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Medicine has seen great strides in general anesthesia safety
The last two decades could be considered the golden age for advances in, capped in October when the Quality Institute started the first nationwide system for the collection of data that includes individual problems from anesthesia in real cases. Executive director and anesthesiologist Dr. Richard Dutton calls it an "early warning system" that will be especially useful when new devices or drugs are introduced. Despite dramatic improvements, the National Institute of General Medical Sciences says general anesthetics are still "among the most dangerous drugs used by doctors, particularly for elderly patients and those with certain chronic diseases." Factors that can increase your risk of problems under general anesthesia include, smoking, , ,, use of and other nonsteroidal anti-inflammatory drugs that can interfere with blood clotting, and some herbs that can cause bleeding, changes in blood pressure and affect anesthesia drugs. That said, anesthesia-related deaths have decreased over the last 25 years from two per 10,000 anesthetics administered to one per 200,000 to 300,000. The American Society of Anesthesiologists says a person is more likely to be struck by lightning than die from anesthesia-related complications. The reasons? Today, anesthesiologists use different intravenous drugs to achieve sedation, unconsciousness, pain prevention and amnesia, and carefully control them to meet each patient's needs, which increases safety. Modern drugs also result in fewer side effects such as nausea. The dosage is dependent on age, sex, weight and the health of the patient, Dutton says. In some complicated cases, a drug will paralyze the patient to prevent movement because even small twitches can cause surgical errors. To maintain the anesthesia, there may be a continuous infusion of an intravenous drug or an inhaled gas. "We have much-shorter-acting inhalation agents today," says Dr. W. Scott Jellish, chairman of anesthesiology at University Medical Center in Maywood. "Once turned off, they dissipate very quickly, so wake-up time is much better. And there are now very short-acting narcotics." In addition, new devices and digital technology enable continuous monitoring of vital signs such as blood pressure,, blood oxygen levels, heart rate and breathing patterns, adds Timothy R. Lubenow, an anesthesiologist at. "We can monitor and measure vital signs almost on a beat-by-beat basis," he says, "and so, are ready to take measures that are necessary to control a problem. Another big advance is the use of nerve blocks before anesthesia to control postoperative pain." This is good news for Andrea Liedtke, of Wheaton, who says she was "scared witless," before being put under for the first time 20 years ago. "I was more scared about the anesthesia than I was about the procedure. You think you're going to go under and die." Education has made her much more comfortable with the idea of general anesthesia. Lack of knowledge about anesthesia and the subsequent fear leads to 1 in 4 patients to put off surgery, according to an ASA report. The lethal potential of general anesthetics grabbed headlines late last year when Dr. received the maximum four-year sentence for involuntary manslaughter in 2009 overdose from. He was convicted of injecting Jackson with propofol,, a general anesthetic that should never be used outside a surgical setting,, and then left him unattended at home. Damian Newberger, of Glenview, has been put under nine times for operations that included a transplant 14 years ago that saved his life and a kidney transplant  last October. Informed and curious, he studied what would happen step by step. When he had a question or a "demand," he spoke to his anesthesiologist at length until he had an answer, which eased any anxiety he had. "Every surgery has its risks, and anesthesia may be the least of them." he says. Ironically, with all the advances in anesthetic effectiveness and safety, researchers still don't know how they work. The prevailing theory is that the drugs target certain molecules in nerve cells, interfering with brain signals. Researchers also believe the different drugs target different molecules. "To me,, it's less important how they work and more important that they work and are safe," Liedtke says.

Florence Henderson admits to getting crabs in an affair - ch
We adore them. We watch them every week. Sometimes we even imagine they're our own family,, but even TV mothers have to be weary with their health. In a recent ,, actress Florence Henderson (the "Brady Bunch" mother) admits that she once got pubic lice (more commonly known as crabs)--parasitic insects found in the genital area of humans--after having an affair. Spreading crabs can happen to anyone who is not careful. Here are tips on how to prevent spreading or getting this STD. -Shamontiel L. Vaughn,, Tribune Newspapers (Source: )

