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THE CONSERVATORY OF MEDICAL ARTS AND SCIENCES
XVII
THE SEARCHLIGHT MESSENGER
THE SEARCHLIGHT MESSENGER
Blog
Children with Super-Refractory Status Epilepticus Respond to Sage Therapeutics’ GABA-A Receptor Modulator
Posted on November 15, 2014 at 9:12 PM |
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Super-refractory status epilepticus is frightening version of status
epilepticus, which on its own can be a life-threatening condition (35,000 of a
total of 150,000 die from it each year). When a patient presents with
status epilepticus, they are usually treated with benzodiazepines, and if no
response, they are treated with second-line, anti-seizure drugs. If the seizure
persists after the second-line therapy, the patient is diagnosed as having refractory status epilepticus and
placed into a medically induced coma. After 24 hours, an attempt is made to
wean the patient from the anesthetic agents to evaluate whether the seizure
condition has resolved. If seizures persist following the weaning
attempts, the patient must be maintained in the medically induced coma and is
diagnosed as having super-refractory status epilepticus. There are currently no
therapies approved for refractory, or super-refractory, status epilepticus.
SAGE-547 is a neurosteroid allopregnanolone that acts as a positive allosteric
modulator of synaptic and extrasynaptic GABA receptors.
Internalization of synaptic GABA receptors may be responsible for
super-refractory status epilepticus.
In the report by Broomhall and colleagues, treatment with SAGE-547 allowed the
general anesthetic infusions for these patients to be weaned with resolution of
status epilepticus. No drug-related serious adverse events were reported. Both
patients were treated with SAGE-547 under emergency-use Investigational New
Drug Applications.
Mark Wainwright, MD, PhD, director of the pediatric neurocritical care program
at Northwestern University Feinberg School of Medicine and senior author of the
study said: "Refractory status epilepticus is a medical emergency
with high risk for poor outcome. In both of these cases, the patient had been
put in a medically induced coma to control seizures, and there were multiple
unsuccessful attempts to wean the patient from anesthetic agents prior to
treatment." "There are no truly effective treatments for refractory
status epilepticus - it is incredibly exciting to work with a new therapy that
may help both pediatric and adult patients affected by this disorder." According to a press release, the following is known about the two
patients' treatment: The
first patient was treated at Ann & Robert H. Lurie Children's Hospital of
Chicago, was an otherwise healthy 11-year-old girl who presented with SE caused
by an autoimmune disorder with antithyroid and anti-glutamic acid decarboxylase
antibodies. She received an infusion of SAGE-547 over five days, after which
pentobarbital sedation was weaned and discontinued. Over the remainder of the
hospitalization she had intermittent, controllable seizures. She was
transferred for inpatient rehabilitation, regained her ability to walk, and is
now back at home, continuing to show cognitive improvement, reading, doing
arithmetic and playing the piano. The
second patient, a two-year-old girl, presented with SE associated with a
febrile illness. SAGE-547 was infused over four days and tapered off between 96
and 120 hours. SE resolved after SAGE-547 treatment and 12 days following the
completion of treatment with SAGE-547 all anti-seizure therapies were
discontinued. She was transferred to inpatient rehabilitation and is now able
to walk and speak. In both patients, there were no drug-related serious adverse
effects detected by any of the laboratory tests used.
Stephen Kanes, M.D., Ph.D., chief medical officer of SAGE and co-author of the
study stated: "Our ongoing Phase1/2 clinical trial has yielded promising results in
adult patients with super-refractory status epilepticus, and we are excited
about the possibility of delivering this treatment to children, as well." |
Health Insurance and Medical Marijuana
Posted on June 21, 2014 at 1:41 AM |
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This is a follow up to my article, "Marijuana and Colorado, a Doctor's Perspective". The venture capitalists are moving in. This was inevitable, as I talked about it in my article. It has become difficult for any investor to ignore the glaring reality of an American "Medical Cannabis economic boom" coming sooner than most are ready for. Start paying attention. The latest on Novus from Venture 17 and The Trinity Venture Capital Group. Read on. Novus (NDEV) Aims to
Fill Key Void in Cannabis Industry The U.S. legal cannabis industry is
expected to reach $2.34 billion in size by the end of the year, according to
ArcView Market Research. With additional states expected to legalize the drug
over the next five years, the same group believes that the U.S. industry could
reach $10.2 billion in size by 2018. These growth rates have attracted both
investors and lawmakers interested in shoring up tax revenue.
Despite these gains, cannabis continues to be classified by the federal
government as a Schedule I Controlled Substance alongside drugs like heroin and
cocaine. Conflicting federal and state laws surrounding the burgeoning industry
have been a source of widespread confusion, which has led many insurance
companies to refuse coverage for medical marijuana treatments for patients in
need.
