Category Archives: Healthcare

Landmark Asthma Study Demonstrates Device Choice Determines Asthma Control

Monaghan Medical Corporation understands that for those with asthma, particularly children, choosing the device that best delivers their medication is an important consideration.

Plattsburgh, NY, USA — Monaghan Medical Corporation understands that for those with asthma, particularly children, choosing the device that best delivers their medication is an important consideration. Research has shown that even when using the same metered-dose inhaler (MDI), not all valved holding chambers perform equally well.[1]

A landmark real-world study involving more than 18,000 asthma patients has demonstrated superior asthma control with the AEROCHAMBER PLUS® FLOW-VU® antistatic Valved Holding Chamber (VHC) compared with other chamber devices.[2] According to the study, published in Pulmonary Therapy, use of the AEROCHAMBER PLUS® FLOW-VU® antistatic chamber resulted in delayed time to first exacerbation, fewer asthma-related emergency department visits, and lower exacerbation-related costs than control chambers.

Asthma is a common respiratory condition that affects an estimated 24.6 million people in the United States. Almost half of them, including nearly 3 million children, experience one or more asthma attack in a year.[3]

As opposed to systemic medications, inhalation is the recommended way to administer asthma medications because it directly targets the drug to the lungs while reducing potential side effects. Inhaled corticosteroids and bronchodilators administered by MDIs are the mainstay of long-term asthma treatment, the goals of which are to improve symptoms and prevent the occurrence of exacerbations.[4]

Poor inhaler operation by users is common, resulting in less of the delivered drug reaching the lungs. Instead, much of it is deposited on the back of the throat (oropharyngeal deposition) and then swallowed.[5] Research shows that between 28% and 68% of patients do not use inhalers well enough to benefit from prescribed medication.[6] In addition, 25% of costs associated with inhalers is wasted due to poor inhaler technique.[6]

Chambers are designed to reduce oropharyngeal deposition by changing the particle size distribution of the inhaled aerosol, and by holding the aerosol in the chamber until the patient is ready to inhale, which reduces the need for good coordination between inhalation and inhaler actuation.[7] Effectiveness of these devices can be adversely affected by the design, including the chamber electrostatic charge, a commonly reported cause of inconsistent medication delivery.[8]

Global respiratory guidelines recommend the use of chambers to improve MDI drug delivery.[4] American Thoracic Society and American Association for Respiratory Care Clinical Practice Guidelines state that the addition of a chamber is recommended and helpful.[9,10] Research also indicates that patients who use a chamber with an MDI have better asthma control than those using an MDI alone.[11]

In this new study, Dr. Chakkarin Burudpakdee (QuintilesIMS, Fairfax, VA, USA) and colleagues compared the effects of the antistatic AEROCHAMBER PLUS® FLOW-VU® aVHC and control chambers on treatment outcomes, resource use, and healthcare costs in a real-world asthma population.[2] More than 18,000 patients were included from an adjudicated claims database containing medical and pharmacy claims for more than 150 million U.S. health plan members.[2]

The analysis showed that among patients with at least 30 days of follow-up, those using the AEROCHAMBER PLUS® FLOW-VU® antistatic VHC experienced a delay in the time to first exacerbation and had fewer asthma-related emergency room visits. In addition, exacerbation-related costs were lower when compared to those using the control (non-antistatic) chambers.[2] A trend toward lower exacerbation rates per patient for the AEROCHAMBER PLUS® FLOW-VU® aVHC was sustained throughout the 12 months of the study.[2]

“This landmark study using a large volume of real-world evidence generated from thousands of patients shows the value of optimizing drug delivery in asthma management and further supports that chambers are not interchangeable,” said co-author Dominic Coppolo, MBA, RRT, FAARC, Vice President Clinical Strategy and Development. “The reduction in exacerbation incidents among users of the AEROCHAMBER PLUS® FLOW-VU® chamber is particularly notable because experiencing an exacerbation is a risk factor for future exacerbation events-and minimizing exacerbation risk is a key goal of treatment.”

“The European Medicines Agency recommended in 2009 that development of a MDI should include the testing of at least one specific, named chamber, and that any substitution must be supported by appropriate in vitro or clinical data demonstrating equivalence,” he said. “We presented laboratory data at the recent Respiratory Drug Delivery Europe meeting[2] that confirmed that not all chambers perform equally well with the same MDI, which underlines the importance of recognizing the impact and potential risks of substituting one device for another.”

