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The best city to have a heart attack?

A trip to Sin City isn't always fun and games, with MGM Resorts properties in Las Vegas averaging roughly 45 to 50 sudden cardiac arrests a year on the casino floor. With heart attacks becoming commonplace in casinos, properties on The Strip are training employees to use defibrillators, also known as AEDs – turning casinos into what some consider the safest place to, well, have a heart attack. “We're able to get anywhere on a property a lot quicker than calling 911,” said Dr. David Slattery, the medical director for MGM Resorts defibrillator training program. A defibrillator applies electrical energy to the affected heart area, giving the individual a better chance of surviving by regaining their natural rhythm. Both MGM and Caesars properties, which make up a majority of the casinos on the Las Vegas Strip, train employees on the casino floor to use these defibrillators at a moment’s notice. Whether the heart attack is noticed by a security officer near a slot machine or by a surveillance camera, the odds are high you'll get some immediate help. “If you look just at the casino floor, where the response time is less than three minutes, about 60 to 70 percent of those come back after sudden cardiac arrest,” said Slattery. The AED training at MGM is certified by the American Heart Association, incorporating regular “mock drills” where employees reenact the situation, attaching the defibrillator to a mannequin while administering CPR. The drill incorporates three individuals, with each person taking a turn at resuscitating the individual. The training is becoming a model for other industries. “There are companies out there, and I'm associated with one called Cardio Ready, and these companies actually model what they do after the Vegas model,” said cardiologist Dr. Kevin Campbell. “They manage AEDs for hotels, businesses and banks, and that sort of thing.” Slattery calls the security officers the “special forces” since the officers arrive within the first minutes of cardiac arrest. It looks to be a special force that's definitely worth betting on.Pete Griffin is part of the Junior Reporter program at Fox News. Get more information on the program here.source : http://www.foxnews.com/health/2013/06/16/best-city-to-have-heart-attack/

