What causes allergies?

To help answer this question, let’s look at a common household example. A few months after the new cat arrives in the house, dad begins to have itchy eyes and episodes of sneezing. One of the three children develops coughing and wheezing, especially when the cat comes into her bedroom. The mom and the other two children experience no reaction whatsoever to the presence of the cat. How can we explain this?

The immune system is the body’s organized defense mechanism against foreign invaders, particularly infections. Its job is to recognize and react to these foreign substances, which are called antigens. Antigens are substances that are capable of causing the production of antibodies. Antigens may or may not lead to an allergic reaction. Allergens are certain antigens that cause an allergic reaction and the production of IgE.

The aim of the immune system is to mobilize its forces at the site of invasion and destroy the enemy. One of the ways it does this is to create protective proteins called antibodies that are specifically targeted against particular foreign substances. These antibodies, or immunoglobulins (IgG, IgM, IgA, IgD), are protective and help destroy a foreign particle by attaching to its surface, thereby making it easier for other immune cells to destroy it. The allergic person however, develops a specific type of antibody called immunoglobulin E, or IgE, in response to certain normally harmless foreign substances, such as cat dander. To summarize, immunoglobulins are a group of protein molecules that act as antibodies. There are five different types; IgA, IgM, IgG, IgD, and IgE. IgE is the allergy antibody.

(In 1967, the husband and wife team of Kimishige and Teriko Ishizaka detected a previously unrecognized type of immunoglobulin in allergic people. They called it gamma E globulin or IgE.)

In the pet cat example, the dad and the youngest daughter developed IgE antibodies in large amounts that were targeted against the cat allergen, the cat dander. The dad and daughter are now sensitized or prone to develop allergic reactions on subsequent and repeated exposures to cat allergen. Typically, there is a period of “sensitization” ranging from months to years prior to an allergic reaction. Although it might occasionally appear that an allergic reaction has occurred on the first exposure to the allergen, there must have been a prior contact in order for the immune system to be poised to react in this way.

IgE is an antibody that all of us have in small amounts. Allergic persons, however, produce IgE in large quantities. Normally, this antibody is important in protecting us from parasites, but not from cat dander or other allergens. During the sensitization period, cat dander IgE is being overproduced and coats certain potentially explosive cells that contain chemicals. These cells are capable of causing an allergic reaction on subsequent exposures to the dander. This is because the reaction of the cat dander with the dander IgE irritates the cells and leads to the release of various chemicals, including histamine. These chemicals, in turn, cause inflammation and the typical allergic symptoms. This is how the immune system becomes exaggerated and primed to cause an allergic reaction when stimulated by an allergen.

On exposure to cat dander, the mom and the other two children produce other classes of antibodies, none of which cause allergic reactions. In these non-allergic members of the family, the dander particles are eliminated uneventfully by the immune system and the cat has no effect on them.

Asthma gets help from injection-acupuncture

CM NEWS – Injection of a traditional Chinese medicine herbal extract into a widely used acupuncture point may have an anti-inflammatory and immune-regulatory effect on bronchial allergic asthma, according to a new South Korean study.

The herb used in the study was perilla seed (Perillae fructus; or 紫蘇, Zisu in Chinese; or Shiso in Japanese). Injection of the herbal extract into an acupuncture point (herbal acupuncture) is a therapeutic technique combining both acupuncture and herbal treatment.

The study was led by researchers at the Department of Acupuncture, College of Oriental Medicine, Daejeon University, South Korea.

In Chinese medicine, perilla has been shown to stimulate interferon activity and thus, the body’s immune system.

The Japanese often eat perilla with sashimi (sliced raw fish) or cut into thin strips in salads, spaghetti, and meat and fish dishes. It is also used as a flavourful herb in a variety of dishes, even as a pizza topping (initially it was used in place of basil).

