Dr. Birke Receives National Diabetes Award for Outstanding
Contributions
Dr. James A. Birke
Baton Rouge (June 29,
2009) – Dr. James A. Birke, PT, Ph.D., was honored
with the Roger Pecoraro Lectureship from the
American Diabetes Association (ADA) at the ADA’s 69th Scientific Sessions,
the world’s largest diabetes meeting, in New Orleans, La.
Clinical
researchers are selected for this award based on their outstanding
contributions to the knowledge and treatment of the diabetic foot.
Director of
Rehabilitation Services at the LSU Health Sciences
Center and the LSU Diabetes Foot
Program at Earl K. Long Medical Center
in Baton Rouge, La., Dr. Birke
has specialized in the treatment of neuropathic foot problems for the past 27
years.
He is a retired
captain in the United States Public Health Service, serving as the director
of the Physical Therapy and Foot Program at the National Hansen’s Disease Center
in Carville, La.
The Roger Pecoraro Lectureship is given in memory of Roger Pecoraro for his scientific contributions and untiring
commitment to improving the understanding of diabetic foot complications
More than 13,000
top scientists, physicians, and other health care professionals from around
the world shared the latest research, treatment recommendations, and advances
toward a cure for diabetes at the Sessions.
Photo of Dr. Birke
is available at http://www.lsuhospitals.org/images/birke.jpg.
Nearly 24 million
children and adults in the United
States have diabetes. Diabetes contributes to the deaths of more
than 230,000 Americans each year and costs our nation $174 billion annually.
The ADA is leading the fight
against the deadly consequences of diabetes and fighting for those affected
by diabetes. The Association funds research to prevent, cure, and manage
diabetes; delivers services to hundreds of communities; provides objective
and credible information; and gives voice to those denied their rights
because of diabetes. The mission of
the ADA,
which was founded in 1940, is to prevent and cure diabetes and to improve the
lives of all people affected by diabetes.
Visit www.diabetes.org for more information.
The LSU Health
System - Health Care Services Division is one of the largest public health
care delivery systems in the country.
It has over 35,000 inpatient admissions, nearly 196,000 inpatient
days, 515,500 outpatient clinic visits, 894,000 outpatient encounters, and
nearly 244,000 emergency department visits.
Each year nearly 500 residents and fellows from the LSU and Tulane
Schools of Medicine and Ochsner Health System and
2,200 nurses and allied health students from many colleges and universities
are trained in LSU facilities.
LSU is the largest
single provider of uncompensated inpatient care in Louisiana.
LSU HCSD hospitals have an economic impact of over $1.4 billion in
asset business activity, $568 million in personal earnings, and generate over
12,000 jobs.
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Dr. James A. Birke
Dr. James A. Birke has been
honored with the Roger Pecoraro Lectureship from
the American Diabetes Association. Clinical researchers are selected based on
outstanding contributions to the knowledge and treatment of the diabetic
foot.
Birke is director of rehabilitation
services at the LSU Health Sciences
Center and the LSU Diabetes Foot
Program at Earl
K. Long
Medical Center.
http://www.2theadvocate.com/news/business/49218337.html
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4 years later, LSU Health
Sciences Center is on the mend
by John Pope, The
Times-Picayune
TED JACKSON / THE TIMES-PICAYUNE
A wooden plaque still adorns an unused office, a
space now filled with old doors. LSU medical school's original building sustained
heavy damages in Hurricane Katrina but has since been renovated in many
areas. Some areas, however are still awaiting work.
View More Pictures here: http://www.nola.com/health/index.ssf/2009/06/4_years_later_lsu_health_scien.html
Nearly four years
after a savage attack left it hobbled, the LSU Health
Sciences Center's
oldest building is definitely showing signs of life.
The eight-story
colossus at 1542 Tulane Ave.
isn't fully occupied -- that isn't scheduled to happen until late next month
-- and much remains to be done. However, the part of the building where LSU's
first class of medical students reported in 1931 will never be occupied again
because equipment that would make the area habitable -- equipment idle since
Hurricane Katrina -- is too fragile to be used anymore, said Ronnie Smith,
the center's vice chancellor for administration and finance.
But in most of the
Clinical Education Building,
where reoccupation began last year, lights shine, air conditioners hum, and
the normal business of running the medical school proceeds, with work crews
sharing space with health-care professionals.
Parts of the
building are even exhibiting some personality.
For instance, Rose
Hrabar has affixed a big yellow smiley face to the
door of her fourth-floor office, where she schedules open-heart surgeries.
It's a pick-me-up, the nurse said, that reflects her outlook.
"I'm thrilled
to be back; I'm thrilled to have a job," said Hrabar,
who moved back into the building in November.
So far, the
Federal Emergency Management Agency has covered slightly more than $24
million in repairs, Smith said.
Trouble down
below
The prospect of
restoring the 304,995-square-foot structure was daunting, he said, and not
just because of the destruction the monster storm wrought. Katrina's
collateral damage included the architectural, mechanical and electrical
blueprints for the building, which were housed in two spots overwhelmed by
the floodwaters: an architect's office in Chalmette
and the basement at 1542 Tulane
Ave.
"At least there
were no patient records there," Smith said.
The medical
building's 38,291-square-foot subterranean chamber, which houses the massive
machinery that powers, heats and cools the building, was full of water up to
the 14-foot-high ceiling, Smith said.
Without the plans,
"we had to figure out how everything worked," he said.
The key to the
building's function is in the vast, dark basement, where Smith pointed out
new pumps and electrical, heating and cooling equipment that replaced what
the floodwaters ruined.
FEMA paid for the
new gear, and the agency also will pay for the machines' future housing: an
enclosed structure about three stories above a side parking lot -- a level planners hope will be far above future floods.
There was another
basement expense, Smith said: "The pipes were insulated with asbestos
material, which fell into the flood. When we pumped the water out, we were
left with hazardous materials."
The eventual water
level was about 6 inches below the first floor, he said. Because the building
is elevated, floodwater didn't rise beyond the basement, except in the
auditorium, where the floor slopes down toward the stage.
The auditorium --
the site of lectures, meetings and joyous Match Day celebrations, when
students learn where they'll go for residencies -- is undergoing repairs,
Smith said. It eventually will be fitted with sophisticated audio-visual and
computer-related equipment.
Yet to be replaced
are the doors next to the stage that bear a water
stain nearly three feet high.
Developed in
phases
The building, which from above looks like an "H"
lying on one side, rose in three phases. The first part, parallel to Tulane Avenue but
set back from that thoroughfare, was dedicated in 1931; the cornerstone is
visible in the parking garage. Then came a section
perpendicular to the first, followed by an addition along Tulane Avenue.
The areas in the
newest section used to be full of offices and laboratories. As part of the
restoration, walls have been torn down and equipment removed, not only
because planners wanted to provide open space for lounge and meeting areas
but also because, Smith said, there was no need for the labs.
Rebuilding the
labs would have been expensive and unnecessary, he said, because laboratories
on the newer part of the campus, on the other side of South Claiborne Avenue, "are most
conducive to carrying on modern research."
The back part of
the building still bears the original Art Deco finery, although, Smith said,
vandals made off with some ornate doorknobs embossed with "LSU" in
the weeks immediately after the storm, when the security system didn't work.
The elevator doors
there still gleam, and the elevators work, but the areas flanking them will
be closed off above the first floor. To show why, Smith led the way into what
used to be the medical-school dean's suite. Using a flashlight, he pointed
out the pipes in the wall that used to carry chilled water for the
air-conditioning system.
"The lines
are so frail that if you touch them, they crumble," he said, brushing
them with his hand as flakes fell from the pipes. "Our professional
opinion was that after sitting for a couple of years, they could not
withstand pressurizing the system, and we didn't want to risk flooding floors
and damaging all the work that we were doing."
Besides, he said,
FEMA wouldn't cover replacement of that system because its damage wasn't
directly attributable to the storm.
Aiming high
In addition to the
federal money, Smith said he expects the repair job could cost as much as $5
million more from non-FEMA sources.
"We have
attempted to take advantage of the extended period of shutdown to make every
aspect of the facility better than it was pre-K," he said. "That
has been our commitment and intent in relation to all of our facilities.
While we have much more to do, significant progress has been made and
continues to be made."
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Shreveport Times | 06.28.09
From Staff Reports
LSU Health Sciences
Center at Shreveport
has became the first academic medical center in Louisiana to earn
accreditation from the Association for the Accreditation of Human Research
Protection Programs Inc.
Also receiving
accreditation is the Overton Brooks VA Medical Center in Shreveport, an affiliated institution that
utilizes the LSUHSC-S Institutional Review Board to review and approve many
of its research protocols involving humans.
LSUHSC-S officials
said the accreditation culminated a process that began in 2008 and
represented an institutional team effort.
