pain) on a 4-point scale (0 points: not affected, 1 points: little effect, 2 points: affected, 3 points: severely affected) showed no difference between the two groups.

2, Anosmia and Dysgeusia (secondary endpoints) (Graph1)

The percentage of patients who scored 0 (not affected) for smell and taste dysfunction among subjective symptoms were high in the L. lactis strain Plasma group compared to placebo group after day 9.

3, Percent change in blood pDC (secondary endpoint) (Graph2)

While the placebo group showed a significant decrease in % pDC in the blood during COVID-19 clinical course, the L. lactis strain Plasma group maintained % pDC in the blood.

4, Percent change in SARS-CoV-2 viral load (secondary endpoint) (Graph3)

The L. lactis strain Plasma group showed a significant reduction of SARS-CoV-2 viral load at day 4 of treatment whereas placebo group showed reduction at day 8.

5, Safety and adverse events

No critical adverse events of safety were observed in this study.

Although this study did not show an effect on the primary endpoint, the subjective symptom total score, these results suggested that maintained pDC by the intake of L. lactis strain Plasma may have resulted in an early reduction of SARS-CoV-2 and early recovery of smell and taste dysfunction.

Nagasaki University and Kirin hope that L. lactis Plasma will become one of the new treatment or adjunctive care to patients with mild COVID-19.

About Kirin Holdings

Kirin Holdings Company, Limited is an international company that operates in the Food & Beverages domain (Food & Beverages businesses), Pharmaceuticals domain (Pharmaceuticals businesses), and Health Science domain (Health Science business), both in Japan and across the globe.

Kirin Holdings can trace its roots to Japan Brewery which was established in 1885. Japan Brewery became Kirin Brewery in 1907. Since then, the company expanded its business with fermentation and biotechnology as its core technologies, and entered the pharmaceutical business in the 1980s, all of which continue to be global growth centers. In 2007, Kirin Holdings was established as a pure holding company and is currently focusing on boosting its Health Science domain.

Under the Kirin Group Vision 2027 (KV 2027), a long-term management plan launched in 2019, the Kirin Group aims to become A global leader in CSV*, creating value across our world of Food & Beverages to Pharmaceuticals. Going forward, the Kirin Group will continue to leverage its strengths to create both social and economic value through its businesses, with the aim of achieving sustainable growth in corporate value.

* Creating Shared Value. Combined added value for consumers as well as for society at large.

View source version on businesswire.com: https://www.businesswire.com/news/home/20230510005547/en/

Contacts

Press ContactCorporate Communication DepartmentKirin Holdings Company, LimitedNakano Central Park South, 4-10-2 Nakano, Nakano-ku, Tokyo+81-3-6837-7028https://www.kirinholdings.com/en/ kirin-cc@kirin.co.jp

General Affairs Section, Nagasaki University Hospital (Public Relations and Evaluations)1-7-1 Sakamoto, Nagasaki, Nagasakihttp://www.mh.nagasaki-u.ac.jp/en/ mhweb@ml.nagasaki-u.ac.jp

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Nagasaki University Presented Results Of a Specified Clinical Trial On The Use of L. lactis strain Plasma For Patients With COVID-19 - Yahoo Finance

Internal Medicine

Post-Roe abortion bans force pregnant people with life-threatening … – Michigan Advance

Jennifer Adkins first pregnancy was near-perfect.

She sailed through her appointments and screenings with no complications, ticking every box and making lists of all the right questions to ask her medical professionals. By the time her unmedicated labor was over and the nurses placed her newborn son on her chest, Adkins felt like a superhero.

So when she discovered she was pregnant again the day after Valentines Day, she was ready for another home run. The baby would be due on Halloween, and she and her husband affectionately referred to it as Baby Spooky. Maybe theyd find out the sex beforehand, maybe it would be a surprise. They hadnt decided yet.

On April 21, Adkins saw her doctor for a routine screening by ultrasound to measure the collection of fluid behind the fetus neck. And even without a medical degree, she could tell by the picture on the ultrasound that something was wrong. Sitting in the genetic counselors office that afternoon,

Adkins learned her 12-week-old developing fetus likely had Turner syndrome, a chromosomal abnormality that ends in miscarriage in 99% of cases. Turners occurs when one of two X-chromosomes for a female is deleted, often from all cells. The few babies that do survive still have deletions in some cells that cause significant heart defects, fertility issues, kidney abnormalities and a range of other disabilities.

The normal measurement is less than 3 millimeters, according to Dr. Maria Palmquist, a maternal-fetal medicine specialist at Saint Alphonsus Regional Medical Center in Boise, Idaho. Palmquist said Adkins fluid measured at 11.7 millimeters, with additional fluid accumulating under the skin and around the body of the fetus, known as edema. The combination of increased fluid and skin edema is a condition known as hydrops fetalis, a severe form of swelling that is often fatal.

The doctor said basically, lightning struck this pregnancy, theres nothing you can do, Adkins said. This just happens in 1% of all pregnancies.

Following the U.S. Supreme Courts decision in June 2022 to overturn Roe v. Wade and allow states to regulate abortion access, 14 states have enacted near-total or total abortion bans, while others continue to pass abortion ban laws that become tied up in state and federal court. The patchwork laws create reproductive health care deserts, sometimes as much as an eight-hour drive or a flight across the country, forcing pregnant people to travel at great financial and often emotional costs, even if the termination of the pregnancy would prevent devastating health effects.

There are no abortion bans yet that criminalize the pregnant person. Instead, criminal penalties are focused on medical providers or others who help someone obtain an abortion. The charges in most states are felonies, with punishment ranging between two years and life in prison, and physicians face suspension or revocation of their medical licenses.

Because Adkins lives in a state with an abortion ban, she faced one of two options: Either continue carrying the pregnancy knowing it would almost certainly end in miscarriage or stillbirth and jeopardize her own health in the process or make a trip out of state for termination.

