Until November 2008, all Americans become lobbyists and the candidates become saviors.

Healthcare is one of the most hotly debated issues that will eventually land one of the contestants a seat in the White House. American healthcare is in need of reform, but are we truly in crisis or accepting a fabrication of half-truths?

Justification for a National Healthcare System
The Democratic Party would have us believe we are in desperate need of a national healthcare delivery system. Justification is offered in an amazing display of half-known facts. The United States cannot possibly have the greatest healthcare system in the world when America spends over 16 percent of GNP on healthcare.

First of all, would we not expect superior healthcare to cost more? Spending more on healthcare should not make our system inferior but rather superior. We as a nation spend 56 percent more on healthcare than any of the other seven industrialized nations. These nations all have a national healthcare system that is almost totally funded by the government and that government in turn controls healthcare. The U.S. government contributes less to healthcare than any other industrialized nation by a low of 44 percent and as much as a high of 91 percent. The most compelling statistic in all of this is the 56 percent more the United States spends is almost exactly the amount covered by private health insurance.

We have the lowest tax rate of any other industrialized country except Switzerland. The Swiss, however, spend more per patient than any other country in the world. The reason for this is behind the layers of delivery in their system. The national system buys one level of healthcare and each preceding level is a function of private pay. These countries have higher tax rates because of the need for funding for their nationalized plans. Each also has a critical situation in which their hospitals are closing at alarming rates due to lack of funds. In other words, for America to go to a nationalized delivery system of healthcare, our tax rate would increase no less than 20 percent and our current system would still be underfunded.

The number of uninsured Americans is at an all time high. More than 47 million Americans do not have health insurance. The facts in this matter are really rather revealing. Almost 20 million represent the age group of 19 and coming off mom and dad’s insurance to 28, in that invincible age where possessions are more important than something they do not use. They simply choose to not have insurance.

Around 10 million represents illegal aliens who are counted among the 47 million to dramatize the numbers of people in the United States who do not have insurance.

One in four Americans — about 12 million people — who don’t have health coverage are eligible for Medicaid and the State Children’s Health Insurance Program (SCHIP) but aren’t enrolled, a new report shows. Reasons cited for the lack of enrollment include unawareness of the programs, uncertainty about how to enroll, fear about being linked with a publicly financed program. Plus, the report said, it can be difficult to stay enrolled.

Health or Healthcare?
In addition to cost, we receive other alarming partial statistics.
Surprisingly, Americans, the citizens of the wealthiest country in the history of the world, have a lower life expectancy rate, higher rates of heart disease and cancer, and an infant mortality rate that is twice as high as other rich industrialized nations.
Even Cuba has a lower infant mortality rate than the United States, according to the CIA Fact Book.
These issues are all a matter of health, not healthcare.

Heart disease is by far the number one killer in the United States, although a third of those deaths could be prevented if people followed better diets and exercised more often, this from a report from the American Heart Association.
Additionally, 50 million Americans have high blood pressure, 12.6 million have coronary heart disease, and 4.6 million have suffered stroke. The crisis in healthcare is that all of the top killers in the United States are related to eating and stress. If we could control these two conditions in our lives, most of us could live to 100 and remain fully functional!

One of the most alarming statistics is the infant mortality rate, which is slightly higher, on average, in the United States. Our rate is attributed to minorities, low birth weights and poor prenatal nutrition. However, the most alarming statistic that is never pointed out is the number one killer of prenatal infants in the United States is abortion and this act is enabled by the Democratic Party. This statistic is a sad commentary on the United States as a nation, yet it has nothing to do with inferior healthcare. The United States births more babies each year than other industrialized nations and 500,000 are born prematurely. We should focus on the fact that we have more infants who survive than any other country in the world. Of these 500,000, we lose less than 1 percent because we have a superior healthcare system.

Healthcare Reform Begins with Technology
As is the case in each of the industrialized nations, the United States has escalating costs and a lack of healthcare funding. We see 98,000 deaths each year caused by medical errors that would be drastically reduced if healthcare providers had access to comprehensive patient information. The U.S. Department of Health and Human Services reports electronic medical records would reduce the cost of healthcare by 30 percent annually and provide a permanent solution.

