The Breakaway Imaging O-arm, distributed by Medtronic Navigation, provides multi-dimensional, surgical imaging for complex spine surgeries. The new technology, available in only a few other hospitals in the nation, provides real-time, 3-D images in the operating room.

Installation, training and use of the technology began in October on the Medical Center’s Riverside campus. The futuristic imaging technology provides two-dimensional fluoroscopy and 3-D imaging for spine surgeries quickly - in less than 30 seconds - that will allow surgeons greater precision in hardware placement and improve patient safety.

The O-arm is the next-generation technology advance of the C-arm, also used by spine surgeons at the medical center. The O-arm, however, provides more precise images onto a digital flat panel screen in the surgical suite. Its donut-shaped telescoping gantry allows for 360-degree imaging around the patient, making it highly beneficial for complicated spine cases.

"It provides intraoperative fluoroscopy through robotic technology, so it’ll decrease fluoroscopy exposure time, and it allows you to do a diagnostic-quality intraoperative computed tomography (CT) scan," says David Polly, MD, medical director of the Spine Center at University of Minnesota Medical Center, Fairview. "Instead of having to take a patient out of the OR and move him or her to a CT scanner to check the placement of an implant, we can do this intraoperatively and adjust things right at the time of surgery. This will, hopefully, decrease the number of times revisions need to be done and allow us to perform surgeries that are technically more demanding."

"Time and precision are critical in surgery," says Carly Deer, neurosciences services director. "By having this innovative technology, we’re able to improve patient outcomes and patient safety for our more complicated spinal surgeries."

Nearly 700 spine surgeries were performed at the medical center in 2005. Polly expects that number to increase with the addition of a new neurosurgeon, Dennis Mollman, MD, a University of Minnesota Physicians specialist who focuses on complex spinal surgery. "There shouldn’t be a spine-related surgical problem that we aren’t able to tackle," says Polly. The Spine Center is known not only for general spine surgeries, but is also a referral center for tumor and deformity-related cases as well as previously operated spine cases.

The medical center is one of only six hospitals in the nation with an O-arm. Hospitals with O-arms closest to the medical center are located in Indiana and Nebraska.

Based on the latest scientific information, MDH has lowered its Health Based Values (HBVs) for perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), two members of PFC group of chemicals that have been found at low levels in groundwater in southern Washington County. The new HBVs are 0.5 parts per billion (ppb) for PFOA and 0.3 ppb for PFOS. The guidelines previously used were 1 ppb and 0.6 ppb respectively.

"We have been reviewing the available data over the last few months and concluded that there is sufficient scientific basis at this time to justify revising the health based values for PFOA and PFOS," said Minnesota Health Commissioner Dianne Mandernach.

While research to date has shown no direct evidence that PFCs cause health problems in humans, studies in laboratory animals indicate that at higher doses, PFCs may interfere with liver and thyroid function and may cause developmental effects.

"The new values are protective, scientifically sound and well-researched," said John Linc Stine, director of the Environmental Health Division for MDH. The new value for PFOA, 0.5 ppb, is the same as a number implemented by the Environmental Protection Agency (EPA) in an enforcement action in West Virginia that became effective Nov. 17, 2006.

A Health Based Value is the concentration of a groundwater contaminant, or a mixture of contaminants, that poses little or no risk to health, even if consumed daily over a lifetime. The updated HBVs for PFOA and PFOS take into consideration the potential for health impacts during fetal and other developmental life stages. A clearer understanding of how long these chemicals stay in the human body is also reflecteded in the revised HBVs.

MDH is working with Oakdale and Lake Elmo to address public and private wells that may be affected by the lowering of the HBVs for PFOA and PFOS. Most residents in the Lake Elmo and Oakdale area will not be affected by the change because they are connected to municipal water systems that don’t contain PFCs or treat the groundwater before distribution.

The lowering of the Health Based Values for PFOA and PFOS does not affect those portions of southern Washington County and northern Dakota County where only perfluorobutanoic acid (PFBA), another PFC compound, has been found in groundwater.

Those areas fall under the department ,, s drinking water advice on PFBA, which the department reiterated.

"We recommend that anyone who has concerns about the potential health impacts from PFBA in their water should limit or reduce their intake of water that has a concentration of more than 1 ppb," Stine said.

Intake of contaminated drinking water can be reduced by drinking bottled water or by filtering tap water used for drinking or cooking through a point-of-use (POU) activated carbon filter, which removes or greatly reduces PFBA. Water used for bathing, showering or other non-ingestive household uses does not pose a health risk, based on current data.