In this article, we'll take a look at a company that aims to change those
dynamics by introducing a health insurance program geared towards medical
marijuana patients. Lack of Insurance Medical marijuana has been shown to
be effective in treating a wide variety of different medical conditions,
including pain, nausea, and appetite. In addition to these conditions,
companies like GW Pharmaceuticals plc (GWPH) are extensively studying the drug
for its potential use in treating major conditions like childhood epilepsy,
Crohn's disease, and certain types of cancer.
Since many health insurance companies work with federal programs like Medicare
and Medicaid, they must adhere to all federal laws including those that
classify medical marijuana as a Schedule I Controlled Substance. The result is
a significant lack of insurance coverage for patients that require medical
marijuana, legal on a state level, to treat serious medical conditions like
childhood epilepsy.
Novus Acquisition & Development Corp. (NDEV) aims to capitalize on the void
in the marketplace by establishing a health insurance program for medical
marijuana patients. These efforts are being led by Ms. Andrea Lopez, MSM, AHFI,
who has more than 15 years of experience in healthcare compliance, delivery,
and development of insurance policies for large companies. Diversified Exposure Novus Acquisition & Development
Corp. also aims to provide structured protocols for physicians that are
compliant with each state's regulation and federal recommendations in order to
ensure they are on the level. The team conducts full-scale risk management
analyses in order to mitigate business liability and promote workplace safety
for employers, municipalities, and businesses.
With its focus on the healthcare side of the business, the company's solutions
differ from compliance related solutions provided by other publicly traded
companies like Integrated Cannabis Solutions Inc. (IGPK). ICS provides
regulatory assistance to new and existing legal cannabis businesses, including
dispensaries, that are trying to navigate their way through the heavily
regulated industry.
The healthcare compliance side of the business also represents significantly
less risk for investors than the growing side of the business. While growing
operations under Canada's new MMPR are relatively safe, including companies
like Abattis Bioceuticals Inc. (OTC:ATTBF) or Creative Edge Nutrition Inc.
(FITX), there may be risks associated with companies operating dispensaries in
the U.S. Growing Need for
Compliance The need for effective healthcare
insurance and compliance solutions are only likely to increase as the medical
benefits of cannabis become more apparent. GW Pharmaceuticals' cannabinoid based Sativex® has already been approved in 25 countries and
received Fast Track status from the FDA and plans to release top-line Phase III
cancer pain data toward years end.
With medical cannabis use being increasingly justified, there's also growing
concern among the public about the risks involved. Two high-profile Colorado
deaths were recently tied to the over-consumption of cannabis
"edibles" containing high levels of THC. These developments
underscore the importance of additional risk management practices, especially
in a new industry with few existing rules.
Businesses are also increasingly in need of compliance solutions. Employers
cannot discriminate against employees simply because they possess medical
marijuana cards, and no employer wants to face the prospect of a lawsuit for
unlawful termination of an employee. Compliance solutions from companies like
Novus can help businesses avoid these types of situations.
And finally, medical marijuana patients are in great need of insurance programs
to help lower their costs and provide affordable coverage. The proven use of
medical marijuana to treat conditions like childhood epilepsy has left many
parents without a lot of options financially, which has created strong demand
for insurance programs like the ones being developed by Novus. Stay tuned for continued posts on this important issue. |
Banking and Investment for Young Professionals
Posted on June 8, 2013 at 11:24 PM |
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Honestly, how many of you
who went to public schools like I did, ever learned about economics and
investment vehicles before college? What’s an annuity, what’s an IRA, what’s a
401 K. What’s a stock, a mutual fund, and an index fund? These are all topics
you could ask any eighteen year old, and quite frankly, they will have no clue.
Forget about discussing value rated index funds, IPOs, the Options market. And don’t
forget about REITs. It’s like “deer in the headlights”. They are taught by their parents to save money in a savings
account, and that their biggest investment is buying a house. Sure, this has
come down generation after generation from our wise and frugal Depression era
parents, and grandparents, but is the thing that pushes the
youngster into a mindset that implies “I will never be an investor, and will
never have more than my house is worth”. This obviously is the worst advice we could hand down to our
children. Just look what happened to all of those homeowners in 2007 through
2010. Where is their investment now? Not to mention that they feel stuck, as
they have no idea about other investment vehicles, because their parents didn’t
either, and neither did their grandparents. So in this article I will touch on a little of each of the
above topics, and try to put it “in English”. In addition, I will mention my
rules. Yeah, they’re simple. First, entrust no one, including those with close
ties to you, with your money, the knowledge of your worth , your investment
techniques, or where you keep cash on hand. Your wife? Maybe, but certainly not
your girlfriends or boyfriends, period! I mean it! “But she loves me”, yeah,
how many times have I heard that one?