Perilla seed has been used to treat respiratory diseases in Chinese medicine. According to TCM theory, perilla seeds enters the lung meridian, arrests coughing and wheezing with copious phlegm, and treats exhalation difficulties and stiffness in the chest. The leaves of perilla (Perilla frutescens) have shown a suppressive effect on type 1 allergies. However, perilla seed has not yet been investigated for use on allergic diseases.
Recent studies have shown that perilla seed polyphenols regulate allergic diseases due to 5-lipoxygenase inhibitory activity and suppression of histamine release from mast cells.

The functional compounds of perilla seed extract are flavonoid aglycons such as luteolin, apigenin, chrysoeriol, and resemarinic acid. It is known that the antioxidative activity and lipoxygenase inhibitory activity of flavonoid aglycons are stronger than that of corresponding glycosides.

Studies have shown that perilla seed extract inhibits the growth of cariogenic and periodontopathogenic microorganisms which in turn reduces plaque formation and acid production, helping to prevent dental carries.

Acupuncture and herbs are widely used to treat bronchial asthma – and according to TCM theory – by clearing the pathogenic factors and reinforcing the body’s resistance.

An important acupoint, zusanli (足三里), was investigated by the researchers in the current study. Zusanli is one of the most widely used acupuncture points, particularly for immune system regulation.

Zusanli is on the foot Yangming stomach meridian. This acupoint is known to strengthen the vital energy (qi). The ‘vital energy’ here means not only stomach qi, even though this acupoint belongs to the stomach meridian, but also the general qi in the whole body.

For this reason, zusanli is used to treat various diseases in different parts of the body or general symptoms in the whole body, including deficiency and weakness.

According to the book Chinese Acupuncture and Moxibustion, zusanli is listed to treat: gastric pain, vomiting, hiccup, abdominal distention, borborygmus, diarrhea, dysentery, constipation, mastitis, enteritis, aching of the knee joint and leg, beriberi, edema, cough, asthma, emaciation due to general deficiency, indigestion, apoplexy, hemiplegia, dizziness, insomnia, mania. (for a detailed explanation of zusanli, check here.)

Asthmatic mice were divided into 6 groups – both experimental and control. The experimental group was treated with perilla seed extract plus the acupuncture while the controlled ones received saline injection or just acupuncture. The treatments went on for 8 weeks.

According to the researchers:

Asthma is generally regarded as a T-cell mediated disease. Allergens cause the differentiation of naive T- cells into Th2 cells, which then secrete cytokines such as IL-4, IL-5 and IL-13 (3).

IL-4, which is pivotal in the pathogenesis of allergic disorders, acts on B cells to facilitate IgE production. Increased IgE production in response to common environmental antigens is the hallmark of atopic diseases such as bronchial asthma.

IL-4 also induces the rolling and adhesion of circulating eosinophils to endothelial cells. Therefore, inhibitors of the IL-4 signaling pathway have been suggested as therapeutic targets.

The results showed that perilla seed extracts + acupuncture at zusanli significantly decreased cytokins IL-4. It is inferred that the treatment may have an anti-allergic effect on allergic bronchial asthma by suppressing IL-4 secretion; and thus reduce eosinophil inflitration into the lungs by reducing the adhesion of circulating esoinophils to endothelial cells, the researchers wrote.

The researchers also found that even by applying acupuncture at zusanli ONLY may suppress asthma, though not as effective as the injection-acupuncture treatment. This result suggests that the mechanical stimulation of zusanli has a beneficial effect on bronchial allergic asthma.

“In summary, we hypothesize that PF-HA may be applicable to bronchial allergic asthma to reduce airway obstruction by inhibiting cellular infiltration and collagen accumulation in the lung, and to relieve airway hyper-responsiveness by reducing IL-4, IL-5, IL-13 and IgE,” the researchers conclude.

“Our data further suggest that PF-HA has a therapeutic effect on bronchial allergic asthma by regulating the immune system (suppressing excess Th2 activity and rebalancing Th1/Th2 in the immune system) and controlling eosinophilic inflammation in the airway. The anti-inflammatory effect of PF-HA may result from its immuno-regulatory effect on Th1 and Th2 activity.”

