Category Archives: Preventative Medicine

Rural adults are less likely than their urban peers to see a dentist for preventative treatments, according to the CDC.

Millions of rural residents have not seen a dentist in over a year, a recent CDC report reveals.

In 2019, before the coronavirus pandemic forced dentists to shut down, 42 percent of adults in rural areas did not receive dental care, according to the survey. In urban areas, roughly a third of adults did not see a dentist that year.

In both groups, people of color and low-income residents were less likely to have seen a dentist in 2019. These disparities were wider in rural areas, where issues such as transportation barriers, dentist and dental hygienist shortages and lack of health insurance are more common. The coronavirus pandemic has likely exacerbated the need, especially for low-income patients, the report says.

The things that really went by the wayside [with the pandemic] are the maintenance, the routine exams and the cleanings things that keep people healthy, said Katherine Jowers, who oversees oral health programs at the Asheville-based Mountain Area Health Education Center. Were still dealing with very old treatment plans for patients we havent seen in two years. Nothing was on fire so they didnt come, and now all of their plans are completely disrupted and we have to start from scratch.

Since cavities and other dental problems dont resolve on their own, what might have been small areas of decay that could have been addressed with a filling have likely advanced to more extensive decay that requires a root canal or even extraction.

Lower-income patients are already predisposed to forgoing preventative dental treatment because of cost, especially if they arent in pain, said Anahita Shaya, a dentist at the Brunswick County Health Department.

People are having to choose between the necessities of life, she added. If theyre having to pay for fillings and a cleaning out of their pocket and thats against having to pay their electric bill or mortgage or rent, [preventative dental care] is not always at the top of the list.

Oral health is an important part of overall wellness and if left untreated, tooth decay can lead to a whole host of other complications. Cavities have been linked to heart disease, pneumonia and sepsis, for example. Pregnant women with poor oral health have been found to have a higher risk of premature births and other complications.

Shaya sees some of these complications in her own practice, with patients turning to the emergency department for dental abscesses.

The same is true for communities nationwide. Dental abscesses accounted for 3.5 million visits between 2008 and 2014 and cost a collective $3.4 billion, research shows. Uninsured people and Medicaid beneficiaries accounted for the bulk of these emergency visits.

Though receiving antibiotics at the ER can cost $1,000 or more out of pocket, Blake Gutierrez, a dentist at MAHEC, said patients go there because they dont think there are other options. In most cases, however, emergency departments cant fully address a dental issue. At most, emergency providers can administer antibiotics and painkillers, but without dental treatment, the source of infection remains and can flare up again.

Even after an ER visit, patients may still be hesitant to seek dental care because of cost. Care Credit, a company that provides financing for dental and other health procedures, estimates that an extraction, the cheapest option for advanced tooth decay, can cost anywhere from $130 to $500, depending on the complexity of the extraction. Root canals, another common treatment, can cost $1,000 or more.

Rural North Carolinians have another significant challenge to deal with when seeking care: lack of dentists. Most dental providers congregate in urban areas, according to data from the Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill. Some rural counties, including Hyde, Tyrrell and Gates, did not have an active dentist in 2019, the data shows.

Greg Chadwick, dean of the East Carolina University School of Dental Medicine, keeps close tabs on that data. By his calculation, the state has roughly 5,600 active dentists, and most of them over 4,500 work in cities. The remaining 1,400 serve North Carolinas 80 or so rural counties.

A study published this year by the American Dental Association notes North Carolina has about 54 dentists per 100,000 residents, behind the national average of about 61 dentists per 100,000. Based on a 2015 analysis generated by the federal Health Resources and Services Administration, North Carolina is likely to remain a state with not enough dentists to meet the demand into the future.

That math alone makes it so patients in rural areas have to travel farther for care, he added, something that many residents struggle with. The only way to address these disparities is to make dental care more accessible, perhaps by coupling it with primary care as many community health centers do across the state.

These health centers arent always enough. MAHECs dental clinic, for instance, has a two-month wait for a cleaning and general exam. Another provider, CommWell Health a community health center with locations in Sampson and surrounding counties has seen a similar trend.

Time, said MAHECs Jowers, isnt on rural patients side, especially since the pandemic delayed care for so many of them.

Youre not addressing needs that were minor needs two years ago, she said. [Dentistry] is the type of health care where if you dont address the problem, it doesnt get better by itself.

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Even before coronavirus, almost half of adults in rural areas went without dental care - North Carolina Health News

Critics say universal healthcare limit American freedom, but it can provide citizens with a more affordable, healthier and happier healthcare system.

Jeremy C. Kourvelas| Guest Columnist

Tennessee Voices: A conversation with Amanda Bracht

Amanda Bracht, senior VP for clinical services of Mental Health Cooperative of Middle Tennessee, spoke with Tennessean opinion editor David Plazas.

Nashville Tennessean

It is no secret that the costs of healthcarein this country have long been spiraling out of control. Two-thirds of all bankruptcies in the United States are due to medical debt whereas medical bankruptcy is virtually non-existent in the rest of the industrialized world.

Americans spend over twice as much for healthcare. Premiums continue to rise with no tangible return on investment.Often critics of socialized medicine laud our quality of care as a reason to support our fractured system,but what good is this argument?

Universal healthcare would free small business owners from having to provide coverage while simultaneously enhancing the freedom of the worker. Lifespans could be longer,people could be happier and healthier in systems that are simpler and more affordable.

