Chiaramente, ogni formato ha i propri vantaggi e svantaggi acquista antibiotici online per effettuare un acquisto, non è necessario fornire la prescrizione medica.
P BOONE COUNTY MEDICAL SOCIETY S
ON THE INSIDE:
Page 3 November Feature
Letter to the Editor
What's Up Doc
What's New in Medicine (1963)
BOONE COUNTY MEDICAL SOCIETY
VOLUME: 32 ISSUE: 11
Bridget Early, M.D.
Hung Winn, M.D.
Raghav Govindarajan, M.D.
Immediate Past President
Kim Cayce, M.D.
is published monthly for
members of the Boone County Medical
Society (physician members in Boone,
John Pardalos, M.D., George (Rich) Nichols, M.D.,
Mark Janzen, M.D., George Parkins, M.D.,
Cooper and Howard Counties)
Steve Keithahn, M.D., Ashish Nanda, M.D.
Deadline for submission of materials is the first of each month preceding
MU AMA-MSS BCMS Liaison
Mitchell Padkins, Nick Arnold
*Disclaimer: BCMS does not assume
responsibility for the statements of
Jerry Kennett, M.D., Past-President
Jerry Murrell, M.D., Past-President
authors and opinions expressed are not
Joseph Corrado, M.D., Councilor, Dist. V
necessarily those of Prescriptions
George Hubbell, M.D., Councilor, Dist. V
BCMS nor should publications or
Lisa Thomas, M.D., Vice Councilor, Dist. V
advertisements be considered an endorsement by the BCMS.
MO AMA Delegate
Ted Groshong, M.D.
AMA Council on Legislation &
TO TELL US
MSMA Council on Judicial and Ethical Affairs
WHAT'S ON YOUR MIND!!!
Jerry Kennett, M.D.
Steven Westgate, M.D.
Managing Editor/BCMS Executive Director
PRESCRIPTIONS MISSION STATEMENT:
"The Boone County Medical Society "Prescriptions" is to
Boone County Medical Society
be used for communication among its members; to
inform members of activities, highlight membership
Columbia, MO 65205
concerns and promote camaraderie. It is also intended
as a forum to address community health needs."
Make healthier gravy by chilling your turkey
drippings and skimming the fat off.
Combine these drippings with reduced sodium chicken broth and dry white wine.
THANKSGIVING MEAL A
"As for the turkey, the main dish," Otteson
MAKEOVER WITH A FEW
says "how it's cooked whether in the oven, roaster or fried doesn't make a huge
nutritional difference. The skin is where you will find most of the fat. Peeling it off
By: Kayla Otteson, RDN at MU Health Care
after the turkey is prepared you will be cutting back on a lot of fat." White meat is
The traditional foods we often eat for
leaner than dark meat so choosing the
Thanksgiving are actually very healthy, according
turkey leg means more fat and calories.
to dietitians at the University of MO Health Care.
Plate size and portions are another way to
But how we prepare the food makes all the
control your holiday eating. You may not
always have control of the plate size, and many families use the biggest plates they
Turkey, cranberries, green beans, sweet potatoes
can find. In this case, try to fill it up with
and pumpkin are all healthy foods," said Kayla
fruits and vegetables. Leafy greens take
Otteson, RDN, registered dietitian nutritionist at
up a lot of space, leaving you little room for
MU Health Care. "But we mask these healthy
the foods with more fat and calories.
foods with fat, sugar and salt. All it takes is making some healthier substitutions."
Serving sizes should be as follows:
Ÿ 3 oz of turkey (which is about ¼ of the
Here are some quick and easy changes you can make to keep your holiday meal healthy.
plate stacked 1" high)
Ÿ ¼ of your plate for the starch or grains
Use reduced-sodium chicken broth instead of
Ÿ ½ of your plate for fruits and vegetables.
regular chicken broth.