"We’ve had an initial round of community meetings where more than 800 people heard our advice and heard us talk about things they can do to limit their exposure if they choose," Stine said. "But we know that there are far more than 800 people in the communities and areas affected by the contamination, so we want to take every opportunity we can to re-emphasize our advice. We also want to share as broadly as possible what we know about point-of-use filters, small, inexpensive filters that can be used to filter tap water."

Point-of-use (POU) filters can be an effective way to reduce exposure, MDH staff found. They recently tested a number of POU filters commonly available in stores. The testing found that a simple pitcher filter that contains activated carbon was partially effective at removing PFBA from the water, but allows more PFBA to pass through as additional water is filtered. A faucet-mounted filter containing activated carbon worked better, showing full removal of PFBA through about half of its manufacturer’s predicted filter lifetime, and good removal at up to 70-80 percent of its lifetime. Faucet-mounted filtering devices commonly range in price from $15 to $25 and replacement filters cost approximately $15 to $20. Additional information on POU filters with activated carbon is available from the MDH Web site or by calling 651-201-4897.

Stine said MDH staff have determined that sufficient toxicity data does not exist to calculate a chemical-specific HBV for PFBA. However, the advice is based on a comparison of the existing PFBA data to what is known about other PFCs.

"The data that are available for PFBA indicate that this chemical is less toxic than PFOA, a similar chemical," Stine said. "We believe that 1 ppb is a protective number for PFBA, based on the most recent science, and is protective even of those who may have higher relative water consumption rates, such as pregnant women, nursing mothers and small children."

Mandernach added, "As more data become available, we will examine it, with the intent of developing a Health Based Value for PFBA. We will continue to work with the EPA, private sector and academia, to accelerate that research and continue to consult with experts on this group of chemicals."

The Missouri Public Health Law Conference, hosted by the Missouri Department of Health and Senior Services’ Center for Local Public Health Services, is set for March 20 in Columbia.

The conference will focus on the legal powers of local public health boards, administrators and other officials when responding to emergencies that could impact the public ,, s health. The conference will also examine the roles of federal, state and local law enforcement and hospitals during a public health emergency.

"In these times of emerging infectious diseases and growing threats of terrorism, an understanding of the legal authority public health professionals may use during a crisis has become an absolute necessity," said Jane Drummond, Director of the Department of Health and Senior Services. "It’s vital that public health and law enforcement officials have a clear understanding of their roles and how they can work together to keep people safe."

Conference speakers include representatives from the state health department, Center for Emergency Response and Terrorism, Missouri Hospital Association, BJC HealthCare Risk Services, Cole County Sheriff’s Office and several county health departments.

"We encourage public health officials across Missouri to attend this important conference," said Anne Locke, director of the Center for Local Public Health Services "We believe it will help better prepare our state should a public health emergency occur."

The conference is being sponsored by:

Missouri Department of Health and Senior Services’ Center for Local Public Health Services and Center for Emergency Response and Terrorism
St. Louis University School of Public Health’s Heartland Centers for Public Health Preparedness and Heartland Public Health Education and Training Center
Missouri Association of Local Public Health Agencies

"I had enough supplies to care for about 75 people," Humphrey recalls. "But when we set up our make-shift clinic, more than 1,000 people came to receive care." When she returned to the United States, it troubled her that Liberians didn’t have the health care they needed. "Pastor Davis and I decided to build a permanent clinic there," she says. With financial support from the church and personal contributions, Humphrey purchased a home in the small Liberian town of Buchanan for $5,000 to use as a clinic.

There, hundreds of people were receiving health care every day. However, that came to an end when bombing from the ongoing civil war totally destroyed the clinic. "It broke my spirit, but I couldn’t just give up," Humphrey says.

She began looking for a place to build a new clinic. In Paynesville, a suburb of Monrovia, with a population of 500,000, Humphrey found three buildings and a church that were also destroyed by bombing. However, all were owned by Worldwide Missions, the same missionary group Karnga works with. Through fundraisers, members of The Greater Shiloh Church collected $20,000 to renovate these buildings.

During the months it took to make the repairs, Pastor Davis passed away in 2005. On Jan. 6, 2006, the clinic was re-dedicated and named in his honor. "The Pastor Fred Davis Memorial Clinic" is a 28-bed facility. It is staffed by one physician (who visits the clinic once a month), a physician’s assistant, five registered nurses, aids and housekeepers. With continued financial support from the church and donations made by medical supply and drug companies, the clinic’s staff is paid and shelves are stocked.