"Participants
in any of the 593 active clinical trials offered by LSUHSC-S and their
families now have external confirmation that our research staff doesn't
settle with just meeting federal standards for human research. LSUHSC-S
voluntarily exceeds those standards so that the safety of every person who
participates in clinical trials here is protected to the fullest extent
possible," said Chancellor Dr. Robert A. Barish.
"Public trust
in research is crucial if we are to recruit volunteers for these important
studies that help pioneer new medical treatments that are proven safe for the
American public. AAHRPP accreditation helps foster public trust in our
programs," he added.
One of the
hallmarks of LSUSHC-S clinical research is following-up with volunteers to
inform them of the outcome of the study in which they participated.
AAHRPP was
established in 2001 by seven founding organizations, the Association of
American Medical Colleges, Association of American Universities, Consortium
of Social Science Associations, Federation of American Societies of
Experimental Biology, National Association of State Universities and Land-Grant Colleges, National Health Council, and
Public Responsibility in Medicine and Research.
AAHRPP employs a
voluntary, peer-driven, educational model of accreditation for organizations
engaged in research involving human participants.
http://shreveporttimes.com/article/20090628/NEWS04/906280321/LSUHSC-earns-research-accreditation
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Gregory Rusovich, Bob Brown, Ron Forman
The Business
Council of New Orleans and the River Region has worked tirelessly to
encourage leaders at Tulane and LSU to work out their differences with
respect to a governance model for the New
Orleans academic medical center. Facilitated by DHH
Secretary Alan Levine, a draft memorandum of understanding was hammered out
last week and offered to both university boards for approval at special
meetings called for that purpose only.
The negotiating
teams were made up of the most senior leaders from both institutions --
including the presidents of the universities as well as the chairmen of their
respective university boards.
The Tulane Board
of Administrators ratified the document as drafted. The LSU Board of
Supervisors made unilateral changes before approving a version to which
Tulane had obviously not agreed. We call on the LSU Board of Supervisors to reconvene
as soon as possible and affirm the document that their leaders developed.
Advertisement
A state of the art
medical center which provides cutting edge research, residency training and
excellent health care for all is crucial to an improved quality of life for
our citizenry. A new teaching hospital will have an enormous, positive
economic development impact on our city.
We urge the LSU
Board of Supervisors to do the right thing for all parties: Reconvene, adopt
the memorandum as originally agreed to and improve the quality of life for
the people of Louisiana.
Gregory Rusovich
Chairman
Bob Brown
Managing Director
Ron Forman
Academic Medical
Center Task Force
New Orleans Business Council
New Orleans
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1246166428175600.xml&coll=1
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Business Council of New Orleans and the River Region | 06.26.09
Greg R. Rusovich, Robert W. Brown, L. Ronald Forman
Dear Chairman Roy
and President Lombardl:
We are writing to
request-in the most urgent possible way-that you reconvene the Board of
Supervisors and ratify the draft Memorandum of Understanding which was
arrived at in the recent negotiations aimed at settling the governance of an
academic medical center in New
Orleans. This should be done as soon as possible,
for there is no time to waste.
Encouraged by
Governor Jindal and facilitated by Department of
Health and Hospitals Secretary Alan Levlne, an
engaged group of leaders from both Tulane and LSU held a series of tough but
principled meetings to hammer out a Memorandum of Understanding which would fully
and fairly settle the governance Issue once and for all.
The changes to the
draft MOU made at Monday's board meeting are patently unfair to a process
which had brought the negotiators to an agreed upon conclusion. This point
has particular relevance since the Tulane University Board of Administrators
had taken action to ratify the draft MOU-as its terms were agreed to by the
negotiators and without modification-on the Friday before the LSU board
meeting:
Starting with an
April 3 letter to Homeland Security Secretary Napolitano in which the
Business Council urged that the full FEMA award of $492 million be made for
the replacement of Charity Hospital, continuing with May 14 and
May 27 letters to
the two of you in which we stressed our support for a fair and final
resolution, we have been as clear and emphatic as we know how in offering
ideas and encouragement. The Business Council has taken a keen interest In
helping to resolve the differences and get us moving with a revitalized
academic medical center and a robust and effective program of care for the
indigent Now we fear that this latest impasse will threaten both. The City of
New Orleans,
LSU and Tulane all need a stable and well-functioning training environment
for allied health and medical students and physician residents. The poor, the
sick and the vulnerable in our community simply cannot continue without
access to the health care that LSU Is charged to provide.
Now we find to our
profound dismay that matters are essentially back at square one. We feel
strongly that the action taken Monday was not prudent and we ask you to
reconsider forthwith.
Greg R. Rusovich
Chairman
Robert W. Brown
Managing Director
L. Ronald Forman
Task Force
Chairman
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Business Council of New Orleans and the River Region | 06.26.09
Dr. John Lombardi,
LSU System President to GNO Business Council
Mr. Gregory R. Rusovich, Chairman
Mr. Robert W.
Brown, Managing Director
Mr. L. Ronald
Forman, Task Force Chair
Business Council
of New Orleans
and the River Region
Dear Mr. Rusovich, Mr. Brown, and Mr. Forman:
Many thanks for
your note of June 26th. Let me offer some facts that may help put your
comments into perspective. I was personally present during the negotiations
and can speak from first-hand knowledge. I have copied the other members of
our negotiating team below.
First: the LSU
System and Tulane through the mediation of Secretary Levine agreed on a large
variety of issues associated with concluding a Memorandum of Understanding
about the Academic Medical Center
in New Orleans.
Second: LSU’s
representatives made clear throughout, and very specifically in the final day
of negotiations, that we did not believe that the Tulane proposal on the
structure of the governing board would meet with the approval of our Board of
Supervisors, but that we could not speak for them, nor poll them in advance
since under state law the Board must meet in public session to consider
matters of this magnitude.
Third: LSU's
representatives agreed, at the insistence of Tulane and Secretary Levine, to
present the Tulane proposal on the structure of the governing board to our
Board of Supervisors, although we believed and clearly stated that the
alternative we proposed would have a greater chance of approval.
Fourth: The LSU
System representatives (including the three members of our Board who
participated in the final negotiation session) presented the Tulane proposal
to our Board. After careful and public consideration, our Board, as we
previously had cautioned Secretary Levine and the Tulane representatives,
chose to recommend approval of the Memorandum of Understanding with the board
structure we had previously presented to Secretary Levine and the Tulane
representatives.
Fifth: We now have
two versions of the Memorandum of Understanding, one approved by the Tulane
Board that represents their best judgment, and one approved by the LSU System
Board that represents their best judgment.
Sixth: We will
continue, as we have before and especially since Katrina, to make available
high quality health care through the LSU Health System to rich and poor
alike.
Given the issues
involved and the significant commitment by the LSU System to this enterprise,
our Board believes that the governance structure that they have approved,
which gives LSU a minority position on the governing board, is appropriate in
connection with an LSU-affiliated entity that exists to support its medical
education and research interests. We hope that Tulane's board, considering
the importance of the issues at stake here, will take up the LSU approved MOU
and approve it at their earliest opportunity.
John V. Lombardi
President
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BUNKIE -- For
years, Dr. Don Hines had a dream to bring the best of big-city health care to
the smallest of rural hospitals.
It's not a dream
anymore.
On Friday, Hines
led a telemedicine demonstration at Bunkie General Hospital,
showing off the equipment and techniques that he hopes will spread and move
rural hospitals throughout the state toward the cutting edge of treatment.
"I think it's real good," said Hines, the former longtime
state senator. "It gives patients in this area access to specialist care
without having to leave the community."
"We are in
the top 20 percent of hospitals in the country as far as Internet
technology," said Bunkie General CEO Linda Deville. "We're ahead of
80 percent. So this is huge for us. The state of Louisiana, can you believe, is ahead of
the nation."
Hines is executive
director of the Louisiana Rural Health Information Exchange, an organization
dedicated to improving patient care at the state's rural hospitals.
As part of its
plan, LARHIX is helping Louisiana's
hospitals hook up to an electronic records network to assist doctors in
accessing patient records and keep them from duplicating expensive tests and
other services, and starting an internal medicine residency program with a
focus on rural medicine to help attract doctors to rural areas.
The third part of
the plan, the one that was demonstrated Friday, is telemedicine, or treatment
via videoconferencing.
In Friday's demonstration, Deville played
the part of a patient at Bunkie General being treated by Hines. Hines,
needing a consult from a specialist, videoconferenced
with a doctor at the LSU Health Sciences
Center in Shreveport.
Hines was able to
share test results, give an overview of the patient's symptons
and perform an on-camera exam in a matter of minutes. The fictional patient
was then scheduled for a test in Shreveport.
