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SAN FRANCISCO, CA--(Marketwired - November 03, 2016) - Due to drug pricing controversies, there has been much concern about how the outcome of the upcoming election will affect pharmaceutical stocks. Dr. Len Yaffe of Stoc*Doc Partners sheds light on the issues in this analysis of drug price negotiation policy, and focuses in on one California ballot proposition that aims to rein in costs. Included in this article is: DURECT Corp. ( : DRRX) One issue of focus in the election rhetoric is Medicare drug price negotiation, which is specifically precluded in the Medicare Modernization Act of 2003. Furthermore, a noninterference provision was included: "In order to promote competition under this part and in carrying out this part, the Secretary (of Health and Human Services): (1) may not interfere with the negotiations between drug manufacturers and pharmacies and PDP sponsors; and (2) may not require a particular formulary or institute a price structure for the reimbursement of covered Part D drugs." Additionally, the Affordable Care Act (ACA) subsequently made into law that Part D drug plans give nearly full access to drugs in six therapeutic categories: anticonvulsants, antidepressants, antipsychotics, antineoplastics, antiretrovirals and immunosuppressants, effectively eliminating price negotiations. California's Proposition 61 would require state agencies to pay the same price as the U.S. Department of Veteran Affairs (VA) for prescription drugs. California spent $3.8 billion on prescription medicines in fiscal year 2014-2015, and almost 83% of that was for Medi-Cal and the Public Employees Retirement System. It should be understood that many programs are excluded, including Medi-Cal Managed Care, local school district employees and local government employees, as well as the majority of Californians with private insurance. Included are the 3.0 million low-income people covered by Medi-Cal Fee for Service, prison inmates, Department of State Hospital patients and some state employees and retirees. From an investment standpoint, I think the recent weakness in pharmaceutical stocks (iShares NASDAQ Biotechnology Index [IBB] and VanEck Vectors Pharmaceutical ETF [PPH] down 10% and 9%, respectively, in the last month) affords an excellent buying opportunity in select names with promising pipelines. In this group I include DURECT Corp. Continue reading this article: Why the Election Is Not as Relevant to Drug Stocks as You Might Believe Investors rely on The Life Sciences Report to share investment ideas for the biotech, pharmaceutical, medical device, and diagnostics industries. The information provided above is for informational purposes only and is not a recommendation to buy or sell any security. The following companies mentioned in this article are sponsors of Streetwise Reports: DURECT Corp. The companies mentioned in this article were not involved in any aspect of the article preparation. Streetwise Reports does not accept stock in exchange for its services. The information provided above is for informational purposes only and is not a recommendation to buy or sell any security. Please see the end of the article for the complete disclosure: Why the Election Is Not as Relevant to Drug Stocks as You Might Believe