About Monaghan Medical Corporation
Monaghan Medical Corporation (MMC) offers leading aerosol drug delivery devices and respiratory management products including AeroEclipse® II BAN, AeroChamber Plus® aVHC and the Aerobika® device exclusively in the United States. MMC’s strength lies in product development around core capabilities in mechanical design complimented by collaboration with a state-of-the-art aerosol research laboratory. MMC focuses on developing cost-efficient, outcome-based solutions for its customers. (http://www.monaghanmed.com)

About AEROCHAMBER® brand valved holding chambers, including the AEROCHAMBER PLUS® FLOW-VU® anti-static chamber
Developed in 1983 to address the needs of asthma and COPD patients having difficulty in taking their MDI medications correctly, the AEROCHAMBER® brand of chamber has innovated continuously to improve patient ease of use and quality of life as well as clinical outcomes and healthcare system savings.

• The AEROCHAMBER PLUS® valved holding chamber is the leading global chamber brand, with safety and efficacy validated in numerous third-party clinical evaluations among various patient populations. It is the chamber most recommended by leading MDI pharmaceutical companies.
• AEROCHAMBER PLUS® FLOW-VU® chamber is an antistatic chamber designed to deliver the intended prescribed dose via the MDI, similar to using an MDI with perfect technique. An additional feature is the incorporation of the FLOW-VU® inhalation indicator for the caregiver to observe effective inhalation. A recent study showed that caregiver quality of life improved almost four-fold when using the AEROCHAMBER PLUS® chamber with FLOW-VU® indicator versus the same chamber without the indicator.[12] The FLOW-VU® indicator provides real-time feedback confirming an effective inhalation and that there are no leakages of ambient air into the space between facemask and face, which could prevent medication delivery altogether. (http://www.monaghanmed.com/AeroChamber-Plus-Flow-Vu-aVHC2)

About the study
Data for more than 18,000 patients with an asthma diagnosis were analysed from the QuintilesIMS Real-World Data Adjudicated Claims Database (PharMetrics Plus) between 1/2010 and 8/2015-9,325 using the AEROCHAMBER PLUS® FLOW-VU® antistatic VHC and a propensity-matched comparison cohort of 9,325 non-antistatic VHCs. Exacerbation incident rates (IR), time to first exacerbation using Kaplan-Meier survival analysis, occurrence of exacerbations, and healthcare resource use and costs were compared.

• Exacerbation IR/100 person-days (95% CI) was significantly higher in the control device cohort than the antistatic chamber cohort (0.161 [0.150-0.172] vs.0.137 [0.128-0.147]); more patients in the antistatic chamber cohort remained exacerbation free.
• 4,293 patients in each cohort were followed up for (greater than or equal to)12 months, during which there was a trend for patients in the antistatic VHC group to be less likely (10-12%) to experience an exacerbation. Fewer patients using the antistatic VHC had an ED visit compared with those in the control group (10.8% vs. 12.4%).
• Exacerbation-related costs for the antistatic VHC cohort were 23%, 25%, 20%, and 12% lower than the control device cohort at 1, 6, 9, and 12 months, respectively.

For clinical inquiries, please contact:
Dominic P. Coppolo, MBA, RRT, FAARC
Vice President Clinical Strategy and Development
Monaghan Medical Corporation
1-800-343-9071

Words or phrases accompanied by ® are trademarks and registered trademarks of Monaghan Medical Corporation or an affiliate of Monaghan Medical Corporation. © 2017 Monaghan Medical Corporation.

References

1 Nagel MW, Suggett JA. Equivalence evaluation of valved holding chambers (VHCs) with albuterol pressurized metered dose inhaler (pMDI). Respiratory Drug Delivery Europe; April 25-28, 2017, 2017; Nice, France.

2 Burudpakdee C, Kushnarev V, Coppolo D, Suggett J. A retrospective study of the effectiveness of the AeroChamber Plus® Flow-Vu® Antistatic Valved Holding Chamber for asthma control. Pulmonary Therapy. 2017. http://doi.org/10.1007/s41030-017-0047-1. Accessed July 14.

3 Asthma Facts. United States Environmental Protection Agency. EPA-402-F-04-019. May 2017.

4 Global Initiative for Asthma: Global strategy for asthma management and prevention, 2017. Available from: http://ginasthma.org/2017-gina-report-global-strategy-for-asthma-management-and-prevention Accessed November 2017.