Accretive CEO counters claims in Minnesota AGs report - chic
Embattled hospital billing and collections company Accretive Health Inc. on Wednesday said it was blindsided by the critical report released last week by Minnesota's attorney general and vowed to explore "legal remedies for the damages" resulting from the fallout. In a letter sent to Lori Swanson's office on Wednesday,, the Chicago-based company accused the attorney general of waging a "public campaign of misinformation" that has harmed the company, the nonprofit Minneapolis-based hospital operator Fairview Health Services and Minnesota patients. Accretive Health said in the letter that the attorney general released the report without notice and that the company was actually in settlement negotiations on a separate lawsuit filed by Minnesota against the company in January. As part of those settlement negotiations, the company said it voluntarily provided confidential documents and agreed to make executives available for meetings. Accretive also said that it had agreed in February to cease its debt collection activities in Minnesota to address issues Swanson's office had raised in the past. But instead of following through on the office's commitment to "conduct settlement negotiations in good faith,," Swanson released the scathing report and "personally staged a media tour" disparaging the company, the letter said. Swanson's report, released April 24, accused Accretive Health of using overly aggressive and unsavory tactics to squeeze payments from patients in Fairview's seven Minnesota hospitals. It alleged that some patients were pressured for payment by Accretive Health employees who didn't properly identify themselves as debt collectors prior to receiving care. Accretive Health said the report contains "numerous distortions of fact" and "significant misinformation" that could have been corrected if the attorney general's office had ever met "with a single business representative from the company." Mary Tolan, Chicago-based Accretive Health's chief executive, said in a brief interview Wednesday that Swanson's report contained "a tremendous amount of innuendo and falsehoods and doesn't represent what we do at all." Tolan said Swanson's six-volume report on the company used information out of context and incorrectly painted Accretive Health as a ruthless debt collector. "When the truth is that you're really advocating for patients and someone says you're something that's the exact opposite of that" the market fills with uncertainty resulting in undue damage to the company's reputation,, Tolan said. "These are not true assertions." Since Swanson's report was made public last week, shares of Accretive Health's stock have fallen by 54 percent. Accretive Health on Wednesday finished at $8.71,, down 5 percent. The Minnesota attorney general's office said in a statement Wednesday that its report "is accurate and documented by the facts." It said it regularly conducts compliance reviews of the state's largest health care organizations. The Fairview report, it said, was based on the review of more than 100,000 pages of documents and interviews with officers and directors of the hospital system. "Patients state that they have been victims of aggressive debt collection tactics orchestrated by Accretive in hospital emergency rooms and at patient bedsides," the attorney general's statement said. By releasing its Wednesday letter, "this company continues to ignore the dignity and rights of those patients." The company earlier this week filed a motion to dismiss the federal lawsuit filed by Swanson in January that alleges the company violated patient-privacy and debt-collection laws when a laptop containing private data on 23,500 patients was stolen from an employee's car. It also lost on Friday the remaining portion of its contract with Fairview. Tolan argued that the market uncertainty brought on by the issues in Minnesota have clouded Accretive Health's underlying value and strong fundamentals,, and she expressed confidence that the company will remain viable. pfrost@tribune Twitter: @peterfrost

Boxing champ Joe Frazier, rival of Muhammad Ali, had liver c
Former undisputed heavyweight boxing champion Joe Frazier,, who died Monday at the age of 67 after a brief bout with, also had -- a major risk factor associated with the disease. Diabetes has been associated with the highest percentage (34%) of cases of the most common type of liver cancer, research by the National  Institute. (The next highest was alcohol-related disorders, with 24%). Men and older adults are at higher risk of the cancer as well. Frazier, perhaps most famous for trouncing bitter rival in the  "Fight of the Century," had reportedly been diagnosed with liver cancer in late September. Though it's unclear exactly what type of cancer Frazier had -- there are many types of liver cancer, including ones that start in the bile duct or in the vessels -- hepatocellular carcinoma accounts for about three in every four cancers that begin in the liver,  the American Cancer Society. Liver cancer, says the ,, is generally caused by scarring of the liver,, known as. That scarring damage can come from, among other things, ,, chronic infection by hepatitis B or C, or long-term inflammation of the liver. "Aggressive surgery or a liver transplant can successfully treat small or slow-growing tumors if they are diagnosed early," according to the encyclopedia entry. "However,, few patients are diagnosed early." For more information on the disease and potential treatments, visit the 's. Follow me on Twitter.

Clout Street - Local political coverage - chicagotribune.com
Chicago aldermen disclose outside jobs,, income New financial disclosure statements show six of the Chicago City Council's 16 new aldermen have outside jobs or own businesses. By Hal Dardick and John Byrne May 2,, 2012  Send to (as many as 3 e-mail addresses,, separated by commas): E-mail addresses:   Send me a copy. From: Name:   E-mail:   Comments:   200 characters remaining                               

Most resembles
On the field:, The Bears have been in need of a pass-catching tight end since trading last summer. Rodriguez is that, but the team hopes he also can block linebackers, seal the edge in the running game and be a vertical threat. Upside: Rodriguez has lot of offense to learn,, but if he can,, he could be a three-down player and provide a boost in all phases. He's a purer receiver than and will add a dynamic that didn't exist under. Downside: Rodriguez is undersized and isn't physically imposing,, which will make him iffy as a blocker in the running game. He also comes with off-the-field baggage, but the Bears hope those issues are behind him. Most resembles: He likes to compare himself to the Patriots' ,, who is about the same size and has similar speed. The Bears will be giddy if he can find similar success.