News Article | December 6, 2016

Taken from the December 2016 issue of Physics World The Radium Girls: They paid with their lives. Their final fight was for justice. Kate Moore 2016 Simon and Schuster £16.99hb 320pp Radium-dial painters, mostly young working-class women, haunt the history of health physics. These young women with untreatable symptoms – whom the contemporary press and they themselves described as “the walking dead” – walk or more often hobble through Kate Moore’s book The Radium Girls. Their cases inspired the development of the field of radiation safety. The infamous photos of gross tumours overtaking the faces of pretty young women triggered a serious re-examination of the dangers of man-made radioactive isotopes in the 1920s, a time when merchants promoted radium as a miracle cure for whatever ails you. The case also led to the development of the first methods to detect radioactivity in living bodies. Indeed, the radium dial workers’ bodies became the raw material around which early health physicists created the notion of “permissible dose”. Moore – a Sunday Times bestselling author – seeks to retrieve the life stories of the radium-dial painters in portraits of several dozen radium-dial workers who pursued lawsuits against watch companies in New Jersey and Illinois. In the 1910s and 1920s, the demand for glowing radium watch-faces grew yearly. Company managers advised their young female employees, paid by the piece, to work with paintbrushes, dipping the points in their mouth to sharpen them. Their counterpart painters in Germany used glass-pointed brushes that held their shape because scientists knew that radium was harmful. Moore shows that the US companies were aware that dipping brushes into one’s mouth was risky, but it was also the cheapest and fastest way to paint watch dials. As the desire for glow in the dark watches was insatiable during and after the First World War, the women painted and dipped all day long, rushing to keep up with the work. The book makes for uncomfortable reading. Moore seeks to draw out the full effect of young lives painfully cut down in their prime. She swings between passages describing happy, pretty, dancing workers delighted to have cash in their pockets; to graphic details of the assault of radium accumulated in their bodies. The “girls” first started feeling aches and pains in their hips, knees and their jaws – their teeth wobbled painfully and when removed by dentists, the lesions did not heal. The young women developed anaemia, lost weight and felt chronically fatigued. As the ingested radium decayed, it broke down their bones into “honeycomb” configurations and ate into joints. Whole sections of the young women’s jaw bones gave way. Femurs snapped. Hip joints froze in place. Confused doctors treated the women, usually with casts and metal braces, measures that only increased their pain. In the second half of The Radium Girls, Moore carefully replays the law suits against the Radium Dial Company in Ottawa, Illinois, and the US Radium Corporation in Orange, New Jersey. She shows the managers’ attempts to evade responsibility for damage, as they drew on a playbook of strategies deployed subsequently in the field of industrial hygiene. The radium-dial companies initially ignored their employees’ complaints of painful symptoms and the first early deaths. They claimed the women’s doses of radium were too low to cause problems, though male workers in labs and loading docks were provided leather aprons, gloves and a set of safety restrictions. Glossing over the radium epidemic was easy. Until 1922 the industrial hygiene department at Harvard University was entirely funded by business, while regional public health offices bowed before the power of local industry. After several more young women died and many others became invalids, the rumours of the dangerous radium factories became a public-relations problem. When medical experts, hired by the companies themselves, ruled unexpectedly that radium poisoning could well be a factor, the reports were manipulated and hidden, and other more malleable specialists were found to vouch for radium’s supposed safety. As the lawsuits got under way, the companies courted public-health officials, lobbied for restricted workmen’s compensation laws, produced their own misleading public-health statements and did their best to sow confusion and stall legal rulings. As the years of court battles wore on, the plaintiffs increasingly had to turn over their bodies to use as evidence. Moore spotlights Harrison Martland, the young and brash new chief medical examiner for Orange, New Jersey, who took the workers’ health complaints seriously. He collaborated to devise a way to ash the bones of a recently deceased radium worker and test the ash with an electrometer. These were the first measurements of radioactivity in the human body. Later, Martland came up with ways to count gamma rays coming from live patients and from radon in expired air from their lungs. Martland surmised that radium settling inside painters’ mouths produced bacteria that led to chronic infections and loss of teeth. He guessed that radium damaged blood-forming cells in bone marrow, leading to deadly anaemias. Radium, he reasoned, also settled in bones, made them brittle and produced sarcomas. He exhumed the body of a painter to make his point. The bone fragments, buried six years earlier, glowed in the dark grave. At the time, toxicology demanded not just that statisticians show a significant increase in disease among radium-dial employees, but that the offending toxin be found in the bodies of the patients themselves. Martland’s measurements made a rare, lucid case in the history of what came to be known as “health physics”; radium known to be in the paint was also found in the workers’ bodies. Even with this clear-cut evidence, it took 14 years for the women to win their case in court. Moore provides a happy ending for this story as she concludes that the “radium girls” drew attention to the dangers of the material, which spawned safe practices in the burgeoning Manhattan Project. She points to the Argonne Center for Human Radiobiology as a laboratory that promoted progress in radiation safety, with a “moral obligation to future generations”. Unfortunately, I feel these are somewhat dubious claims. As the media attention about the dial-painters’ pain and death grew, scientists began to purposefully expose human subjects to man-made radioactive isotopes. Between 1931 and 1933, scientists at the Elgin State Hospital in Illinois injected half a dozen patients with 70 to 450 mg of radium-226. Later the Argonne lab located those patients, not to treat them, but to continue the experiment and measure retention of radium in their bodies. Scientists in the Manhattan Project began in 1943 to inject patients with the first micrograms of plutonium that they produced. In subsequent decades, the US Atomic Energy Commission funded hundreds of studies using human subjects exposed to internal and external radiation. Happy endings are nice, but I am not sure this sad tale deserves one.