While touring another Liberian clinic, Humphrey was present to see the birth of a child. "The woman was lying on the floor," she recalls. "When she delivered, they took the baby and placed it on a rusty metal shelf. The mother was asked to clean herself up, take her baby and move on." The experience prompted Humphrey to include a mother-baby unit in her clinic where 200 babies are born annually. "There are linens on the bed and people are treated with dignity," she says. The clinic also has an emergency room and a general practice area. Caregivers commonly treat patients with malaria, hypertension, stomach disorders and post-traumatic stress disorder resulting from the memories of war.

Humphrey’s efforts are not going unnoticed, even by the country’s leadership. When a shift in political power ended the civil war, Humphrey was personally invited to attend the inauguration ceremony of Liberia president-elect Ellen Sirleaf-Johnson. "In America, we have so much. They have nothing," Humphrey says. "I can’t stand to see my fellow man in that condition. I’m just trying to give them a small piece of the American dream."

The New Mexico Clinical Prevention Initiative, a collaboration between the Department of Health and the state Medical Society, supported the idea of adopting the treatment. In January of this year, the New Mexico Medical Board adopted a rule change to allow physicians to provide expedited treatment. "This allows New Mexico clinicians to improve the care of their patients with sexually transmitted diseases by ensuring that their partners will also receive treatment. Studies have shown this to be a safe and effective practice," said Dr. Bruce Trigg, New Mexico Department of Health Medical Director of the Sexually Transmitted Disease Program for northwest New Mexico.

Expedited partner treatment is an evidence-based public health approach that has been shown to lower re-infection rates of people infected with chlamydia, gonorrhea and trichomoniasis; the most common curable sexually transmitted disease in young, sexually active men and women.

Studies show that women who are treated for chlamydial infection are at high risk for re-infection if their partner is not treated. This is of special concern because women with repeat infections are at increased risk of developing pelvic inflammatory disease, a condition that can cause infertility, a future tubal pregnancy, or chronic pelvic pain.

"The Board endorsed the expedited partner treatment rule change because this approach has proven to be a safe, cost saving, and clinically effective approach in physicians’ management of sexually transmitted diseases in their patients and their patients ,, partners," said Dr. Grant La Farge, Medical Director of the New Mexico Medical Board.

The trial site for the study is Hospital General Universitario Gregorio Mara n in Madrid, Spain. Dr. Fernandez-Avil s, Professor of Cardiovascular Medicine and Chief of Cardiology Service at Gregorio Mara n and Dr. Perin, Director of New Interventional Cardiovascular Technology and Director of Stem Cell Center at the Texas Heart Institute at St. Luke’s will serve as co-principal investigators.

The procedure involves removing adult stem cells from adipose tissue just as in a liposuction procedure. The cells are processed with a proprietary process developed by Cytori Therapeutics, Inc. After about one hour of processing, the stem cells are injected directly into damaged but viable areas of the heart muscle through an investigational device called a NOGA catheter. This catheter allows three-dimensional color-coded maps of the mechanical and electrical function of the heart’s left ventricle.

"This is the first time we have used adipose-derived stem cells in humans. We had good results in our pre-clinical tests and we are excited about taking this research to the next level," said Dr. Perin.

A variety of clinical functional and imaging endpoints will be assessed in the study. The outcomes of the study will be evaluated after a six month follow up. The doctors expect to present the six month outcomes of the study in 2008.

"This is another significant advance in our international collaboration to find solutions to heart failure and other cardiovascular diseases through adult stem cell treatment. The Texas Heart Institute at St. Luke’s has been conducting the first FDA-approved adult stem cell study for heart failure patients using stem cells taken from the patients’ own bone marrow. We have almost completed enrolling the final patient in that 30-patient study and look forward to sharing those results later this year," said James T. Willerson, M.D., president-elect and medical director of the Texas Heart Institute at St. Luke ,, s. Dr. Willerson is also president of The University of Texas Health Science Center at Houston.

Heart failure is a condition in which the heart can’t adequately pump sufficient blood to the body’s other organs. It is the only cardiovascular condition which continues to rise in the U.S. More than half a million Americans are diagnosed with heart failure each year.

Recent U.S. Supreme Court decisions have resulted in recommendations for adolescent drug testing in schools, and products made available for parents to test their children at home. An addendum to the 1996 AAP Policy Statement, "Testing for Drugs of Abuse in Children and Adolescents," opposes involuntary drug testing of adolescents at school or at home and believes more research is needed on both the safety and effectiveness before testing programs are implemented.