I have to tell you, I
nearly blew this rule myself, two years ago. Whew! That was close! Obviously
this rule is somewhat difficult to live up to, but a reminder for all of you,
to be careful and aware. I have also seen greed rear its ugly head with friends.
What am I telling you? I’m telling you to keep your mouth shut. Be the guy next door. Nobody needs to know about your cash,
except you. That’s right, do not attract attention. You don’t need a Big house
or a Big car, just ask Warren Buffet. Published monthly, The AAII Journal provides you with a
continuing stream of insight and ideas that focus on how you can improve your
investment results. The Journal
doesn’t tout “Must Buy Lists” or speculative “Stock Tips”, but rather stresses
hands-on participation in your financial future through education and
understanding. Here’s the other thing. The AAII Journal doesn’t contain
advertising, and they promote an unbiased posture. Their website is easily
navigated. The cost? $30 will get you annual membership. Do it. I would also recommend that you watch CNBC at least an hour every day, Monday through Friday. You will get tickers from the New York Stock Exchange (NYSE), and the NASDAC, as well as commodities. They have good discussions on every issue in the investment world. Sometimes they get a little dramatic, and sensationalist, but it's excellent information you can use. At our office we always have it on all the screens with the sound turned down very low. Not an hour goes by without something I see out of the corner of my eye, catching my attention. It is usually something equitable you might not see in The Wall Street Journal until a week has gone by. Yeah, I know. Thirdly, bank most of your assets in trusts so that it is
not easy to get to or make liquid, even for you. Liquidity, basically is how
fast your assets can be turned into cash. Next, find good, smart, and forthcoming partners that keep
their mouths shut. Surrounding yourself with business savvy investment partners
is critical, and your money is safe because you’re working together and
investing together. For young
professionals, this can be done through an investment club. You can glean more
and earn more with experts in the investment world. Find them. And lastly, start a charity. Sure, it has tax advantages,
but you shouldn’t look at it that way. See it for what it is. “Giving back” is
very big with me. Give to charity to benefit others, relieve poverty, and
advance the community, period. You can find detailed information on starting a
non-profit foundation easily at any public library. You can find funding at razo.com; crowdwise.com; indiego.com; and kickstart.com. Because they are new to the world of banking and finance,
one of the first things I teach my students on this topic, is how to bank and
work with money right now. We discuss “paying yourself first”, and how to make
money go to work for you, in addition to finding a place to park it. I discuss
my investment heroes and gurus, and also recommend their books. Let’s talk about how you get paid from your employer. You
should make sure your check is electronically deposited to your main bank.
That’s right, you’ll need 3 banks. Why? The first one is a receiving tank. From
this bank you “pay yourself first”. How? Earmark at least 10% to invest. This,
you electronically move to a money market vessel that channels moneys into
different market investment vehicles. Wait, what? This is easily done with brokering
banks like E-Trade, Scottrade, Sure Trader, or Sharebuilder. There are many, but I like
these three because they are user friendly, have robust and easily navigated sites, offer research
links and tutorials, as well as prospectus reviews (a summary of the company,
its worth, and liquidity). These accounts are very easy to open online. So what’s the third bank for? It’s for all the things you
purchase as a “consumer”. Deposit however much you need to pay your bills, and
buy your toys, here. You now have a bank that feeds your investment bank and
consumer bank. You did this to screen your investments from your merchant
accounts. Do not allow the bank you write checks against, to interface with
your investment bank. Your debit bank is there only for purchasing consumables.
Your merchants see only this bank. Again, all of this can easily be done
online.
Remember though, that if you have a 401K (a pre-tax retirement
vehicle offered by employers), the 401K can be your investment bank. Again, toss 10% here. What’s
nice about 401Ks is that your employer also matches your investment. Some,
100%, some 50%, and so on. If your employer offers it, take it seriously. If
you put in one thousand dollars and your employer matches 100%, two thousand
dollars are now making money for you at probably 10%. “Really?” Yeah, really,
$200 the first year on each $1000 you put in, and don’t forget the thousand you
got from your employer. Don’t touch it. Here’s the rub though. 401Ks are different packages of
stocks we call mutual funds (a diversified stock portfolio). Some are “safer’
and some are “more risky”. Your human resources office will help you pick one.
Keep in mind, you can contact the fund managers and manipulate the stocks held,
yourself. A lot of people don’t know this. That means study the stock market
and its indices. I kid you not! In addition, always remember that many
Americans lost everything in their 401Ks during “The Recession Depression” of
2007. Yeah, there is always risk. Thanks, George. Here’s a curve ball. If you have a 401K, set up that third investment
bank anyway. Why? Because you need to apply some heavy risk now and again. You
will want a place to conduct business as a speculator, and entrepreneur. You can
immediately place these profits, which are usually large if done right, into a
long-term holding called a Roth IRA (Roth Individual Retirement Account). Yeah, IRAs. Here’s the deal. Traditional IRAs are much like
a private 401K without matching funds, done with your pre-tax dollars; Roth’s
are done with post tax dollars. They are great tax shelters, but both have very
tight ceilings at a $5000 contribution per year. They generally are used when
rolling over a 401K from let’s say, a previous employer. When you think about
this, it’s perfect for the young professional starting out.