If you are filling up on fruits and vegetables
Use fresh cranberries instead of canned jellied
you might be less likely to go back for
cranberries. Make cranberry relish with
seconds," said Otteson.
whole fresh cranberries, orange zest and
"Drinking a zero-calorie drink with your meal can help you feel full and also make you
Used canned, evaporated skim (fat-free) milk
less likely to feel the need for a second
instead of heavy cream.
Roasted sweet potatoes can substitute for
candied yams with marshmallows and butter or mashed potatoes and gravy. Roast cubed sweet potatoes with olive oil, cinnamon and small amount of maple syrup.
Choose whole-wheat bread for stuffing and
rolls instead of white bread.
Pick pumpkin pie over pecan pie to save about
200 calories. Make pumpkin pie without the crust.
For appetizers set out a vegetable tray instead
of chips and dip or sausage and cheese.
Drink water or zero-calorie beverages instead
ID/password combination. However, if one site is compromised, all sites with the same password are as well.
One way to get around this is to incorporate the site name or something specific about the site into your password. For example, let's say your password is always "password123" (not a good choice, by the way). If you're creating
Get Ready for Cyber
an account for a shoe store, it's a bit safer to make it something like "password_shoe123".
Easy to remember for you, and less useful to an automated cracking program.
Cyber Monday is November 30th, and is expected
You don't have to save card info. Again, if
to be one of the biggest online shopping days of the
you're ordering from a site you're not sure
year. But before you click "buy", make sure to
you'll ever be using again, there's usually a
check out these tips first – they could save you a
way to check out as a "guest". This both
prevents the password issue discussed earlier, and prevents your card info from being tied to
Make sure the payment site is secured. In
your browser's address bar, check that it says "https" rather than just "http" (the "s" stands
Entering in credit card data usually only takes
for "secure"). Some browsers also add a little
a minute or two – a small amount of extra
lock icon to make this easier to read – check
work if you do end up making a repeat
for this in the top left corner of the window.
Check for the lock icon, or look for the "s"
after "http", to verify the site is secured.
You, too, can be the proud owner of this
What this means is that the connection is
photo of a PS4!
encrypted – in other words, the information
you send will be coded, so anyone intercepting it won't be able to read it.
Read all the details! Everyone knows that if
it's too good to be true, there's a good chance it
Double-check your shipping dates. What
is. But sometimes even not-so-great things
may seem like a great deal can end up being a
turn out worse than you'd assume. Take, for
disappointment if it doesn't arrive until the
instance, people paying more than retail price
New Year. Many sites are upfront about what
for the newest video game systems on eBay.
shipping methods you'll have to select for
Except instead of buying a system, they'd
Christmas delivery, but some sites pair their
missed the fine print where the seller
"great deals" with highly inflated shipping
explained the auction was for a photograph
and handling rates. Make sure to check the
of the system.
delivery guarantees – and if you're not shopping for Christmas gifts, don't pay extra
Naturally, eBay determined that these
on shipping if you don't need to.
auctions were fraudulent… but it probably made for a disappointing holiday nonetheless.
Use varying passwords. When creating
Double-check the details, especially on any
accounts on multiple sites you're not sure
auction or resale site.
you'll use again, it's very tempting to reuse an
Reprint permission granted from The Socket Connection Nov 2014
Letter to the Editor
I sincerely hope you are doing great.
I'm glad to inform you that as a result of your unceasing efforts, the outpatient department (OPD) of proposed oncology department (first of its kind in Afghanistan) started its services yesterday, Monday, August 16, 2015. This is the first big step towards establishing a comprehensive cancer center within the structure of Ministry of Public Health.
Please join me in thanking the MoPH leadership, especially distinguished Dr. Ahmad Jan Naeem, the Deputy Public Health Minister, for making it possible.
We would like to express our sincere appreciation to the oncologists who are providing their precious time, energy and skills voluntarily without any incentives.
Maihan Abdullah **Cancer Control Committee Coordinator
**Maihan Abdullah, MD, PDG, MPH was a guest speaker for our DIG meeting on November 11, 2014. Dr. Abdullah is a general surgeon from Afghanistan with much passion for the health of Afghanistan. He was a Fulbright Scholar at MU and received his MPH from MU in 2013. He spoke to us about how a Health Promotion Department in a third world country works, the structure, the technical capacity, the funding, the problems they face, what health conditions and diseases they focus on and their vision, goals and objectives.