Asparagus root lowers cholesterol, nurtures heart

CM NEWS – Asparagus roots, or tian dong (天冬 or 天門冬) can lower cholesterol and blood lipid, thus help prevent atherosclerosis and other cardiovascular diseases, a new study says.
Hyperlipidemia and hypercholesteremia are major risk factors for atherosclerosis and cardiovascular diseases. Atherosclerotic cardiovascular disease is rapidly becoming a major cause of death in many societies throughout the world due to changed dietary habits and occupational stress. In recent years, natural compounds found in plants are gaining scientific attention for their potential therapeutic value in fighting multifactorial atherosclerotic disorders.

A study done at the Department of Biosciences, Sardar Patel University in India investigated the hypocholesteremic and antioxidant potential of the asparagus root root in both normal and hypercholesteremic animals. The results are published in medical journal Evidence-based Complementary and Alternative Medicine.

What is atherosclerosis? The hallmark of atherosclerosis is the accumulation of cells containing excessive lipids (i.e. foam cells) within the arterial wall. The major risk factors for the development ofatherosclerosis are hypercholesteremia and elevated low-density lipoprotein cholesterol (LDL-C) concentration. Persistent hypercholesteremia results from prolonged circulation of lipid-rich lipoproteins that increase oxidative stress leading to oxidative modification of LDL to oxy-LDL.

In the present study, normal and hypercholesteremic male albino rats were administered with root powder of asparagus (5 and 10 g% dose levels) along with normal and hypercholesteremic diets, respectively, for a duration of 4 weeks.

Plasma and hepatic lipid profiles, fecal sterol, bile acid excretion and hepatic antioxidant activity were assessed.

What is asparagus root? A perennial with a woody root stock, asparagus grows from 1 to 5 feet high. The female Asparagus plant is slimmer than the male, which is shorter and stockier.

The dried root of asparagus is used in Chinese and Indian medicines as a tonic, galactogogue, aphrodisiac, rejuvenator, antispasmodic, antiulcerous and antiinflammatory. The medicinal/pharmacological value ofasparagus root is attributed to the presence of steroidal saponins and sapogenins. The root of asaparagus is also used in the treatment of nervous disorders, dyspepsia, diarrhea, dysentery, tumours, hyperdipsia, neuropathy and hepatopathy. This plant is reported to have immunostimulant, antihepatotoxic and antioxytocic activities. Recent reports on asparagus indicate that the root extracts haveantioxidant and antidiarrheal activities in laboratory animals.

Asparagus has also been used in its wild form in Ancient Greece and Rome as a natural diuretic that flushes out the kidneys and helps prevent the formation of kidney stones. It is because that the asparagus acts to increase cellular activity in the kidneys and thus increases the rate of urine production.

Asparagus roots also encourages evacuation of the bowels by increasing fecal bulk with undigested fiber. The roots are considered diuretic and laxative and are said to induce sweating, an they are recommended for gout, dropsy and rheumatism.

Chinese medicine says the asparagus root can increase feelings of compassion and love. In India, Asparagus is used to promote fertility, reduce menstrual cramping and increase milk production in nursing mothers.

In the Eastern and Western world, it has been touted as an aphrodisiac. These customs and beliefs are not mere superstition – the root contains compounds called steroidal glycosides (asparagoside) that directly affect hormone production and may very well influence emotions.

Chinese studies report that the roots may also lower blood pressure. The powdered seeds have antibiotic properties and help to relieve nausea while calming the stomach. Japanese studies report that green Asparagus aids protein conversion into amino acids.

Asparagus is also high in folic acid, which is essential for production of new red blood cells. Other primary chemical constituents of Asparagus include essential oil, asparagine, arginine, tyrosine, flavonoids (kaempferol, quercitin, rutin), resin and tannin.

The researchers found that rats that took diet with asparagus root powder have a reduction in their plasma and hepatic lipid profiles. Other observations include: increased fecal excretion of cholesterol, neutral sterol and bile acid, and increases in hepatic HMG-CoA reductase activity and bile acid content in hypercholesteremic rats.

Further, the asparagus root diet also improved the hepatic antioxidant status (catalase, SOD and ascorbic acid levels). However, there were no significant changes in lipid and antioxidant profiles occurred in rats with normal cholesterol levels.