Losing your job is a direct threat to your health-- the added stress alone can be caustic.Mental health coverage could bedramatically improved under universal coverage.It'sno surprise that every country with some form of universal healthcare is statistically happier than the United States.

Health insurance was originally created to save patients from the economic impact of illness.Access to primary, preventative care would improve under universal healthcare.Catching diseases before they become emergencies not only leads to better healthcare outcomes, but its also cheaper.

Unfortunately we havea for-profit system and economic burden is the rule, not the exception.The foremost criticism of universal healthcare is long waits, but this tragically ignores the fact that the U.S. already has unacceptably long wait times, especially for specialists.

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People avoid treatment for fear of cost, ultimately depending upon the ER for treatment that could have been handled far more efficiently and inexpensively. Other countries, likeSwitzerland and the U.K., with universal health carebeat us in terms of wait times.

Medicare and Medicaid were created to cover seniors and low income populations, as they are most at risk of being uninsured. However, because their collective risk for illness is also higher, they have to be subsidized, in this case by tax dollars.Unfortunately, Medicaid varies dramatically by state and Medicare is running out of money.

Younger people are far less likely to use the healthcare coverage they pay for by the simple fact of being healthier.Currently, the majority buy insurance from for-profit companies that keep a large chunk of that cash.

In other words, money paid by patients for healthcare services is kept as private gains by denying coverage.If the healthier individuals were included in the same risk pools as those of higher risk, the surplus could instead subsidize, significantly bringing costs down in onestreamlined system.There is plenty of money to spare, as health insurance CEOs make tens of millions of dollars every year.

Those who argue against universal healthcare often claim that it limits the freedom to choose ones doctor, hospital or treatment. The freedom to choose the doctors thatwe want is already limited by forcing us into networks.

In our current system, losing your job means you can lose your doctor.With universal coverage, you could lose your job and still be able to keep your doctor without a single interruption. Universal healthcare is a fiscally responsible system that facilitates more freedom,more health service and better outcomes.

Jeremy C. Kourvelas is the Vice President of the Public Health Graduate Student Association and a Master's candidate at the University of Tennessee, Knoxville.

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Universal healthcare provides Americans the security need in uncertain times | Opinion - Tennessean

Sometime in 2019, I was multi-tasking and racing between exam rooms amid a controlled chaos that defines an average day in my busy clinic. I was behind as usual, and I could sense the frustration in the air from my patients who had been waiting for a while. I knocked and entered a room to meet a patient for follow up on his MRI study.

The encounter was brief, as the patient was notably irritable from having to wait. At the end of the appointment, the patient's final comment stuck with me for weeks to come: "How come you can't call me with this result?"

Initially, I was insulted, to be honest. I thought to myself, I could literally call all my patients for follow ups, but then I wouldn't really need to work in a clinic and what type of practice would that be?

Fast forward a year. The world has turned upside down and, ironically, I am one of the providers who utilizes telehealth the most in my large organization. I estimate about 90% of my visits were telehealth visits during the first four months of the pandemic.

Several studies have found over the years that patients are willing to engage with physicians via technology, and many patients have reported high satisfaction with their telehealth experience.

For years, however, thanks largely to reimbursement and regulatory challenges, and sometimes limited technology access, telehealth didn't quite catch on as much as many hoped.

But since the start of the COVID-19 public health emergency, our organization has expanded its telehealth capabilities. In addition, our state workers compensation system has rolled out several temporary telehealth policies to allow injured workers to receive virtual medical treatment during this pandemic.

A brief background about myself and my practice: I am an occupational medicine physician working under a not-for-profit health care system. My clinic is situated in a suburb surrounded by many industries and in a densely populated community. My visit type is 95% work injury-related with the rest employment-related exams. My patient population is the working class, ages 14 and older.

My organization's leaders assumed at first that face-to-face interaction was the preferred healthcare experience, and that telehealth visits dehumanized the medical encounter.

To test this assumption, I surveyed my patients.

Our telehealth visits are all pre-scheduled utilizing a web-based application. We use a HIPAA-compliant software that allows for two-way, high definition video and audio. We can also effortlessly share media online. There were no exclusions in this survey. I included patients who did not have a smart device or lived in a poorly networked area.

Over the course of three weeks, from the end of August through early September 2020, I collected a total of 115 surveys. About two-thirds of the patients I surveyed were follow-up patients. All new injury visits were done in-person. Each result was from a unique individual.

The survey consisted of one question: Considering the current COVID-19 pandemic, would you prefer a virtual visit (video or phone) or an in-person/in-clinic visit?

The survey question was given to the patient either on paper or read word-for-word in the case of virtual visits. The patient could only select one preference. Much to my surprise, 60% of in-person patients preferred a virtual encounter and 86% of virtual patients wanted their future visits to remain virtual.

Here are some comments from my patients:

"I like the first visit to be in-person but follow up visits can be virtual."

"Virtual is good, but when I had that spasm last time, I actually preferred an in-person, so you can feel it."

"Virtual visits are nice considering the pandemic, but I'd like to be looked at and examined every now and then."

"I'm an essential worker, so virtual visits are convenient for me."

"I don't see anything you cannot do virtually that you have to do in-person."

"I kinda like this, this is the collateral beauty of the pandemic."

According to a similar survey in 2013, where healthcare consumers (1,547) were pooled from around the world, 74% of them were comfortable with virtual doctor visits. Here I highlight an example where modern patients, with modern technology, prefer a new way of medical experience virtually.

I learned several lessons through this experience.