Laboratory testing for drugs is a scientifically complex procedure, which may be prone to both false-positive and false-negative tests.

Drug testing should only be carried out by professionals with special training in the procedure; most pediatricians have not been adequately prepared to do this.

The majority of physicians surveyed in the 2006 Journal of Adolescent Health (83 percent) disagreed with drug testing in public schools, which can be perceived by adolescents as an unwarranted invasion of privacy.

The AAP encourages parents who are concerned their child may be using drugs or alcohol to consult their child’s pediatrician rather than rely on school or home-based drug testing products.

Secondhand smoke is an "invisible killer", according to a shocking new advertising campaign, launched by Public Health Minister Caroline Flint. Nearly 85 per cent of tobacco smoke is invisible and odourless, but it causes just as much harm to people’s health as the smoke that is visible.

In the TV advert, which will be broadcast from Monday 5 March, pervasive, dark smoke curls around guests at a wedding reception revealing the actual amount of smoke emitted by a single cigarette. And the smoker’s well intentioned attempts to blow or waft smoke away from non smokers does not reduce the potential risk of secondhand smoke to health. The ads make this "invisible killer" visible in this family celebration. The TV commercial will be supported by press, online and outdoor advertising from 5 March.

Whilst most smokers and non-smokers believe secondhand smoke can cause harm, a new survey released today to support the campaign shows over half of smokers continue to smoke in a room with adult non-smokers, and a further quarter will still smoke when they’re near children.

Secondhand smoke contains around 4,000 different chemicals. It can increase your chance of developing lung cancer and heart disease and can also cause a variety of serious health conditions including respiratory disease and cot death in children. It’s made up of both side stream smoke from the burning tip of the cigarette, and mainstream smoke exhaled by the smoker. Side stream smoke accounts for nearly 85 per cent of the smoke in a smoky environment and contains a much higher concentration of toxins, such as hydrogen cyanide, ammonia and carbon monoxide.

Launching the new campaign Public Health Minister Caroline Flint said:

"Smoking is harmful not just to smokers but to the people around them. What this new campaign brings home very clearly is the full impact of secondhand smoke. 85 per cent of smoke may be invisible and odourless but it is still damaging people’s health. Wafting and blowing away smoke may seem like the right thing to do but in reality, it makes little difference to the amount of secondhand smoke inhaled by people around you.

"With England going Smokefree on 1st July, there has never been a better time to stop smoking. We have already exceeded our three-year target to help 800,000 people quit by 2005/06, and still more and more people are successfully kicking the habit."

Professor Jarvis, University College London commented: "Children are particularly affected by breathing the poisons in secondhand tobacco smoke, because their bodies are still developing. Their bronchial tubes and lungs are smaller and immune systems less developed, making them more vulnerable to the toxins in smoke. Despite smokers’ efforts to blow their smoke away, or to not sit near children, they are still causing harm. People need to see secondhand smoke for the invisible killer that it is."

Mikis Euripides, Asthma UK’s Assistant Director of Policy & Public Affairs said:

"For people with asthma the effects of smoking can be deadly. 82 per cent of people with this serious condition tell us that other people’s cigarette smoke triggers their asthma and many cannot go out to bars and clubs without the fear of a fatal asthma attack. About 800,000 people with asthma in England are also smokers themselves (iv), increasing their risk of asthma symptoms, asthma attacks and permanent damage to the airways."

The ads will run until 8th April coinciding with National No Smoking Day on Wednesday 14th March: nosmokingday.org.uk

The best way to protect your family and other adults from secondhand smoke is to stop smoking. For further information phone the NHS Smoking Helpline free on 0800 169 0 169. Smokers who want to quit can also find details of their local NHS Stop Smoking Service by visiting gosmokefree.co.uk texting ‘GIVE UP’ and their full postcode to 88088 or asking at their local GP practice, pharmacy or hospital.

The state health department was presented today with the National Influenza Vaccine Summit’s Overall 2006-07 Season Activity award for its "innovative and collaborative approach" to vaccinate school-aged children aged five to 11 for seasonal flu. The project was also noted as a valuable preparation tool for a possible influenza pandemic.

The recognition took place during the Centers for Disease Control & Prevention’s (CDC) National Immunization Conference in Kansas City.

"Maryland is the first state to reach out to this age group with a statewide influenza vaccination program," said DHMH Secretary John M. Colmers. "This award is acknowledgment of all of the hard work performed by health and school officials at the local level and by our community partners to make this campaign a success."