Health Information Technology available today to the physician will literally pay for itself in less than a year. When you consider IT eliminates the disparity payments to a physician between $.63 and $1.00 or 37 percent, a physician already has a handsome return on investment. When paper changes to electronic charts, each physician saves more than $15,000 per year. Add to these the elimination of duplicate tests, lost charts, lost charges, coding, diagnostic testing and so on and so forth, and we need to wake up and realize the reality is we cannot afford to put this off any longer.

Conclusion
Candidates seeking office will promise anything to gain position. A careful examination of the facts will find that much of what they say is, at best, half of the detail. We are blessed to live in the most advanced civilization in the world. Placing the wrong ideology in office can take away our most valuable resource, healthcare. Placing the right candidate in office will reform our current system and maintain our world dominance in healthcare and technology. It is important to understand the facts are not always as they are presented.

Newswise — When kids complain that math homework won’t help them in real life, a new answer might be that math could help cure cancer.

In a recent study that combined math and medicine, researchers have shown that patients with chronic myelogenous leukemia (CML) may be cured of the disease with an optimally timed cancer vaccine, where the timing is determined based on their own immune response.

In the June 20 edition of the journal PLoS Computational Biology, University of Maryland associate professor of mathematics Doron Levy, Stanford Medical School physician and associate professor of medicine (hematology) Peter P. Lee, and Dr. Peter S. Kim, École Supérieure d’Électricité (Gif-sur-Yvette, France) describe their success in creating a mathematical model which predicts that anti-leukemia immune response in CML patients using the drug imatinib can be stimulated in a way that might provide a cure for the disease.

“By combining novel biological data and mathematical modeling, we found rules for designing adaptive treatments for each specific patient,” said Levy, of the University of Maryland Center for Scientific Computation and Mathematical Modeling. “Give me a thousand patients and, with this mathematical model, I can give you a thousand different customized treatment plans.”

Math and Leukemia
While the marriage of math and biology is only beginning to catch on in science, there have been other attempts to use equations to understand how leukemia develops and evolves over time. Levy, Lee, and Kim‘s study differed in that it took into account the patient’s natural immune response in conjunction with the effects of imatinib, a drug that has been successful in putting CML patients into remission.

They wanted to see if they could develop a mathematical model, or set of rules, that would increase chances for long-term remission in individual patients. Over four years, Lee’s laboratory collected data from CML patients, measuring the strength of each patient’s immune response, in the form of the numbers and the activity of the anti-leukemia T cells, at different times during imatinib therapy.
“Our results suggest that it is not only the drug that sends the leukemia into remission, it’s also the natural immune response,” Levy said. “After starting imatinib, the anti-leukemia immune response gradually increases. However, it begins to weaken after it reaches a peak. This typically happens well into the treatment.

“Leukemia cells are still present, but in relatively low numbers that causes the immune response to wind down. Unfortunately, this is an ideal time for the cancer cells to develop drug resistance and render the therapy ineffective.”

Best Time for Immune Response
Incorporating Lee’s clinical data on immune response, Levy’s model suggests that the immune response of the patients should be boosted at the time when their immune response starts weakening.

The authors suggest that such a stimulation can be provided in the form of “cancer vaccines,” in which pre-therapy blood taken from patients is irradiated to kill active cancer cells, then introduced back to the patient. A strong stimulation of the immune system was shown to be active in vitro in Lee’s lab experiments.
“The mathematical approach showed that it is imperative to connect the timing of the cancer vaccine with the individual profile of the immune response of each patient,” Levy said. “The mathematical simulations suggest that a vaccine administered within the initial months of the treatment will have no effect on the progression of the disease. On the other hand, a well-timed vaccine can potentially cure the disease.”

Individual Therapy Plan
But the dynamics of each patient’s immune response differ. That’s where the math comes in, says Levy. “We can find rules for application to a specific patient. We can measure each patient’s parameters to find when the dosage will be most effective. Mathematics provides the tools that are necessary to tailor the treatment to the patient.”

“While some parameters can be measured in the lab,” said Levy. “The mathematical model helps us understand the mechanisms that control the disease and show how to use this knowledge to our advantage.”