First, have robust and easy-to-use telehealth software and affirm that it is HIPAA-compliant. Next, targeting your patient population is critical. Younger generations (Gen X, Y and Z) are much more comfortable with adopting technology. Also, be flexible and have a threshold to convert the virtual visit to in-person when situations arise.

In addition, avoid telehealth visits during the acute infection and trauma phase. Advertise and offer telehealth visits to patients who live far and/or have limited transportation. Consider grouping the telehealth visits separate from the in-person visits for better workflow.

Finally, make plans to have in-person visits intermittently for the virtual patients, and remember, follow-ups and patients with chronic conditions are the best candidates for telehealth visits.

Today, 76% of hospitals use telehealth technology.5 Telehealth services save time and money for all parties involved. Its advantages and benefits are immeasurable. Timeliness of care is critical to better quality of care.

Through telehealth, one can access the healthcare system easily and more quickly than ever before simply at the touch of a button. Loss of productivity is hugely minimized since the patients do not have to take a half-day or a whole day off work just to attend a doctor's appointment.

According to one survey, nine in 10 Americans stated that they would cancel or reschedule a preventative care appointment due to workplace pressures.6 Less transit to and from the doctor's clinic reduces traffic congestion, traffic accidents and air pollution.

Over the years, a few of my patients have informed me that they were involved in motor vehicle accidents either coming to or leaving my clinic. I, too, find myself rushing to make it to my own medical appointments during or after work. The anxiety and stress related to being on time have caused a few near accidents of my own.

Telehealth helps reduce unnecessary visits to urgent care or the emergency room before a worker goes to see a doctor, he/she can first consult with a healthcare provider via telehealth to determine whether such a visit is necessary or indicated.

A research study showed that telehealth visits for the most common health conditions save employers an average of $472 per visit. Telehealth allows a team-based approach and collaboration where other support members can join in on the virtual visit, e.g. dietician in a weight loss visit, prosthetist and/or orthotist in an amputee visit, vocational counselor in an occupational medicine appointment.

Telehealth is here to stay, and it will be a large platform in the future of medical delivery. We must learn to adopt and use it to our advantage instead of as a perceived hindrance.

Future challenges and opportunities include insurance recognition for proper reimbursement, establishing best practices, training and certification on utilizing the platform, tightening cyber security, and, finally, expanding into every aspect of medicine (e.g. ancillary telemedicine services like telepathology and telepharmacology).

To the patient I met last year, who wanted his MRI results given virtually, I want to say, thank you!

Dr. Archie Adams is a board-certified occupational medicine provider. He currently sees patients at MultiCare Centers of Occupational Medicine in Puyallup, Washington.

More here:
One physician's perspective on why patients prefer telehealth visits - Healthcare IT News

LOS ANGELES, Calif. (NewsNation Now) Some businesses across the country are still doing temperature checks to spot potential coronavirus cases, but according to some medical experts, its a waste of time and effort.

With the easing of restrictions, L.A. Boutique owner Anna Tabakman also eased up on taking temperatures.

Obviously if someone had a high temperature I wouldnt let them in, but that never actually happened, said Tabakman.

Im not against it, but I dont think it really helps that much, said one person.

For over a year they became part of the daily routine.

The temperature check and the symptom screening really have no value, and theyre really worthless, said Dr. Jeffrey Klausner, a University of Southern California preventative medicine specialist.

Klausner is among those health experts urging the Centers for Disease Control and Prevention to update its guidance for medical offices and businesses.

Theres no benefit to continuing the temperature or symptom screening. In fact, the CDC itself stopped temperature screening its own employees many, many months ago, said Klausner.

The CDC recommends the screening of employees as an optional strategy and admits it is not completely effective.

The agencys own study of more than 760,000 travelers last year found only one case of COVID-19 for every 85,000 screened.

With coronavirus cases way down and many people now vaccinated, fewer businesses are doing temperature checks.

Some business owners say theyve provided some peace of mind during the pandemic.

So the more you have sanitizer here and everyones in masks then theyre not scared to come in, especially if youre checking temperature, checking everyones temperature, so were fine, said Tabakman.

Doctors say there is no real harm in doing the screenings still. They emphasized that the safety measures like temperature checks were in response to a brand new disease.

According to Dr. Klausner, hindsight will reveal other response missteps. As an example, he cited the fact that some COVID-19 patients never developed a fever so the temperature checks would miss cases.

Theres a lot of measures that were put in place over the past year. Its gonna take some time to roll things back. I would prioritize the rollback of this measure because it really doesnt have much value at all, said Klausner.

While temperature screenings could go, experts say social distancing and masking remain effective prevention tools in many settings, especially for the unvaccinated.

California is one state thatll continue requiring masks for employees, including those that are vaccinated.

The CDC also still encourages mask wearing in areas with large crowds like concerts and airports.

Read more:
Debate over continued temperature checks at businesses - NewsNation Now

ST. LOUIS, Mo. Summer has only just unofficially begun, but tick season is already well underway. While you can find ticks year-round, the summer push to get outside means this is when we see the bloodsuckers more often. That can be worrisome because ticks can carry serious diseases.

Lyme disease, Rocky Mountain Spotted Fever, there is tularemia, said Dr. Deanna Bajala, a Family Medicine physician with SSM Health Medical Group.

Lone star ticks, American dog ticks, and deer ticks are common in both Missouri and Illinois. If you plan to spend a lot of time outdoors, be ready.