Idaho has a near-total ban on abortions that applies to any stage of pregnancy, with exceptions for cases of rape and incest with an accompanying police report during the first trimester or to save a patients life. Health care providers who violate the statute put their medical licenses at risk and face between two and five years in prison, along with civil penalties of $20,000 against individual providers if family members decide to sue.

Since Roe fell, residents in states with bans like Texas have to travel much farther to obtain an abortion. TheTexas Observerreported the average number of miles a resident must travel increased from 44 miles to 497 miles. Texans often go to New Mexico, where some abortion providers fled andopened new clinics. Washington abortion providers have reported seeing patients fromseven statesaround the country within one day.

In the Southeast, where nearly every state has a highly restrictive ban, states such as Louisiana and Mississippi arehours awayfrom the nearest abortion clinic. For many, the closest state is Florida, and the outcome of a Florida Supreme Court case over a law banning abortion at 15 weeks could determine whether a six-week bansigned in Aprilby Republican Gov. Ron DeSantis will go into effect. If it does, the distance to access abortion for many residents in that region of the country will become much greater.

A studyreleased in Aprilconducted by international reproductive health care journal Contraception found that women who were forced to travel for abortion care described it as emotionally burdensome, saying it caused distress, anxiety and shame.

Because they had to travel, they were compelled to disclose their abortion to others and obtain care in an unfamiliar place and away from usual networks of support, which engendered emotional costs, the study said. Additionally, travel induced feelings of shame and exclusion because it stemmed from a law-based denial of in-state abortion care, which some experienced as marking them as deviant or abnormal.

Adkins said seeking care in another state made her feel like a criminal and a medical refugee of sorts, and she worried about what others would think of her for terminating. Another physician she saw for a separate issue wanted to keep the pregnancy out of her record entirely as a precaution.

They make this out to be like people that seek abortions are horrible, horrible people, and murderers, and all this stuff, and Im like, that could not be further from the truth. This is a baby that we love with all of our heart and soul. And because we are loving parents, we are choosing this route, not only to be loving parents to that baby, but also to our living son, because I have to think about whats in my best interest so that I can still be here and be healthy enough to take care of my son who needs me, Adkins said.

Idaho physicians have also stopped making referrals for patients in situations similar to Adkins in the wake of a legal opinion sent by Attorney General Ral Labrador at theend of March. Until there is a decision in a lawsuit over the opinion, physicians and Planned Parenthood facilities in Idaho have said they will not make any referrals for abortion-related care outside of the state.

Adkins said if she wasnt as informed about the states laws, she wouldnt have understood what doctors were saying about her options.

They said that I was welcome to leave the state on my own accord and seek health care outside of the state, Adkins said. It was a very odd experience because we were talking basically in code. I understood the nuance, and I understood what they were implying, but it was a very surreal experience.

A brief filed in the lawsuit on behalf of a health system in Idaho detailed a scenario nearly identical to Adkins on the same day she was diagnosed at a different facility. Like the case outlined in the brief, Adkins would be at risk for developing a condition called mirror syndrome, which causes the pregnant person to experience similar symptoms to that of the fetus. Dr. Palmquist told States Newsroom that it can lead to preeclampsia, a life-threatening state of high blood pressure in pregnant people that can cause seizures and organ damage.

Knowing all of this, Adkins decided it was in the best interests of her family, including the nearly 2-year-old son she already had and the daughter she would never get to hold, to terminate the pregnancy.

She hoped to miscarry within the following week so they wouldnt have to make the emotional three-day trip. So she scheduled another ultrasound, but there was still a heartbeat. She was desperate to fix it desperate to stop being a walking coffin for a dying dream.

Its hard knowing that my body and the fetus are trying so hard to hang on, Adkins said. And we had to make a really hard decision. Do we try? But for what purpose? Theres no sense in bringing a child into this world thats not going to survive anyway or have severe complications. And its not fair to any of us.

Idaho legislators made minor changes to the states abortion law toward the end of the legislative session in March to clarify that certain instances where the fetus has already died or ectopic or molar pregnancies would not fall under Idahos abortion ban, declining to proceed with anearlier iterationof the bill that included a clause exempting medical professionals from criminal liability. In that version, providers had to determine if an abortion was necessary to prevent the death of the pregnant woman or to treat a physical condition of the woman that, if left untreated, would be life-threatening.

Dr. John Werdel, an obstetrician-gynecologist at St. Lukes in Boise, said he wasnt sure if Adkins situation would have qualified under the health language in the original bill. She likely would have had to wait until the health effects were more severe, he said.

Many reproductive care physicians in states where abortions are banned have left to practice in other states in recent months, including one maternal-fetal medicine doctor in Tennessee whomoved to Coloradoin January after starting what she described as a dream job in Tennessee in August.

Idahos abortion laws caused Palmquist, one of three maternal-fetal medicine physicians at Saint Alphonsus, to take a job at Desert Perinatal in Las Vegas, Nevada. She is one of several specialists in the state to leave over the new laws since January. She was packing her belongings on Thursday, hoping the laws change soon and allow her to return.

Since June, its just become so complicated to take care of pregnancy complications. Things before that were so straightforward now make us take an extra four to six hours and multiple meetings, Palmquist said. Making sure were protected by EMTALA, making sure this is an emergency medical condition. Does the hospital administration agree, does legal counsel agree? All of that.

A recent study published in the Journal of General Internal Medicine found from a survey of more than 2,000 current and future physicians on social media that 82% preferred to work or train in states with preserved abortion access. More than 76% of respondents said they wouldnt even apply to states with legal consequences for providing abortion care.

At least monthly, we are faced with caring for moms with significant complications, and theres no chance of a viable outcome. But with Idahos restrictions, theres a lot of anxiety about essentially practicing the standard of care, Palmquist said. A year ago, it wouldve been just so straightforward, and now theres all this caution and hesitancy.