Motorcycle injuries worsen with weaker helmet law

The average medical claim from a motorcycle crash rose by more than one-fifth last year in Michigan after the state stopped requiring all riders to wear helmets, according to an insurance industry study. Across the nation, motorcyclists opposed to mandatory helmet use have been chipping away at state helmet laws for years while crash deaths have been on the rise. For more than 40 years, Michigan required all motorcycle riders to wear helmets. State legislators changed the law last year so that only riders younger than 21 must wear helmets. The average insurance payment on a motorcycle injury claim was $5,410 in the two years before the law was changed, and $7,257 after it was changed — an increase of 34 percent, the study by the Highway Loss Data Institute found. After adjusting for the age and type of motorcycle, rider age, gender, marital status, weather and other factors, the actual increase was about 22 percent relative to a group of four comparative states, Illinois, Indiana, Ohio and Wisconsin, the study found. “The cost per injury claim is significantly higher after the law changed than before, which is consistent with other research that shows riding without a helmet leads to more head injuries,” said David Zuby, chief research officer for the data institute and an affiliated organization, the Insurance Institute for Highway Safety. The data institute publishes insurance loss statistics on most car, SUV, pickup truck and motorcycle models on U.S. roads. While other studies have shown an increase motorcycle deaths after states eliminate or weaken mandatory helmet requirements, the industry study is the first to look specifically at the effect of repealing helmet requirements on the severity of injuries as measured by medical insurance claims, Zuby said. Some states have sought to mitigate the repeal or loosening of mandatory helmet laws by setting minimum medical insurance requirements, but “that doesn't even come close to covering the lifelong care of somebody who is severely brain-injured and who cannot work and who is going to be on Medicaid and a ward of the state,” said Jackie Gillan, president of Advocates for Highway and Auto Safety, which backs mandatory helmet requirements for all riders. Jeff Hennie, vice president of the Motorcycle Riders Foundation, dismissed the study, saying the insurance industry views helmets as “the silver bullet that's going to change the landscape of motorcycle safety.” He said insurers are upset because “life has gotten more expensive for them and they have to pay out more.” “The fact is our highways are bloody,” Hennie said. “This (the Michigan helmet law change) doesn't make helmets illegal. ... No one is forcing anyone to ride without a helmet.” Vince Consiglio, president of American Bikers Aimed Toward Education of Michigan, blamed the increase in the severity of injuries on bikers who don't take safety courses required to obtain a special motorcycle license. He said bikers without motorcycle licenses have made up an increasingly larger share of fatalities and injuries in recent years. But Gillan said the study “clearly shows there is no such thing as a free ride, and the public is paying the cost for this.” There's no way to know how many of the Michigan claims involved motorcyclists not wearing helmets, the study said. But another recent study by the University of Michigan's Transportation Research Institute found a significant increase in motorcyclists involved in crashes who weren't wearing helmets after the law changed. From April 13, 2012, the first full day after the change took effect, through the end of the year, 74 percent of motorcyclists involved in crashes were wearing helmets, compared with 98 percent in the same period for the previous four years, the study found. Nationally, motorcycle deaths have risen in 14 of the past 15 years, and appear to have reached an all-time high of more than 5,000, according to an analysis by the Governors Highway Safety Association of preliminary 2012 data. Currently, 19 states and the District of Columbia require all motorcyclists to wear a helmet, 28 states require only some motorcyclists — usually younger or novice riders — to wear a helmet, and three states have no helmet use law. States have been gradually repealing or weakening mandatory helmet laws for nearly two decades. In 1967, to increase motorcycle helmet use, the federal government required that states enact helmet laws in order to qualify for certain federal safety programs and highway construction aid. The federal incentive worked. By the early 1970s, almost all states had motorcycle helmet laws that covered all riders. In 1976, Congress stopped the Transportation Department from assessing financial penalties on states without helmet laws, and state lawmakers began repealing the statutes. In 1991, Congress created new incentives for states to enact helmet and seat belt laws, but reversed itself four years later. The National Highway Traffic Safety Administration, which sent observers to states last year to count how many motorcyclists wore helmets, found that 97 percent of motorcyclists in states with universal helmet laws were wearing helmets compared with 58 percent of motorcyclists in states without such coverage.source : http://www.foxnews.com/health/2013/05/30/motorcycle-injuries-worsen-with-weaker-helmet-law/