Without the video
consult, that patient would have had to travel to Shreveport and perhaps be subjected to some
of the same tests she had in Bunkie before she was scheduled for the
follow-up test. She would then have to go back for that test and follow-up
exams, which thanks to the videoconferencing, can now be done in Bunkie.
"That just
saved her two or three trips to Shreveport,"
Hines said. "Many that we see are disabled. They lack transport or they
have to borrow money for gas. This solves the problem. It gives our patients
access to specialists in Shreveport."
"It means our
patients will have access to specialists," Deville said. "It means
less travel time, and some of our patients can't travel."
LARHIX was born in
the aftermath of Hurricane Katrina, when LSUHSC-New Orleans was devastated
along with much of the city. That resulted in many more patients being
referred to the hospital in Shreveport,
which had a hard time dealing with the overflow.
The telemedicine
and electronic records programs, it is hoped, will save money and time that
can be spent on improving other medical programs. Hines said 15 hospitals
currently have the telemedicine capabilities, and he hopes to expand to 23
hospitals in the north and central parts of the state.
"This is very
impressive," said Dr. Robert Barish,
chancellor at LSUHSC-Shreveport. "This is the future of medicine. This
is how we need to deliver medicine going forward."
http://www.thetowntalk.com/article/20090627/BUSINESS/306270001
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By MICHELLE
MILLHOLLON
Advocate Capitol
News Bureau
Festivals
celebrating mayhaws, jazz, movies and Christmas
lights found a place in the state budget despite a financial crunch.
Lawmakers also
made room for senior citizen programs, highway beautification, museums,
small-town high schools and furniture shopping in the $28 billion budget for
the fiscal year that starts in less than a week.
Most of the
amendments are small monetarily — such as $15,000 for fire hydrants in St.
Mary Parish and $7,755 for the Starks Mayhaw
Festival in Calcasieu Parish. Added together, projects important to
legislators’ districts total $34 million.
Lawmakers inserted
the amendments into House Bill 881, a supplemental budget bill after Gov.
Bobby Jindal stripped them from the main budget
legislation.
The House
leadership advocated strongly for the amendments. They were approved in the
last half hour of the two-month legislative session.
House Speaker Jim
Tucker, R-Terrytown, said the projects no longer
deserve the criticism they once attracted.
“We’re down to
what we should be doing the ‘member amendments’ for,” he said, citing
economic development and small projects.
“Member
amendments” include funding for roads and nongovernmental organizations, or
NGOs, and often are derided as being “pork projects.”
The Purple Circle
Social Clubs of the “member amendments” are gone, Tucker said, referring to a
Baton Rouge
project that raised eyebrows two years ago.
Senate President Joel Chaisson
II, D-Destrehan, said the Senate refused to back a “member amendment” total
that exceeded additional funding for health care.
He said the $45 million that legislators
agreed to for health care on the last day of the session paved the way for
$34 million in “member projects.”
“It shouldn’t be a top priority, and I
don’t think it was here,” Chaisson said of the
projects.
Jindal’s
vetoes of projects from the main budget bill were largely for technical
reasons. The Senate tied them to funding that was unlikely to materialize.
The contingency impediment now is removed.
However, Jindal
took a strong stance on the projects last year, purging $16 million of them
because he disagreed they belonged in the state budget.
Jindal
also has line-item veto power over the supplemental budget. Kyle Plotkin, Jindal’s press
secretary, said the governor is reviewing HB881, line-by-line.
Using the state’s “rainy day” fund, a
dormant insurance fund, economic development money and unneeded health care
funds, lawmakers found $210 million in additional dollars on the final day of
the session to bolster the state budget.
Higher education
received an extra $100 million. The state agriculture department, arts
programs, health care and legislators’ projects also got funding.
The additional
funding by no means made higher education and health care whole.
The Public Affairs
Research Council of Louisiana took note of the “member amendments” in its
wrap-up report on the legislative session that ended Thursday.
“In the midst of a
fiscal crisis, budget-makers continued their usual practice of loading up the
budget bill with parochial amendments (a.k.a. slush, earmarks, non-state expenditures),” the nonprofit group that
researches governmental issues wrote.
Barry Erwin with
the Council for A Better Louisiana said that lawmakers could have sent a
strong message by not funding “member amendments” in the face of budget cuts
to higher education and health care.
CABL is a
nonprofit group that advocates positions on public policy.
“My sense is that
a lot of people would look at many of these amendments and conclude that they
fall short of being a top priority, particularly at this time,” Erwin said.
The budget
dominated the final days of the legislative session.
A $1.3 billion
drop in state revenue prompted Jindal to propose
deep cuts to higher education and health care in the upcoming fiscal year.
Legislators
disagreed on how to minimize those cuts. The disagreement divided the House
and the Senate.
The state Senate
focused on chopping in half the $219 million in cuts proposed for public
colleges and universities.
The chamber
advanced two proposals — delaying an income tax break and withdrawing money
from the state’s “rainy day” fund.
The House rejected
the tax break delay and negotiated on the “rainy day” fund withdrawal.
On the final day
of the session, the two chambers agreed to take $86 million from the $775
million “rainy day” fund, which was set up to tide the state over during a
budget deficit.
PULL OUT
Area projects in
the state budget
A number of area
projects found their way into the state budget on the final day of the
legislative session.
* Louisiana
Arts and Science
Museum, $150,000
* East Baton Rouge Council on Aging, $25,000
* Baton Rouge
Area Alcohol and Drug
Center, $50,000
* Baton Rouge Child
Advocacy Center,
$50,000
* LSU Fire and Emergency Training
Institute, $1.3 million
* DNA storage facility equipment for
LSU’s Museum of
Natural History,
$40,000
* Southern University Lab
School for student
support programs, $200,000
* Joy Corp. of Baton Rouge, $25,000
* Ascension Parish Government for the
purchase of Lamar-Dixon
Expo Center,
$600,000
* Greenwell Springs-Airline Economic
Development District, $25,000
* East Baton Rouge Parish School Board
for middle school truancy center, $100,000
* Ascension Parish Sheriff’s Office for
emergency equipment, $20,000
* City of Baton Rouge Constable’s Office, $25,000
* City of Baton Rouge for community services for the
elderly, youth and victims against crime, $300,000
http://www.2theadvocate.com/news/49350667.html
[BACK TO TOP]
By MARSHA SHULER
Advocate Capitol
News Bureau
Private
health-care providers who treat Louisiana’s
poor are facing a $180 million cut in the government health insurance program
that pays them.
The amount is far
less than originally expected. But the cut’s impact will be hard to measure
until the state Department of Health and Hospitals drafts new rules.
“We are trying to
figure out what this does or doesn’t do,” Louisiana Hospital Association
president John Matessino said of the situation.
“People keep wanting me to give them a percentage they
are going to be cut.”
But Matessino said he won’t know until DHH comes up with new
rules that would tell how much private providers
would be paid for the care they render to Medicaid patients.
Some private
health-care providers worry that the cuts could result in private physicians
leaving the Medicaid program and hospitals reducing services and laying off
employees.
The budget for the
Medicaid program that pays private providers – hospitals, physicians,
pharmacists and others – is expected to be $4.25 billion for the fiscal year,
which begins Wednesday.
It had been $4.43
billion.
But those
calculations are based on an initial review of what happened on the last day
of the session.
Legislators
scrambled in the final hours of the legislative session and found about $26
million in state money that they hope could bring in another $200 million or
so in federal funding.
Medicaid is the
government insurance program that provides medical care
to the lower income and some elderly, roughly one out of four Louisiana residents.
Shortly after the
state’s budget crisis became clear, DHH issued emergency rules that would
employ 7 percent cuts in the original budget proposal for the reimbursement
rates of private providers.
DHH Secretary Alan
Levine said he has sent his agency’s fiscal staff back to the drawing board
to develop new rules detailing the size cuts required to stay within the
dollars provided.
“I’m going to try
to target these reductions in a way that preserves access” to primary care,
Levine said.
He said he also
wants to get more dollars to high-end hospital services for critically ill
babies and children and services for the disabled.
Both time and
legal issues present a challenge for how the budgets are reduced, Levine
said.
The longer the delay,
the greater the impact of cuts because they have to be absorbed in a shorter
time period, Levine said. In addition, “people have their legal rights to
sue.”
In the waning
minutes of the two-month 2009 regular session of the Louisiana Legislature,
lawmakers directed an additional $26 million to the Medicaid private provider
program. For every $2 the state puts up, the federal government contributes
$8.
Out of an initial
$200 million cut to hospitals, Matessino said some
$62 million was added back in by using some money in a Medical Assistance
Trust Fund.
Of the money,
$25.4 million goes for inpatient services; $7.3 million to outpatient care
and $30.7 million to outliers — hospitals that care for critically ill babies
and children.