Adkins and her husband left their son with grandparents to make the trip to Oregon on a Thursday for her appointment the following morning. TheNorthwest Abortion Access FundandCascade Abortion Support Collectivehelped pay for a hotel room, a rental car and the surgical procedure, which was $850 by itself without insurance. Friends and family sent her Venmo donations for other expenses.

I just started calling organizations because I was like, I dont know what to do. And they said, Were here to help you. And it was so relieving but also absolutely heartbreaking to hear multiple times from multiple people, You are not the only one. We get stories like yours all the time, every day, Adkins said. Every day.

Abortion access in northern Michigan is already limited. Restrictive laws make it worse.

The Planned Parenthood clinic was supportive and professional, she said, and they honored her request to be deeply sedated for the procedure. When she told them why she needed to terminate the pregnancy, they offered to take ultrasound photos beforehand.

Everybody was like, Oh my god, Im so sorry you had to come all this way for this, Adkins said. And theyre right. I shouldnt have had to leave my son and travel hundreds of miles to do this.

Since the procedure was performed in another state and at a Planned Parenthood clinic, Adkins had to ask the doctor to collect the remains of the fetus, the pregnancy tissue and the placenta and package them properly to be sent to a genetic testing clinic. She was also faced with rushing the package of remains to FedEx herself that same day.

While she doesnt regret the decision, Adkins said it was a painful experience that could have been much easier if she had been able to access care in her own state.

I deserve better, and so does everybody else, she said. We cant stop things from happening in pregnancy. Thats why we have modern medicine, to help guide us and protect the things we do have control over. So if we cant stop those horrible things from happening why make it even worse by making the worst experience someone has to go through learning that they will not give birth to a happy, healthy baby why do we make that even worse by saying, We dont value your life enough to try to save it or prevent something bad from happening to you in the meantime?

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Post-Roe abortion bans force pregnant people with life-threatening ... - Michigan Advance

Internal Medicine

Is mineral water good for you? Benefits and disadvantages explained. – USA TODAY

Delaney Nothaft| Special to USA TODAY

Minerals are essential for our bodies to operate smoothly. Dr. Pedro R. Rodriguez Guggiari, an internal medicine specialist and Chief of Staff at Banner Del E. Webb Medical Center in Sun City West, Arizona, says, Minerals help in a variety of ways: like iodine for thyroid (energy and stamina); calcium fluoride for bone and tooth health; iron for blood cell formation and to prevent anemia; magnesium and potassium for muscular function and structural tissues.

Are the minerals found in mineral water also good for you? Whats the best way to get minerals? We spoke with the experts to find out.

Dr. David Nazarian, a board-certified internal medicine specialist and founder of VitaminMD.net, says, Mineral water comes from springs and underground reservoirs and the mineral content can vary depending on the source and geographic location. In general, it can be a source for essential trace minerals such as calcium, magnesium and potassium.

But, mineral water alone, he says, is not enough. Nazarian adds, While mineral water does have higher mineral content than purified or filtered water, it does not contain all the minerals and should not be the sole source for these nutrients.

Elise Heeney, a clinical dietitian at Banner Del E. Webb Medical Center says, The best way to obtain all the vitamins and minerals our bodies need is by eating a diet that includes a variety of fruits, vegetables, whole grains, beans, nuts and seeds, lean proteins and low-fat dairy products. Aim for a well-balanced plate at each meal.

There are also certain foods you can eat that target specific minerals. For example, to get more calcium in your diet, you can try:

Or, if you are trying to get more potassium into your diet, you can try foods like:

There's no question that the vitamins found in vitamin water are important to one's health. What's more,electrolyte-infused drinks are proven to improve physical performance during exercise and can help hydration.

At the same time, the Centers for Disease Control and Preventionwarns againstconsuming food and drinks with too many "added sugars"because they are known to contribute to obesity, type 2 diabetes and heart disease.

Is vitamin water actually good for you? It's complicated, experts say.

What do minerals do for the body? Calcium, magnesium, iron, zinc and what to know.

More: Zinc is an important nutrient, but get it from food, not supplements, experts say

Many people take daily vitamins. What they should know first.

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Is mineral water good for you? Benefits and disadvantages explained. - USA TODAY

Internal Medicine

From Boston to Ann Arbor and back: Doctor-to-be, Graduation … – Michigan Medicine Headlines

Holly Roberts journey to become a doctor has come full circle during her time as a medical student at U-M by distance and also by how she learned the art and practice of medicine.

Roberts, a native of Hudson, New Hampshire, soon will return home to begin a residency in pediatrics at Boston Childrens Hospital, which she hopes to follow with a fellowship in pediatric hematology/oncology. She earned her undergraduate degree from Boston University, and her hometown is a mere 45 minutes north of the city.

When she leaves Michigan soon after Commencement activities on Friday, May 12, Roberts will do so as a member of the Class of 2023 that overcame so much during its four years together. This group was just getting started at U-M in 2020 when the COVID-19 pandemic hit. It still affects them as they prepare to graduate.

Our entire world, and especially the world of medicine, was instantly shaken. However, through flexibility, innovation and dedication to patients, health care professionals worked tirelessly to meet the evolving needs of our community, said Roberts, who added that her extracurricular focus shifted to supporting the local community, from assembling hand sanitizer kits for those experiencing houselessness to assisting patients with telehealth visits. Overall, this has taught me to be flexible in order to support the ever-changing needs of my patients and community.

Ironically, the pandemic has affected Roberts personally as she completes her medical degree. She and her husband, Dylan, both contracted COVID-19 in March and had to stay home instead of attending the annual Match Day festivities. Both are feeling much better these days and she is looking forward to being among 162 Michigan graduates.

The medical school community is invited to attend the Commencement ceremony at 3 p.m. in Hill Auditorium. It also will be livestreamed at: https://youtu.be/fLbGpMJOsDg.