Heart device approval delays leave U.S. doctors frustrated

Americans accustomed to immediate access to the newest technology may be shocked to find that is not the case when it comes to devices that treat ailing hearts. U.S. approval requirements for cardiac devices are much more stringent than in Europe, where there is no centralized decision-making body. But a growing number of U.S. heart doctors feel the regulations are so demanding that patients are being denied access to beneficial therapies. From 2006 to 2011, European regulators approved mid-to-high-risk medical devices, including heart devices, an average of four years ahead of the more conservative U.S. Food and Drug Administration, according to a report last year by Boston Consulting Group. The quicker road to market in Europe did not lead to a discernible increase in recalls or safety problems, according to BCG and the California Healthcare Institute, which conducted the study, and Eucomed, the European trade group. “There is frustration among the U.S. investigators(researchers) and U.S. care providers around delayed access to certain interventions that appear to be a winner,” said Dr. Patrick O'Gara, a cardiologist with Brigham and Women's Hospital in Boston. An example cited by several doctors is a replacement for diseased heart valves made by U.S. device maker Edwards Lifesciences. The Sapien transcatheter aortic valve replacement (TAVR) system is particularly suited for elderly and frail patients, since it can be put in place via a catheter threaded through an artery rather than replacing a valve by cracking open the chest for heart surgery. “With this disease, if you wait two or three years, 60 or 80 percent of (patients) are dead. So not to have the most updated version of the device to treat more patients like this doesn't seem to be a particularly good idea,” said Dr. Martin Leon, director of the Center for Interventional Vascular Therapy at Columbia University Medical Center in New York. Heart disease remains the world's No. 1 killer. An estimated 500,000 Americans suffer from severely diseased heart valves, according to the American Heart Association. Many could be candidates for valve replacements. The approval delays are also costing device makers, such as Edwards and Medtronic Inc, hundreds of millions of dollars in potential sales while they are being asked to help pay for U.S. healthcare reform through new taxes. Dismay among heart doctors over delayed access to new devices gained momentum at this year's American College of Cardiology (ACC) meeting, which featured several U.S. clinical trials of devices long available in Europe. One top researcher at the meeting called the United States “a Third World country” when it comes to availability of cutting-edge heart devices. Only Edwards' original Sapien valve has U.S. approval - which it received in 2011, four years after Europe and elsewhere. European cardiologists have been using a next-generation version, which doctors find easier to maneuver into place and believe may cause less trauma to the artery, for three years. That is why Leon, who is co-lead investigator of U.S. clinical trials for both the original Sapien heart valve and the smaller, newer Sapien XT, sends some patients to Europe for treatment if he believes them better suited for the sleeker XT. Medtronic has a similar heart valve replacement awaiting U.S. approval that has been used in Europe since 2007. Asked at the ACC meeting if he found the situation frustrating, Dr. Gary Mintz, chief medical officer of the Cardiovascular Research Foundation in New York, shot back: “You mean because Algeria had TAVR before the U.S.?” “Even the FDA recognizes the problem, but they are answerable to Congress, not us,” Mintz said. FDA'S BID TO STREAMLINE The FDA requires proof of efficacy as well as safety through carefully controlled, randomized clinical trials before approving products, and may ask for long-term follow-up data. “We recognize that some of our regulatory requirements have been viewed as impediments compared to other parts of the world,” said Andrew Farb, medical officer in the FDA's division of cardiovascular device evaluation. The FDA is working on a new program to help streamline the path to U.S. approval that would involve the agency much earlier in device development - possibly discussing results with researchers after use in the first patient, according to Farb. The agency expects to publish this year its “early feasibility study guidance,” which it hopes will outline a path toward swifter reviews and approvals of devices in development in the United States, Farb said. “When you're starting a new way of thinking, getting this really ramped up is a challenge, but we're hopeful,” he said. Some companies, eager for faster returns on their investments, have moved early-stage device trials overseas, since they know they are likely to be able to begin selling the products there years earlier. That has added to delays of U.S. trials and approvals, Farb and others said. Enrolling patients in randomized U.S. trials mandated by the FDA is also being hampered by patient fear they would be put in a control group that did not get the new device, doctors said. Farb said the FDA is concerned by such trends and is seeking ways to move early-stage human trials back to the United States. EUROPE MAY SEEK TIGHTER CONTROLS In Europe, device makers must prove a product's safety to the satisfaction of one of some 80 designated regulator bodies and show it functions as intended. Effectiveness is determined through post-approval surveillance as it is used in patients. Some European politicians view the system as too lax and have called for a model closer to the U.S. “I think we need to meet somewhere in between,” said Dr. David Holmes, a cardiologist at the Mayo Clinic and a past ACC president, of the two regulatory systems. He said Europe may need to tighten its regulations without necessarily adding years to its process. One suggestion put forward by Eucomed - a device industry trade group that represents thousands of companies - and others would significantly cut the number of European regulators allowed to approve higher-risk devices. U.S. doctors are actively looking for ways to address the issue. “We need a coalition of involved, thoughtful and balanced individuals who see things on both sides of the equation and look for every opportunity to shorten this time line,” O'Gara said. Holmes said such a coalition, including researchers, manufacturers and physician groups like ACC and the Society of Thoracic Surgeons, is looking to work more closely with the FDA on the issue. He said the group is compiling a database of all patients getting TAVR to enhance understanding of the procedure's long-term performance and aid the FDA in making decisions. MILLIONS IN LOST SALES The approval lag means companies are leaving money on the table when it comes to their newest devices. Edwards' original Sapien sells for about $32,000 per patient and had U.S. sales of about $200 million in its first year on the market. Had it been available in the United States at the same time as Europe, the company could have rung up at least an additional $800 million in sales, said Joanne Wuensch, an analyst with BMO Capital Markets. “That assumes no growth, which is ridiculous, so that is an extraordinarily conservative number,” she said. Proving efficacy can be a lengthy process. St Jude Medical's Amplatzer Occluder device, used to close a tiny hole in the heart, is awaiting an FDA decision. The decisive U.S. trial, which was not deemed complete until a pre-specified number of patients suffered strokes or died, took eight years. Eucomed is campaigning to keep in place the system that brings new products to those markets earlier. “As you get physician experience developing, you also start immediately improving the product,” said Eucomed CEO Serge Bernasconi. “That explains why by the time it gets to market in the U.S., often in Europe we are already on the second or third generation.” Edwards, which considers the original Sapien valve to be obsolete and manufactures it only for U.S. use, expects European approval for its third-generation version by the end of 2013. Meanwhile, U.S. doctors still await its predecessor.source : http://www.foxnews.com/health/2013/05/28/heart-device-approval-delays-leave-us-doctors-frustrated/