Levy and Lee are currently conducting further extensive study to expand on the results of this research, to prepare for possible experiments on animal models and conduct clinical trials.

The research was funded by the American Cancer Society, by the National Cancer Institute, and by the National Science Foundation.

It takes more than one punch to fight tumors. Often, tumors have more than one way of surviving, and attacking the tumor alone is not enough. Now, in a new study, University of Missouri researchers have developed a new non-toxic treatment that effectively reduces breast cancer cells, by combining a small molecular drug that targets tumor cells with an antibody that causes selective shutdown of tumor blood vessels.

In 50 percent of breast cancer cases, a mutated protein, known as p53, is present. Previous research has indicated that when p53 is functionally abnormal, tumor cells are prolific and develop quickly. PRIMA-1, a small molecular drug, targets and returns normal function to the mutated p53, but PRIMA-1 alone is not enough to stop tumor growth. Proliferating blood vessels supply oxygen and other nutrients that the tumor needs to grow. However, a specific antibody, 2aG4, has the ability to destroy these blood vessels and prevent future growth. According to the MU research team, no one has previously tried to attack tumor cells by targeting mutated p53 and the tumor-associated blood vessels with this combination of PRIMA-1 and 2aG4.

“Tumors are entities that want to live,” said Salman Hyder, professor of biomedical sciences in the College of Veterinary Medicine and the Dalton Cardiovascular Research Center. “They adapt under conditions that would cause anything else to die. In order to effectively treat tumors, treatments must attack the breast tumor cells and the blood vessels that supply nutrients to the tumor. Treatment strategies in our study that targeted both areas resulted in improved and more potent responses.”

In the pre-clinical trials, mice bearing tumors of human origin were given the drug combination to combat tumor growth. After four weeks of treatment, the mice that were given the combination showed a dramatic decrease in the development of tumors and had better results than the mice that were given only one of the compounds. In addition, the treatment combination proved to be non-toxic as the mice maintained their body weight and displayed few side effects.

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Article adapted by Medical News Today from original press release.
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“Mutated p53 in tumor cells plays a key role in promoting tumor cell survival and tumor cell resistance to chemotherapeutic drugs. The mutated protein is found in 50 percent of breast cancer cases,” Hyder said. “The results of this study are very promising and show the possibility of broad anti-cancer potential.”

The study, “Targeting Mutant p53 Protein and Tumor Vasculture: an Effective Combination Therapy for Advanced Breast Tumors,” was presented at the 98th Annual American Association of Cancer Research Meeting. It was co-authored by Hyder ’s colleagues at MU: Yayun Liang, research assistant professor in the Dalton Cardiovascular Research Center; Cynthia Besch-Williford, associate professor in the College of Veterinary Medicine; Indira Benakanakere, post doctoral fellow; and by Philip Thorpe from University of Texas Southwestern in Dallas.

Source: Kelsey Jackson
University of Missouri-Columbia

Newark Beth Israel plugs in software that automatically generates reports
By João-Pierre Ruth
6/16/2008

Fred Schroeder, a programmer at Newark Beth Israel Medical Center. [Steven J. Dundas]

NEWARK — The growing amount of data that managers must review is getting ever-harder to keep track of. While billings, customer s and status reports can be swiftly entered into computer networks, it can be a challenge to assemble the information later into easy-to-read reports. Software that automates this process can help companies and organizations save time and money.Newark Beth Israel Medical Center needed to free its information technology staff from generating the daily s that administrators require. “All our outpatient clinics need to know what happened the day before,” says Fred Schroeder, senior programmer at the hospital. “Did they check out patients properly? What was the diagnosis? Who worked on which patient? How much payment was collected?”

Newark Beth Israel turned to ActiveBatch software from Advanced Systems Concepts, a Morristown company with 40 employees. The system coordinates different programs to generate electronic reports and perform other tasks that include alerting Schroeder to any technical errors that he must personally resolve.

Such report-generating software is an increasingly hot item and versions are available from companies including IBM Corp., Sun Microsystems Inc. and Tidal Software, a provider of performance-management systems in Palo Alto, Calif.

