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Tweet By Hospital Employee: What information is considered PHI?

bafonavy — Tue, 01 Nov 2011 10:12:59 GMT

Tweet By viagra cialis online pharmacy pharmacy Employee: What information is considered PHI?

Interesting Tweet HIPAA Breach story coming out of Mississippi involving Governor Haley Barbour. The incident involved a response to Governor Barbour's tweet by a University Medical Center employee.

Ves Dimov, M.D. at Clinical Cases and Images Blog posts about the story - Single tweet by hospital employee to Mississippi Governor allegedly violates HIPAA, forces her to resign.

The incident will provide a good case study for health privacy lawyers who regularly consider the question of what information is and is not protected health information (PHI) under 45 CFR 160.103. PHI is defined under HIPAA as:

The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information "protected health information (PHI)."

“Individually identifiable health information” is information, including demographic data, that relates to:
the individual’s past, present or future physical or mental health or condition,
the provision of health care to the individual, or
the past, present, or future payment for the provision of health care to the individual,
and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual. Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number).

Thanks for the tip @RLBates and @EdBennett.

Watermelon Body Fluid Replacement

bafonavy — Sat, 29 Oct 2011 09:02:49 GMT

Watermelon is a fruit that is very often encountered in the market, supermarket, mini market, and stalls. Lots of watermelon spread throughout the world with many-different types and colors. There are colored yellow and red watermelon. There are so many benefits you can get when eating watermelon.

Watermelon most often served as a fruit and desserts in a variety of events, because of easily available and contain many vitamins and antioxidants that are good for health. It also contains important nutrients that are beneficial to man's sex life. What is it?

In addition to many contain vitamin C, potassium and vitamin B6, watermelon also contains antioxidant compounds that help fight free radicals cause cellular damage.

Not only that, watermelon is also rich in amino acids citrulline and arginine, which both have a positive impact on the body. Research shows that nutrients in watermelon is to provide an abundance of benefits, especially for male sexual capability.

Some of the benefits of watermelon for the sex life of men as reported by LIVESTRONG on Thursday (01/19/2011):

1. Preventing prostate cancer.

According to research from Curtin University of Technology in Australia, watermelon contains many antioxidant lycopene that may protect men against prostate cancer.

Prostate cancer is the second most deadly cancer. In addition, men with prostate cancer may experience decreased sexual function and fertility because of radiation treatment techniques.

Diabetes

2. Treating type 2 diabetes.

High content of arginine in watermelon can help treat diabetes type 2 (due to lifestyle). Studies have found arginine can improve glucose metabolism and insulin sensitivity, both of which help lower the high glucose levels and is associated with diabetes.

Men who have diabetes is associated with loss of sexual performance due to erectile online pharmacy.

3. Improve blood vessel function.

According to research from Texas A & M University, citrulline is found in watermelon can help improve blood vessel function. Researchers found that citrulline can increase nitric oxide production, namely the gas molecules that help expand and dilate blood vessels. Therefore, the watermelon is often referred to has the effect of Viagra because it can facilitate blood flow to the penis.

4. Lowering blood pressure.

Watermelon also has long been known as a fruit that can lower blood pressure. With normal blood pressure, men increasingly turned away with all the dangerous diseases such as heart disease and stroke.

There are so many benefits of watermelon for your body. From now on get used to eating watermelon for dessert.

Back to your male might

bafonavy — Tue, 24 May 2011 07:16:41 GMT

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ADHD Drugs Can Cause Sudden Cardiac Deaths

bafonavy — Tue, 17 May 2011 12:07:38 GMT

The death of a beloved child means that the future is a thing of the past.
-- Peter De Vries (1910-1993), from The Blood of the Lamb (1961)

So... not only are ADHD drugs ineffective, they can also kill your child. And yet the doctors and authorities who undoubtedly have many fingers in the pie urge you to keep your child drugged up in spite of the horrendous risks. Hypocritical much?

Seriously, isn't it time you considered safer and more effective alternatives? Or, perhaps you might want to move to Canada, where the government has enough morals to keep Big Pharma from pushing potentially fatal drugs to children.

Continue reading »

Study Shows Possible Link Between Deaths and ADHD Drugs
By Shankar Vedantam
Washington Post
June 16, 2009

Children taking stimulant drugs such as Ritalin to treat attention-deficit hyperactivity disorder are several times as likely to suffer sudden, unexplained death as children who are not taking such drugs, according to a study published yesterday that was funded by the Food and Drug Administration (FDA) and the National Institute of Mental Health (NIMH).

While the numbers involved in the study were very small and researchers stopped short of suggesting a cause and effect, the study is the first to rigorously demonstrate a rare but worrisome connection between ADHD drugs and sudden death among children. In doing so, the research adds to the evolving puzzle parents and doctors face in deciding whether to treat children with cheap cialis.

Doctors have speculated about such a connection in the past because stimulants increase heart rate and have other cardiovascular effects.

Read the full article at the Washington Post

FDA urges caution in weighing risks of ADHD drugs

By Matthew Perrone
The Associated Press
June 15, 2009

WASHINGTON -- Federal health regulators are urging parents to keep their children on attention deficit drugs like Ritalin and Adderall, despite new evidence from a government-backed study that the stimulants can increase the risk of sudden death.