Make sure you are wearing long sleeves, long pant legs, and long socks. Youll actually tuck the pant legs into the socks, Bajala said. Make sure you are wearing your hair up if you have long hair. And use an EPA registered insect repellent.

When you come inside, get do a thorough tick check. If you find one, remove it.

Get some sort of tweezers, she said. You want to grab as close to the head as possible, try not to squeeze, and just pull it directly out.

Watch for any side effects. Thats when youll need to see a doctor.

Theyll come in with some sort of rash. They might come in with fever or chills or headaches, she said.

But what about your pet? The Humane Society of Missouri often sees dogs and cats covered in these blood suckers and anemia and tick-borne illness is a big concern.

Rocky Mountain spotted fever and Ehrlichiosis are much more prevalent in Missouri and they can really affect pets. Theres an emerging tick-borne disease in cats call bobcat fever, said Dr. Travis Arndt, medical director of the Animal Medical Center of Mid-America.

Dogs and cats have a lot of fur but you should give them a thorough check after a prolonged period of time outside.

Ticks really like to attach inside the pets ear. So really try to look in there. There isnt as much hair in there. Also, look on the inside of their rear legs, Dr. Arndt said.

The best thing to do to help your best friend is to make sure they are on a tick preventative medicine.

Theres an external preventative. Its a topical you apply on their coat, on their neck and between their shoulder blades. Or theres the oral products which can last anywhere from one to three months.

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Summer is here and so are ticks! - KTVI Fox 2 St. Louis

It's one of the most important elements of a healthy lifestyle. There's no sweat or pain, no major time commitment, and no memberships or high-priced equipment to buy. Still, men are incredibly apprehensive and do everything they can to avoid it, despite the added risk men carry due to the unhealthy choices they make.

What could be so treacherous to prompt the manliest of men to do almost anything to avoid it? How about the annual physical?

While it represents the foundation for healthy behavior, the routine doctor's visit is not so routine for many men. The "why" behind this behavior is well documented, though not well reasoned. The answer, like so many of the behavior-based challenges in medicine, seems to lie somewhere between the stereotypical views of manhood and a change in cultural norms.

Yes, while some men may perceive themselves as the less-emotional, more rational gender, when it comes to the simple act of making a doctor's appointment, a man's behavior is quite the contrary.

In a survey conducted by the Cleveland Clinic,only 50% of men said they consider getting their annual check-up a regular part of taking care of themselves. Worse, even among the men who take their health more seriously, researchers foundthat 20% admitted they have not been completely honest with their doctors.

The American Academy of Family Physicians found that 55% of men surveyed had not seen their doctors for a physical exam in the previous year, even though 40% of them had at least one chronic condition. Nearly one-fifth of men ages 55 and over said they had never undergone screening for colon cancer, and almost 30% said they "wait as long as possible" to seek medical attention when they are feeling sick or in pain.

An online survey issued by the Orlando Health hospital system found there are several reasons whymen may be reluctant to visit the doctor for an annual exam. They included: too busy to go (22%), afraid to find out what may be wrong (21%), getting prostate, rectal or other uncomfortable exams (18%), answering personal questions (8%), getting on the scale (7%), not wanting to be naked under a gown (7%), the exam rooms are cold (4%), and something else (9%).

Really? Clearly, while men may profess to be concerned about their health, if not for themselves but for the others in their lives, the evidence proves otherwise and the rational is lame.

According to Duke University Health System,annual physicals create a health baseline and strengthens the patient-physician relationship, which is important to maximize wellness. They suggest that a face-to-face wellness visit helps you connect with your doctor, establish trust and share your health care preferences before serious illness hits. It's also an opportunity to discuss important health issues like disease screening and lifestyle changes tailored to you. The best way for you to receive comprehensive, personal care is for your doctor to know you at all levels of health.

Mount Sinai Medical Centersays that when you have regular medical checkups, there's a much greater chance of discovering any health issues than if you were to rely on discovering them at home. Doctors are trained to observe symptoms, and to know what causes those symptoms, so early detection gives you a much better chance of overcoming a health problem or disease, because it's caught in its early stages. Early detection also leads to far less expensive medical treatment. Whether you're paying for health costs out of pocket, or you have a good insurance package, the cost of prevention and early detection is far less than the cost of treating a disease or any kind of significant health issue.

Research from Frontiers in Psychologyacknowledges that motivating people disinclined to engage in health behavior presents a significant challenge. They argue that effective strategies to promote behavior change among so-called"amotivated individuals" are relatively scarce.

However, the researchers contend that there are viable approaches. For example, by focusing on your values the things that are most important to you, what you want most in life, and reconciling how your behavior fits in with your goals and values you can help spur the motivation to change your behavior. Examining the discrepancies between your ideal life conditions and actual conditions may induce a desire to recalibrate daily behaviors to be more congruent with deeply-held, amotivated beliefs.

Other research has focused on behavioral economics, the use of financial incentives to spur healthy behavior. We're seeing this today with COVID-19 vaccines, but such strategies have been in use for several years.

Many health insurers have started member incentive programs that provide cash payments or other forms of value tied to physician visits or other healthy behaviors such as health club memberships. For the insurer, these payments are investments that reduce the risk to them of covering more serious and expensive health outcomes. It is also a bet that the member may ultimately continue these behaviors in the absence of the incentive.

Critics of behavioral economics argue that the key to sustaining behavior change is the internalization of the behaviors, and finding value beyond the monetary incentive, which they believe is restricted short-term change.