The researchers explain that the lipid-lowering effects of the asparagus root in hypercholesteremic rats are related primarily to an increased excretion of cholesterol, neutral sterols, bile acid and an increase in hepatic bile acid content. In this context, the phytosterol and saponin contents of asparagus root could be responsible.

On one hand phytosterols are reported to compete and displace cholesterol from the intestinal bile acid micelles and decrease the cholesterol circulation, the researchers say. On the other hand, saponins precipitate cholesterol from micelles and interfere with enterohepatic circulation of bile acids making it unavailable for intestinal absorption of cholesterol leading to a reduction in plasma cholesterol levels.

Although the main component of the Asparagus root is a steroidal saponin, the root also contains alkaloids, flavonoids, sterols, terpenes, tannins, phenolics and mucilage.

In all, the results of the present study indicate that the potent therapeutic phyto-components present in the asparagus root i.e. phytosterols, saponins, polyphenols, flavonoids and ascorbic acid, could be responsible for increased bile acid production, elimination of excess cholesterol and elevation of hepatic antioxidant status in hypercholesteremic conditions.

Hypertension Drugs May Cut Alzheimer’s Risk

By Bill Hendrick
WebMD Health News

Reviewed By Louise Chang, MD

Jan. 12, 2010 — Drugs commonly used to treat high blood pressure and heart disease may reduce the risk of dementia and Alzheimer’s disease, a new study suggests.

Boston University scientists, reporting in the journal BMJ, say a class of high blood pressure drugs called angiotensin receptor blockers is associated with a striking decrease in the risk of occurrence and progression of dementia.

The researchers, using information from a U.S. Department of Health System Veterans Affairs database of more than 5 million people, examined records of more than 800,000 predominantly male patients 65 or older.

The researchers compared the patients in groups that included those using an angiotensin receptor blocker (ARB); those using an ACE inhibitor called lisinopril (Prinivil, Zestril); and those using other blood pressure/heart disease medications (excluding statins).

Angiotensin receptor blockers include candesartan (Atacand), irbesartan (Avapro), losartan (Cozaar), and valsartan (Diovan).

There were no differences in average blood pressure among the three groups.

The patients taking an angiotensin receptor blocker had a 19% lower risk of developing dementia compared to those taking lisinopril and a 24% lower risk compared to use of other blood pressure/heart medications. People taking both an ACE inhibitor and an angiotensin receptor blocker, which both target the angiotensin system, had a 46% lower risk of dementia compared with those taking other medications.

The researchers also studied records of patients who already were suffering from dementia or Alzheimer’s. Those patients taking ARBs, the scientists report, had a lower risk of being admitted to a nursing home or dying. Those taking both an ARB and an ACE inhibitor had a 67% lower chance of being admitted to a nursing home.

The results suggest that ARBs might protect against developing Alzheimer’s disease and dementia, the researchers write.

“For those who already have dementia, use of ARBs might delay deterioration of brain function and help keep patients out of nursing homes,” says Benjamin Wolozin, MD, PhD, professor of pharmacology at Boston University and one of the study researchers. “The study is particularly interesting because we compared the effects of ARBs to other medications used for treating blood pressure or cardiovascular disease.”

The researchers write that they do not know exactly why ARBs might be so beneficial, but they believe the drugs may help prevent and reduce nerve cell injury from stroke or blood vessel damage.

The researchers say they’ve conducted the first large-scale study to investigate whether angiotensin receptor blockers reduce the risk of developing Alzheimer’s or dementia.

The findings of the study are “immense,” write Colleen J. Maxwell, PhD, and David B. Hogan, MD, of the University of Calgary in an accompanying editorial. “About 36 million people worldwide have a form of dementia such as Alzheimer’s disease,” they write. “If survival, prevention or treatment do not improve dramatically, this number could double over the next 20 years.”

However, they add, though the findings of the study are dramatic, further work is needed to verify the results.

Is swine flu (H1N1) a cause of an epidemic or pandemic in 2009?