Published Monday in the American Journal of Psychiatry, the study suggests a link between use of the stimulant drugs and sudden death in children and adolescents. The drugs, used to treat attention deficit and hyperactivity disorder, already carry warnings about risks of heart attack and stroke in children with underlying heart conditions.

Healthy children taking the medications were six to seven times more likely to die suddenly for unexplained reasons than those not taking the drugs, according to the study from the National Institute of Mental Health.

Read the full article at AP

Cardiac Screening Recommended for Kids Taking Stimulants for ADHD

By Alan Mozes
HealthDay Reporter
April 21, 2008

Children with underlying heart disease who take stimulants for ADHD appear to face an increased risk for sudden cardiac arrest, the American Heart Association (AHA) noted. This risk association is particularly troublesome for young ADHD patients, because heart disease often goes undiagnosed in children and may be present without noticeable symptoms.

The AHA also pointed to a number of studies that suggest that between 33 percent and 42 percent of pediatric heart patients also have ADHD.

FDA data collected for the period 1999 through 2004 revealed that 19 children following an ADHD prescription regimen had died suddenly, while 26 experienced heart complications such as stroke, heart attack, and/or heart palpitations.

Vetter noted that, in 2005, the Canadian equivalent of the FDA -- Health Canada -- decided to place a ban on Adderall, an amphetamine-based ADHD medication designed for kids over the age of 3. The Canadian decision was actually based on a review of FDA records concerning 12 reported deaths among American children taking ADHD drugs.

Read the full article at HealthDay

See also:

• Does your child really have ADHD?

• Biomedical Treatment for ADHD

Nitrate use in Heart Failure

bafonavy — Tue, 03 May 2011 16:08:01 GMT

See also: cheap cialis | cialis |

Isosorbide dinitrate can be used with hydralazine in heart failure as an alternative to ACE-inhibitors or ARBs. The medications act complementary to dilate the blood vessels. Hydralazine reduces afterload by decreasing both pulmonary and systemic vascular resistance. Its effects on vasodilation are not completely understood. It also has some moderate inotropic effects. It reduces renal vascular resistance, though not by as much as ACE-inhibitors.¹

Nitrates like isosorbide dinitrate relax blood vessels by releasing NO. Isosorbide dinitrate improves exercise capacity in patients with heart failure^1,2. Nitrates can inhibit vascular and myocardial remodeling³. Nitrates must be dosed so that there is a six to eight hour period of negligible drug levels or tolerance may develop. Hydralazine may decrease nitrate tolerance. ^1,3

The V-HeFT trial in 1986 showed decreased mortality with the use of hydralazine and isosorbide dinitrate compared to prazosin². The V-HeFT II trial compared isosorbide dinitrate to enalapril in patients with moderate heart failure and found decreased survival due to a higher incidence of sudden death in the isosorbide dinitrate-hydralazine arm. There was no difference in mortality rate in African Americans taking isosorbide dinitrate-hydralazine compared to enalapril. ²

The A-HeFT trail in 2004 compared the addition of isosorbide dinitrate with hydralazine or placebo to standard heart failure treatment in patients of African descent in NYHA stage III or IV heart failure. The trial was terminated early due to increased survival in patients taking hydralazine with isosorbide dinitrate. The target dosing used in this trial was 75mg hydralazine and 40mg isosorbide dinitrate three times daily for a total daily dose of 225mg hydralazine and 120mg isosorbide dinitrate.⁴

Compliance is more difficult with a regimen containing isosorbide dinitrate and hydralazine because these medications are dosed three to four times a day. The new product, BiDil, contains both medications but is about twice as expensive and must also be taken multiple times per day. There is also a high discontinuation rate due to incidence of headache and GI upset.³

There is a lack of trials evaluating the use of isosorbide dinitrate without hydralazine in heart failure; these medications should be used together³. The ACC/AHA guidelines recommend to consider the addition of hydralazine with isosorbide dinitrate in African Americans. However, hydralazine with isosorbide should not be considered before an ACE-inhibitor if the patient has no history or ACE-inhibitor intolerance or if they are tolerating ACE-inhibitor therapy.³ The HFSA guidelines recommend to consider the use of hydralazine and isosorbide dinitrate in African Americans in standard therapy, as they do not respond as well to ACE-inhibitors as white patients. The HFSA also recommends to consider the addition of hydralazine with isosorbide dinitrate in African Americans with stage II or III heart failure and LV dysfunction even if their regimen includes an ACE-inhibitor or beta-blocker.⁵

*Note: images are not of heart failure but are of the beach

References:

Brunton LL, Lazo JS, Parker KL, editors. Goodman & Gilman’s: the pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill Companies, Inc.; 2006.

Elkayam U, Bitar F. Effects of nitrates and hydralazine in heart failure: clinical evidence before the African American heart failure trial. American Journal of Cardiology 2005;96(suppl):37i-43i.

Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult. Circulation 2005;112:e154-e235.

Taylor AL, Ziesche S, Yancy C, Carson P, D’Agostino R, Ferdinand K et al. Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. The New England Journal of Medicine 2004;351(20):2049-2057.

Adams KF, Lindenfeld J, Arnold JMO, Baker DW, Barnard DH, Baughman KL et al. Executive summary: HFSA 2006 comprehensive heart failure practice guideline. Journal of Cardiac Failure 2006; 12(1):10-38.

Nitrate use in Heart Failure

bafonavy — Tue, 03 May 2011 13:31:04 GMT