Brain Health from a Jellyfish

+=Healthy Brain?

A protein originally found in a jellyfish has been shown to help maintain healthy brain function.  Apoaequorin, the active ingredient in a new dietary supplement Prevagen Professional, helps maintain brain health via the maintenance of calcium levels in aging brains.^*

Patients often have concerns about memory loss, forgetfulness, or what might be described, tongue-in-cheek, as “early-onset senior moments.”  As the media and researchers give more attention to topics like the difference between normal age-related cognitive decline and dementia, patients may be more willing to talk about mental lapses.  The sheer numbers of aging baby boomers will make the subject of age-related cognitive decline an increasingly frequent topic of conversation between healthcare providers and their patients. 

Quincy Bioscience is a biotechnology company dedicated to facilitating these conversations and providing healthcare providers with an innovative approach towards brain health in the supplement Prevagen® and the professional strength version, Prevagen Professional.  Quincy Bioscience is located in the University Research Park in Madison, Wisconsin.

Prevagen contains the active ingredient apoaequorin, a calcium-binding photoprotein first discovered in the jellyfish Aequorea Victoria.  Apoaequorin is part of a class of compounds called EF hand proteins and is very similar to endogenous human calcium-binding proteins, which participate in maintaining intracellular calcium balance/homeostasis. 

Calcium ions are required for the transmission of signals within the nervous system [1].  Calcium has also been labeled as a “second messenger” because when chemical signals arrive at a brain cell, calcium may be released and trigger events inside the cell [2, 3].  When released into the interior of cells, calcium “carries” the message by binding to certain proteins.  These proteins, now “activated”, can induce changes in cell function by calcium and cause changes in the cell including turning on the expression of specific genes.

The concentration of calcium inside cells is closely regulated because of calcium’s importance to proper cell function.  Calcium levels are 10,000 times lower on the inside than on the outside of brain cells [4].  Even a tiny flux of calcium into the cell may cause huge changes in cellular activity.  For this reason, brain cells have the ability to regulate calcium levels through pumps and an elaborate network of proteins that buffer excess calcium. When the production of these proteins diminish,  the regulation of calcium levels is reduced and elevated calcium can lead to chronic activation and ultimately, cell death [5].

Studies have implicated calcium as a mediator of the normal aging process [6].  The levels of calcium-binding proteins, vital to buffering excess calcium, are not as abundant in the cells of older brains [7-11].  Calcium pumps, also part of the calcium regulatory apparatus may not be as active in older brain cells [5, 12, 13]. As a result, each time a brain cell fires, calcium enters the cell as usual, but in older brains, calcium concentrations rise for longer periods of time before they return to normal.  These elevated calcium levels are a stress on the cell and eventually can cause permanent damage.  This damage can be measured as a slower response times and poorer memory.  This damage may also make the individual more susceptible to other neurodegenerative conditions [6].

Research conducted at the University of Wisconsin-Milwaukee demonstrated the ability of apoaequorin to protect neurons and reduce cell death in an ischemic protocol [14].  Ischemic models are frequently used to replicate neurodegenerative diseases.

In an open-label human study of fifty-six individuals using a validated Quality of Life survey instrument, Prevagen improved cognitive function in a majority of the participants in areas such as the ability to find words in conversation, recall events, and remember driving directions over the ninety days of the study[15].  Additionally, there were no drop-outs in the study due to adverse events. 

http://www.integrativepractitioner.com/

The Death of High Fructose Corn Syrup

Submitted by Drew Kaplan on April 19, 2010 – 3:44 pm

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The back-to-back, double whammy announcements that PepsiCo (PEP) is ditching high fructose corn syrup in Gatorade along with the results of a scathing new study from researchers at Princeton make it official — allies of the controversial sweetener have lost the war. For years, the Corn Refiners Association, a trade group consisting of companies like Cargill and ADM (ADM), has been hammering away at the bad press gushing out about high fructose corn syrup. In ads, in the press and online, they argue that the sweetener is a perfectly natural product and that it is no worse for you than regular old sugar.

To which consumers have responded with a collective “Yeah, right.” Con Agra (CAG) is taking HFCS out of its Hunt’s ketchup, Kraft (KFT) is banishing it from Wheat Thins and you will no longer find it in Snapple drinks. It’s all in response to what food companies say is overwhelming consumer demand. “We know moms don’t like it, and they don’t want to feed it to their kids,” supermarket expert Phil Lempert told Ad Age. Last month, outraged San Francisco parents forced high fructose corn syrup out of chocolate milk in the school system. More products are sure to follow.