Schroeder says Newark Beth Israel started using ActiveBatch last July to enable IT staffers to focus on their primary jobs of providing computer support. The hospital previously relied on computer help-desk personnel to compile the reports at night.

Newark Beth Israel has 673 beds, sees 25,000 admissions and more than 300,000 outpatient visits annually. Daily data can include the number of patients inside its clinics and the number of newborns in the maternity ward, giving rise to a mountain of information over time.

“Administrators, department heads, managers need to review their [data] and we are required to report to regulatory agencies,” Schroeder says. The hospital sends regular reports to the Department of Health and Senior Services, as well as daily s on its emergency room admissions to city officials in Newark. “If I don’t send the reports, the phone rings,” Schroeder says. Now, “I don’t have to have someone constantly checking on this.”

At the same time, “the [hospital] administration at 9 a.m. each morning can say, ‘This is what happened yesterday,’” Schroeder says. “That is a very critical report.”

Joseph Carr, chief information officer for the New Jersey Hospital Association in Princeton, says hospitals face mushrooming information demands. Many hospitals run computer programs that track patients throughout their stays, he says, generating information that is needed by health insurers for billing purposes as well as the Department of Health. “Hospitals in New Jersey are required by law to submit information on all in-patient surgeries, same-day surgeries and emergency-room visits,” Carr says.

He says the state has been collecting data on same-day surgeries since 1982, and on emergency room visits since 2004. The files include treatments performed, charges for treatments and reimbursements for the charges. He says the state may expand its requests for outpatient data to include information on chemotherapy at oncology clinics.

Jane Horowitz, chief operating officer for the National Alliance for Health Information Technology in Chicago, says a national push is under way for more efficient information tracking within hospitals. She says billing information and other administrative data is frequently spread across different computer systems that do not communicate smoothly with one another. “When you start building electronic health records that exchange data, that is where some of the problems come,” she says.

Jim Manias, vice president of sales and marketing for Advanced Systems Concepts, says customers include companies in the manufacturing, government and services sectors. “Any organization that has more than one computing system can benefit,” he says.

Mehul Amin, senior development engineer with the company, says the software acts to consolidate disparate systems, “which is becoming one of the biggest challenges lately.”

According to the _Shulchan Arukh_, the 16th Century Codification of Jewish Laws, we should prioritize using communal funds for the care of the sick over other obligations, including the construction of a
synagogue. The _Shulchan_ _Arukh_ tells us that health care is not only a priority but also a community responsibility. Today I would like to speak to you about universal health care.

It may seem odd to have a physician speak in favor of universal health care when historically physicians have strongly opposed government interference in, and regulation of, the health care industry. But having been engaged in the private practice of medicine for more than 30 years — and having witnessed and experienced the deterioration of our once model health care system— I can no longer accept the American Medical Association’s position that we have the best health care system in the world, and that all we need to do is tweak it here or there. What this country has at the present time is a chaotic and ineffective system that serves the population poorly. We are all aware that there are almost 50 million US citizens without health care. However, equally worrisome is the fact that there are another 50 million citizens who are inadequately insured — the so-called “under-insured.” In other words, the health care problem is not limited to whether one has insurance; even if one has insurance, there are grave issues with the adequacy of the benefits provided.

I make my case for the support of a universal or national health care program from the perspective of the various constituents involved in that system. First, consider the standpoint of the patient or potential patients seeking medical care. At the present time, a large segment of our population obtains medical insurance through its employers. No one knows for sure, but it is estimated that there is a substantial portion of our workforce that accepts employment positions and stays at jobs that it does not like just so that it can continue to receive health care benefits. The benefits these employees do receive, to a large extent, are the health care plans that are most affordable for theemployer, regardless of the quality of those plans. Clearly, what the citizens of this country need — and deserve — is a standardized health care plan that they can understand, and which is unrelated to employment and geared toward their protection and welfare. Sick individuals need plans which cannot be cancelled at the whim of the insurance company. Overnight, a universal health care program would eliminate the uninsured class and the under-insured class; it also would eliminate the expensive and inefficient state-run Medicaid programs, which support the little discussed (and rarely acknowledged) second class care received by the poor in this country.