5 Price D, Bosnic-Anticevich S, Briggs A, et al. Inhaler competence in asthma: common errors, barriers to use and recommended solutions. Respiratory Medicine. 2013;107(1):37-46.

6 Fink JB, Rubin BK. Problems with Inhaler Use: A Call for Improved Clinician and Patient Education. Respir Care 2005;50(10):1360-74.

7 Lavorini F, Fontana GA. Targeting drugs to the airways: The role of spacer devices. Expert opinion on drug delivery. 2009;6(1):91-102.

8 Mitchell JP, Coppolo DP, Nagel MW. Electrostatics and inhaled medications: influence on delivery via pressurized metered-dose inhalers and add-on devices. Respiratory care. 2007;52(3):283-300.

9 Chung KF, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. European Respiratory Journal 2014 ;43:343-373.

10 Ari A, et al. Aerosol Delivery Device Selection for Spontaneously Breathing Patients:2012. Respir Care 2012;57(4):613- 626.

11 Levy ML, et al. Asthma patients’ inability to use a pressurized metered-dose inhaler (pMDI) correctly correlates with poor asthma control as defined by the Global Initiative for Asthma (GINA) strategy: a retrospective analysis. Prim Care Respir J. 2013; Dec;22(4):406-11.

12 Ammari WG, et al. Evaluation of asthma control, parents’ quality of life and preference between AeroChamber Plus and AeroChamber Plus Flow-Vu spacers in young children with asthma. J Asthma 2015; 52(3):301-7.

FED Publishing Releases New Book, “My Journey, A Victory Over Cancer Through Alternative Methods” by Valarie Hendriks

My Journey, A Victory Over Cancer Through Alternative Methods, by Valarie Hendriks, is a story about one courageous woman’s journey and victory over cancer through alternative methods.

Oakland Township, MI, USA — Valarie Hendriks’ My Journey, A Victory Over Cancer Through Alternative Methods is a book that will make you laugh, make you cry, inspire you and motivate you. However, most of all it will help you in battling one of the most dreaded diseases plaguing mankind, cancer.

Valarie Hendriks grew up in the Midwest part of the United States. After college she got a job in the Optical field and is currently working as a Manager and ABO Certified Optician. Along the way she got married to her spouse of twenty five years. Her hobbies are tennis, horseback riding and Ball Room Dancing. She competed in Ball Room Dancing and won several competitions over her career. Then one day she was diagnosed with cancer. At this point in her life she thought her entire world was falling apart. However, she was determined to defeat this dreaded disease.

Her book My Journey, A Victory Over Cancer Through Alternative Methods is a book that Valarie wrote that outlines how she beat cancer. In her book she provides all of the information that she learned through two years of research so that she could help other people in their battle against cancer without going through the trauma of traditional cancer treatments. Her book is uplifting, inspiring, and motivational. It will make you laugh and it will make you cry but most of all it could help you to defeat one of the most dreaded diseases in the world, the disease that we call cancer.

Genre – Cancer, Cure, Alternative Methods, Alternative Medicine, Cancer Cure, Inspiration, Treatment, Motivational

The ebook version of My Journey, A Victory Over Cancer Through Alternative Methods ISBN 9781506903477, published by First Edition Design Publishing (http://www.firsteditiondesignpublishing.com), is available on-line wherever ebooks are sold. The 194 page print book version, ISBN 9781506903460, and ISBN 9781506903453 hardback, are published by First Edition Design Publishing and distributed worldwide to online booksellers.

Media Contact:
Valarie Hendriks
+1(941)921-2607
monty-nbf@att.net

Significant Cost Reduction in COPD Care With Simple, Drug-free Device

Aerobika® OPEP device proves to be a cost-effective treatment option in the management of post-exacerbation COPD patients.

Plattsburgh, NY, USA — The Aerobika® Oscillating Positive Expiratory Pressure (OPEP) device (Monaghan Medical Corporation) is a cost-effective treatment option in the management of COPD exacerbations, according to a study published October 20th in the International Journal of COPD.[1] This study, which used data from the published literature and national fee schedules to model the cost-effectiveness of the Aerobika® OPEP device, shows that it provides both clinical benefit and direct medical cost savings in a post-exacerbation care COPD population.