Elmas A.T.,Inonu University | Tabel Y.,Inonu University | Elmas O.N.,State Hospital
Pediatric Nephrology | Year: 2013

Background: We aimed to compare serum cystatin C levels (sCysC) in preterm neonates with respiratory distress syndrome (RDS) with a control group and to investigate whether it could be used as a predictor for acute kidney injury (AKI). Methods: sCysC was measured in 62 neonates with RDS (n = 28) and control neonates without RDS (n = 34), whose gestational ages (GA) were between 27 and 29 weeks (subgroup 1) and 30-32 weeks (subgroup 2). AKI was defined as oliguria and/or increase of serum creatinine. Blood samples were obtained on postnatal days (PND) 3 and 30. sCysC levels were determined by particle-enhanced nephelometric immunoassay. Results: There were six neonates with AKI (RDS-AKI subgroup) and 22 neonates without AKI (RDS-no AKI subgroup) during the first 7 days. Although sCysC levels were lower in neonates with RDS than controls on PND3 in both GA subgroups, the differences were not significant. However, in neonates with RDS and AKI, sCysC levels were significantly higher than neonates with RDS but no AKI and neonates in the control group on PND3. sCysC level was found to have a statistically significant association with AKI development in preterm neonates with RDS. Conclusions: sCysC is an independent predictor of AKI in preterm neonates with RDS. © 2012 IPNA.

Gonen K.A.,State Hospital | Simsek M.M.,Haydarpasa Numune Training and Research Hospital
European Journal of Radiology | Year: 2010

Objective: Estimation of the prognosis of infarction by using diffusion weighted imaging (DWI) and quantitative apparent diffusion coefficient (ADC) measurements. Methods: 23 patients having acute stroke symptoms with verified infarction in magnetic resonance imaging (MRI) were included in this study. Their MRI studies were performed between 6 and 12 h after the onset of their symptoms and were repeated on the fifth day. The infarction volumes were calculated by using DWI and the patients were divided into two groups as the ones having an expansion in the infarction area (group 1, n = 16) and the others having no expansion in the infarction area (group 2, n = 7). Quantitative ADC values were estimated. The groups were compared in terms of the ADC values on ADC maps obtained from DWI, performed during the between 6 and 12 h from the onset of the symptoms, referring to the core of the infarction (ADC IC), ischemic penumbra (ADCP) and the nonischemic parenchymal tissue (ADCN). P values < 0.05 were accepted to be statistically significant. Results: During the between 6 and 12 h mean infarction volume calculated by DWI was 23.3 cm3 for group 1 patients (ranging from 1.1 to 68.6) and this was found to be 40.3 cm3 (ranging from 1.8 to 91.5) on the fifth day. For the group 2 patients these values were found to be 42.1 cm3 (ranging from 1 to 94.7) and 41.9 (ranging from 1 to 94.7) for the same intervals respectively. A significant statistical result was failed to be demonstrated between the mean ADC IC and ADCN values (p = 0.350 and p = 0.229 respectively). However the comparison of the ADCP values between the groups was found to be highly significant (p < 0.001). When the differences between the ADCP and ADCIC and ADCN and ADCP were compared the results proved to be statistically significant (p = 0.038 and p < 0.001 respectively). Conclusions: We believe that ADC results that would be obtained from the core and the penumbra of the infarction area will be beneficial in the estimation of the infarction prognosis and in the planning of a treatment protocol. © 2009 Elsevier Ireland Ltd. All rights reserved.