Roberts is among the Class of 2023s most-honored graduates. She is recipient of the Deans Commendation for Excellence in Clinical Skills and the Art of Medicine, and the Andrew J. Zweifler Award for Excellence in Clinical Skills. She also is graduating with distinction (top 10% of students based on grade-point average) and distinction in medical education. Further, she is recipient of an Academic Recognition Award and a Glasgow-Rubin Citation for Academic Achievement.

Roberts said Michigans emphasis on clinical education and compassionate patient-centered care has paved the path for her to become the type of physician, educator and researcher she wants to be. In medical education, she has had opportunities to teach from high school to medical students and create an elective course for senior medical students about hospice and palliative care.

UMMS has also provided me with exceptional mentorship, opportunities and training in clinical research related to pediatric neuro-oncology, she said. I hope to continue my work in this field to improve care and outcomes for children with aggressive brain tumors, and I am endlessly grateful to my mentors for setting the stage for this aspect of my career.

As she completes her educational circle this week, Roberts looks forward to developing meaningful relationships with patients and families, supporting them through challenges and celebrating their victories.

The field of pediatrics, and specifically pediatric oncology, provides a unique opportunity to support patients and their families through some of lifes greatest challenges, while also celebrating the everyday joys of childhood, she said.

Below is a full list of student, departmental and faculty awards:

Student Awards

Deans Award for Research Excellence

This award is given by the faculty to those students who have made outstanding research contributions during their medical school career.

Deans Commendation for Excellence in Clinical Skills and the Art of Medicine

This award is given to ten percent of senior students, based on top Comprehensive Clinical Assessment (CCA) scores and clinical grades from the required junior clerkships, for outstanding skills in verbal communication with patients, interviewing, counseling, and physical diagnosis.

Puneet Ashu Ailawadi Memorial Award

This award honors Dr. Puneet Ashu Ailawadi, a 2000 graduate of the Medical School who was completing a residency in the Department of Psychiatry at the University of Michigan Health System at the time of his death. Dr. Ailawadis family, friends, and colleagues have established a memorial fund to honor him. In keeping with Dr. Ailawadis dedication to helping underserved communities, this award is presented annually to a senior medical student who has demonstrated a commitment to serving underprivileged and underserved populations.

George R. DeMuth Medical Scientist Award for Excellence

This award honors Dr. George R. DeMuth, the founding Director of the University of Michigan Medical Scientist Training Program. The award is given to a graduating senior in the University of Michigan Medical Scientist Training Program who has demonstrated outstanding accomplishments in research and who exhibits the personal and professional qualities desired in the complete physician.

Paul DeWolf Award

In memory of Paul DeWolf, a member of the Class of 2014, this award was created by the Student Council to honor the most unique and extraordinary qualities that he possessed. Paul was an includer, someone who used his enthusiasm for life to rally everyone around himself and help people contribute their voice on equal ground. He was also tireless in his dedication to patient-centered care, going the extra mile to connect on a much deeper level with each and every one of his patients. And he had an indefatigable joie-de-vivre with an infectious attitude of play hard and work hard. Most of all, he strove to improve himself for the purpose of bettering the condition of others. This award is presented every year to a senior who best exemplifies these attributes.

Ralph M. Gibson Award

This award honors Dr. Ralph Gibson, a distinguished African American faculty member in the Department of Pediatrics who also served as an assistant dean for student affairs in the Medical School. Dr. Gibson consistently emphasized the pursuit of academic excellence and demonstrated a concern for all students, their health, welfare, and career development. The award is presented to the senior student(s) who has best demonstrated these same qualities and who has had a dedication to addressing the health disparities experienced by minority and disadvantaged populations in the United States.

Patrick John Niland Award

This award is presented in memory of Patrick John Niland, a member of the Class of 1986, who died in an automobile accident. This award was established by the Class of 1986 to recognize the important attributes that Pat possessed: a cheerful, friendly demeanor and a patient, honest, and compassionate approach to medicine. It is given annually to a senior student who, in the eyes of the graduating class, best exemplifies these traits.

Sujal Parikh Award

This award is presented in memory of Sujal Parikh, a member of the Class of 2011, who died as a result of an accident while serving as a Fogarty Fellow in Uganda. This award was established by Student Council and the Class of 2011 to recognize the spirit and passion that Sujal dedicated to issues of social justice, global health, and collegiality. It is given annually to a senior who, in the eyes of the graduating class, best exemplifies these traits.

Dr. Jane Skillen Award

This award honors Dr. Jane Skillen, a 1928 graduate of the Medical School. Dr. Skillen was an Irish immigrant who came to the United States at age 16 and worked diligently to support herself and eventually earn her undergraduate and medical degrees at the University of Michigan. Dr. Skillen had a highly accomplished career as a thoracic surgeon in California. Her achievements stemmed from strength of character and a love of medicine, and her children honored her by establishing this award.

Andrew J. Zweifler Award for Excellence in Clinical Skills

This award is given to a graduating senior who has consistently demonstrated outstanding care and competence in verbal communication with patients in terms of interviewing and counseling, as well as excellence in physical diagnosis.

Leonard Tow Humanism in Medicine Award presented by The Arnold P. Gold Foundation

This award honors one graduating medical student who best demonstrates the ideals of outstanding compassion in the delivery of care and respect for patients, their families, and health care colleagues, as well as demonstrated clinical excellence.

Gold Humanism Honor Society (GHHS)

The GHHS recognizes students who practice patient-centered care by modeling the qualities of integrity, excellence, compassion, altruism, respect and empathy. Members are nominated by their peers for being a person they would like by their side in a medical emergency, who personifies good patient care, shows exceptional interest in community service, and a classmate they would want as the doctor of their loved ones.

Graduation with Distinction

The Graduation with Distinction honor is awarded to the top 10% of students based primarily on grade-point average.