In my book, I've discussed the neanderthal culture that still persists among men. To this day, it is frequently cited when men are asked about their aversion to an annual physical. Men continue to believe that they are not supposed to be vulnerable to illness, and that visiting a physician is a sign of weakness.

Guys, its 2021. Come out of the cave. Put down your club, and get to the doctor. Be part of a cultural shift where men give their bodies the preventative care and attention they give to their cars. It's a rational choice and a routine worth starting.

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Men, it's time to make the routine doctor's visit a habit - PhillyVoice.com

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In this Sept. 2, 2020, file photo, a student receives a temperature check before leaving the car to enter STAR Eco Station Tutoring & Enrichment Center in Culver City, California.

When you enter doctor's offices, hospitals, gyms, and many other businesses in southern California, you will still get your temperature taken before being allowed inside -- a method used for over a year to screen people for COVID-19.

But now the CDC, and some medical experts, say temperature screenings are useless and even misleading.

"Temperature screening will miss many many people with infections," said Dr. Jeff Klausner, a preventative medicine specialist at USC's Keck School of Medicine.

When the pandemic began, many businesses and medical offices required temperature screenings before letting people indoors, and if you had a temperature over 100.4 degrees, you would be turned away.

But over the course of 2020, the CDC examined cases of 766,044 travelers entering the U.S. who were screened for temperatures and other symptoms. The report says only 1 case of COVID was found for every 85,000 travelers screened.

The CDC has now concluded "Symptom-based screening programs are ineffective."

"I think temperature screenings are problematic because many times people can have Covid without a fever," said USC's Dr. Klausner.

The NBC4 I-Team has found another problem with temperature screenings, specifically with the accuracy of no-touch thermometers used by most businesses.

Last summer, the I-Team's Joel Grover tried out five popular no-touch thermometers sold online, with the help of registered nurse Alice Benjamin, a professor at the Charles R. Drew University of Medicine and Science.

Nurse Benjamin first took Grover's temperature with a standard oral thermometer, which gave a reading of 98.5within the range considered normal.

But two of the five no-touch thermometers gave a reading of about three degrees less; that's well out of the normal range.

"As a healthcare professional, that concerns me," said Benjamin.

Other medical experts also told the I-Team they also have concerns about no-touch thermometers.

"I think these devices, in general are less reliable and less accurate," said Dr. James Lawler of the Global Center for Health Security, at the University of Nebraska.

Even though the CDC now says temperature checks are ineffective, LA County's Department of Public Health is still recommending that businesses do them.

That could change June 15, when the state of California goes to a full reopening and further updates protocols for preventing COVID-19.

"I think people got in the habit of doing temperature checks," said Dr. Klausner. He added, "Its tough to break a bad habit."

Read more from the original source:
Temperature Checks Now Thought to Be 'Useless' to Screen for COVID-19 - Reverb MSN Music

BRYAN-COLLEGE STATION Diarrhea is a natural part of life all pets (and pet owners) have had it at some point.

While diarrhea can be smelly, messy, and potentially embarrassing, Dr. Michael Hung, a small animal internal medicine resident at the Texas A&M University College of Veterinary Medicine & Biomedical Sciences, explains what causes it and when a pet owner should be worried.

Diarrhea is defined as loose, watery, and more frequent bowel movements, and simply indicates that something is irritating the GI tract, according to Hung.

It occurs when something either impairs the intestines ability to absorb water or causes the intestine to secrete more water, he said. This can be from a problem originating within the intestines such as parasites, inflammatory bowel disease, a sudden change in diet, or even stress.

When diarrhea is caused by something obvious such as a pet getting into the garbage or eating too many table scraps, intestinal worms, or stress from a recent move and the episode passes quickly, it can be considered normal and self-resolving.

However, diarrhea can also reflect a more serious issue elsewhere in the body, Hung warns.

More sinister causes may include infectious diseases, the ingestion of poisonous substances, and a variety of illnesses, such as kidney disease or even cancer.

While there are serious causes for diarrhea, the majority of diarrhea cases are uncomplicated and do not require hospitalization, Hung said.

If a pet has a sudden bout of diarrhea, there are some at-home measures that pet owners can take to help their loved ones.

Hung says that pet owners can make sure that plenty of water is available to their pets, although they should never force feed the water.

A bland and low-fat diet can also be offered for a short period of time. Examples include shredded, non-seasoned, fully cooked chicken breast or cottage cheese mixed with cooked, plain white rice. Since this diet is not balanced, however, it should not be offered for more than a couple of days.

Pet owners also can try to prevent diarrhea by making sure their pets are on appropriate, thoroughly cooked, and balanced diets.

Treats (including human food) should be kept to a minimum, Hung said. Any changes to diet should occur gradually over a couple of days. Pets should also be kept on a consistent parasite preventative regimen and vaccine schedule.

Occasional diarrhea is unavoidable, and a pet may be able to overcome minor bouts on their own or with the help of their owners.

Ultimately, the cure for diarrhea depends on its cause, Hung said, adding that some pets may need to see a veterinarian for medical help.

Any diarrhea that is profuse and watery, mostly bloody, or that lasts longer than seven to 14 days should be addressed by a veterinarian, Hung advises. Because diarrhea can be a warning sign of a systemic disease, if not addressed in a timely manner, these systemic diseases can progress and become harder to treat.

Ongoing diarrhea can result in weight loss, nutrient deficiencies, and dehydration. Signs of dehydration, including lethargy, inappetence, unwillingness to drink, also indicate the need for veterinary attention.