Arik F.,Selcuk University | Yaldiz T.,State Hospital
Clean - Soil, Air, Water | Year: 2010

The investigation area is located to the east of Kütahya-Tavşanli and, covers an area about 150 km2. The units cropping out in the study area comprise of metamorphic, volcanic, and sedimentary rocks ranging from Upper Paleozoic to Quaternary. There are some polymetallic ore deposits represented by silver, zinc, lead, and antimony deposits and some enrichments related to them such as As, Cd, Tl, Cu, Mn, Ba, and Sr around the Aktepe at the southeast of the study area. In order to investigate the heavy metal contents and contamination in soil and plants, some leaves, branches, and fruits of trees (Salix, oak: Quercus sp., pine: Pinus sp., apple: Malus communis, walnut: Juglans regia, poplar: Populus sp., plane: Platanus orientalis, pear: Pyrus communis, oleaster: Elaeagnus angustifolia) and some herbaceous plants like prickle and meadow samples have been collected and subjected to geochemical analysis. Mean element concentrations of soil samples are 0.7 ppm Ag, 82.6 ppm Pb, 165.3 ppm Zn, and 8.5 ppm Sb. The concentration of As, Cd, Tl, Cu, Mn, Ba, and Sr are 203.3, 1.5, 1.7, 32.6, 1059.5, 718.4, and 289.6 ppm, respectively. With respect to plants the average heavy metal concentrations are 0.14 ppm Ag, 2.49 ppm Pb, 52.34 ppm Zn, and 1.05 ppm Sb and the average concentration of As, Cd, Tl, Cu, Mn, Ba, and Sr are 4.41, 0.64, 0.19, 6.54, 119.80, 39.46 versus 41.21 ppm, respectively. Element distributions of soil and plants depend on to the distance from the present Ag-Pb-Zn-Sb deposits. Element concentrations of plants differ depending on not only plant type like tree and herbaceous plants but also the types of samples such as leaves, branches, or fruits of trees. Especially leaves of trees and herbaceous plants have relatively higher element concentrations. Therefore, people who and animals which live in this area and benefit from these soil and plants have vital risks. © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Background: Misshapen or weak lateral crura can cause an inward collapse of the lateral crus observed on deep inspiration. The lateral crural strut graft is a popular technique for reinforcing lateral crura. Failure to stabilize the graft properly can, however, result in graft displacement postoperatively and an accompanying aesthetic deformity. Objectives: The authors discuss lateral crus reinforcement with the sandwiched lateral crural reinforcement (SLCR) graft. Methods: An SLCR graft was placed in 30 nonconsecutive primary open-approach rhinoplasty procedures by the senior author (I.K.) between February 2010 and May 2012. Cephalic excess of the lateral crura was incised and placed under the lateral crura; the lateral crural strut grafts were placed between the 2 cartilages, and the cephalic edges of both the superior and inferior lateral crura segments were sutured together. Results: Of the 30 patients, there were 5 men and 25 women ranging in age from 22 to 45 years (median, 35 years). Half (50%) of the patients received the SLCR graft for external valve collapse; in 30% of the patients, it was placed to support the lateral crura after correcting cephalic malpositioning; and 20% had an SLCR graft placed for lateral crural reinforcement after deformity secondary to dome-shaping sutures. No graft displacement or tip disfigurement was observed in the follow-up period (mean, 24 months). Conclusions: The SLCR graft technique represents a powerful tool for reinforcing lateral crura without discarding the cephalic portion of the cartilage, thus securing a stable graft pocket while minimizing any postoperative structural dislocation. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

Cakmaz R.,State Hospital
The Libyan journal of medicine | Year: 2013

There is no valid and reliable diagnostic test for early diagnosis of acute mesenteric ischemia (AMI). The aim of this study was to measure the plasma levels of diamine oxidase (DAO) and citrulline in AMI to gain insight into its early diagnosis. A total of 21 Wistar albino rats were divided into three groups, that is, control group, short-term ischemia group, and prolonged ischemia group. The superior mesenteric artery was occluded for 15 min in the short-term ischemia group and for 12 h in the prolonged ischemia group. Twelve hours later, the experiment was terminated and plasma DAO and citrulline levels were measured. Intestinal tissue was evaluated for the histopathological changes. Compared to the control group, the short-term and prolonged ischemia groups showed significant increases in the plasma levels of DAO, whereas the plasma citrulline levels decreased significantly. Prolonged ischemia caused a larger increase in the plasma DAO levels and a larger decrease in the plasma citrulline levels compared to the short-term ischemia (p=0.011 and p=0.021, respectively). Intestinal damage was shown to develop more in the prolonged ischemia group (p=0.001). In the early period of AMI, the plasma DAO levels increase while citrulline levels decrease, and the extent of these changes depends on the duration of ischemia.