Graduation with Distinction in Medical Education

The Graduation with Distinction in Medical Education honor is awarded to 10% of the class based on the students commitment to medical education research and evaluation, involvement with innovation in education and academic program development, and exceptional teaching skills in clinical and non-clinical settings.

Graduation with Distinction in Research

The Graduation with Distinction in Research honor is awarded to 10% of the class based on the students research training experiences, publications, presentations, and letters of support from faculty. Standard and MSTP students were considered separately.

Graduation with Distinction in Service

The Graduation with Distinction in Service honor is awarded to 10% of the class based on the students service to the community and the Medical School, drawn from the students curriculum vitae and letters of support.

Academic Achievement Award

The Academic Achievement Award, on the recommendation of the faculty of the Medical School, is given to the graduating senior who has achieved the highest academic standing in his or her class.

Academic Recognition Awards

Academic Recognition Awards are presented to the top five graduates who have demonstrated academic excellence throughout the four years of their medical education.

Alpha Omega Alpha (AOA)

AOA is the only national honor medical society. Its mission is to recognize and enhance professionalism, academic excellence, service, and leadership within the profession. The societys motto is Worthy to serve the suffering and membership is based upon scholarship and character.

Glasgow-Rubin Certificate of Commendation for Academic Achievement

This award is given to a woman medical student, graduating with academic distinction, should she graduate first in her class.

Glasgow-Rubin Citations for Academic Achievement

These awards are presented by the American Medical Womens Association to those women who graduate with academic distinction from medical schools throughout the country.

United States Public Health System 2023 Excellence in Public Health Award

The USPHS awards program recognizes medical students across the United States who advance public health and those who exemplify the USPHS mission to protect, promote, and advance the health and safety of our nation.

Departmental Awards

American Academy of Neurology (AAN) Medical Student Prize for Excellence in Neurology

This award is given to a graduating medical student who exemplifies outstanding scientific achievement and clinical acumen in neurology or neuroscience, outstanding personal qualities of integrity, compassion, and leadership.

Roger A. Berg Prize in Radiology

This award is given each year to a fourth-year medical student or students for outstanding performance in radiology. The award is made possible through a gift from Dr. Roger A. Berg, a University of Michigan Medical School alumnus.

C. Gardner Child 3rd Award

The career and dedication of Dr. Child, former chair of surgery, are honored in this award to a graduating senior or seniors for outstanding performance in the junior clerkship, senior electives, and research in surgery.

Terence C. Davies, M.D. Award

This award, in honor of the founding chair of the Department of Family Medicine, is presented to a graduating senior or seniors for clinical and scholarly excellence in family medicine. These students exemplify the qualities of the outstanding family physician: dedication to patient needs, intellectual curiosity, personal integrity, community service, and leadership.

Henry Fitzbutler Award for Excellence in Hospital Medicine

This award is conferred upon the fourth-year medical student who best displayed clinical and scholarly excellence in the field of hospital medicine. The award honors the life and accomplishments of Dr. Henry Fitzbutler who was the first African American to graduate from the Medical School in 1872. He then went on to establish both a hospital and medical school in Kentucky.

Albert C. Furstenberg Award

This award is given to a medical student for outstanding performance in otolaryngology. scholastic achievement, clinical work, and research efforts are considered in addition to interest in otolaryngology.

Robert I. Goldsmith, M.D. Award

This award is given by the Department of Ophthalmology and Visual Sciences to a senior medical student who has demonstrated outstanding scientific achievement or clinical prowess in ophthalmology and visual sciences. This student exhibits a high level of integrity, compassion, and intellectual curiosity towards optimizing vision and preventing and curing eye disease. The award is in honor of Dr. Robert I. Goldsmith, a distinguished alumnus and loyal friend of the W. K. Kellogg Eye Center.

Timothy R. B. Johnson Global Womens Health Award

The Timothy R. B. Johnson Global Womens Health Award is presented to a graduating medical student recognizing their authentic global engagement and anticipating their future contributions embodying Dr. Johnsons vision of global academic partnerships and his commitment to safe motherhood and global womens health.

Edgar A. Kahn Award

This award is given each year in memory of Dr. Kahn, former chief of neurosurgery, to a senior medical student(s) for outstanding performance in clinical or laboratory work in neurosurgery.

William Dodd Robinson Award

This award is given by the faculty of the Department of Internal Medicine to a graduating senior or seniors for outstanding performance in the junior medicine clerkship and senior electives in Internal Medicine. The award honors Dr. William Robinson, chair of the Department of Internal Medicine from 1958-75.

Eli G. Rochelson Memorial Award

This award is given for the most outstanding performance in pulmonary and critical care medicine by a graduating medical student. It honors Dr. Rochelson, a pulmonary physician and father of an alumnus of our school.

SAEM Excellence in Emergency Medicine Award

The members of the Department of Emergency Medicine honor a graduating senior for outstanding performance in the specialty of emergency medicine. This award is sponsored by the Society for Academic Emergency Medicine.

Robert B. Sweet Award

This award is given to a senior medical student who has shown the highest achievement and the greatest potential in the field of anesthesiology. The award is in honor of Dr. Robert B. Sweet, founding chair of the Department of Anesthesiology.

William B. Taylor Dermatology Clinical Science Award

The faculty of the Department of Dermatology honors a graduating senior medical student(s) for outstanding performance in dermatology clinical science. The award honors Dr. William B. Taylor, a faculty member of the department from 1950-92 and recipient of the National Dermatology Teacher Award.

Harry A. Towsley Award

This award is given by the faculty of the Department of Pediatrics to senior students for outstanding performance in the junior pediatrics clerkship and senior pediatrics elective. The award is named in honor of Dr. Harry A. Towsley, a distinguished member of the Department of Pediatrics from 1935-72.

Raymond W. Waggoner Award

This award is given by the faculty of the Department of Psychiatry to a graduating senior for distinguished performance in psychiatry. This award honors Dr. Raymond W. Waggoner, chair of the Department of Psychiatry from 1937-69.