That said, if your pet has diarrhea but is eating and drinking and seems like themselves don't panic. Although a pet with diarrhea in the house can certainly be stressful, it is not necessarily an emergency, he said. You can schedule an appointment with your family veterinarian, and they can help you decide what is needed for your pet.

Pet Talk is a service of the College of Veterinary Medicine & Biomedical Sciences, Texas A&M University. Stories can be found on the Pet Talk website . Suggestions for future topics may be directed to editor@cvm.tamu.edu .

Continued here:
PET TALK: Pet diarrhea: When to go to the vet - Houston Chronicle

During May, Integrated Diagnostics Holdings (IDH) the Company, IDHC on the London Stock Exchange a leading consumer healthcare company with operations in Egypt, Jordan, Sudan, and Nigeria, announced that it had listed 30 million shares on the EGX to be the first listed company to do a dual listing of ordinary shares on the EGXs main market.

The action came few days after the call by the Egyptian Immigration Minister that urged the Egyptian expats to trade on the listed companies on the EGX and to tap the securities investment ground as a bid to spur investment climate in Egypt.

The listing was the first for the company in the EGX.

In an exclusive interview, Ahram Online discussed with IDHs CEO Hend El-Sherbini what the action means for the company and for Egypt's market.

She also covered the companys future plans in Egypt.

El-Sherbini unveiled that IDH eyes value accretive acquisitions in African and Middle Eastern markets where its business model is well suited to capitalise on similar healthcare and consumer trends as well as capture significant shares of fragmented markets.

Ahram Online: How does IDH see the Egyptian market among others in the region?

Hend El-Sherbiny: There are compelling structural growth drivers in the Egyptian market that we have seen. These include a large, rapidly growing population and growing health consciousness among the patient populations we serve. The medical sector in Egypt is very fragmented. Patients and customers drive the market in terms of quality and choose their service provider based on where they receive the best care.

Our presence in Egypt has allowed us to raise the bar in terms of quality. Our competitive edge stems from our unwavering commitment to quality and the provision of best-in-class diagnostic services. We have obtained the College of American Pathologists (CAP) accreditation in 2010 and are currently the sole operator of a CAP-accredited facility in Egypt.

In terms of behaviour and mindset, Egypt has invested in creating a culture shift towards preventative medicine. Raising awareness is a critical part of that and IDH is playing its part. Presidential initiatives, such as the '100 Million Healthy Lives' campaign, have also encouraged more testing, particularly for Hepatitis C and diabetes. The IDH has carried out over four million tests. This was done across the country through our network of over 430 branches in Egypt, where we operate under the brands: Al-Borg Laboratories and Al-Mokhtabar along with Al-Borg Scan.

In addition to services, I believe Egypt is rich in qualified human resources. Our management team combines several decades of healthcare experience and our board of directors is composed of healthcare and finance experts with knowledge around the region.

AO: Was the companys performance and revenues affected by the COVID-19 crisis, especially in Egypt?

HS: 2020/21 has been an eventful year for IDH. Despite the exceptional difficulties it faced at the start of the pandemic in 2020 with the country being in lockdown and several branches operating under shorter hours, IDH leveraged its flexible business model and adaptive service offering to deliver strong growth and robust profitability. We have achieved excellent results and shown a strong performance during FY2020; with recorded revenues of about EGP 2.7 billion - equivalent to an increase of about 19 percent compared to FY2019. We have also recorded profits of EGP 609 million - equivalent to an increase of 21 percent, while the net profit margin reached 23 percent.

IDH has also served over 7.1 million patients in 2020 and performed more than 27.1 million tests across our regional network of over 480 branches in Egypt, Nigeria, Sudan and Jordan. In Egypt we have expanded our network, adding up to 35 new branches during the year.

AO: How do you assess the actions and policies Egypt has been adopting to protect its economy and navigate the crisis?

HS: The Egyptian governments goal to address the current crisis and place Egypt on a strong footing for economic recovery is clear. Since the beginning of the COVID-19 outbreak globally, many decisions have been taken to protect Egyptian citizens and to achieve the highest safety levels for them in a way that does not conflict with providing all the necessities of their daily life and firmly dealing with this crisis to reduce the spread of the virus.The performance of the Egyptian economy considering the coronavirus pandemic exceeded expectations, according to the testimony of international institutions and credit rating institutions, including the International Monetary Fund; the World Bank; Golden Man Sachs; Standard & Poor's; Moody's, and Fitch

AO: From your perspective, what sort of procedures does Egypt need to take to catalyse the private sector and to unleash its role in the countrys development and economy?

HS: Egypts government and leaderships vision along with its directives have dictated synergy between the public, private and civil society sectors and that is evident in the number of projects and developments that are in terms of infrastructure, healthcare and manufacturing in recent years.

Egypt's economic reform plan within the framework of Egypts Vision 2030 has also proven successful, with the first phase demonstrating economic resilience. The second phase is expected to help Egypt recover from the repercussions of the pandemic, through private sector-led development efforts.

AO: How do you see the recent initiative on the EGX launched by the Minister of Immigration along with EGX in boosting Egypts stock market during the present?

HS: The recent initiative, launched by the EGX in cooperation with the Ministry of Immigration and Egyptian Expatriates Affairs, will see great benefits for us and other local brand names in boosting performance. This initiative helps spread the culture of saving and investment through the Egyptian capital market, while raising awareness for the fundamentals of investing, therefore encouraging Egyptians abroad to benefit from the Egyptian economic development, and helps them invest in their home country.