Stanley Kroenke - Forbes
, Profile                                                                                                                                                                                     Billionaires: March 2012                                                                                                                                                                                                                        Forbes 400: September 2011                                                                                                                                                                                                                        Billionaires: March 2011                                                                                                                                                                                                                        Forbes 400: September 2010                                                                                                                                                                                                                        <option value="stanley-kroenkeBillionaires2010">Billionaires: March 2010                                                                                                                                                                                                                        <option value="stanley-kroenkeForbes 4002009">Forbes 400: October 2009                                                                                                                                                                                                                        <option value="stanley-kroenkeBillionaires2009">Billionaires: March 2009                                                                                                                                                                                                                        <option value="stanley-kroenkeForbes 4002008">Forbes 400: October 2008                                                                                                                                                                                                                        <option value="stanley-kroenkeBillionaires2008">Billionaires: March 2008                                                                                                                                                                                                                        <option value="stanley-kroenkeForbes 4002007">Forbes 400: October 2007                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Real estate mogul Stanley Kroenke has been rumored to be in the running to buy the Los Angeles Dodgers. Already the owner of the basketball franchise,, the Denver Nuggets,, and the Colorado Avalanche hockey team,, Kroenke upped his stakes in the St. Louis Rams football team and the English soccer club Arsenal in the last year. To comply with NFL ownership rules, he will have to relinquish ownership of the Nuggets and Avalanche before 2015. He made his first fortune developing commercial and retail properties. Today his THF Realty operates shopping centers in nearly half the U.S., many anchored by Wal-Mart. Kroenke owns Canada's largest cattle ranch and two wineries. He is married to Ann Walton Kroenke,, daughter of James (Bud) Walton and niece of Wal-Mart founder Sam Walton.

Matthew Herper - The Medicine Show - Forbes
See also my on Cerner, from the May 7, 2012, issue of Forbes Magazine. Neal Patterson,, the chief executive of health care IT firm Cerner, believes that in the future the insurance companies that act as intermediaries between governments and consumers and the providers of medical care will be replaced by a new middle layer of cheap and powerful computers. &#8220;About a third of health care never gets to health care delivery,&#8221; he says. &#8220;Instead, it gets consumed in this high friction middle. I broadly envision a new middle that is a frictionless system. Instead of taking 20% to 30% of the dollar it should be operating in single digits. This should be consuming less than a dime of our health care dollar.&#8221; Patterson is a Republican, and a believer in the philosophies of Ayn Rand who says both political parties &#8220;frustrate&#8221; him on health care policy. He says that he believes a pure single payer health care system would make America&#8217;s innovation engine go stagnant. But part of the move to this new, more computerized system is coming from the left, and the Affordable Care Act �C Obamacare. Part of the law, not the controversial individual mandate that landed it in front of the Supreme Court, but another section that related to Medicare,, has created a new idea: the Accountable Care Organization. Right now, if a surgeon drops his scalpel into you,, requiring a second operation,, he and the hospital get paid both times. The ACO tries to change this. ��We don��t have a business model for health care in this country,�� says Patterson ��We just have a business model for care. The way doctors and hospitals get paid is something bad has got to happen. It��s a pure reactive model. Between here and there, we��re going to make it a predictive system, and we��re going to avoid a lot of costs that today we just incur.�� Dennis Cortese, the former chief executive of the Mayo Clinic and a member of Cerner&#8217;s board of directors, says that the Centers for Medicare and Medicaid Services didn&#8217;t really need a law to give them authority to experiment with ACOs. Now that the changes have been pushed into motion, CMS is unlikely to stop. &#8220;It&#8217;s too bad the good parts of the bill,, which will help drive this change, are getting bogged down,&#8221; says Cortese. &#8220;But it doesn&#8217;t matter if the whole bill goes down. CMS has embarked on a course.&#8221; Cortese says that doctors, right now, have no financial interest in preventing people from showing up sick in their offices in five years, or ten. The way to measure how a hospital treats asthma, or heart failure, is whether patients wind up in the emergency room or back in the hospital again, not how many times they get treated. John Halamka, the chief information officer at Beth Israel Deaconess in Boston, which designed its own IT system, is one of the pioneer ACOs under the new plan. He says that too thinks that ACO is here to stay, because even some private insurers are exploring it. &#8220;No matter what the Supreme Court does we&#8217;re not going to change because we believe the future of health care is in the idea that you&#8217;re treating the whole patient. We just don&#8217;t think fee for service is going to stick around.&#8221; For some hospital systems, that could be a business opportunity. David Bradshaw, the chief information and marketing officer at Memorial Hermann, a hospital system in Texas that is a Cerner customer, says he thinks that there is &#8220;significant growth&#8221; to be had from the change. &#8220;A typical hospital in America is paid by fee for service,&#8221; he says. &#8220;There&#8217;s very little incentive about systems like us getting in front of wellness and personal accountability and better management of the chronically ill. But we see the whole marketplace changing.&#8221;