An epidemic is defined as an outbreak of a contagious disease that is rapid and widespread, affecting many individuals at the same time. The swine flu outbreak in Mexico fit this definition. A pandemic is an epidemic that becomes so widespread that it affects a region, continent, or the world. As of April 2009, the H1N1 swine flu outbreak did not meet this definition. However, as of June 11, 2009, WHO officials determined that H1N1 2009 influenza A swine flu reached WHO level 6 criteria (person-to-person transmission in two separate WHO-determined world regions) and declared the first flu pandemic in 41 years. To date, the flu has reached over 74 different countries on every continent except Antarctica in about three month’s time; fortunately, the severity of the disease has not increased.

Herbal sex remedy linked to cancer

Reuters, CanWest – Two men seeking to boost sexual performance and grow bigger muscles instead ended up with advanced prostate cancer after taking “herbal” supplements, US doctors said.

They said many supplements marketed as “safe” and “natural” could contain unknown and potentially dangerous ingredients, and noted that the US Food and Drug Administration has little authority to regulate them.

“Physicians need to ask their patients not only about the prescription drugs they may be taking, but — perhaps even more importantly — about the over-the-counter drugs andsupplements, which may have a profound impact on certain health conditions,” Claus Roehrborn, chairman of urology at the University of Texas Southwestern medical school, said yesterday.

Dr Roehrborn’s team became concerned about what it calls herbal/hormonal dietary supplements, or HHDSs, after two men developed aggressive prostate cancer within months of taking the same supplement.

For legal reasons the researchers won’t name the supplement, which was removed from the market, and say they have no direct proof that the product caused the highly suspiciousprostate cancers.

The team analysed the product and found it contained two hormones — testosterone and estradiol. When the product was tested on tumour cells in the lab, it fuelled the growth ofprostate cancer cells more potently than testosterone alone, the team reported in the journal Clinical Cancer Research.”We filed an adverse event report with the FDA, who issued a warning letter. The manufacturer responded by removing this HHDS product from the market,” the researchers wrote.

“Individuals use HHDS for self-improvement, failure or distrust of conventional medicine, and because they believe that these natural products are safe and drug-free.”

The researchers searched websites promoting such products and found they promised maintenance of a “youthful” heart, relief of stress, and improvements in stamina, energy, strength and virility.

The patients, a 67-year-old and a 51-year-old, have both survived but cancer has spread throughout their bodies.

“Unlike prescription and over-the-counter drugs, the law does not require nutritional supplements to undergo pre-market approval for safety and efficacy,” the researchers wrote, with manufacturers allowed to assume the sole responsibility.

“Thus, the current Food and Drug Administration regulatory system provides little oversight or assurance that HHDS will have predictable pharmacological effects or even that product labels provide accurate information to consumers.”

A leading Canadian urologist warns that men who take nutritional supplements advertised as having male hormones are “really playing with fire.”

“Many men are on androgen replacement therapy or some kind of male hormone replacement and there’s always been a concern this may stimulate the growth of prostate cancer cells,” says Dr. Laurence Klotz, chief of the division of urology at Toronto’s Sunnybrook Health Science Centre.

“It’s a very controversial question and the answer is still not clear.”

A separate study, this one the latest to look at the risk of hormone therapy for women, found that taking an estrogen-plus-progesterone combination for as little as three years significantly increases the risk of certain breast cancers.

It was thought only women who use these hormones for at least five years have an increase in breast cancer risk.

The study involved more 1,500 postmenopausal women, age 55 to 74, in western Washington. Researchers at the Fred Hutchinson Cancer Research Center in Seattle found that women who used the combined hormone regimen had a three- to four-fold relative increased risk of lobular cancer, but only if they used the hormones for three or more years.

Lobular cancer accounts for about only 15 per cent of all invasive breast cancers. It’s hard to detect and its incidence soared 52 per cent in the U.S. between 1987 and 1999, according to the researchers.

“These findings are still of considerable public-health importance considering the estimated 57 million prescriptions for menopausal hormone therapy that continue to be filled in the United States,” lead author Dr. Christopher Li said in a release issued with the new study, published in the journal Cancer Epidemiology, Biomarkers and Prevention.