Matessino said one of the major problem areas is in
payments to hospitals such as Woman’s Hospital in Baton
Rouge and Children’s Hospital in New Orleans. Lawmakers found money to
provide an additional $30 million in payments, but that’s far shy of the $69
million cut they took, Matessino said.
Hospitals would
get $213 million in one-time funding to help them with added expenses they
have had in the wake of recent hurricanes as they care for the poor and
uninsured. Some $170 million of it would go to hospitals in Orleans
and Jefferson parishes.
On the physician
front, lawmakers identified $18.8 million to help offset a proposed $48
million cut in their reimbursements for care of the poor under the
government’s Medicaid health insurance program.
Berkley Durbin,
executive director of the Louisiana Maternal and Child Health Coalition, said
the physician services funding would be cut a little more than 5 percent.
The big question
is which physician rates are going to get cut and by how much, Durbin said.
“We will learn how
that is going to impact access to health care and hope physicians don’t drop
out of the program,” said Durbin.
Matessino said, “I’m still concerned there will be
layoffs. There will be some hospitals reducing some services, and when you
cut $30 million in payments to physicians there will be some physicians
saying ‘I’m not doing Medicaid anymore.’”
If physicians quit
caring for Medicaid patients, those people would have to rely on the far more
expensive care provided in hospital emergency rooms, Matessino
said.
Louisiana State
Medical Society executive Dr. Vincent Culotta said
estimated reductions for the payments to individual physicians could be
anywhere from 2 to 10 percent, depending on the final DHH rules.
“There’s a lot
riding on how the department interprets it,” Culotta
said.
On top of the
state budget cut, Durbin said the administration has been talking about
implementing a program that could lead to a further reduction in the dollars
that pediatricians and other primary care physicians get for managing the
care of patients.
The extra $3 a
month payment would be tied to the physicians hitting certain goals, with
penalties for non-compliance under the proposal Levine floated earlier this
year, Durbin said.
http://www.2theadvocate.com/news/suburban/49394802.html
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The Associated
Press
BATON ROUGE, La. -- Private health-care providers who treat Louisiana's poor are
facing a $180 million cut in the government health insurance program that
pays them.
The amount is far
less than originally expected. But the cut's impact will be hard to measure
until the state Department of Health and Hospitals drafts new rules.
"We are
trying to figure out what this does or doesn't do," Louisiana Hospital
Association president John Matessino said of the
situation. "People keep wanting me to give them
a percentage they are going to be cut."
But Matessino said he won't know until DHH comes up with new
rules that would tell how much private providers
would be paid for the care they render to Medicaid patients.
Some private
health-care providers worry that the cuts could result in private physicians
leaving the Medicaid program and hospitals reducing services and laying off
employees.
The budget for the
Medicaid program that pays private providers -- hospitals, physicians,
pharmacists and others -- is expected to be $4.25 billion for the fiscal
year, which begins Wednesday.
It had been $4.43
billion.
But those
calculations are based on an initial review of what happened on the last day
of the session.
Medicaid is the
government insurance program that provides medical care
to the lower income and some elderly, roughly one out of four Louisiana residents.
DHH Secretary Alan
Levine said he has sent his agency's fiscal staff back to the drawing board
to develop new rules detailing the size cuts required to stay within the
dollars provided.
"I'm going to
try to target these reductions in a way that preserves access" to
primary care, Levine said.
http://www.wwltv.com/topstories/stories/wwl062909bhmedicaid.1acf1250.html
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By Mike Hasten
BATON ROUGE -
While approving funding that reduced cuts to higher education and health
care, state lawmakers also included $34 million to fund select projects in
their districts.
The local projects
are "pretty much" the same as the ones in the House Appropriations
Bill (House Bill 1) sent to Gov. Bobby Jindal on
June 15, said state Rep. Jim Fannin, D-Jonesboro,
who chairs the House Appropriations Committee.
Jindal vetoed those projects on June 24 because
they were tied to "contingency funding" - revenue that depended
upon other bills that had not been approved - which he said violates the
state constitution.
In his veto
message, the governor said he cautioned lawmakers he would veto any such
items but the House concurred with the Senate plan, anyway.
Fannin and several other lawmakers said the
"member amendments" are important and belong in the bill. They say
small municipalities and rural parishes don't get a lot from the state, so
lawmakers have to help them.
"They're
important in my part of the state," Fannin
said at a press conference on the budget. Rural communities don't receive a
lot of tax revenues because "we have to drive to urban areas to buy
things."
Fannin said North Louisiana
is providing the state significant severance tax revenue but "we don't
get back in services anything near what we send to the state."
Member amendments
also support nonprofit organizations that serve communities, said state Sen.
Lydia Jackson, R-Shreveport. "Nonprofits across the state are facing
hard times" and those agencies often serve as "a safety net"
for people who don't receive help from the state.
Committee chairmen
are allotted a certain amount of funds to allocate to their districts or
spread regionally, said state Rep. Joel Robideaux,
I-Lafayette.
Robideaux, chairman of the House retirement
Committee, said earlier in the session he used his allotment for highway
projects and that he wasn't really disappointed that the governor vetoed
member amendments in HB1.
"I don't
think the public likes member amendments anyway," he said.
"Overall, the health of the state's better off" without the
amendments. "If that money can be used for higher education, that's
better."
One of the critics
of using state funds for lawmakers' chosen projects is political watchdog and
former House Appropriations Committee chief counsel C.B. Forgotston.
"That amount
of state money could have been used to match at least $100 million in federal
health care dollars for a total of $134 million to offset reductions to the
state's health-care programs," Forgotston
said.
"Perhaps the
folks who don't get necessary health care will take comfort in knowing that
the Louisiana Political Hall of Fame and Museum got funded instead," he
said.
Just because the
items are scheduled for funding doesn't mean they will survive the governor's
review, Fannin said.
"There's another
pen," he said, referring to the governor's veto pen, after signing the
conference committee report approving the funds.
Jindal laid down his expectations last year for
"nongovernment organizations" (NGOs) to receive state funds and
renewed them this year. He said they must have applied for funding through
the House and Senate Web sites, been reviewed in a public hearing, serve a
wide area and supplement state services.
The original
version of HB881, before additional funds and projects were added, supplements
the current year's budget and provides money to a variety programs,
including:
# $800,000 to UL
Monroe College of Pharmacy for library and education resources to ensure
accreditation by the Accreditation Council for Pharmacy Education (ACPE).
# $6.88 million to
the LSU Health Sciences Center-Shreveport.
# $162,353 to the Louisiana Special
Education Center
in Alexandria.
# $3.26 million to
cover TOPS Tuition Program increases because of approved tuition increases at
the state colleges and universities.
# $28,555 to help
local governments, including: town of Chatham $2,500; Iberia Parish Sheriff's
Office, $5,000; town of Junction City, $500; village of Maurice, $7,500;
village of Mer Rouge, $250; city of New Iberia,
$375; city of New Orleans, $875; three payments to the town of Newellton, $722, $500 and $361; town of Richwood, $722;
Vernon Parish Police Jury, $500; and town of Youngsville, $5,000.
# $2.1 million
deputy sheriffs supplemental pay.
# $75,556
firefighters supplemental pay.
# $100,000 for the
East Carroll Medical Clinic shall be combined with the $100,000 for the Lake
Providence Medical Clinic so that the total amount allocated for the Lake
Providence Medical Clinic is $200,000.
In Lafayette
Parish, it also shifts $100,000 in the current budget from the Bayou
Vermilion District to the Lafayette Parish Convention and Visitors Commission
and removes the restriction that the Lafayette City-Parish Consolidated
Government could use $140,000 for road improvements only on La. 733 and U.S.
167. The funds can now be used on any road project.
http://www.dailyworld.com/article/20090629/NEWS01/906290304/1002
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By Melinda Deslatte, Associated Press Writer
BATON ROUGE, La. — Watching
lawmakers work can be frustrating. The creation of laws and public policy is
messy, fraught with hidden agendas and often driven by ego, rather than the
best interests of regular folks.
Even when the
motives appear to be pure, the process is unappetizing at best, frightening
at worst.
The work at the
Louisiana Capitol proved to be just as cringe-worthy this year in the
now-ended regular legislative session, particularly the crafting of the $28
billion-plus state operating budget that takes effect this week.
It'll be a wonder
if anybody truly can describe the details of what's in the budget as the new
fiscal year starts Wednesday. Legislative leaders could hardly offer more
than generalities as they urged their colleagues to pass the spending plans
in the final hour of the session.
"This is a
hell of a way to do business," lamented Sen. Joe McPherson, D-Woodworth,
as he struggled to plow through the 55-page budget deal that was delivered to
senators only minutes before they were asked to pass it.
The march down to
the wire on a final budget compromise was inevitable given the sharp
philosophical and political disagreements of the House and Senate -- and the
staunch refusal on either side to give in.