Again we want to thank Lynelle Phillips and Steven Westgate for bringing Dr. Abdullah and his mission to
our attention and for keeping us updated on the progress he is making in Afghanistan.
Maihan Abdullah is pictured
above 4th from the left.
FASTEST 2016 DUES
Gregory Renner and
If you have not paid your 2015 MSMA dues of $395 and your BCMS dues of $205, please log
onto the MSMA website and pay them together or mail your check and dues
statement to MSMA at Box 1028, J.C., MO 65102. Remember, BCMS is a component society of MSMA and you must belong to
MSMA before you can become a BCMS member.
Hugh S. Harris, Jr.
Thomas R. Highland
MSMA has revitalized the Young Physicians
Section for physician members age 40 and under.
The new Chair for this Section will be our BCMS
Joseph J. Muscato
Secretary/Treasurer, Raghav Govindarajan.
If you are a BCMS member under 40 and
interested in this program, please contact our
office. MSMA will be coordinating some
William G. Marshall
activities throughout the year with BCMS. We'll
James E. Fairlamb
keep our members informed of activities.
One Hospital Dr. DC018.00
Retired physician luncheon meets on
Columbia, MO 65212
the 3rd Wednesday of each month at 12:00PM (noon)
One Hospital Drive DC043.00
Columbia, MO 65212
1305 Grindstone Parkway,
Columbia, MO 65203
Congratulations and welcome to the Boone County Medical Society.
No reservation needed, just show up.
Physician of the Day
(Picture of Capitol)
PHYSICIAN OF THE DAY
October 20, 2015
Mizzou vs. Florida Gators
PHYSICIAN OF THE D
SICIAN OF THE D Y
Between January 6
physician every Tuesday,
the House and Senate typically adjourn around noon.
contact Kenny Jackson from MSMA
MARCH 18-20, 2016
If you are available to attend the convention, please let the BCMS office
know by January 15, 2016. Any BCMS member can be a delegate. If you are planning to submit a Resolution, it is advisable to attend the convention so that you can
updated information concerning hotel reservations and
Rubbing Away Psoriasis
Of 96 patients with psoriasis who were treated by
rubbing in a cream containing tar and allantoin (Alphosyl) some of whom had shown no
improvement after years of other therapy—73
responded with 75 to 100% improvement; only 8 were not helped at all. When the cream was used
Overcoming Allergy To Penicillin
again at the first sign of recurrence, it was effective in bringing psoriasis under control once more. It
Many people have become sensitive to penicillin
is important that the cream be rubbed in briskly.
to the point where its use may produce strong
In a previous test it was found that patients who did
reactions. Yet, despite availability of many other
not benefit had only patted the medication on.
antibiotics, penicillin is considered the drug of choice in some severe infections. Now
Treating Chronic Ear Infection
physicians at a New York hospital report that simultaneous use of prednisone, a hormone, may
Persistent infection of the middle ear has been
solve the problem. In three patients with
overcome with a bismuth compound, Bistrimate,
infections of the lining of the heart and with
which may work in some cases even when
histories of allergy to penicillin the hormone
antibiotics and other treatments have failed. In
allowed the antibiotic to be used without causing
one difficult case, discomfort and drainage of the
reactions, and in all three the heart infection was
right ear started after an upper respiratory infection
and persisted for 2 months. Various antibiotics taken by mouth, followed even by puncture of the
New Aid For Allergy
eardrum and irrigation of the middle ear over a period of three weeks, with an antibiotic solution,
A new long acting form of a widely used
failed to help. When tablets of Bistrimate were
antihistamine, Chlor-Trimeton, appears to be a
tried, the ear discharge began to subside on the 3
significant improvement in the treatment of
day; at the end of the 7 day, the ear was dry and
allergy, three physicians report after studying it in
43 patients with respiratory and skin allergies. Taken only once every 12 hours, and in some
Acute Leukemia In Children
cases, once every 24 hours, the new preparation, called Minitrol, produced excellent relief in 30
Although it has thus far produced no cure, a new
patients, moderate in 12 and failed in only 1.