Warner/Goldberg Womens Health Program Award for Excellence and Commitment to Womens Health

This award is given to a graduating senior(s) for their outstanding academic achievement and commitment to the ideals of its sponsor, the University of Michigan Center of Excellence in Womens Health. It is named for Patricia Warner, former associate hospital director, UMHS, and Dr. Edward Goldberg, founding chief of the Division of Womens Health, in recognition of their vital roles in the initiation and success of the Womens Health Program.

Wiegenstein Leadership in Emergency Medicine Award

This award is presented to the graduating medical student who best demonstrates the potential for leadership in emergency medicine, as exemplified by Dr. John Wiegenstein, Medical School Class of 1960, a pioneer in the field of emergency medicine.

J. Robert Willson Award for Outstanding Achievement in Obstetrics and Gynecology

The J. Robert Willson Award, in honor of the former chair of the Department of Obstetrics and Gynecology, is given to a senior student(s) for outstanding performance in obstetrics and gynecology. A Medical School professorship is established in his name.

Faculty Awards

Senior Year Award

This award is given each year to the faculty member below the rank of associate professor who, in the opinion of the graduating class, has best upheld the ideals of medical education.

The American Medical Womens Association Gender Equity Award

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From Boston to Ann Arbor and back: Doctor-to-be, Graduation ... - Michigan Medicine Headlines

Internal Medicine

LEADING PHYSICIAN-SCIENTIST DR. BRADLEY A. MARON APPOINTED SENIOR ASSOCIATE DEAN FOR PRECISION MEDICINE AT UMSOM AND CO-DIRECTOR OF NEW UNIVERSITY OF…

Dr. Maron also Named Director of Scientific Operations for UM-IHC

Baltimore, May 8, 2023 /PRNewswire/ -- University of Maryland School of Medicine (UMSOM) Dean Mark T. Gladwin, MD, announced today that Bradley A. Maron, MD, Associate Professor of Medicine at Brigham & Women's Hospital (BWH) and Harvard Medical School (HMS), and Co-Director of the Pulmonary Vascular Disease Center at the VA Boston Healthcare System, has been appointed Co-Director of the UMB's new Institute for Health Computing (UM-IHC), Director of Scientific Operations for the UM-IHC at UMSOM, as well as Senior Associate Dean for Precision Medicine at the UMSOM, effective May 1, 2023.

In his new role as Co-Director of the UM-IHC, Dr. Maron will work with University of Maryland, College Park (UMCP) and University of Maryland Medical System (UMMS) partners in establishing the new Institute as an international leader in the interdependent fields of clinical analytics and computational biology, using advanced data science technologies. He also will lead efforts to build centers within the Institute that focus on therapeutic target discovery, population health, pragmatic clinical trials, and an educational core curriculum that emphasizes scientific entrepreneurship.

Launched in November, 2022, UM-IHC seeks to leverage recent advances in network medicine, artificial intelligence (AI), and machine learning to create a premier learning healthcare system that evaluates both de-identified and secure digitized medical health data to improve outcomes for patients across the state of Maryland.

As Senior Associate Dean for Precision Medicine, Dr. Maron will oversee initiatives that build UMSOM's capacity to pursue research that advances the school's leadership in precision medicine, a new area of medicine that uses information captured from a patient's own biological and clinical profile to prevent, diagnose, or treat disease. These initiatives will include acquiring funds for operational advances, building new partnerships with key federal health agencies such as the NIH and FDA, identifying appropriate faculty recruits, and advocating for precision medicine approaches to clinical care. In collaboration with the Senior Associate Dean for Undergraduate Medical Education, Dr. Maron also will ensure that precision medicine is represented in the medical school curriculum and that UMSOM is preparing students to lead clinical and research initiatives in this emerging area.

Story continues

Dr. Maron is a recognized physician-scientist in the rapidly growing fields of precision medicine, network medicine, and computational data analysis. Currently, he is engaged as the Co-Principal Investigator in an ongoing study entitled, "Network Medicine and Systems Pharmacology to Advance Precision Medicine in Combined Pulmonary Hypertension," and a second, as the Principal Investigator, entitled, "Personalized protein-protein interactomes and precision medicine in pulmonary arterial hypertension." He is also the co-author of numerous papers published in flagship journals for the American Heart Association, American Thoracic Society and Nature family discussing how multi-omics technologies can contribute to precision medicine

"Dr. Maron is a highly-effective and strategic leader who is ideally suited to move this new Institute forward," said Dean Gladwin, who also is Vice President for Medical Affairs, University of Maryland, Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor. "His experience and entrepreneurial management skills are perfectly aligned with our new vision to utilize disruptive technology and embrace and harness the power of clinical analytics and precision medicine to enhance patient care and provide populations health services."

In 2021, he was inducted into the American Society of Clinical Investigation, one of the oldest and most prestigious medical societies in the United States. At BWH, he was Vice-chair of the Cardiovascular Life Sciences Section in the Division of CV Medicine and Medical Director of the Cardiopulmonary Exercise Center. Additionally, he is the recipient of the Excellence in Tutoring Award, Eleanor and Miles Shore Scholar in Medicine fellowship, Chair's Research Award, and Distinguished Master Clinician Award and Master Clinician Award from BWH and Harvard Medical School.

Dr. Maron is a widely-published and NIH-funded investigator, with co-authorship on more than 200 peer-reviewed articles and book chapters. His research focuses on understanding novel molecular mechanisms involved in the pathobiology of cardiovascular disease. He is currently the principal investigator on three major NIH Project Grants, totaling over $1.6 million per year in funding. The American Heart Association, National Scleroderma Foundation, Pulmonary Vascular Research Institute and National Institutes of Health have supported his research.