The differences
emerged nearly as soon as Gov. Bobby Jindal
introduced a 2009-10 budget in March that included deep cuts to higher
education, health care and other state programs.
House leaders
began to talk about the need to "do more with less," to cut the
state work force and to downsize government while Senate leaders went to
back-room discussions with their fiscal staff about patchwork proposals to
drum up additional cash to fill in budget holes.
At times it
appeared as though the two chambers were operating in parallel worlds.
The House passed a
budget bill that slightly lessened higher education cuts, deepened state
worker layoffs and patched money in agriculture and tourism programs to
offset reductions.
The Senate all but
ignored those plans and rewrote the entire budget bill, using money from a
Senate-backed tax break delay and the state's "rainy day" fund to
restore dollars to colleges, health care, tourism and agriculture programs.
The problem was
the House had no interest in passing the tax break delay or using the rainy
day fund. And even as that became clear, the Senate kept adding those
proposals into money bill after money bill, creating a stalemate that lasted
until the final week of session.
There was no
public give-and-take. Senators dug in their heels, and House members used
procedural move after procedural move to derail the money-raising proposals
of the Senate, rather than debate the ideas.
Meanwhile, health
care programs, colleges and state services hung in the balance, with no
agency really able to ready themselves for the ever-nearing budget year
because officials had no idea what level of funding they would receive.
Jindal offered little direction, at least
publicly, and lawmakers openly complained about a lack of guidance and help
for the budget negotiations from the governor. Four former governors trooped
to the Capitol, urging Jindal to get involved --
and to lead -- in lessening planned cuts to higher education that college
leaders and the ex-governors said would devastate campuses.
Publicly
pressured, Jindal offered recommendations for
compromise. The House took longer to agree than Jindal,
but eventually backed a limited use of the rainy day fund that was less
sweeping than the Senate plan. The House also finally took a vote on the
Senate tax break delay it had refused to even debate, soundly defeating it.
A compromise was
brokered on the final day of the session, with praise on all sides and both
House and Senate leaders applauding themselves.
"I think it's
a real success," said House Speaker Jim Tucker, R-Terrytown.
Dollars were
plugged into higher education, health care, tourism initiatives and
legislators' pet projects. Cuts were lessened, though still substantial in
some areas. Then, lawmakers packed up their desks and went home.
Maybe within a few
weeks -- or months -- they'll be able to describe to their constituents what
they did.
http://content.usatoday.net/dist/custom/gci/InsidePage.aspx?cId=thetowntalk&sParam=31063697.story
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Sid LeBlanc
The U.S.
health care system broken. But the solution is not in any of the Democrats'
health plans.
The U.S.
spends a higher percent of its per capita income on health care than any
other country in the world. And we have health outcomes that are not as good
as many other countries.
The problems are:
Every American expects to receive the best possible health care and does not
care what it costs. And, the more providers (doctors, hospitals and labs) do,
the more they are paid. So they provide as much health care as possible to
make more money.
Obama's plan does
nothing to fix these two basic problems; in fact, it exacerbates them.
Given the deficits
we have, we do not need to spend $1.5 trillion and not fix the basic problem.
Sid LeBlanc
Kenner
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1246253406178870.xml&coll=1
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Boustany
steers GOP plan: Louisiana
lawmaker leads alternative proposal for health-care reform
Deborah Barfield Berry
Gannett Washington Bureau
WASHINGTON - Republican U.S. Rep. Charles Boustany Jr. recently stepped to a lectern in the Capitol
and vowed on behalf of his party to help overhaul the nation's health-care
system.
He's also
delivered a GOP radio address on the issue, talked about the party's plan on
TV and hosted a teleconference town hall.
Boustany, a former cardiothoracic surgeon, has
taken a leading GOP role on one of the most pressing issues before Congress.
"It's been
pretty much a nonstop endeavor on health care," said Boustany
of Lafayette. "It's the issue of the day."
He isn't the only
Republican doctor from Louisiana.
Freshmen U.S.
Reps. John Fleming of Minden and Bill Cassidy
of Baton Rouge
also are doctors and members of their party's health-care caucuses.
"We've had a
lot of input" with Republican leaders, said Fleming, who still runs a
family practice in Minden.
"We relate to them all the day-to-day experiences that we deal with that
are so important to this debate."
Boustany, serving his third term, has more
seniority and serves on the powerful Ways and Means Committee, which has
jurisdiction over health care and Medicare.
He said Republican
leaders asked him this month to lead GOP lawmakers in delivering the party's
health care message. So, he's helping craft the GOP counterproposal to the
plan pushed by Democrats, who outnumber Republicans on the Ways and Means
panel 26-15.
Pollster Bernie Pinsonat said it's natural for Boustany
to take a leading role.
"He's
practiced medicine. He's been in the system," Pinsonat
said. "If you want someone to articulate health care, he obviously is
someone who is very well qualified."
Boustany has been in the medical field for more
than 20 years. He's worked at community health centers and in the charity
hospital system.
House Minority
Leader John Boehner, R-Ohio, said Boustany's
medical background and experience give him credibility on the health-care
issue.
Republicans
outlined a plan last week that would offer health-care tax credits to
low-income and moderate-income families and small-business owners. It also
would allow dependents up to 25 years old to remain on their parents'
health-care policies. The plan lacked specifics, including cost.
Fleming agreed
with Boustany's claim that President Barack Obama's
proposal for government-run health care would take the decision-making out of
the hands of doctors and patients and would cost too much.
"The
government-run health-care system is just a nonstarter," he said.
"We practicing physicians see ... that (Medicare) is draining resources.
We're terrified that if we go to a larger system, it's only going to drain
resources more."
Democratic leaders
want Congress to vote on a bill by the end of the year that would provide
insurance coverage for an estimated 46 million uninsured people.
"Of course,
there's no chance that the Republican alternative will be adopted," said
Richard Himelfarb, a political scientist at Hofstra University in New York who specializes in health care.
"But it does take away any arguments that Obama and the Democrats (have)
that Republicans are a bunch of naysayers who don't want to do anything about
health care."
And taking a lead
role will only help Boustany's political career, Pinsonat said.
"Louisiana is seeing
one of its own on the national stage," he said.
"He's certainly capable of being somebody who not only represents Louisiana, but the
rest of the country."
Democrats note
that Boustany voted against a measure this year to
expand the federal health insurance program for low-income children.
"Congressman Boustany's so-called 'answer' to the health care crisis
that is driving costs up for hardworking Americans is to 'just say no' and
protect the status quo," said Jessica Santillo,
a spokeswoman for the Democratic Congressional Campaign Committee.
http://www.theadvertiser.com/article/20090628/NEWS01/906280354/1002
[BACK TO TOP]
By George Harrel
Guest commentary
Very rarely does
one encounter a column or letter on the editorial pages that is so
ill-informed your mouth waters when you think about replying to it. Such was
the case when I read Ron Grant's column in The Town Talk recently titled
"Health-care debate needs our voices."
First of all, a
disclaimer. I do have a dog in this hunt as I am in the health insurance
industry.
We do agree,
however, that quality health care should be available at an affordable price
to every citizen of the United
States.
That being said,
right off the bat, Mr. Grant rails against Blue Cross for being a
"for-profit" company. He might be interested in knowing that Blue
Cross/Blue Shield of Louisiana is a not-for-profit company, one that is a
mutual company owned by its policyholders, not by shareholders. He may also
be interested to know that the CEO of BCBSLA is not one of those
"fat-cat" Wall Street types and that he receives a very modest
salary and incentives, particularly considering the gravity of his job in
these difficult economic times.
While I'm on that
subject, when did the term "for-profit" become a term loaded with
sneering disdain? Isn't capitalism, based on the profit motive, what this
country is all about? Isn't it the basis for many of the freedoms and
privileges we enjoy and the architect of the greatest civilization yet built
by man?
The next point
raised by Mr. Grant is how much more efficient the federal government will be
at providing such health care. He specifically mentions a figure of "30
percent" of our health-care dollars go for profits (there's that word
again!) and big payouts to company execs. However, he provides absolutely no
documentation nor does he cite any figures for the "bloated" pay
system he cites. In actual fact, for the year 2007, the real national average
was 12 percent. In Louisiana
for BCBSLA, the real number is 15 percent, higher because of taxes. And while
we're at it, did he really hold up Medicare and Medicaid as shining examples
of efficiency? Yes, he did. I'm not making this stuff up.
I quote Mr. Grant
once again: "The duplicity of private insurance is that it has dumped
those most in need of health insurance onto the backs of taxpayers."
Gee, what insight! Who does he think is going to pay for universal, national
health care?
I could go on for
several pages pointing out other inaccuracies and downright fabrications in
Mr. Grant's column, but for now, I only want to take issue with one other
figure that we hear often in the debate over national health care and a
figure mentioned prominently in Mr. Grant's column: 47 million. You've all
heard that figure as being the number of uninsured people in the United States.