agent Cytoxan, is providing helpful in treating children with acute leukemia. Physicians in
Easing Leg Cramps Of Pregnancy
Houston, Atlanta and St Louis studied the drug in 44 children with advanced leukemia, who were in
Cramping spasm of the calf muscles, a common
relapse after conventional treatment with ACTH,
and very painful complaint in the later months of
steroids and other compounds. Complete
pregnancy, can be relieved in most cases by
remissions lasting from 3 to 15 months were
isoxsuprine hydrochloride. The compound,
obtained in 8 of the children, partial remissions in 5
although originally developed to relax or dilate
blood vessels, brought marked relief of leg cramps for 96 out of 100 pregnant women in a study
Relieving "dumping" Syndrome
conducted by a New Jersey physician.
Following stomach surgery for ulcer or other
Ultrasound For Plantar Warts
problems, some patients develop the "dumping" syndrome, experiencing such symptoms as
Often exquisitely tender and difficult to treat
flushing, sweating, cramps and weakness when
effectively, plantar warts on the soles of the feet are
they eat. Now 4 University of Washington
common warts flattened by pressure. Now
surgeons report excellent results in such cases with
excellent results with ultrasound (high frequency
Periactin. In every one of 16 patients, moderate to
sound waves) have been reported by doctors at
severe symptoms present for as long as 9 years
University Hospital in Ann Arbor, Michigan. The
were greatly relieved or completely eliminated
cure rate –44 out of 55 cases—was the highest
when the drug was taken two hours before meals.
among those who had had warts for no more than 6 months.
Taken from Cosmopolitan magazine July 1963
Ÿ For Anthem you should contact the
Provider Service Call Center for the locality and line of business involved (telephone numbers can be found on Anthem.com)
Any issues with practice management systems,
electronic health records, billing vendors or
clearinghouses should be directed to the company.
BY NOVEMBER 1
ICD-10 HAS BEEN
Of Note: CMS announced that the ICD-10
IN EFFECT FOR 31 DAYS
Coordination Center and claims processing will
continue to operate even if there is a
government shutdown due to the budget.
HOW ARE YOU DOING?
Reprinted from enews.ama.assn.or, ICD 10 Resources
If your office has experienced any problems with
September 29, 2015
the processing of your claims or other administrative transactions, please have your business office manager go to:
The AMA has created an ICD-10 complaint form
Medicare and Medicaid
that will be available on the AMA ICD 10 web
page to report problems with Medicare claims. Forms will be forwarded to the Centers for Medicare & Medicaid Services. The AMA will
This summer marked the 50th anniversary of the
not provide individual responses to each
enactment of Amendments to the Social Security
Act that established the Medicare and Medicaid programs.
Physicians can also contact their Medicare Administrative Contractor (MAC) or monitor
On July 30, 1965 President Johnson signed
their MAC's website for information on problems
legislation to establish Medicare for the elderly
with ICD-10. You may also contact CMS directly
and Medicaid for low income adults, children,
by emailing the ICD-10 ombudsman, Dr. William
pregnant women and people with disabilities.
Rodgers, at ICD10 Ombudsman@cms.hhs.gov
Though Medicare and Medicaid started as basic health coverage programs for Americans, the
programs have evolved over the years to provide
Check the state Medicaid website for information
more Americans with improved access to quality
about ICD-10 implementation and a method of
and affordable health care coverage. These
contact for issues.
programs have transformed the delivery of health care in the U.S.
Check the payer's website for information about
In 1966 approximately 19.1 million Americans
ICD-10 implementation and a method of contact
were covered by Medicare. In 2012 there were
nearly 52 million beneficiaries covered by Medicare. As the Baby Boom generation has
started to retire Medicare has seen a three million
For United Health Group you can use
person increase in the last three years.