COPD is a major (and growing) source of morbidity, mortality and healthcare utilization, with hospitalization for acute exacerbations being the biggest cost driver.[2] Once a patient experiences an exacerbation, the risk of further exacerbation is increased two- to four-fold[3], and many patients experience two or three exacerbations every year.[4] As many as one in five patients discharged from hospital following an exacerbation are re-admitted within 30 days.[5]

The economic burden on the healthcare system associated with COPD is significant; in the US alone, the cost of COPD in 2010 was estimated to be US $50 billion; $30 billion in direct healthcare expenditure, with the remainder accounted for by indirect costs such as productivity losses and costs to families.[6] Approximately half of the direct costs could be accounted for by hospital care for COPD exacerbations,[6] which supports the GOLD guideline treatment goals of minimizing the negative impact of exacerbations and preventing recurrences.[2] Healthcare systems in many countries acknowledge the problem, and policies are now being put in place to try to address it; the US Medicare Hospital Readmission Reduction Program penalizes hospitals for excess 30-day, all-cause readmissions after a hospitalization for an acute exacerbation of COPD.[7]

The Aerobika® OPEP device is a drug-free, handheld mechanical oscillating positive expiratory pressure (OPEP) device that has been designed to address the structural and functional challenges in the airways of patients with COPD. When the patient exhales through the device, it helps to expand the airways, loosen and expel mucus from the lungs and may also enhance drug deposition. It has been shown to improve lung function, exercise capacity and quality of life in COPD patients,[8] and a recent real-word study showed that the device reduced exacerbation rates in patients during the critical 30-day post-exacerbation period.[9] Using data from the latter study to provide real-world input, the authors of this current analysis showed cost savings ($553 per patient) and improved outcomes (equivalent to 6 fewer exacerbations per 100 patients per year) with the Aerobika® OPEP device compared with no OPEP/PEP use, and concluded that the device provides cost-effective treatment for post-exacerbation COPD patients.

The authors also used various scenarios to investigate the likelihood of the benefit continuing over a full year, and predicted further clinical and cost benefits (21 exacerbations per 100 patients per year; cost savings of $1,952 per patient). Author Dominic Coppolo, MBA, RRT, FAARC, Vice President Clinical Strategy and Development noted, “Our model provides evidence of clinical and cost benefits of the Aerobika® OPEP device in that critical 30-day period following an exacerbation. Given the high burden of COPD – in particular, costs relating to exacerbations – in the US population, we would expect that even a small benefit would have a significant impact on the healthcare system”. He went on to say that, although further studies would be needed to validate the long-term effectiveness, these data also give a good indication that the benefits will be sustained with long-term use.

“With the increasing pressure to improve care and reduce hospital admissions, the previously-published real-world study showing exacerbation reductions in the critical 30-day post exacerbation period gave us useful insights into the benefits of integrating the Aerobika® OPEP device into standard clinical practice”, noted Dr Jason Suggett (Group Director of Global Science and Technology, TMI). “This new analysis now gives us clear evidence that such clinical benefits would be translated into cost-effectiveness in this post-exacerbation population. In addition, new data presented at CHEST 2017 demonstrating that the generation of the proprietary pressure/oscillation pattern of the Aerobika* device efficiently generates oscillations throughout a high percentage of each exhaled breath, and with consistently high pressure amplitudes. The Aerobika* device demonstrated efficient and effective performance related to therapeutic effectiveness nearly twice that of other devices tested.”[10]

About Monaghan Medical Corporation (MMC, USA)
MMC offers leading aerosol drug delivery devices and respiratory management products including AeroEclipse® II BAN, AeroChamber Plus® aVHC and the Aerobika® device (http://www.monaghanmed.com/aerobika) exclusively in the United States. MMC’s strength lies in product development around core capabilities in mechanical design complimented by collaboration with a state-of-the-art aerosol research laboratory. MMC focuses on developing cost-efficient, outcome-based solutions for its customers.

About the Aerobika® device
The Aerobika® OPEP device (http://www.monaghanmed.com/Aerobika-OPEP) is a hand-held, robust, easy-to-use, drug-free oscillating positive expiratory pressure (OPEP) device designed to help expel mucus from the lungs, expand airways and enhance drug deposition. When the patient exhales through the device, intermittent resistance creates a unique pressure-oscillation dynamic, which expands the airways, helps expel the mucus to the upper airways where it can be coughed out. The Aerobika® OPEP device is designed to function independent of angle of use or flow rate, and allows for a direct aerosol pathway for patients using a nebulizer for medication delivery. The Aerobika® OPEP device has been shown to significantly improve forced vital capacity (FVC), 6-min walk distance (6MWD), and St. George’s Respiratory Questionnaire (SGRQ) score in COPD patients.[8] The Aerobika® OPEP device is available in the US via Monaghan Medical Corporation (http://www.monaghanmed.com), and in Canada, Mexico, and select European countries including the UK and Germany through Trudell Medical International (http://www.trudellmed.com).