That figure sounds
dreadful and makes you wonder how a country as great as the United States can let 47 million
people fall through the cracks. In actuality, there are about 16 million
people in the U.S.
who want health insurance but can't get it for one reason or another. That,
ladies and gentlemen, is only 5 percent of our total population, yet there is
a tremendous outcry to "fix the system," only most people don't
know that only a very small percentage of our population is in that
predicament.
I can't speak for
other states, but I know for a fact that every single resident of Louisiana has access
to quality health care. No one is turned away. What really constitutes this
47 million: illegal immigrants (7 million), eligible for an already existing
public plan but not signed up for whatever reason (12 million), opting out
either because they make too much money to care about insurance or because
they simply don't want it (12 million). This leaves the 16 million that I
cited above. These people make too much money to qualify for Medicaid but not
enough to buy private insurance.
Mr. Grant could
have done the research work that I did to look into these figures. He
obviously did not, accepting at face value the erroneous information that has
been repeated for so often for so many years that most of us don't even
question it any more. If he wants, I can provide all the actual facts and
figures and Web sites to back them up. However, I'll bet Mr. Grant doesn't
want to hear the facts of the matter anyway because in his last paragraph he
destroyed any illusion that I might have had that he was going to present his
arguments fairly.
I must admit that
I didn't expect to see in print a "retired editorial page editor of The
Town Talk" arguing against the First Amendment to our blessed
Constitution. Where was he during civics and free enterprises classes in high
school?
Again quoting Mr.
Grant, "we have to muffle the insurers and the ideologues wedded to a
health insurance system driven by the profit motive"». All other
participants are just background noise".
Last but far from
least, on a personal note, I am a two-time cancer survivor, first with
prostate cancer 16 years ago and last year with bladder cancer.
Unfortunately, I know for a fact that had I been a resident of either Canada or of a country in Europe,
I would have been dead long ago, long before any of my six wonderful
grandchildren had been born.
I just hope that
whatever comes out of the national health-care debate is something that will
provide coverage for everyone while still involving the private sector, not
only to preserve my job and the job of thousands like me who are employed in
the health insurance business, but also to preserve and continue the American
way of life, which has always included personal choice, particularly in
matters such as health care.
Thanks Mr. Grant:
You've just heard from a bit of "background noise."
George Harrel lives in Monroe
and works in the health-insurance industry.
http://www.thetowntalk.com/article/20090628/OPINION/906260317/My-turn--Private-sector-is-where-we-get---quality-health-care-originates
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By Greg Hilburn
Northeastern
Louisiana’s most powerful legislators, committee chairs who drive much of the
agenda in the state House and Senate, said the cuts made to balance the
upcoming budget were mere nicks compared to what could come during the next
two years.
“The cliff we were
on this year was Driskill
Mountain,” said House Appropriations
Chairman Jim Fannin, D-Jonesboro, referring to the
highest point in Louisiana
at just 535 feet in Bienville Parish. “In 2011, it’s going to be Pike’s Peak.”
That’s because in
2011, Louisiana
won’t have the benefit of $1 billion in federal stimulus money that it had
this year and again in 2010.
“I still believe
we’re in a precarious situation during the next two years,” said House Health
and Welfare Chairman Kay Katz, R-Monroe.
But this year the
Legislature was ultimately able to reduce the cuts to higher education from
about $219 million to $110 million and to health care from $440 million to
$280 million.
“In the end we
were able to help higher education and health care some, but we didn’t have
the money to restore it fully and won’t have for several years,” Fannin said.
The cuts were
lessened in part by the Legislature taking $86 million from the state’s rainy
day fund. Fannin was among those who fought raiding
the fund for even more money.
“There are people
who want to spend it all now and not worry about three years from now, but I
don’t think that’s the responsible thing to do,” he said. “We’re going to
have to take the full amount from the rainy day in 2011.”
Sen. Francis
Thompson, D-Delhi, disagreed, saying he fears that the federal government
will eventually require states to exhaust all of their rainy day funds before
qualifying for stimulus money.
“We short-striped
higher education and health care, and I think we should have taken more from
the rainy day fund and taken better care of them,” Thompson said.
But all three said
that the budget crafted in the final hours of the session last week was less
punitive to state-funded programs than was projected initially.
“I wish there had
been more money available for necessary projects, particularly health care
and higher education, but we have to manage with what we have,” Katz said.
And northeastern Louisiana’s
legislative chairs said their region fared particularly well with state
investments outside of the general budget.
The Legislature
approved spending a combined $117 million from the state’s economic
development megafund to save the former Pilgrim’s
Pride chicken processing operations in Union Parish and to recruit the new V
Vehicle Co. to Ouachita Parish.
“Those two
projects are huge economic shots in the arm for northeastern Louisiana,” said Sen.
Bob Kostelka, R-Monroe. “I can’t remember when the
state invested that much money to attract or save jobs in our community.”
http://www.thenewsstar.com/article/20090627/UPDATES01/90627007/-1/UPDATES/Even+tougher+budget+times+ahead++Fannin+says
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NanoViricides,
Inc. Eye Drug Testing Has Begun
NanoViricides, Inc. (OTC BB: NNVC.OB) (the
"Company"), reported today that testing of its topical eye drops
drug candidate has begun at two different, independent facilities.
Testing of this
broad-spectrum, topical, eye drug candidate by a major pharmaceutical company
("Party") is now in progress. The Company had previously announced
in March that it had signed a Material Transfer Agreement with this Party. In
addition, the Company is also evaluating this drug candidate against herpes keratitis of the eye at Thevac,
LLC, a spin-off of the Louisiana
State University
(Study Director, K. G. Kousoulas, PhD).
The testing at the
two facilities will independently evaluate performance of this drug candidate
against several types and strains of many different viruses that cause keratitis or conjunctivitis of the eye. Cell culture
studies as well as animal studies with different animal models have been
planned.
"Execution of
the material transfer agreement (MTA) is a step towards a potential licensing
agreement," said Eugene Seymour, MD, MPH, CEO of Nanoviricides,
Inc. The terms of the agreement do not allow the
disclosure of the identity of the Party or the exact terms of the MTA.
HSV and some
adenoviruses cause most of the cases of keratitis,
a serious infection of the cornea. Importantly, HSV infection can lead to
corneal scarring that may necessitate corneal transplantation. In addition,
some adenoviruses cause a majority of conjunctivitis cases ("pink eye").
The remaining cases of conjunctivitis, caused by bacteria, are treatable with
topical antibiotics. Currently, there are no effective treatments for viral
diseases of the exterior portion of the eye.
The Company has
already demonstrated strong efficacy against an adenovirus-caused external
eye disease called epidemic kerato-conjunctivitis
(EKC). Rapid clinical improvement in the treated animals was reported by
independent researchers who tested the effects of the nanoviricides
drug candidate against adenoviral EKC. Based on computer modeling, the
Company believes that the broad-spectrum nature of the ligand
used in this nanoviricide should enable it to be
effective against HSV.
The total market
for all forms of viral conjunctivitis/keratitis is
estimated to be in the billions of dollars. The incidence of severe herpes
(HSV) keratitis is estimated to be 250,000 cases
per year in the USA.
In Japan,
where EKC is a reportable disease, it is estimated that there are at least
one million cases per year. The number of cases of non-specific
conjunctivitis (pink eye) is considered to be far greater, possibly into tens
of millions in the US,
and into hundreds of millions worldwide.
http://www.medicalnewstoday.com/articles/154133.php
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The New York Times | 06.28.09
By NICHOLAS WADE
A new method of
attacking cancer cells, developed by researchers in Australia, has proved
surprisingly effective in animal tests.
The method is
intended to sidestep two major drawbacks of standard chemotherapy: the
treatment’s lack of specificity and the fact that cancer cells often develop
resistance.
In one striking
use of the method, reported online Sunday in Nature Biotechnology, mice were
implanted with a human uterine tumor that was highly aggressive and resistant
to many drugs. All of the treated animals were free of tumor cells after 70
days of treatment; the untreated mice were dead after a month.
The lead researchers,
Jennifer A. MacDiarmid and Himanshu Brahmbhatt, say their company, EnGeneIC
of suburban Sydney,
has achieved a similar outcome in dogs with advanced brain cancer. “We have
been treating more than 20 dogs and have spectacular results,” Dr. Brahmbhatt said. “Pretty much every dog has responded and
some are in remission.” These experiments have not yet been published.
Cancer experts who
were not involved with the research say that the new method is of great
interest, but that many treatments that work well in laboratory mice turn out
to be ineffective in patients.
Bert Vogelstein, a
leading cancer researcher at Johns
Hopkins University,
called the method “a creative and promising line of research,” but noted the
general odds against success.