Rightly or wrongly, HFCS is deeply entrenched as the most popular symbol of the growing consumer distrust of a food system that churns out nutritionally empty, overprocessed foods with a long list of strange, unpronounceable ingredients.

And now the Princeton study gives HFCS foes the scientific bombshell they’ve been looking for, since actual evidence that eating lots of HFCS is going makes you fatter and unhealthier than simply eating lots of sugar is scant. The university reports that rats that ate HFCS gained significantly more weight than those that ate table sugar, even when their overall caloric intake was the same. The fact that the results of this study may be based on inconclusive results and thus not really offer convincing evidence, as NYU nutrition expert and no fan of HFCS Marion Nestle, points out, will likely get lost in the shuffle.

If only the Corn Refiners Association had changed the name of their beleaguered product, things might have worked out differently. Despite its name, high fructose corn syrup is only marginally higher in fructose, which has been clearly linked to obesity and metabolic syndrome, than regular sugar. (The fructose however is not chemically bonded to glucose as it is in sugar and thus more freely available to the body, so that could actually make a difference, though it’s never been proven).

But when you’re trying to tell people that your product doesn’t have a lot of fructose, but it’s called high fructose corn syrup, it’s a bit like naming your new butter alternative Extra Trans Fat Margarine. No one’s going to buy it.

http://industry.bnet.com/food/10001771/the-death-of-high-fructose-corn-syrup/

Naturopathic Medicine

PHILOSOPHY
Naturopathic Medicine is a distinctively natural approach to health and healing that recognizes the integrity of the whole person. Naturopathic Medicine is heir to the vitalistic tradition of medicine in the Western world, emphasizing the treatment of disease through the stimulation, enhancement, and support of the inherent healing capacity of the person. Methods of treatments are chosen to work with the patient's vital force, respecting the intelligence of the natural healing process. The practice of Naturopathic Medicine emerges from six underlying principles of healing. These principles are based on the objective observation of the nature of health and disease, and are continually reexamined in light of scientific analysis. It is these principles that distinguish the profession from other medical approaches:

• The healing power of nature. vis medicatrix naturae
  The body has the inherent ability to establish, maintain, and restore health. The healing process is ordered and intelligent; nature heals through the response of the life force. The physician's role is to facilitate and augment this process, to act to identify and remove obstacles to health and recovery, and to support the creation of a healthy internal and external environment.
• Identify and treat the cause. tolle causam
  Illness does not occur without cause. Underlying causes of disease must be discovered and removed or treated before a person can recover completely from illness. Symptoms are expressions of the body's attempt to heal, but are not the cause of disease. Symptoms, therefore, should not be suppressed by treatment. Causes may occur on many levels including physical, mental, emotional, and spiritual. The physician must evaluate fundamental underlying causes on all levels, directing treatment at root causes rather than at symptomatic expression.
• First do no harm. primum no nocere
  Illness is a purposeful process of the organism. The process of healing includes the generation of symptoms which are, in fact, an expression of the life force attempting to heal itself. Therapeutic actions should be complimentary to and synergistic with this healing process. The physician's actions can support or antagonize the actions of the vis medicatrix naturae. Therefore, methods designed to suppress symptoms without removing underlying causes are considered harmful and are avoided or minimized.
• Treat the whole person. The multifactorial nature of health and disease
  Health and disease are conditions of the whole organism, a whole involving a complex interaction of physical, spiritual, mental, emotional, genetic, environmental, social, and other factors. The physician must treat the whole person by taking all of these factors into account. The harmonious functioning of all aspects of the individual is essential to recovery from and prevention of disease, and requires a personalized and comprehensive approach to diagnosis and treatment.
• The physician as teacher. docere
  Beyond an accurate diagnosis and appropriate prescription, the physician must work to create a healthy, sensitive interpersonal relationship with the patient. A cooperative doctor-patient relationship has inherent therapeutic value. The physician's major role is to educate and encourage the patient to take responsibility for health. The physician is a catalyst for healthful change, empowering and motivating the patient to assume responsibility. It is the patient, not the doctor, who ultimately creates/accomplishes healing. The physician must strive to inspire hope as well as understanding. The physician must also make a commitment to his/her personal and spiritual development in order to be a good teacher.
• Prevention. Prevention is the best "cure"
  The ultimate goal of any health care system should be prevention. This is accomplished through education and promotion of life-habits that create good health. The physician assesses risk factors and hereditary susceptibility to disease and makes appropriate interventions to avoid further harm and risk to the patient. The emphasis is on building health rather than on fighting disease.

http://www.pandamedicine.com/naturopathic_medicine.html

How the Passage of Federal Health System Reform Legislation Impacts Your Practice

On March 23, President Obama signed the Patient Protection and Affordable Care Act (H.R. 3590) into law. A number of key provisions in the new law may have an immediate impact on your practice and your patients, while others have a much longer time frame before they will take effect.