About the study
A one-year Markov model was used to estimate the cost-effectiveness of the Aerobika® OPEP device in patients who had experienced an exacerbation in the previous month, or a post-exacerbation care population, with input data from the published literature and national fee schedules. Using a base-case assumption that the benefit of the Aerobika® OPEP device would last 30 days, cost-savings ($553 per patient) and improved outcomes (ie, 6 fewer exacerbations per 100 patients per year) were demonstrated when compared with no OPEP/positive expiratory pressure use. Assuming a scenario with effect beyond the conservative 30 day time frame, the Aerobika® OPEP device continued to show benefit (21 exacerbations per 100 patients per year; cost savings of $1,952 per patient). One-way sensitivity analyses were conducted for all input variables, increasing or decreasing the effect by 20%, to determine the impact of change on costs and health effects; the results supported the robustness of the base-case conclusions.

For clinical inquiries, please contact:
Dominic P. Coppolo, MBA, RRT, FAARC
Vice President Clinical Strategy and Development
Monaghan Medical Corporation
1-800-343-9071

Words or phrases accompanied by ® are trademarks and registered trademarks of Monaghan Medical Corporation or an affiliate of Monaghan Medical Corporation. © 2017 Monaghan Medical Corporation.

1. Khoudigian S, Kowal S, Suggett J, D. C. Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations. International journal of chronic obstructive pulmonary disease. 2017;In Press.
2. Global strategy for the diagnosis, management and prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017.
3. Khakban A, Sin DD, FitzGerald JM, et al. The Projected Epidemic of Chronic Obstructive Pulmonary Disease Hospitalizations over the Next 15 Years. A Population-based Perspective. Am J Respir Crit Care Med. 2017;195(3):287-291.
4. Puhan MA, Chandra D, Mosenifar Z, et al. The minimal important difference of exercise tests in severe COPD. Eur Respir J. 2011;37(4):784-790.
5. Guerrero M, Crisafulli E, Liapikou A, et al. Readmission for Acute Exacerbation within 30 Days of Discharge Is Associated with a Subsequent Progressive Increase in Mortality Risk in COPD Patients: A Long-Term Observational Study. PLoS One. 2016;11(3):e0150737.
6. Guarascio AJ, Ray SM, Finch CK, Self TH. The clinical and economic burden of chronic obstructive pulmonary disease in the USA. Clinicoecon Outcomes Res. 2013;5:235-245.
7. Shah T, Press VG, Huisingh-Scheetz M, White SR. COPD Readmissions: Addressing COPD in the Era of Value-based Health Care. Chest. 2016;150(4):916-926.
8. Svenningsen S, Paulin GA, Sheikh K, et al. Oscillatory Positive Expiratory Pressure in Chronic Obstructive Pulmonary Disease. COPD. 2016;13(1):66-74.
9. Burudpakdee C, Seetasith A, Dunne P, et al. A real-world study of 30-day exacerbation outcomes in chronic obstructive pulmonary disease (COPD) patient managed with Aerobika OPEP. Pulmonary Therapeutics. 2017.
10. Meyer A and Suggett J. A Laboratory Assessment into the Efficiency and Effectiveness of Different Oscillating Positive Expiratory Pressure Devices by Means of Patient Simulated Expiratory Waveforms. Presented at CHEST 2017.

Monaghan Medical Corporation Receives Innovative Technology Designation from Vizient for the AEROBIKA® OPEP device

Designation recognizes products that bring improvements to the health care industry.

Plattsburgh, NY, USA — Monaghan Medical Corporation announced its AEROBIKA® Oscillating Positive Expiratory Pressure (OPEP) device has received a 2017 Innovative Technology designation from Vizient, Inc., the largest member-driven health care performance improvement company in the country. The designation was based on direct feedback from hospital experts who interacted with the AEROBIKA® OPEP device at the Vizient Innovative Technology Exchange in Denver on Sept. 14, 2017.