Ginger eases nausea from cancer treatment Ginger eases nausea from cancer treatment

Ginger inhibits overian cancer cell growth

Reuters – Ginger, long used as a remedy for upset tummies, can help ease the nausea caused by cancer drugs, researchers reported.

They found the lowest doses of ginger worked best.

“Patients ask all the time what else they can do to relieve their symptoms,” Dr. Richard Schilsky, president of the American Society of Clinical Oncology and a blood cancer specialist at the University of Chicago, said in an interview.

“Ginger has been used for thousands of years for all types of stomach problems.”

Dr. Julie Ryan and colleagues at the University of Rochester in New York tested 614 people with various cancers who were being treated with chemotherapy and standard anti-nausea medications.

They got either a placebo or one of three doses of powdered ginger in a capsule.

“All of the doses of ginger were effective in reducing nausea,” Schilsky said.

The lowest two doses — half a gram and one gram of powdered ginger — were more effective than 1.5 grams, Ryan’s team reported.

Ryan said it was not exactly clear how ginger helps relieve nausea in these patients. “There is other research that shows it is a potent anti-inflammatory agent in the gut,” she told reporters in a telephone briefing.

She said it might be possible to get the same effect by eating ginger cookies, depending on how much ginger is used.

Researchers find prostate cancer stem cell

WASHINGTON (Reuters) – Researchers have found a stem cell, a kind of master cell, that may cause at least some types of prostate cancer.

Their findings are only experimental — the stem cells were found in mice — but could explain at least some types of prostate cancer and eventually offer new ways to treat it, they reported on Wednesday in the journal Nature.

The findings also show a potential new source for prostate tumors — so-called luminal cells, which secrete various compounds used in the prostate.

“The role of stem cells in the development of prostate cancer has been a focus of speculation for many years,” Dr. Helen Rippon of Britain’s Prostate Cancer Charity said in a statement.

“Importantly, this new stem cell does not rely on androgens — the male sex hormones that control prostate growth — to survive and grow. This may give a clue as to why prostate cancer often becomes resistant to treatments designed to regulate these androgens in the later stages of the disease,” added Rippon, who was not involved in the research.

“This improved knowledge will also be a step forward in learning how we might help to prevent the disease from developing in men in the first place.”

Michael Shen of Columbia University Medical Center and colleagues named the new stem cells CARNs, for castration-resistant Nkx3.1-expressing cells.

They normally regenerate part of the tissue that lines the inside of the gland, which produces semen. But the cells can also form tumors if certain genes meant to stop out-of-control growth get turned off.

Shen said researchers had believed that tumors arise from a different layer of cells in the prostate, called basal cells.

“Previous research suggested that prostate cancer originates from basal stem cells, and that during cancer formation these cells differentiate into luminal cells,” Shen said in a statement. “Instead, CARNs may represent a luminal origin for prostate cancer.”

Prostate cancer is the second most common cancer in men worldwide after lung cancer, killing 254,000 men a year globally.

(Writing by Maggie Fox; Editing by Philip Barbara)

HIV Screening Tests Proposed to Be Added to Medicare’s List of Covered Preventive Services

The Department of Health and Human Services (HHS) today announced a new proposal that would cover Human Immunodeficiency Virus (HIV) infection screening for Medicare beneficiaries who are at increased risk for the infection, including women who are pregnant and Medicare beneficiaries of any age who voluntarily request the service.

“The President has set clear priorities for an improved national response to ending the HIV epidemic,” said HHS Secretary Kathleen Sebelius. “Today’s action by HHS’ Centers for Medicare & Medicaid Services (CMS) sends a strong signal that this Administration takes prevention very seriously, especially when it comes to HIV and AIDS.”

“While younger age groups account for most cases of HIV infection in the United States,  the Centers for Disease Control and Prevention (CDC) estimates that in 2006, approximately 19 percent of all U.S. residents with AIDS were age 50 years or older when the disease was diagnosed, ” she added.  “Knowing about their HIV status can help patients live longer, fuller lives as well as avoid unintentional transmission of the virus to others.”