Ÿ For Humana you can use
CMS.gov Centers for Medicare & Medicaid Services
July 30, 2015
Dr. Ed Weisbart
Physician for National Care
Former MO Representative and
COME JOIN US FOR A FREE LIVELY
Boone County Judge
(GET THE FACTS FROM EXPERTS)
PUBLIC DEBATE ON WHETHER
Keith Frederick, M.D
MEDICAID SHOULD OR SHOULDN'T
BE EXPANDED IN MISSOURI
Karen Edison, M.D.
MONDAY, NOVEMBER 16
SPONSORED BY THE BOONE
COUNTY MEDICAL SOCIETY
For more information contact
Boone County Medical Society at 814.1894 or
COLUMBIA PUBLIC LIBRARY
submit any questions you would like addressed to
100 W. BROADWAY, COLUMBIA
2016 Country Club of
Comedian & Musician
GALA 7:00pm Dinner
January 23rd, 2016
SAVE THE DATE
Please join us for the 18 annual MUlation!
This is an opportunity for medical students to gain
knowledge about life in medicine from local
When: Wednesday, January 20th, 2016
Where: Peachtree Catering and Banquet Center
120 E Nifong Blvd # 104, Columbia, MO
Who: Community physicians, residents, MU
Program: 6:30-7:15 pm social time
round table discussions
Dress: Business casual
Complimentary appetizers and drinks provided.
Please RSVP by 5pm on Friday, January 15th to:
Melanie Bryan firstname.lastname@example.org or 314-330-0895
*please indicate your field to help us organize the round table
Boone County Medical Society
Columbia, MO 65205-0196
Return Service Requested
atch your mail for further details.
ANDED IN MISSOURI
AID SHOULD OR SHOULDN'T BE
Vitamin D accelerates resolution of inﬂammatory responses during tuberculosis treatmentAnna K. Coussensa, Robert J. Wilkinsona,b, Yasmeen Hanifac, Vladyslav Nikolayevskyyd, Paul T. Elkingtone,Kamrul Islamc, Peter M. Timmsf, Timothy R. Ventonf, Graham H. Bothamleyf, Geoffrey E. Packeg,Mathina Darmalingamh, Robert N. Davidsoni, Heather J. Milburnj, Lucy V. Bakerk, Richard D. Barkerl,Charles A. Meinm, Leena Bhaw-Rosunm, Rosamond Nuamahm, Douglas B. Younga, Francis A. Drobniewskid,Christopher J. Grifﬁthsc, and Adrian R. Martineauc,a,b,1
EPIDEMIOLOGY SERIES Blinding in randomised trials: hiding who got what Kenneth F Schulz, David A Grimes Blinding embodies a rich history spanning over two centuries. Most researchers worldwide understand blindingterminology, but confusion lurks beyond a general comprehension. Terms such as single blind, double blind, and tripleblind mean different things to different people. Moreover, many medical researchers confuse blinding with allocationconcealment. Such confusion indicates misunderstandings of both. The term blinding refers to keeping trialparticipants, investigators (usually health-care providers), or assessors (those collecting outcome data) unaware ofthe assigned intervention, so that they will not be influenced by that knowledge. Blinding usually reduces differentialassessment of outcomes (information bias), but can also improve compliance and retention of trial participants whilereducing biased supplemental care or treatment (sometimes called co-intervention). Many investigators and readersnaively consider a randomised trial as high quality simply because it is double blind, as if double-blinding is the sinequa non of a randomised controlled trial. Although double blinding (blinding investigators, participants, and outcomeassessors) indicates a strong design, trials that are not double blinded should not automatically be deemed inferior.Rather than solely relying on terminology like double blinding, researchers should explicitly state who was blinded,and how. We recommend placing greater credence in results when investigators at least blind outcome assessments,except with objective outcomes, such as death, which leave little room for bias. If investigators properly report theirblinding efforts, readers can judge them. Unfortunately, many articles do not contain proper reporting. If an article claims blinding without any accompanying clarification, readers should remain sceptical about its effect on bias reduction.