A universal health care system would provide standardized and therefore understandable benefits to all citizens. People have very little knowledge of the details of their benefits until they become ill. Under a universal health care system where everyone has the same benefits, family and friends could help one another understand the benefits both before and after an illness. And a true statement of equality under the law would certainly be to have a standard quality of health care for everyone.

What do people deal with at the present time? They deal with companies that are always trying to deny coverage. For example, about three weeks ago, there was a segment on Good Morning America highlighting the experience of a woman in California whose health care company, HealthNet, terminated her benefits when she was half-way through chemotherapy for breast cancer. The woman sued the health care company and recovered several million dollars as compensation for the health care company’s actions. Most shocking to me was the discovery that HealthNet — whose 2007 profits were between $1 and $2 billion — had offered bonuses to employees who found reasons to cancel policies for individuals with high utilization. To earn their bonuses, company employees searched personal medical records looking for something that might disqualify a patient who now had a serious medical problem. The California woman’s policy had been cancelled because she failed to acknowledge that she had elevated cholesterol on an application filed four years previously.
The apparent greed of private health care companies is so pervasive that it is both depressing and demoralizing. This year, Andrew Cuomo, Attorney General of the State of New York, investigated and may well fine United Health Care, the largest private health insurance company in the United States, for manipulating what is referred to as “usual and customary charges.” United Health Care charges extra premiums to individuals who want policies that permit them to use out of network physicians and hospitals. When an individual goes out of network, these policies routinely pay 80% of the usual and customary charge for a geographical location. How does United Health Care determine usual and customary charges? They rely upon a company who claims it uses objective data to calculate that information. However, Attorney General Cuomo found that United Health Care owns that company, and that the company bases its numbers on an average of the fees charged not only for physicians but also for nurses, nurse practitioners, and physician assistants in order to make the “usual and customary charges” as low as possible. In fact, the Attorney General did his own calculations and found that in the New York City area, the usual and customary charge for a physician visit was $200 and not $65, the number determined by United Health Care, thereby costing individuals in excess of $100 out-of-pocket for each physician visit. In addition to United Health Care, 16 other major private health care insurers use the same source for their usual and customary charges. Are people really served well by these companies who seem to be motivated only by profit?

Second, from the perspective of the medical profession, including physicians and hospitals, a universal health care system would be a tremendous cost-saver. The difficulty and expense of billing the insurance companies for appropriate fees, as well as the constant resubmission of forms, requires dozens of extra personnel in billing departments in hospitals and physicians’ offices across the country.

Truly what we have at the present time is a Tower of Babel, with constant bickering as health care professionals and hospitals attempt to be fairly reimbursed for services rendered by companies who, whether intentionally or otherwise, maximize profits by denying services and delaying payments. Private companies continually try to influence medical care by coercing doctors to discharge patients from hospitals earlier than the doctors believe is safe and, at times, refusing to pay for a hospital admission they deem unnecessary. How can they do that you may be thinking? They do it in subtle ways by suggesting to the doctor that he or she can do what he or she wishes but that the patient will be left with a large hospitalbill. The last call I personally accepted from a health care company physician was approximately four years ago: A physician from Philadelphia called me at the hospital and suggested that my patient in room 430 was well enough to be discharged that day. I asked the physician how she could know that without seeing the patient. Did she know that I, a board certified oncologist, and Dr. Decker, a board certified infectious disease specialist, felt strongly that the patient needed to be hospitalized because he had pneumonia and required intravenous antibiotics? The
physician said that the patient’s white blood count was normal and he should do just fine on oral antibiotics. I asked if she was comfortable with her assessment and discharge order and she said yes. I then explained to her that the patient actually had acute leukemia and although his total white count was normal he, in fact, had no normal white blood cells. They were all leukemic blast cells. The patient was critically ill and likely to die, so I certainly was not going to take her suggestion about discharging the patient. Before I hung up, I asked the physician how she slept at night making decisions over the phone, and whether she actually took the Hippocratic Oath, which requires heralways to make decisions based on the welfare of the patient. The physician actually called me a few weeks later to tell me that she took my remarks to heart and resigned her position with the insurance company. She thanked me.