The innovative and collaborative program enabled more than 50,000 school children to receive FluMistТ vaccine at no cost to their families. DHMH, CDC and Gaithersburg-based MedImmune, Inc., each contributed doses to immunize the students.

The program was implemented with the support of Maryland’s 24 local health departments, the state ,, s 24 local school systems and other key partners, such as the community-based Maryland Partnership for Prevention and the Maryland chapter of the American Academy of Pediatrics. The local health departments and school systems provided staff and other in-kind support to help implement the campaign.

"With the help of our partners, we were able to establish nearly 200 clinic dates in schools and non-traditional settings to provide vaccine to students with parental consent," said Greg Reed, program manager of the DHMH Center for Immunizations. "We are hopeful that healthier children and reduced school absenteeism encourages parents to have their children vaccinated every year."

This one-time initiative was based on a pilot program conducted by the department during the 2005 - 2006 flu season in Calvert and Carroll counties. The result was a demonstrated decrease in student and staff absenteeism due to influenza-like illnesses.

The program has drawn the attention of public health officials from other states, including Colorado, Hawaii and Pennsylvania. A formal evaluation and analysis of the DHMH campaign is expected to be complete this fall.

The Overall 2006-07 Season Activity award is one of three that the vaccine summit uses to recognize individuals and organizations that have made extraordinary contributions towards improved adult and/or childhood influenza vaccination rates within their communities. The other categories are Healthcare Worker Campaign and Late Season Activities.

The National Influenza Vaccine Summit, started in 2000, is co-sponsored by the American Medical Association and CDC. The summit is comprised of more than 400 members who represent over 100 public and private organizations. The summit ,, s Web site is www.preventinfluenza.org.

According to compliance data generated from complaint referrals and routine inspections by the Marion County Health Department Food Safety and Water Quality and Environmental Health departments, businesses and food establishments are complying with the law.

"We know Indianapolis is a healthier community because of the smoke free workplace law," said Virginia A. Caine, M.D., director, Marion County Health Department. "The cooperation of the community has made this law a success story for our city," said Dr. Caine.

Health officials predicted that after an early transition period, the law would be self-enforcing. Data indicates 163 of the 209 complaints received from March 1, 2006 through February 16, 2007 were made in the first six months. Only 46 complaints have been received in the last six months.

"Our Smoke Free Indy coalition partners did an outstanding job of educating our community and businesses. This sense of cooperation has led to the high rate of compliance we have documented in the last year," said Dr. Caine.

Compliance data from March 1, 2006 to February 16, 2007:

Number of complaints: 209
Number of fines: 8
Number of court cases: 2
Number of exempted establishments: 387

"As we expected, compliance with the law has been high, and most businesses were able to adapt without much effort," said Missy Lewis, Public Policy Chair for Smoke Free Indy. "Because of this law, thousands of employees in Indianapolis have been able to go to work without putting their health in jeopardy. We look forward to the day when no one in Indianapolis is denied this protection," said Lewis.

"Every year between 950-1,690 Hoosier deaths are attributed to secondhand smoke. Workers exposed to secondhand smoke are at risk for heart disease, cancer, respiratory problems, stroke, and eye and nasal irritation," said Dr. Caine.

The economic costs associated with secondhand smoke are equally dramatic. In 2002, at least $16.7 million were spent for the hospitalization and health care of Marion County residents with secondhand smoke exposure-caused deaths. Increased medical costs, higher insurance rates, lower productivity, and high absentee rates can be attributed to tobacco use by local workers.

According to an indoor air monitoring study commissioned by the Smoke Free Indy Coalition from the Roswell Park Cancer Institute, data indicates the air quality in Indianapolis establishments that have been smoke free in the last year has improved. The indoor air monitoring results included:

• The average level of fine particle indoor air pollution declined 85% after the Indianapolis ordinance went into effect in those venues that went smoke-free as a result of the law.
• Businesses that went smoke free saw a decline in the level of fine particle air pollution after the law went into effect.
• Places that are exempt from the provisions of the Indianapolis ordinance and that continued to allow indoor smoking experienced no change in indoor air pollution and still have unhealthy air according to U.S.

Environmental Protection Agency (EPA) standards. During the coming year, the Marion County Health Department will continue to educate the community on the health risks associated with tobacco products and second hand smoke. Part of this process will include promotion of free smoking cessation classes offered by the health department and other agencies.