With this initiative, the Egyptian Stock Market adds another layer of attractiveness to international and local business, considering listing as it brings access to a different investor base across different markets.

AO: How is the new finance secured through the IFC expected to boost healthcare services in Egypt, particularly via IDH?

HS: IDH holds the largest market share in Egypt in terms of private sector diagnostics and we place customer healthcare at the top of our priorities. Our competitive advantage comes from our strict commitment to quality and the provision of the best medical diagnostic as well as analysis services in all its forms.

The IFC has stringent policies when providing finance and IDHs strong strategy for growth and solid financial position, gave us an advantage in securing the financing. Through this new debt financing agreement, we are once again reinforcing our commitment to the healthcare sector across emerging markets, delivering on our shared strategy and aligned ESG goals to provide communities with the tools they need to better their lives.

Our multi-pronged approach to sustainable growth revolves around the strategic expansion of our branch network to improve accessibility and reach new segments of the population, where we, on average, add 30 to 35 new branches yearly.

The $45 million debt financing package will allow IDH to expand healthcare accessibility by growing its regional footprint through potential acquisitions, as well as expanding our current medical service offering, geographical reach and digital offering. All to ensure that we provide access to as many patients as possible.

Additionally, this new agreement further strengthens our existing long-term strategic cooperation that began with our co-investment in Nigeria, where we have jointly deployed millions of dollars to bring best-in-class medical diagnostic practices and technology to Africas most populous country.

AO: What are IDHs future plans for the Egyptian market?

HS: Currently, at the top of our priorities is implementing our four-pronged growth strategy that focuses on expanding customer reach beyond opening laboratories in new geographies, in addition to reaching out to new customers with focused tactical marketing activities as well as new customer services.

In addition to organic expansion, we continue to seek value accretive acquisitions in African and Middle Eastern markets where the business model is well suited to capitalise on similar healthcare and consumer trends and capture a significant share of fragmented markets. While opening more branches will add both patients and tests, our strategy also looks at increasing tests per patients. This means that we will further diversify the test portfolio in combination with compelling offerings of promotionally-priced test packages which will drive the key financial metric of number of tests per patient.

The Group also looks to add diagnostic and medical services not currently provided on a large scale, believing its scale and experience position it well to take advantage of developing services opportunities that would raise the IDH profile to that of a one-stop-shop provider.

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INTERVIEW: Egypt's call on expats to tap the EGX opportunities will see great benefits to domestic market: IDH's CEO - Economy - Business - Ahram...

NEW HAVEN, Conn., June 3, 2021 /PRNewswire/ --Biohaven Pharmaceutical Holding Company Ltd. (NYSE: BHVN), today announced that 19 abstracts, including one late-breaking presentation and two oral presentations, will be presented at the virtual 63rd Annual Scientific Meeting of the American Headache Society (AHS) being held June 3-6. The presentations will be available to view on the AHS website from June 3, 2021 for one year.

Biohaven will be presenting new and encore data presentations for Nurtec ODT (rimegepant), the first and only calcitonin gene-related peptide (CGRP) receptor antagonist in an orally disintegrating tablet (ODT) approved by the FDA for the acute and preventive treatment of migraine in adults. Nurtec ODT received FDA approval for the preventive treatment of episodic migraine in adults on May 27. Efficacy and safety results from the pivotal Phase 2/3 clinical trial of rimegepant for the preventive treatment for migraine will be presented including data showing a rapid reduction in migraine days. Additionally, posters feature data from the Phase 3 trials and the long-term safety study of rimegepant as an acute treatment for migraine, including in people who have a history of treatment failure with triptans. Health economics and outcomes research analyses shed light on the impact of redosing on cost utility outcomes and demonstrate that the use of rimegepant taken as an acute treatment on an as needed basis over one year was associated with a reduction in monthly migraine days and tablet utilization as well as improved quality of life outcomes. An oral presentation for the Phase 2/3 dose-ranging study of intranasal zavegepant, the only intranasal CGRP receptor antagonist currently in late-stage clinical trials for the acute treatment of migraine, will also be presented.

Elyse Stock, MD, Chief Medical Officer of Biohaven commented, "We continue to build on our deep body of research that demonstrates Nurtec ODT's clinical efficacy and safety for the acute and preventive treatment of migraine. We are energized by the recent FDA approval for Nurtec ODT as a preventive treatment for episodic migraine and are excited to bring forward this oral dual therapy indication to physicians and patients alike. The clinical and health economics data presented at AHS emphasize this paradigm changing treatment approach as the first and only medication that can treat and prevent migraine attacks."

Notable highlights include:

The complete list of accepted abstract titles is below and full presentations will be available on the 2021 AHS virtual annual meeting website beginning June 3, 2021.

Oral Presentations:

Late-Breaking Poster Presentation:

Poster Presentations:

About NURTEC ODTNURTEC ODT (rimegepant) is the first and only calcitonin gene-related peptide (CGRP) receptor antagonist available in a quick-dissolve ODT formulation that is approved by the U.S. Food and Drug Administration (FDA) for the acute treatment of migraine with or without aura and the preventive treatment of episodic migraine in adults. The activity of the neuropeptide CGRP is thought to play a causal role in migraine pathophysiology. NURTEC ODT is a CGRP receptor antagonist that works by reversibly blocking CGRP receptors, thereby inhibiting the biologic activity of the CGRP neuropeptide. The recommended dose of NURTEC ODT is 75 mg, taken as needed, up to once daily to treat or every other day to help prevent migraine attacks. For more information about NURTEC ODT, visit http://www.nurtec.com. The most common adverse reaction was nausea and abdominal pain/indigestion. Avoid concomitant administration of NURTEC ODT with strong inhibitors of CYP3A4, strong or moderate inducers of CYP3A or inhibitors of P-gp or BCRP. Avoid another dose of NURTEC ODT within 48 hours when it is administered with moderate inhibitors of CYP3A4.