The third perspective that we should consider is that of the employer. It became commonplace in American industry for companies to offer health care benefits at a time when health care benefits were quite inexpensive. In my own medical practice, I recall that 30 years ago, Blue Cross/Blue Shield and Major Medical for a family cost approximately $500 annually. That same policy, with higher deductibles and greater out of-pocket expenses, now costs approximately $13,000 annually, or 26 times what it cost 30 years ago. The dramatic increase in premiums by health care insurance companies has effectively paralyzed American industry, causing companies to become less competitive and acting as an incentive for these companies to outsource manufacturing to other countries. If you think about it, why should the ever-increasing cost of health care be the responsibility of an employer?

The rising cost of health care is something that an employer has no control over and, again, is one of the major reasons why American industry cannot compete with companies in Europe or Asia. A universal health care system in which people pay for health care directly would be a godsend to business and industry at the present time.

The fourth perspective, that of the health care industry, is predictable. These companies have a vested interest in keeping the status quo. Many make more than a billion dollars a year in profit. In fact, in 2007, the top six private health care companies had a combined profit of more than $10 billion. In addition, CEOs and executives earn millions of dollars a year. These companies spend millions of dollars a year lobbying Congress so that the current sub-par system continues. Do you believe that their actions are for the benefit of subscribers or for the benefit of their shareholders?

Several years ago, many insurers adopted software called Claim Check. Why did they do this? The software company promised millions of dollars in savings but was later charged with manipulating claims in a way that cheated doctors and hospitals out of money that they had earned. To illustrate, after one large local health insurer started using Claim Check, it stopped paying for an office visit and chemotherapy treatment on the same day. I notified the company and suggested that it had a software problem. Thecompany’s representatives claimed that it was just following Medicare guidelines. Clearly it was not and, when I was able to prove that this was not in the Medicare guidelines, the company said it was following the AMA CPT codes. Finally, the company told me that this was in fact a new policy change on its part. We negotiated for almost a year until it became apparent that the only way to deal with this computer-generated payment change was to provide the services on different days, even if it would be terribly inconvenient to patients and families. Eventually Claim Check was exposed by _The Wall Street Journal_, which charged their practices fraudulent, and state medical -societies across the country sued. Only then did our local healthcare insurer acknowledge that Claim Check was the problem all along.

Generally, when I bring up the subject of universal health care the overwhelming response is the familiar refrain that the government cannot run anything well. Everyone then mentions the postal system or the interstate highway system, Bbut the fact is that government can — and actually does — run health care well. Most people do not realize that Medicare, a government-sponsored program started in the 1960s during the Johnson administration, actually insures almost 40% of the population and, by my own estimation, 65 to /75% /of all individuals requiring substantial health care. Essentially, Medicare covers the cost of the sick while the private health insurance companies fight over the mostly healthy.
Medicare is far and away the most efficient of all health care insurers with 95 to 97% of all health care dollars actually going for health care. Your average private company, including many of the Blues, spends anywhere from 20 to 40% of the health care dollar on administration. In addition, and I state this from personal experience, Medicare is accurate, provides the best service to physicians and hospitals, pays in a timely manner, and has the best systems in place to settle disputes.

Currently Medicare works through many intermediaries with Highmark Blue Cross being the intermediary for Pennsylvania. It is my experience that Higbmark is efficient and fair to deal with regarding their Medicare services. So when you realize that Medicare is already in place, is government managed, covers the vast majority of sick patients, and has contracts with physicians and hospitals (except for pediatricians), it does not require great imagination to envision a universal health care system as a Medicare-type program. Strangely, when one discusses universal health care, most individuals envision the much criticized Canadian or United Kingdom programs. People, for some reason, fail to consider our Medicare program. I believe that implementing Medicare for everyone would be relatively easy. Medicare already has systems in place to cover all aspects of health care delivery and reimbursement. In addition, Medicare has a mechanism in place to pay for health care.

Everyone currently pays a Medicare tax to the Federal Government as part of their income tax. An increased Medicare tax would cover the expanded Medicare program. One never likes to hear about an increase in taxes.

However, when one considers the vast amount of money currently going to pay the premiums of private health care companies and the enormous cost of state Medicaid programs, I believe that the health care costs per individual or family would be significantly less even with an increase in Medicare taxes with no one, even those in the highest income brackets, paying more than they are already paying at the present time.

