On May 9, 2009 Nobel Peace Prize laureate the Dalai Lama offered an invocation for the New York State Senate, calling for compassion during tough times. The 73-year old spiritual leader of Tibet spoke from the chamber floor about honesty and transparency and told the senators and spectators about his deep respect for American values. “This house,” he said, “I think demonstrates the American democratic system.” Ya think?
Many people have been concerned about cholesterol levels in liver disease, especially in patients with primary biliary cirrhosis. People with primary biliary cirrhosis or simply, PBC, have elevated cholesterol levels in the blood. In the early stages of the disease, the good cholesterol or HDL is markedly elevated. As the disease progresses, the paradigm switches and LDL or the bad cholesterol becomes more dominant. The ramifications of an elevated serum cholesterol in PBC are not clear. In the absence of other risk factors, most studies show that elevated cholesterol in this condition is not associated with an increased risk of heart disease. This should be good news for the many people in our area with PBC.
The potential effects of common medications on liver function often lead to concerns about their use. Almost every medication in existence today can cause liver test abnormalities and most carry warnings to use with caution in people with underlying liver disease. We are all aware that too much acetaminophen can be toxic to the liver or that some cholesterol lowering agents can cause mild changes in liver enzymes. The real questions are: Are these changes important? How do they occur and are they preventable? The last question is the easiest to answer. Most of the minor changes in liver enzymes are not preventable. Many people take over-the-counter products called “liver detoxifiers or purifiers” in order to prevent liver injury. Although many people spend a lot of money on these natural products, the whole concept of a liver purifier is non-scientific and none of these products have been proven to be advantageous to the taker. They are, of course, advantageous to the seller. In fact, many of these products are associated with significant liver injury.
In the 2007-08 school year, Long Island schools took more than $11 million in state aid for pre-K and . . . sent it back unused. Over 4,000 allocated seats were left empty.
Unemployment is still rising. Businesses continue to fail. Municipal governments require assistance to avoid further slashing of vital social programs. Nassau County needs help from Albany to avoid layoffs and the closing of many of our offices, parks and facilities.
The international community recognized the importance of liver disease on May 19, World Hepatitis Day. One in 12 people worldwide have chronic hepatitis, including roughly 350 million with HCV and 170 million with HBV. Morbidity and mortality from these conditions are high with the world’s health authorities estimating that at least one million people die each year of hepatitis, especially in Asia, sub-Saharan Africa and Latin America where it is endemic.
More low income and middle-class families than ever are in need of low cost, high quality community-based mental health care. Yet, as I reported in my April 2009 column, the New York State Office of Mental Health (OMH) in conjunction with the New York State Department of Health is aggressively pursuing a “reform” plan (clinic reform) for these critical services that will result in a system of community care where only those children and families with Medicaid “fee for service” insurance coverage will be assured continued access to care. This will leave a significant number of children and adults living on Long Island in the lurch.
Beginning over a month ago the Nassau County Department of Health and Public Works began mosquito surveillance and control activities for the West Nile Virus. The departments work closely together to help control the spread of mosquito-borne disease. The summer of 2008 saw a sharp increase in the number of confirmed West Nile Virus cases in Nassau County compared to the last five years. While there is no way to predict what 2009 will bring it is best to assume a similar level of activity as 2008. With the steady and at times heavy rainfall we have experienced during the late spring and early summer mosquito populations are expected to increase. The best way for residents to prepare their families and properties to minimize exposure to the virus is by taking the following preventative steps:
This past week was the American Heart Association’s National CPR and AED Awareness Week. It is an occasion to remind us all how vital it is to be trained in CPR and in the use of an AED (automated external defibrillator). When someone falls victim to sudden cardiac arrest, every minute without bystander CPR decreases 7-10 percent. The interval between the 911 telephone call and the arrival of Emergency Medical Services personnel is usually longer than five minutes. Without CPR being initiated, and the use of the life-saving shock delivery of an AED, a victim simply will not survive.
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