Medicare payment changes

Although Congress will address the flawed sustainable growth rate formula in separate legislation later this year, H.R. 3590 includes a number of payment improvements for physicians that, combined, will result in immediate and significant Medicare payment increases for many physicians.

• 10 percent incentive payments for primary care physicians. All physicians in family medicine, internal medicine, geriatrics and pediatrics whose Medicare charges for office, nursing facility and home visits comprise at least 60 percent of their total Medicare charges will be eligible for a 10 percent bonus payment for these services from 2011–16.

• 10 percent incentive payments for general surgeons performing major surgery in health professional shortage areas. All general surgeons who perform major procedures (with a 10- or 90-day global service period) in a health professional shortage area will be eligible for a 10 percent bonus payment for these services from 2011–16.

• 5 percent incentive payment for mental health services. For 2010, Medicare will increase payment for psychotherapy services by 5 percent.

• Geographic payment differentials. The national average “floor” on Medicare’s geographic payment adjustment (commonly known as the GPCI) for physician work expired at the end of 2009. The law re-establishes that floor in 2010. In 2010 and 2011, Medicare will also reduce the GPCI adjustment for physician practice expenses in rural and low-cost areas. And, beginning in 2011, the practice expense GPCI adjustment will be brought up to the national average for “frontier” states (Montana, North Dakota, South Dakota, Utah and Wyoming). Physicians in 56 localities in 42 states, Puerto Rico and the Virgin Islands will benefit from these geographic payment adjustments.

• Medicare quality reporting incentive payments extended. Incentive payments of 1 percent in 2011 and 0.5 percent from 2012–2014 will continue for voluntary participation in Medicare’s Physician Quality Reporting Initiative (PQRI). An additional 0.5 percent incentive payment will be made to physicians who participate in a qualified Maintenance of Certification Program (quality practice-based learning programs through specialty boards). Following the practice now in place for hospitals, beginning in 2015 physician payments will be reduced if they do not successfully participate in the PQRI program. In 2015, the penalty will be 1.5 percent; in subsequent years it will be 2.0 percent.

Medicaid payment changes

Separate legislation, the Health Care Education Affordability Reconciliation Act (H.R. 4872), still pending at press time, would raise Medicaid payments to family medicine physicians, general internists and pediatricians for evaluation and management services and immunizations to at least Medicare rates in 2013 and 2014. The legislation also provides 100 percent federal funding for the incremental costs to states of meeting this requirement.

Administrative simplification

Beginning in 2010, national rules will be developed and implemented between 2013 and 2016 to standardize and streamline health insurance claims processing requirements. Physicians should benefit from the changes because it will be easier to track claims and, in many cases, should improve physician revenue cycles and lower overhead costs.

Employer requirement to offer coverage

Employers with more than 50 employees with at least one full-time employee who receives a premium tax credit are required to offer health insurance coverage to their employees or be assessed a range in fees, effective in 2014. Employers with 50 employees or less, who represent the vast majority of physician practices are exempt from this requirement. A range of small business tax credits for employers contributing at least 50 percent of the costs of coverage for their employees will also be established, with credits phasing out as firm size and average employee wages increase.

Medical liability protection and grants

The Secretary of Health and Human Services (HHS) is authorized to award five-year demonstration grants to states to develop, implement and evaluate alternative medical liability reform initiatives, such as health courts and early offer programs, beginning in 2011. Medical liability protections under the Federal Tort Claims Act will be extended to officers, governing board members, employees and contractors of free clinics.

Preventive and screening benefit expansions

Beginning in 2010, Medicaid will be required to cover tobacco cessation services for pregnant women. In 2011, cost-sharing for proven preventive services will be eliminated in Medicare and Medicaid. Medicare payments for certain preventive services will be increased to 100 percent of payment schedule rates (that is, co-payments will be eliminated), and incentives will be available to encourage Medicare and Medicaid beneficiaries to complete behavior modification programs.

In the private sector, beginning in 2010, health plans will be required to provide a minimum level of coverage without cost-sharing for preventive services such as immunizations, preventive care for infants, children and adolescents, and additional preventive care and screenings for women.

Medicare prescription drug coverage

Medicare patients whose prescription expenses reach the so-called Medicare Part D coverage “doughnut hole” ($2,700 to $6,150) in 2010 will receive a $250 rebate. During the next 10 years, the beneficiary co-insurance rate for this coverage gap will be narrowed in phases from the current 100 percent to 25 percent in 2020.