In 2020, he led an international research program resulting in a publication in Lancet Respiratory Medicine entitled, "The association between pulmonary vascular resistance and clinical outcomes in patients with pulmonary hypertension: A retrospective cohort study." This work contributed to a change in the definition of the disease pulmonary hypertension. His seminal paper on "NEDD9 targets COL3A1 to promote endothelial fibrosis and pulmonary arterial hypertension" that was published in Science Translational Medicine, a marque journal of the American Association for the Advancement of Science, established the foundation for a U.S. patent and implicated NEDD9 as an important mediator of pulmonary vascular fibrosis and thrombosis. He also is the lead Editor of the seminal text, Pulmonary Hypertension: Basic Science to Clinical Medicine (Springer, 2016).

"We are in a transformative period for healthcare in Maryland, in which building computational systems using individual patient-level information to tailor disease prevention and treatment strategies is a reality," said Dr Maron. "The key is building systems with the capacity to improve health, wellness and longevity for all of the people of Maryland---that is our mission. I am extremely excited and fortunate to work with the Co-Directors from the University of Maryland College Park and University of Maryland Medical System in this endeavor. "

Dr. Maron is a graduate of Williams College and received his M.D. degree from The Warren Alpert Medical School of Brown University before completing an internal medicine residency at Boston Medical Center. He then finished cardiovascular medicine research and clinical fellowship programs at Brigham and Women's Hospital (BWH). Dr. Maron is an American Board of Internal Medicine-certified in Cardiovascular Medicine.

About the University of Maryland School of Medicine

Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world -- with 46 academic departments, centers, institutes, and programs, and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research. With an operating budget of more than $1.3 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic, and clinically based care for nearly 2 million patients each year. The School of Medicine has nearly $600 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of nearly 9,000 faculty and staff, including 2,500 students, trainees, residents, and fellows. The combined School of Medicine and Medical System ("University of Maryland Medicine") has an annual budget of over $6 billion and an economic impact of nearly $20 billion on the state and local community. The School of Medicine, which ranks as the 8th highest among public medical schools in research productivity (according to the Association of American Medical Colleges profile) is an innovator in translational medicine, with 606 active patents and 52 start-up companies. In the latest U.S. News & World Report ranking of the Best Medical Schools, published in 2021, the UM School of Medicine is ranked #9 among the 92 public medical schools in the U.S., and in the top 15 percent (#27) of all 192 public and private U.S. medical schools. The School of Medicine works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu

Provided by Newswise, online resource for knowledge-based news at http://www.newswise.com

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LEADING PHYSICIAN-SCIENTIST DR. BRADLEY A. MARON APPOINTED SENIOR ASSOCIATE DEAN FOR PRECISION MEDICINE AT UMSOM AND CO-DIRECTOR OF NEW UNIVERSITY OF...

Internal Medicine

PET TALK: Prioritizing Health And Comfort For Show Animals | FCT … – Freestonecountytimesonline

Throughout the year, youth across the country prepare and travel to various events, such as livestock shows, rodeos and fairs, to show their animals.

Because an animals performance at an event can be impacted if they are stressed or sick, Dr. Kevin Washburn, a professor of large animal internal medicine at the Texas A&M School of Veterinary Medicine and Biomedical Sciences, offers tips for keeping animals relaxed and healthy every step of the way.

First, owners should ensure that their animals are appropriately vaccinated so that they are healthy enough to travel.

The best prevention of any disease process is proper vaccinations when they are young and booster vaccines when necessary, Washburn said. Giving your animals booster vaccines about three weeks prior to the exhibition is a great practice for prevention.

Most importantly, show animals need to be vaccinated against respiratory disease before arriving at an exhibition.

Respiratory disease is the most common problem in exhibition animals due to the stress of travel, a new environment, and comingling with animals from many different locations and backgrounds, Washburn said. More specifically, cattle should be vaccinated against common respiratory pathogens before and at weaning.

Owners should also prepare trailers in a way that keeps show animals calm and comfortable, since traveling can be stressful for them.

Trailers should have adequate protection from extreme weather conditions and need to have a non-slip surface on them regardless of whether they are bedded or not, Washburn said. Non-slip surfaces prevent animals from slipping, losing balance, and falling in trailers, so it is less likely for animals to be injured.

Washburn explained that ensuring an animal is as comfortable as possible in their trailer will reduce stress, which is better for their immune system.

If cattle are tied, they should have enough length of rope to hold their heads in a natural position; for longer trips, cattle should be untied, the floor should be deeply bedded with mats or straw, and there should be enough room for them to lie down, Washburn said. For pigs and small ruminants like sheep and goats, there should be comfortable bedding so they can lie down during travel.

Once animals arrive at the show barn, they will need frequent access to fresh water to prevent dehydration and be fed their normal portion of food since dietary changes can cause digestive issues. Washburn also suggests owners provide fans or misters in warmer months and space heaters in colder months to improve animal comfort.

To maintain an animals health at an exhibition and decrease the risk of spreading diseases, especially when surrounded by other animals, Washburn encourages owners to be careful when walking from one animal stall to another.

Many diseases are spread through fecal-oral transmission, and contaminating bedding with fecal material from other farms can lead to animals picking up diseases, Washburn explained. So pens and tie stalls should only be entered by their owners to avoid bringing fecal material from one farm to another. If fecal material is picked up on boots and shoes from other places at the exhibition area, owners should wash them off prior to handling their own animals.

As another method of disease prevention, owners should avoid sharing with other animal caretakers their combs, brushes, clippers, feed tubs, water buckets, and tools used to clean bedding and stalls.

Lastly, Washburn pointed out that an animals health should continue to be a priority when they arrive back home.

Any exhibition animal should return to their normal environment and be allowed to rest from further training for at least the first five to seven days after returning home, Washburn said.

By practicing good health management before, during and after 4-H events, you can ensure that your show animals are healthy and comfortable every step of the way to the exhibition so that they have a successful performance.