CMS’ efforts mark the first time that Medicare has proposed to expand its list of covered preventive services under a new authority established by Congress.  The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) gave CMS the ability to consider whether Medicare should cover “additional preventive services,” if certain requirements are met.

Acquired immunodeficiency syndrome (AIDS) is diagnosed when an HIV-infected person’s immune system becomes severely compromised or a person becomes ill with an HIV-related infection. Of the more than one million Americans estimated to have the HIV infection, the CDC has estimated that about a quarter of them do not realize they are infected.  Without treatment, the HIV infection usually develops into AIDS within 8 to 10 years.  While there is presently no cure for HIV, screening can help identify infected patients so that they can receive medical treatment that could help delay the onset of AIDS for years.

“This proposal to cover HIV screening for our Medicare population has great potential in terms of saving lives and improving the quality of life for many seniors, as well as beneficiaries under age 65,” said Acting CMS Administrator Charlene Frizzera.

The White House’s top HIV/AIDS official saluted the move by HHS, calling it a critical step in helping HIV and AIDS patients to get the treatment they need.

“The President is committed to re-focusing national attention on the domestic HIV epidemic and salutes this decision as an important step in our overall strategy,” said Jeffrey S. Crowley, the Director of the White House Office of National AIDS Policy. “We are working with agencies across the government to achieve the President’s goals of reducing HIV incidence, getting all people living with HIV/AIDS into care and improving health outcomes, and reducing HIV-related health disparities. The actions taken by the HHS today are an important part of our efforts.”

Under MIPPA, CMS can consider whether Medicare should cover preventive services that Congress has not already deemed as covered or non-covered by law, as long as they have been “strongly recommended” or “recommended” by the U.S. Preventive Services Task Force..  For instance, the Task Force graded HIV screening as “strongly recommended.”  More information about the Task Force is available online at http://www.ahrq.gov/clinic.

CMS uses the national coverage determination process to make decisions on these types of preventive services.  This process provides transparency about the evidence that CMS considers when making its decisions and allows opportunity for the public to comment on CMS’ proposals.

“We are pleased to be able to propose an expansion to Medicare’s portfolio of preventive services,” said Barry M. Straube, M.D., CMS Chief Medical Officer and Director of the Agency’s Office of Clinical Standards & Quality.  “Before the MIPPA law, CMS had not been able to expand preventive services without Congressional action.  Now we can take more active steps to evaluate the evidence about CMS Office of Public Affairswhich services are reasonable and necessary to help keep Medicare beneficiaries healthy.”

Health Care Co-Ops Option on Table

With the raging debate over health care reform, which I don’t think anyone debates the fact that we need it, it’s just highly debatable as to which way is the best way to come at this thing, there has been a newer proposal floating around that might catch the ear of some conservative Republicans who are dead set against the idea of government run health care.  The Obama administration keeps getting a lot of pushback on their health care plan, which entails a lot of government intervention, and with good reason. People typically are very leery of most anything that is government run because the government is notorious for being no good at running business.

If you’ve ever lived in a college town, you may know what a co-op is.  When I think of co-op, I think of co-op food places, like an organic produce co op or things like that, where farmers come together to provide a service, selling home grown veggies and fruits and a variety of other organically grown and natural foods, to the public. It’s not really a for-profit venture, because everything that is received by the business is put right back into it, so everyone is contributing, the people that run it, the people that buy stuff there, and so on and so forth.  It takes the cooperation of many parties to make it work, hence the name.

This could present it’s own family of challenges though.  Cooperative ventures are notoriously hard to break into, because they may face greater problems trying to get hospitals, doctors and other providers to provide them services for agreed upon reduced costs.  These co op health providers would be like a mutual insurance company where they provide services to clients for a reduced cost, however, getting everyone to agree to what those lower costs would be is the challenge, and also the fact that these co ops may not gain enough market share to really make a difference in the amount people are paying for their health insurance is another big “if”.

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