“Unfortunately our
track record shows that far less than 1 percent of our promising approaches
actually make the grade in patients,” he said.
The EnGeneIC researchers said they had conducted successful
safety tests in a large number of monkeys and will start safety trials in
patients with all kinds of solid tumors in three Melbourne hospitals next month. They said
they had discussed licensing their technology with large pharmaceutical
companies and others.
Stephen H. Friend,
head of cancer research at Merck until early this year, said he had been
following EnGeneIC’s work for more than a year, and
praised the company for trying a method that others had written off without
trying.
“I consider the
approach is remarkable and more than intriguing,” said Dr. Friend, who is now
at Sage Bionetworks in Seattle.
But he warned that cancer cells are very versatile and can “evolve around any
pressure you put on them,” so that no single approach is likely to afford a
cure.
The EnGeneIC method uses minicells
to deliver a variety of agents to tumor cells, including both anticancer
toxins and mechanisms for suppressing the genes that make tumors resistant to
toxins.
The minicells are generated from mutant bacteria which, each
time they divide, pinch off small bubbles of cell membrane. The minicells can be loaded with chemicals and coated with
antibodies that direct them toward tumor cells.
No tumor cell, so
far as is known, produces a specific surface molecule for toxins to act on.
But 80 percent of solid tumors have their cell surfaces studded with
extra-large amounts of the receptor for a particular hormone, known as
epidermal growth factor.
The minicells can be coated with an antibody that recognizes
this receptor, so they are more likely to attach themselves to tumors than to
the normal cells of the body. The tumor cells engulf and destroy the minicells, a standard defense against bacteria, and in
doing so are exposed to whatever cargo the minicells
carry.
What also helps
direct the minicells toward tumors, the EnGeneIC researchers say, is that the blood vessels
around tumors tend to be leaky, and the minicells
are small enough to leave the circulation at the leak sites.
The minicells do not seem to be highly provocative to the
immune system, even though they are made of bacterial cell membrane. The
reason may be that the provocative parts of the membrane are masked by
antibodies with which the minicells are coated, Dr.
Brahmbhatt said.
In the experiments
reported Sunday, EnGeneIC treated cancer-ridden
mice with two waves of minicells. The first wave
contained an agent that suppressed an important gene for toxin resistance.
The gene makes a protein that pumps toxin out of cells, and is a major cause
of the resistance that tumors often develop toward chemotherapeutic agents.
After the
toxin-expelling gene had been knocked down in the tumor cells, the EnGeneIC researchers injected a second wave of minicells, each loaded with half a million molecules of
doxorubicin, a toxin used in chemotherapy.
The two-wave
treatment arrested tumor growth in mice implanted with either human colon or
human breast tumors, and enabled mice with drug-resistant human uterine
tumors to eliminate the tumors altogether.
“The technology
looks very good,” said Bruce Stillman, president of
the Cold Spring Harbor Laboratory on Long Island.
It provides a general method of delivering chemicals to tumors, he said,
especially those that are usually degraded in the bloodstream.
Dr. Stillman, who has advised EnGeneIC
and is a co-author of its report, said the minicells
could be particularly helpful for delivering silencing RNAs,
a promising new class of drug that is rapidly destroyed in the body unless
protected.
Though the minicells can be varied to attack different receptors and
to import any gene of interest on elements called plasmids, the method still
has several hurdles to jump.
Robert M. Hoffman,
of the University of California, San
Diego, said that the minicells
were “good strategy and good science” but that the researchers had implanted
the human tumors under the mice’s skin, a position from which they do not
usually spread through the body. So the experiments do not answer the
question of whether minicells can attack
metastasized cancer, he said.
Dr. Hoffman, who
is president of AntiCancer Inc., has obtained
striking remissions with metastasized cancers in mice by treating them with
salmonella bacteria. The bacteria have been engineered to lack two kinds of
amino acid, which makes them unable to grow in normal tissues. In cancer
cells, however, where the missing amino acids are in more plentiful supply,
the bacteria are highly virulent and kill the cells.
The idea of
treating cancer with bacteria goes back to the 19th century, when physicians
noticed that cancer patients who became infected sometimes enjoyed a
remission. Both Dr. Hoffman’s method and the minicells,
in different ways, revisit these old observations. Both may face special
scrutiny from regulators concerned at the prospect of putting bacteria into
people.
Dr. Hoffman said
his studies with the defective bacteria were going well and that his company
might be ready to start a safety test in patients in two years if it can find
a good partner. Use of bacteria in cancer “is an old story but there is
definitely a lot of promise there,” he said.
http://www.nytimes.com/2009/06/29/health/research/29drug.html?_r=1&ref=health
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The New York Times | 06.27.09
By GINA KOLATA
Bryce
Vickmark for The New York Times
Dr. Ewa T. Sicinska turned to a private foundation to finance her
research.
Among the recent
research grants awarded by the National Cancer Institute is one for a study
asking whether people who are especially responsive to good-tasting food have
the most difficulty staying on a diet. Another study
will assess a Web-based program that encourages families to choose more
healthful foods.
Many other grants
involve biological research unlikely to break new ground. For example, one
project asks whether a laboratory discovery involving colon cancer also
applies to breast cancer. But even if it does apply, there is no treatment
yet that exploits it.
The cancer
institute has spent $105 billion since President Richard M. Nixon declared
war on the disease in 1971. The American Cancer Society, the largest private
financer of cancer research, has spent about $3.4 billion on research grants
since 1946.
Yet the fight
against cancer is going slower than most had hoped, with only small changes
in the death rate in the almost 40 years since it began.
One major
impediment, scientists agree, is the grant system itself. It has become a
sort of jobs program, a way to keep research laboratories going year after
year with the understanding that the focus will be on small projects unlikely
to take significant steps toward curing cancer.
“These grants are
not silly, but they are only likely to produce incremental progress,” said
Dr. Robert C. Young, chancellor at Fox
Chase Cancer
Center in Philadelphia and chairman of the Board of
Scientific Advisors, an independent group that makes recommendations to the
cancer institute.
The institute’s
reviewers choose such projects because, with too little money to finance most
proposals, they are timid about taking chances on ones that might not
succeed. The problem, Dr. Young and others say, is that projects that could
make a major difference in cancer prevention and treatment are all too often
crowded out because they are too uncertain. In fact, it has become lore among
cancer researchers that some game-changing discoveries involved projects
deemed too unlikely to succeed and were therefore denied federal grants,
forcing researchers to struggle mightily to continue.
Take one transformative
drug, for breast cancer. It was based on a discovery by Dr. Dennis Slamon of the University of California, Los Angeles, that
very aggressive breast cancers often have multiple copies of a particular
protein, HER-2. That led to the development of herceptin,
which blocks HER-2.
Now women with
excess HER-2 proteins, who once had the worst breast cancer prognoses, have
prognoses that are among the best. But when Dr. Slamon
wanted to start this research, his grant was turned down. He succeeded only
after the grateful wife of a patient helped him get money from Revlon, the
cosmetics company.
Yet studies like
the one on tasty food are financed. That study, which received a grant of
$100,000 over two years, is based on the idea that since obesity is associated
with an increased risk of cancer, understanding why people have trouble
losing weight could lead to better weight control methods, which could lead
to less obesity, which could lead to less cancer.
“It was the first
grant I ever submitted, and it was funded on the first try,” said the
principal investigator, Bradley M. Appelhans, an
assistant professor of basic medical sciences and psychology at the University of Arizona. Dr. Appelhans
said he realized it would hardly cure cancer, but hoped that “it will provide
knowledge that will incrementally contribute to more effective cancer
prevention strategies.”
Even top federal
cancer officials say the system needs to be changed.
“We have a system
that works over all pretty well, and is very good at ruling out bad things —
we don’t fund bad research,” said Dr. Raynard S. Kington, acting director of the National Institutes of
Health, which includes the cancer institute. “But given that, we also
recognize that the system probably provides disincentives to funding really
transformative research.”
The private
American Cancer Society follows a similarly cautious path. Last year, it
awarded $124 million in new research grants, with some money coming from
large donors but most from events like walkathons and memorial donations.
Dr. Otis W.
Brawley, chief medical officer at the cancer society, said the whole cancer
research effort remained too cautious.
“The problem in
science is that the way you get ahead is by staying within narrow parameters
and doing what other people are doing,” Dr. Brawley said. “No one wants to
fund wild new ideas.”
He added that the
problem of getting money for imaginative but chancy proposals had worsened in
recent years. There are more scientists seeking grants — they surged into the
field in the 1990s when the National Institutes of Health budget doubled
before plunging again.
That makes many
researchers, who need grants not just to run their labs but also sometimes to
keep their faculty positions, even more cautious in the grant proposals they
submit. And grant review committees become more wary about giving scarce
money to speculative proposals.