Pet Talk is a service of the School of Veterinary Medicine & Biomedical Sciences, Texas A&M University. Stories can be viewed on the web at vetmed.tamu.edu/news/pet-talk. Suggestions for future topics may be directed to vmbs-editor@tamu.edu.

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PET TALK: Prioritizing Health And Comfort For Show Animals | FCT ... - Freestonecountytimesonline

Internal Medicine

Expert panel that sparked mammogram controversy now says tests … – Los Angeles Times

A new look at the science of preventing breast cancer deaths promises to reshape when, and how many, mammograms American women will get again.

An influential panel intends to recommend that U.S. women begin mammograms to screen for breast cancer at 40 and continue getting them once every two years until age 75. Doing so is expected to reduce the number of breast cancer deaths by 19% compared with following the mammography regimen it previously endorsed.

The new slate of draft recommendations from the U.S. Preventive Services Task Force marks a major shift from the controversial advice it promulgated in 2009 and largely reiterated in 2016 that most women could safely wait until 50 to begin having their breasts scanned for signs of potential malignancies. The panel also said women at average risk could be screened every other year instead of annually.

In calling for fewer mammograms over a womans lifetime, the task force cited the frequency with which breast cancers were overdiagnosed, leading to invasive yet unnecessary treatment, as well as the harms that come from needless biopsies and other work-ups done in response to false-positive test results. It also recognized that mammograms expose women to radiation, which in some cases could wind up causing cancer in otherwise healthy women.

Those recommendations touched off a firestorm and were denounced by womens health advocates, who have long argued that early detection gives the best chance of survival.

What prompted the task force to change its mind and advise that screening mammograms begin at 40? The members said they were strongly influenced by the experiences of Black women, who tend to develop aggressive breast cancers earlier than white women do, and to die of them more often. According to one study, Black women are 39% more likely to die of breast cancer than the population of women as a whole.

Screening women of color for breast cancer earlier is just the first of many steps that must be taken to close persistent gaps along ethnic lines. For Black, Hispanic, Latina, Asian, Native American and Alaska Native women, timely follow-up and effective treatment for breast cancer will be needed as well, the experts warned.

Also driving the changes in the draft recommendations is a growing recognition of the risks faced by women with dense breasts, which make malignancies both more common and harder to detect on mammographic images.

Almost half of all women have dense breasts, and the task force members said they had little research to guide them on whether to recommend additional screening or other kinds of imaging, such as MRI or ultrasound.

New and more inclusive science about breast cancer in people younger than 50 has enabled us to expand our prior recommendation and encourage all women to get screened every other year starting at age 40, said Dr. Carol Mangione, chief of internal medicine at UCLA and the chair of the group that wrote the task forces proposed recommendation. The new guidelines will help save lives and prevent more women from dying due to breast cancer, she added.

Dr. Patricia Ganz, a breast cancer expert at UCLA who has served on many cancer-screening panels, said that there is little new evidence driving the task forces shift. But she called the groups focus on addressing racial inequities in breast cancer very, very important. And she said the every-other-year mammography schedule is in line with practices in Canada and Europe.

I do think this is a very good recommendation: It leaves doctors and their patients a lot of flexibility to decide how aggressive or relaxed their breast cancer screening should be, Ganz said. The fact that they recommend starting at 40 means these women will have an opportunity early to engage in a process of calculating their personal risks.

In doing so, women find they are subject to a range of breast-cancer screening recommendations.

The American Cancer Society suggests women begin annual mammograms at 45, then consider switching to biennial tests at 55. Women who would prefer to begin annual screening at 40 can do so, and they should continue getting mammograms as long as they expect to live at least 10 more years, the ACS adds.

The American College of Radiology and Society of Breast Imaging recommend annual mammography screening for all women ages 40 and older who are at average risk of breast cancer.

Neither group suggests that 75 should be a hard upper limit for screening mammograms. But the American College of Radiology has recommended that all women have a risk assessment for breast cancer by the age of 25, and discuss with their doctor whether earlier screening with mammography and/or MRI is needed.

Dr. Debra L. Monticciolo, a radiologist at Massachusetts General Hospital, was highly critical of the task forces decision to recommend mammograms every other year considering that Black women and Jewish women die from breast cancer prior to age 50 or even 40 more often than white women as a whole. Thats just going to exacerbate the racial disparities, she warned.

Their own evidence shows that the most lives are saved with yearly screening, said Monticciolo, who led the drafting of the American College of Radiology/Society of Breast Imaging recommendations. With annual screening of women 40-to-79, you get a 42% mortality reduction. Limit that to every other year, and it drops the mortality reduction to 30%. These are womens lives that would be saved. I dont know what their thinking is here.

The task force noted other consequences of shifting from the least-intensive to the most-intensive screening schedule, however. The number of mammograms a typical woman received tripled, as did the number of false positive readings. The rate of overdiagnosis more than doubled, from 8% of cases to 17%.

Dr. Otis Brawley, a Johns Hopkins oncologist and cancer epidemiologist, said that while it seems counterintuitive that screening less often could save more lives, its a possibility that cries out for rigorous testing.

Even many experts cant come to grips with how many cancers are caused by mammogram screening and how many deaths are diverted by that screening, said Brawley. People who carry genes that predispose them to some cancers may be particularly vulnerable to radiation-induced mutations, he said. But thats not a trade-off thats been explored with strong research, he added.

The task force made clear that its new recommendations were not undergirded with rock-solid confidence. That women should begin getting mammograms at 40 had its most solid research backing. But the task force assigned far lower confidence values to its every-other-year schedule of mammography, and to the idea that breast-cancer detection after 75 may not be lifesaving.

There is very limited research on this age population, the groups report acknowledged.

The draft recommendation will be open for public comment until June 5. Comments can be submitted on the task forces website.

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Expert panel that sparked mammogram controversy now says tests ... - Los Angeles Times