“But I don’t have a 401K . What do I do”? The first thing
they hear from me is, “do not open a savings account”. Oops, really? This is
another dogma our parents pushed onto us unrelentingly. Why would I tell my
students that? Because if you take $100 and put it in a savings account today,
next year it will be worth a whopping $101.50. Wow! You made a buck fifty!
Let’s go get coffee! I may not have enough. Are you kidding me? If you work with a valued index fund, that $100 will be
worth $140 next year. Get it? A forty percent return is not unreachable if you
know what you’re doing. If you make the current US Bond rate, the $100 will be
worth $107 next year, still six to seven times more than a savings account can
obtain for you. This isn’t rocket science. It is here that you can pick a company that is public
(issues shares called stock in the company). You can pick one or 2 initially to
get started. Study them, find there price per share, then buy. You now own
shares in a company. Leave them alone. Wow! That was easy. You can also sell
when you want, but remember each time you buy or sell, you are trading stock,
and you will be charged on average, about $10 a trade. As you start to educate yourself, you will find out things
like, IPOs (initial public offerings). These are companies that have come out
of the private sector and are now issuing stock to interested buyers. Keep in
mind that companies generally do this when one of three things are happening. The
company wants to make vast improvements and expand; needs liquidity to make
major acquisitions; or pay off creditors. This is speculation, people. Study
hard what they can bring. Wouldn’t it have been great to get in on Google’s IPO
in the late 1990’s? Funds like the S&P are what we call cap funds that rate out on
companies trading billions, like Apple®. Many experts agree that funds we call
fundamental and an even tighter fund we call value-rated or value funds can
actually earn more when you study. These pick up moderate to small companies
with more dynamic room to move, and are not generally watched by big brokers,
because they’re too busy calculating value on the giants. Warren Buffet pays
very close attention to these and so should you. Don’t be afraid to invest in
them. You can also trade bonds here. Bonds are long term contracts
of generally guaranteed rates. Like when you hear about “a bond issue” to build
a highway. When you buy these bonds, you’re giving the builders cash to build
with an interest rate guaranteed to you. Bonds are long term vehicles used to
stabilize most diversified portfolios. Do not step into the Options Trading side of the market. You are not
ready. It is a true Speculative Market and can take cash out of your pockets as
fast as a “Long Straddle” can make you a fortune. Study it for now and know
it’s there. Many brokering investment portals like E-Trade will ask for a
letter of credit just to work the Options Trading side of the NYSE. Careful here, I
mean it! Do not forget about REITs. REITs are Real Estate Investment
Trusts. These are essentially Real Estate Stock you can buy and sell like the
stocks at the NYSE. Did you ever want to own a sky scraper or a hotel? This is
one way to do it. Study them carefully, just like stocks. Pick them, buy them,
and leave them alone. You now own part of a building, infrastructure or Real
Property.
Your news letter will help guide you through these
instruments and make a choice that best suits your agenda. Remember, study, study, study. Use experts that are around
you. I don’t mind being stopped after class to discuss an investment you want
to make. Remember to use the AAII website for help too.
Now you see why you can’t just run in and start buying stock
willi nilli. You have to walk in educated and slightly guarded. Here’s another
curve ball. What we just discussed is only the tip of the iceberg. Start
reading and talk to me. Let’s talk about my stock market heroes and why they are. Just click their images, and see their books. His book, Security Analysis, with David Dodd, was published
in 1934 and has been considered a bible for serious investors since it was
written. Graham wrote that investment is most intelligent when it is most
businesslike, a statement which Warren Buffett regarded as the most important
words about investment ever written.
Buffett is called the
"Wizard of Omaha", and is known for the value investing philosophy
and for his personal frugality, despite his immense wealth. Buffett is also a
notable philanthropist, having pledged to give away 99 percent of his fortune
to philanthropic causes, primarily via the Gates Foundation.
Greenblatt is a graduate of the
The Wharton School at the University of Pennsylvania, receiving his B.S. in
1979 and M.B.A. in 1980. The Wharton School is considered to be the best
business and economics college in the United States. Many billionaires have
been produced by this school. I truly hope this article was a
good primer, and helps you to see a little more clearly how education is
absolute to managing your money, but moreover, putting it to work. For more on this very important
subject, please go to The Conservatory Book Store, or your public library, where you will find detailed
information on everything we talked about in this article. |
CURRENT STRATEGIC PLANNING IN HEALTH CARE HUMAN RESOURCES
Posted on January 25, 2013 at 10:38 PM |
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