Philanthropies,
which helped some researchers try outside-the-box ideas, are now having
financial problems. And advances in technology have made research more
expensive.
“Scientists don’t
like talking about it publicly,” because they worry that their remarks will
be viewed as lashing out at the health institutes, which supports them, said
Dr. Richard D. Klausner, a former director of the
National Cancer Institute.
But, Dr. Klausner added: “There is no conversation that I have
ever had about the grant system that doesn’t have an incredible sense of
consensus that it is not working. That is a terrible wasted opportunity for
the scientists, patients, the nation and the world.”
A Big Idea
Without a Backer
For 25 years,
Eileen K. Jaffe received federal grants to run her lab. As a senior scientist
at the Fox Chase Cancer
Center, with a long
list of published papers in prestigious journals, she is a respected,
established researcher.
Then Dr. Jaffe
stumbled upon results that went against textbook explanations, suggesting
that it might be possible to find an entirely new class of drugs that could
disable proteins that fuel cancer cells. Now she wants to find chemicals that
might be developed into such drugs.
But her grant
proposal was rejected out of hand by the institutes of health, not even
discussed by a review panel. She had no preliminary data showing that the
idea was likely to work, something reviewers always want to see, and the idea
was just too unprecedented.
Dr. Jaffe
epitomizes the scientist who realizes that if she were to single-mindedly
pursue her unorthodox idea, her “career may be ruined in the process,” in the
words of Dr. Brawley of the American Cancer Society.
Dr. Jaffe is just
conceiving her project; it is much to soon to know
whether it will result in a revolutionary drug. And even if she does find
potential new drugs, it is not clear that they will be effective. Most new
ideas are difficult to prove, and most potential new drugs fail.
So Dr. Jaffe was
not entirely surprised when her grant application to look for such cancer
drugs was summarily rejected.
“They said I don’t
have preliminary results,” she said. “Of course I don’t. I need the grant
money to get them.”
Dr. Young,
chancellor at Fox Chase, said Dr. Jaffe’s situation showed why people with
bold new ideas often just give up.
“You can’t prove
it will work in advance,” he said. “If you could, it wouldn’t be a high-risk
idea.”
It is a long haul,
Dr. Jaffe knows. And she has already had to downsize her lab. But, she said,
she will persist.
Angels Outside
Government
At the Dana-Farber
Cancer Institute in Boston,
Dr. Ewa T. Sicinska knew
she would have a similar problem with her research. She wanted to grow human
cancers in mice. Unlike Dr. Jaffe, though, Dr. Sicinska
did not even apply for government money.
It is not that the
project was unimportant.
“Rather than have
to start a human clinical trial to test new drugs, we want to test them first
in mice with real human tumors,” said Dr. George D. Demetri,
who leads the research group supporting Dr. Sicinska.
Researchers have
studied mouse cancers but, they acknowledge, they are just not the same as
human cancers — they are much easier to treat, and drugs that cure mice often
do nothing in people. So, over the years, scientists have tried to implant
human cancer cells in mice, but with little success.
“Everyone told us
that if you take tumors out of patients and put them in mice, they don’t
grow,” Dr. Demetri said. The tumor cells usually
were put in a plastic dish before being implanted in mice. “We said — wait a
minute. The cells are not growing in the plastic dish. They probably are
dying. What if we bypass the dish?’”
With that idea in
mind, Dr. Demetri, convinced it was too speculative
to get federal money, tapped an unusual source, the Ludwig Fund. Endowed by
Daniel K. Ludwig, one of the world’s richest men in the 1960s and 1970s, the
fund supports unfettered cancer research at six medical centers in the United States,
including Dana-Farber, to be used at the institutes’ discretion. That put Dr.
Sicinska in a very different position from that of
Dr. Jaffe. She could try something chancy without a grant.
Dr. Sicinska used a quarter of a million dollars of Ludwig
money for this project, buying mice without immune systems, which meant they
could not reject human tumors, and housing them in a germ-free basement lab.
She spent months learning to implant tumors in the mice and enlisted
geneticists to study the implanted tumors, making sure they did not mutate
beyond recognition.
She spends her
days in the lab, using a miniature ultrasound machine to scan the mice,
hairless creatures with prominent ears. Four types of sarcomas — cancers of
fat, muscle or bone — are growing in them and look genetically identical to
the tumors removed from patients.
Dr. Elias A. Zerhouni, former director of the National Institutes of
Health, said he was not sure that a grant for the project would have been
turned down. The N.I.H., he said, does finance research on mouse models for
human cancer.
But Dr. Demetri said he did not apply “because we have lots of
experience in what’s fundable.” His mouse work, he said, is exploratory, and
he cannot predict what he will find or when. He certainly could not lay out a
road map of what he would do and promise results in a few years.
Studies With a
Different Goal
Researchers like
Dr. Appelhans, who is studying weight control and
tasty foods, do not expect to change the outlook for cancer patients anytime
soon. But, they say, that does not mean their work is unimportant.
Dr. Appelhans will study 85 overweight or obese women,
measuring how much the tastes and textures of food drive their eating. Then
they will be given a weight loss diet and nutritional counseling. Dr. Appelhans will ask whether those who are most tempted by
the tastes and textures also have the most trouble following the diet.
As for the grant
to assess a Web-based program to improve food choices, it is predicated on
studies indicating that what people eat in childhood and adolescence may have
an impact on cancer risk in middle and old age, said the grant recipient,
Karen Weber Cullen, associate professor of pediatrics at Baylor College of Medicine.
Some studies have found that people who reported having eaten fruits and
vegetables when they were younger and maintaining a healthy weight were less
likely to have cancer.
Of course, it
would not be feasible to follow participants for 30 or 40 years to see if
their cancer risk was altered, Dr. Cullen noted. But, she added, “we try to
achieve improvements in diet and physical activity behaviors that become
permanent and will make a difference in later years.”
In the study
asking whether a molecular pathway that spurs the growth of colon cancer
cells also encourages the growth of breast cancer cells, the principal
investigator ultimately wants to find a safe drug to prevent breast cancer.
She received a typical-size grant of a little more than $1 million for the
five-year study.
The plan, said the
investigator, Louise R. Howe, an associate research professor at Weill Cornell Medical
College, is first to
confirm her hypothesis about the pathway in breast cancer cells. But even if
it is correct, the much harder research would lie ahead because no drugs
exist to block the pathway, and even if they did, there are no assurances
that they would be safe.
Dr. Howe said she
hoped that she would find such drugs, or that companies would. Then she wants
to develop a way to selectively deliver the drugs to precancerous breast
cells. If it all works and the treatment is safe, women with precancerous
conditions could avoid developing cancer.
Dr. Howe has
reviewed grants for the cancer institute herself, she said, and realizes
that, among other things, those that get financed must have “a novel
hypothesis that is credible based on what we know already.”
Trying to
Change the System
The National
Institutes of Health has started “pilot experiments” to see if there is a
better way of getting financing for innovative projects, its acting director,
Dr. Kington, said.
They include
“pioneer awards,” begun in 2004 for “ideas that have the potential for high
impact but may be too novel, span too diverse a range of disciplines or be at
a stage too early to fare well in the traditional peer review process.” But
only 3 percent to 5 percent of the applicants get funded. Now the institutes
have decided to set aside up to $25 million for “transformative R01 grants,”
described as “proposing exceptionally innovative, high risk, original and/or
unconventional research with the potential to create or overturn fundamental
paradigms.”
About 700
proposals have come in, but only a small number are expected to be financed,
according to Dr. Keith R. Yamamoto, a molecular biologist and executive vice
dean of the school of medicine at the University
of California, San Francisco, and co-chairman of the
committee that reviewed the proposals last week.
“From reading the
applications so far, there are really some fantastic things,” Dr. Yamamoto
said.
There also is new
money from the federal economic stimulus package passed by Congress, which
gives the National Institutes of Health $200 million for “challenge grants”
lasting two years or less.
But the N.I.H. has
received about 21,000 applications for 200 challenge grants, and researchers
who have applied concede there is not much hope.
“I did submit one
of these challenge grants recently, like the rest of the lemmings,” said Dr.
Chi Dang, professor of medicine, cell biology, oncology and pathology at the
Johns Hopkins University School of Medicine. But, he added, “there are many,
many more applications than slots.”
Some experienced
scientists have found a way to offset the problem somewhat. They do chancy
experiments by siphoning money from their grants.
“In a way, the
system is encrypted,” Dr. Yamamoto said, allowing those in the know to wink
and do their own thing on the side.
Great discoveries
have been made with N.I.H. financing without manipulating the system, Dr. Klausner said.
“But,” he added,
“I actually believe that by and large it is despite, rather than because of,
the review system.”
http://www.nytimes.com/2009/06/28/health/research/28cancer.html?ref=health
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