Background: Urothelial carcinoma (UC) is a malignant neoplasm that most commonly occurs in the urinary bladder. The primary aim of this study was to evaluate the clinicopathologic features, recurrence and progression in patients with bladder urothelial cancer. Materials and Methods: The medical records of patients diagnosed with UC in the state pathology laboratory between January 2006 and July 2014 were retrospectively included. Carcinomas were categorized according to age, gender, histologic grade, tumor configuration, pathologic staging, recurrence status, and progression. Results: A total of 125 (113 men, 12 women) patients were examined. The mean age was 65.9 years and the male-to-female urothelial cancer incidence ratio was 9.4:1. Low-grade UCs were observed in 85 (68%) and high-grade in 40 (32%). A papillary tumor pattern was observed in 67.2% of the UCs. Cases were classified with the following pathological grades: 34 (27.2%) cases of pTa, 70 (56%) of pT1, and 21 (16.8%) of pT2. Recurrence occurred in 27 (21.6%) patients. Ten progressed to a higher stage (pT1 to pT2), and three cases to higher grade (low to high). We also analyzed the results separately for 70 (56%) patients 65 years of age and older. Conclusions: With early detection and diagnosis of precursor lesions in older patients, by methods such as standard urologic evaluation, urinary cytology, ultrasound scanning and contrast urography, and cystoscopy, in addition to coordinated efforts between pathologists and urologists, early diagnosis may reduce the morbidity and mortality of patients with urothelial carcinoma.

Polat F.R.,State Hospital
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques | Year: 2012

AIM:: The aim of this retrospective study was to evaluate the reliability and feasibility of the laparoscopic approach in hydatid cyst cystectomy. MATERIALS AND METHODS:: A retrospective review of the medical records of 21 patients diagnosed with hydatid cyst disease between July 1999 and January 2011 was conducted at Van State Hospital and Toyota Emergency Hospital. Two patients with calcified cysts were excluded. Hydatid cystectomy was performed by laparoscopy (LC) in 7 patients and by laparotomy (OC) in 12 patients. The preoperative and postoperative parameters were compared. RESULTS:: There were 11 female (52.3%) and 8 male (47.7%) patients with a mean age of 31.7 years (range, 14 to 50 y). The mean duration of hospitalization was 4.8 days (range, 2 to 15 d). Recurrence was not seen in any cases in both groups. The morbidity rates of LC and OC were 14.2% and 33.3%, respectively. The most frequent postoperative complications were wound infections (1 case in LC and 3 cases in OC), hemorrhage (1 patient in the OC group), and hernia (as the late complication in 2 patients in the OC group). The operation success was graded as excellent in 18 patients and good in 1 patient. CONCLUSIONS:: The laparoscopic technique is an easy-to-apply, safe, and effective method to conduct liver and spleen hydatid cyst surgery. This technique can be used in patients with unique, small-sized, superficially located cysts, and also has the advantages of other abdominal laparoscopic operations. Copyright © 2012 by Lippincott Williams & Wilkins.

Lymphedema can be defined as the abnormal accumulation of protein-rich interstitial fluid that occurs primarly as a consequence of malformation or acquired distruption of the lymphatic circulation. Upper extremity lymphedema can develop in a significant proportion of patients after mastectomy. Currently, complex decongestive physical therapy is accepted as international standard treatment approach for the treatment of lymphedema. Complex decongestive physical therapy includes skin care, manual lymphatic drainage, compression bandage, compression garments, exercise and sometimes addition of intermittent pneumatic compression pump. When conservative treatments is not sufficient surgical intervention is an alternative to the patients. In this review, current treatment approaches are discussed.

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