Women escorted from mall for wearing “F— CANCER” hats

Two sisters were escorted from a mall in King of Prussia, Pa., on Sunday because they were wearing hats reading “F--- CANCER” with the “C” in the expletive replaced by a pink breast cancer awareness ribbon, the Philadelphia Daily News reported. Zakia Clark, 29, and Tasha Clark, 27, said that they were wearing the shirts to honor their mother, Jackie Underwood, who had passed away on May 14 at the age of 51 after a battle with breast cancer. The women, both from Philadelphia, were at the King of Prussia Mall with a group of friends and relatives, shopping for a dress for Zakia’s daughter to wear to their mom’s funeral. After two-and-a-half hours of shopping, the women were approached by a security guard in the mall’s food court. Zakia told the Philadelphia Daily News that the guard approached them without a greeting and said, “‘Take your hats off.’” Zakia removed her hat, but Tasha – a former mall employee – asked to see something in writing. “He said, 'Since you don't want to take your hat off, you can leave my mall,'” Zakia told the Philadelphia Daily News. “He stood there while we ate and threatened to call the cops.” The women stated that seven more guards then approached them and escorted them to the mall office. “I was very embarrassed,” Zakia told the Philadelphia Daily News. “My daughter was so scared she was crying.” At the mall office, the women were met by a police officer who had been called by mall security. “The officer said, 'I find it offensive that you even have that hat that says 'F--- CANCER,' ” Zakia recalled. “He said, 'It's their mall, they want you out, you have to get out.'” The women were escorted out of the mall, and two security cars waited by the sisters’ car until they left. After the Philadelphia Daily News looked into the incident, Les Morris, a spokesman for Simon Property Group in Indianapolis, IN., which owns King of Prussia Mall, called Zakia to apologize. “Certainly this could have been handled in a much more empathic and sensitive manner,” Morris told the People Paper. “We're very sorry about her loss and wanted to apologize for the way her party was treated.” “I do think this is an entirely different situation than a 16-year-old kid with a swear word on his T-shirt cruising the mall,” Morris said. Click for more from the Philadelphia Daily News.source : http://www.foxnews.com/health/2013/05/22/women-escorted-from-mall-for-wearing-f-cancer-hats/

Breakthrough in the understanding of how pancreatic cancer cells ingest nutrients points to new drug target

Now new research reveals a possible chink in the armor of this recalcitrant disease. Many cancers, including pancreatic, lung, and colon cancer, feature a mutated protein known as Ras that plays a central role in a complex molecular chain of events that drives cancer cell growth and proliferation…