IndicationNURTEC ODT orally disintegrating tablets is a prescription medicine that is used to treat migraine in adults. It is for the acute treatment of migraine attacks with or without aura and the preventive treatment of episodic migraine. It is not known if NURTEC ODT is safe and effective in children.

Important Safety InformationDo not take NURTEC ODT if youare allergic to NURTEC ODT (rimegepant) or any of its ingredients.

Before you take NURTEC ODT, tell your healthcare provider (HCP) about all your medical conditions, including if you:

Tell your HCP about all the medicines you take,including prescription and over-the-counter medicines, vitamins, and herbal supplements.

NURTEC ODT may cause serious side effects including allergic reactions, including trouble breathing and rash. This can happen days after you take NURTEC ODT. Call your HCP or get emergency help right away if you have swelling of the face, mouth, tongue, or throat or trouble breathing. This occurred in less than 1% of patients treated with NURTEC ODT.

The most common side effects of NURTEC ODT were nausea (2.7%) and stomach pain/indigestion (2.4%). These are not the only possible side effects of NURTEC ODT. Tell your HCP if you have any side effects.

You are encouraged to report side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatchor call1800FDA1088or report side effects to Biohaven at18334NURTEC.

Please click here for fullPrescribing InformationandPatient Information.

About ZavegepantZavegepant is a third generation, high affinity, selective and structurally unique, small molecule CGRP receptor antagonist from Biohaven's NOJECTION Migraine Platform and the only CGRP receptor antagonist in clinical development with both intranasal and oral formulations. The efficacy and safety profile of intranasal zavegepant for the acute treatment of migraine, as compared to placebo, was shown in a randomized controlled Phase 2/3 dose-ranging trial with a total of over 1000 patients who received zavegepant. In this study, zavegepant showed statistical superiority to placebo on the coprimary endpoints of 2 hour freedom from pain and freedom from a patients' most bothersome symptom (either nausea, photophobia or phonophobia). Following successful end of Phase 2 interactions with FDA (clinical and nonclinical), zavegepant is advancing to Phase 3 for the acute treatment of migraine in adults. For more information, visithttps://www.biohavenpharma.com/science-pipeline/cgrp/bhv-3500.

About BiohavenBiohaven is a commercial-stage biopharmaceutical company with a portfolio of innovative, best-in-class therapies to improve the lives of patients with debilitating neurological and neuropsychiatric diseases, including rare disorders. Biohaven's neuroinnovation portfolio includes FDA-approved NURTEC ODT (rimegepant) for the acute treatment of migraine and a broad pipeline of late-stage product candidates across three distinct mechanistic platforms: CGRP receptor antagonism for the acute and preventive treatment of migraine; glutamate modulation for obsessive-compulsive disorder, Alzheimer's disease, and spinocerebellar ataxia; and MPO inhibition for multiple system atrophy and amyotrophic lateral sclerosis. More information about Biohaven is available atwww.biohavenpharma.com.

Forward-looking StatementThis news release includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. The use of certain words, including "believe", "may" and "will" and similar expressions, are intended to identify forward-looking statements. These forward-looking statements involve substantial risks and uncertainties, including statements that are based on the current expectations and assumptions of Biohaven's management about NURTEC ODT as an acute or preventative treatment for patients with migraine. Forward-looking statements include those related to: Biohaven's ability to effectively commercialize NURTEC ODT, delays or problems in the supply or manufacture of NURTEC ODT, complying with applicableU.S.regulatory requirements, the expected timing, commencement and outcomes of Biohaven's planned and ongoing clinical trials, the timing of planned interactions and filings with the FDA, the timing and outcome of expected regulatory filings, the potential commercialization of Biohaven's product candidates, the potential for Biohaven's product candidates to be first in class or best in class therapies and the effectiveness and safety of Biohaven's product candidates. Various important factors could cause actual results or events to differ materially from those that may be expressed or implied by our forward-looking statements. Additional important factors to be considered in connection with forward-looking statements are described in the "Risk Factors" section of the Company's Annual Report on Form 10-K filed with the Securities and Exchange Commission on March 1, 2021. The forward-looking statements are made as of this date and Biohaven does not undertake any obligation to update any forward-looking statements, whether as a result of new information, future events or otherwise, except as required by law.

NURTEC and NURTEC ODT are registered trademarks of Biohaven Pharmaceutical Ireland DAC.

Neuroinnovation and NOJECTION are trademarks of Biohaven Pharmaceutical Holding Company Ltd.

Biohaven ContactDr. Vlad CoricChief Executive Officer[emailprotected]

Media ContactMike BeyerSam Brown Inc.[emailprotected] 312-961-2502

SOURCE Biohaven Pharmaceutical Holding Company Ltd.

http://biohavenpharma.com

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Biohaven Showcases CGRP-Antagonist Franchise Data including Nurtec ODT (rimegepant), Now Approved to Treat and Prevent Migraine Attacks, and...