Such a system would not only create universal health care coverage, it would enable businesses to get out from under the burden of health care costs and permit hospitals and physicians to deal with a single payer system which would result in dramatic savings from a billing and
reimbursement standpoint.

When you consider that just about all non-third world countries have a universal health care program, how can we assume that we have it right and they have it wrong? Yes, safeguards would need to be implemented to assure fairness to physicians, hospitals and patients, but as with all
programs, the devil (as well as the benefits) is in the details. It is time that we demand that Congress meets its responsibilities to the citizens of this great country and start working on those details.

Clearly, we have an obligation and responsibility to support a universal or national health care program and the sooner the better.

Indeed, Ramesh, president and founder of Anamika Medical, a dealer in used and refurbished medical equipment with a specialty in X-ray and imaging, gladly takes weekend calls or late-night follow-ups, a carry over from a successful career in sales. Such access keeps him close to both his clients and the competition.

Ramesh created Anamika in 2002 after years working as international sales manager at Bennett X-Ray, Lorad and Hologic, three well-known names in the radiology industry. Ramesh also managed sales in the domestic market as a dealer.

“These sales positions helped me to develop a wide network of dealer contacts who have been graciously supporting me ever since I ventured on my own,” Ramesh says. “Relationships built on trust are the key to success in this business.”

In fact, Ramesh, born in Madras, India, began his business life working with medical equipment sales, first for Philips in India, then spending years in the Middle East.

Still, when he launched his company, he decided to keep his profile low and remain under the radar. “Anamika means ‘nameless’ in India,” Ramesh says with a smile, noting it’s better to begin humble, then earn your bragging rights.

Another insight he discovered early was finding and filling a need.

“Medical is such a huge spectrum,” Ramesh explains. “Every company will develop a niche area of expertise in order to survive. For example, we see companies on DOTmed that are specialized in selling just bone densitometers. Jack of all Trade companies cannot withstand the competitive pressures.”

Today, the company, based in Long Island City, NY, remains small (with only three on staff) but it’s been growing financially, with 20 to 25 percent billing increases annually. And it’s been expanding the company’s business relationships and brand as well.

“At the beginning of the year, we tied up with Huestis Medical, a well recognized remanufacturer of GE R/F systems, portable X-ray and OEC C-Arms,” Ramesh begins. “They needed another sales arm to sell their products and they needed our inventory. They are our strategic partner and the relationship is proving to be valuable to both companies.”

Anamika also launched “CR Tech,” its own new computed radiography system brand available in the U.S. and internationally.

“This CR system is ideal for imaging centers, orthopedic practices, doctors’ offices, chiropractors and veterinary practices in terms of product features and price,’ Ramesh says. The product is assembled at Anamika’s Long Island plant and sold through its network of dealers in the U.S. and in Latin America, the Middle East and Asia.

Ramesh has been a DOTmed user since 2001 and DOTmed Certified and his 1,500-square-foot plant has an inventory of mammography and radiographic systems, as well as C-Arms and Angio Injectors.

“DOTmed is a quick way for us to source equipment when we have firm requests from our customers,” he notes. “The brokers who work with us may not have a certain piece of equipment we are looking for. Also, when we see that a vendor is DOTmed Certified, we feel comfortable transacting business with them.”

There is a lot of debate over the use of human growth hormones, aka HGH. There are benefits and drawbacks, and whenever considering using this medication, as with any other medication or supplement; you can not be too well informed. The human growth hormone information you are seeking can be found online. Find many comprehensive, informational, and factual sites, available for your research. You can read an assortment of research papers and quickly find the facts needed to make the right decision for your needs in regards to the use of HGH. For example, you may not know that HGH is a natural substance once derived from cadavers, but, now, HGH is produced synthetically and can be used in a spray, powder, or pill form, making injections unnecessary; thereby, making HGH cheaper and more convenient. You will discover that the first uses of HGH were to treat children with growth development problems. The diagnosis is a lengthily process made by a doctor, but, once made, the treatment is quite successful.

HGH can treat growth issues in adults as well. Log on and learn more about HGH for growth stimulation. While nutrition, exercise, and genetics play a part in a person’s height, HGH is proven to stimulate growth when these are not enough.

The use of human growth hormones used by athletes is widely reported and at times has gotten some bad press. This negativity is due to competitive sports issues and not the hormone itself. Interesting anecdotal and factual information can be found online, and this evidence can help you decide whether HGH is right for you body shaping and strength goals.

Some very exciting news regarding HGH and the elderly is coming to the forefront. Studies found that the use of HGH by elderly men increased muscle mass, decreased fat, and improved skin integrity. Most encouraging was that this 1990 study showed that HGH treatment reversed aging on human tissue from 10 to 20 years. However, this remains a controversial treatment and to understand all the issues, pros and cons, of a possible reversal in the aging process, you should read the research for yourself and determine whether growth hormone is worth the investment for you.

There are some claims of adverse affects from the use HGH, but many people have favorable results and enjoy looking and feeling their best and living life to the fullest.

HGH, Human Growth Horomone, has produced increases in the levels of insulin-like growth hormone 1 (IGF-1). Human Growth Hormone is synthetically reproduced and deliverable in injection, spray, powder, and pill form.

Cerebral autosomal predominant arteriopathy with subcortical infarcts and leukoencephalopathy is the almost popular kind of genetic shot disorder. CADASIL is an inherited kind of shot and new impairments. This circumstance affects tiny blood vessels, mainly in the mind. CADASIL patients are too at increased danger of eye blast (myocardial infarction) because of participation of the blood vessels in the eye. CADASIL is a genetic reason of shot, dementia, migraine with atmosphere, and climate disorders. CADASIL is characterized by migraine headaches and dual strokes progressing to dementia. Other symptoms include light-colored issue lesions throughout the mind, cognitive worsening, seizures, imagination problems, and psychiatric problems such as serious depression and changes in conduct and personality. Individuals may too be at high danger of eye blast. Symptoms of this disorder seem from the mid-twenties to around 45 years of age and affected individuals typically perish by age 65. There is no handling to stop this hereditary disorder. Individuals are given positive maintenance. Migraine headaches may be treated by distinct drugs and a regular aspirin may cut shot and eye attackrisk. Drug therapy for depression may be given.

Anti-coagulants can be used to decelerate downward the disease and assistance forbid strokes. Given the tendency for cardiovascular and cerebrovascular complications, minimizing vascular danger factors and implementing therapy for main or incidental prevention of shot and myocardial infarction seems careful. Stopping oral contraceptive pills is justified especially in cases with migraine with atmosphere. Aggressive handling of hypercholesterolemia and hypertension is rational although the utility of statins. Homocysteine levels are raised in CADASIL and handling with folic acid is rational.

Café-au-lait spots are dark spots on the skin that look like birthmarks. Most children have the pigment from birth, and it almost never becomes more extensive. The pattern of the pigment distribution is unique, often starting or ending abruptly at the midline on the abdomen in front or at the spine in back. Most commonly the patches are on the buttocks and lumbosacral back. The patches are usually large, and have irregular borders resembling the “coast of Maine”. This is in contrast to the spots of neurofibromatosis, which have a smooth border resembling the “coast of California”. They are light to medium brown. As reflected by the name - which of course means “coffee with milk”. They are usually present at birth, but may arise later in the first few years of life. They are much more common in black infants. Café-au-lait spots range from about about five millimeters to more than several centimeters in Café-au-lait spots are harmless. CAL spots are caused by an increase in melanin content with the presence of giant melanosomes. A significant increase in melanocyte density is noted in the CAL spots of patients with NF1 compared with patients who have isolated. About 50% of individuals with NF1 have a spontaneous mutation.

The high incidence of new mutations is thought to result from the large size of the gene, which increases the likelihood of spontaneous mutations. CAL spots without NF1 involvement. About 95 percent of people with NF1 have café-au-lait spots. In fact, birthmarks that could be classified as café-au-lait spots often show up in people who don’t have NF1. A person will only have one or two such birthmarks. CAL spots are more frequently observed in children of African American race. Café-au-lait spots are usually present at birth, increasing in size and number with age. CAL lesions do not require medical care. Monitoring of associated conditions is required.