The AEROBIKA® OPEP device is a drug-free, handheld mechanical oscillating positive expiratory pressure (OPEP) device that has been designed to address the structural and functional challenges in the airways of patients with COPD. When the patient exhales through the device, it helps to expand the airways, loosen and expel mucus from the lungs and may also enhance drug deposition. It has been shown to improve lung function, exercise capacity and quality of life in COPD patients,1 and a real-world study showed that the device reduced exacerbation rates in patients during the critical 30-day post-exacerbation period.2 These improved outcomes (equivalent to 6 fewer exacerbations per 100 patients per year) equate to a cost savings of $553 per patient with the AEROBIKA® OPEP device compared with no OPEP/PEP use, making the device a cost-effective treatment for COPD patients.

“We are extremely pleased to have been awarded this prestigious recognition from Vizient,” said Dominic Coppolo, MBA, RRT, FAARC, Vice President Clinical Strategy and Development. “Our device was recommended by Vizient members, which is a validation of all of the design and clinical work we have done to support our customers. We are the only OPEP device to have received this designation at this year’s Innovative Technology Exchange, and are proud it was recognized to deliver improved outcomes and enhanced safety.”

“Based on feedback from attendees at the Vizient Innovative Technology Exchange, it was determined that the AEROBIKA® OPEP device should be recognized with an Innovative Technology designation. This designation will be noted in our online member contract catalog. Congratulations to Monaghan Medical Corporation on receiving this status,” said Debbie Archer, director of procurement and Vizient Innovative Technology Program lead.

Vizient represents a diverse membership base that includes academic medical centers, pediatric facilities, community hospitals, integrated health delivery networks and non-acute health care providers and represents more than $100 billion in annual purchasing volume. Through its Innovative Technology Program, Vizient works with member-led councils and task forces to review potentially innovative products. If it is determined that a product is innovative, Vizient may award a contract outside of the competitive bid cycle.

About Monaghan Medical Corporation (MMC, USA)
MMC offers leading aerosol drug delivery devices and respiratory management products including AeroEclipse® II BAN, AeroChamber Plus® aVHC and the Aerobika® device exclusively, directly and through distributors, in the United States. MMC’s strength lies in its commitment to product quality, outcome based solutions for customers, and its collaboration with a state-of-the-art aerosol research laboratory. (http://www.monaghanmed.com)

1. Svenningsen S, Paulin GA, Sheikh K, et al. Oscillatory Positive Expiratory Pressure in Chronic Obstructive Pulmonary Disease. COPD. 2016;13(1):66-74.
2. Burudpakdee C, Seetasith A, Dunne P, et al. A real-world study of 30-day exacerbation outcomes in chronic obstructive pulmonary disease (COPD) patient managed with Aerobika OPEP. Pulmonary Therapeutics. 2017.

For clinical inquiries, please contact:
Dominic P. Coppolo, MBA, RRT, FAARC
Vice President Clinical Strategy and Development
Monaghan Medical Corporation
1-800-343-9071

Stanford University Trial Demonstrates Accuracy of Accuro Automated Ultrasound

Anesthesia & Analgesia Publishes Results of RIVANNA’s Image-Guided Technology’s Epidural Success.

Charlottesville, VA, USA — A clinical trial conducted at Stanford University Medical Center published this week in Anesthesia & Analgesia* proved the accuracy of the Accuro® image-guided spinal navigation system in calculating the optimal site and needle depth for epidural anesthesia administration. The research is the latest in a series of studies supporting the efficacy of RIVANNA‘s handheld ultrasound system with proprietary pattern recognition software, which identifies spinal landmarks and provides automated epidural placement guidance. The innovative Accuro platform also has application in a range of additional medical procedures that benefit from visualization of targeted anatomical areas.

In the trial, RIVANNA® Accuro identified the appropriate epidural injection sites along the lower spine and calculated the depth to the epidural space, a narrow hollow area in the spine. Actual epidural depth was confirmed by measuring needle penetration during successful epidural delivery by anesthesia providers. Accuro predicted this depth within an average of .61 cm.

In addition, Accuro identified the appropriate spinal interspace for needle insertion in 94% of patients and enabled 87% success in first-attempt epidural administration. The research was conducted under the direction of Brendan Carvalho, MD, at Stanford Medical Center and led by Katherine Seligman, MD, currently faculty at the University of New Mexico.

“The ability to visualize spinal anatomy in detail during epidural needle placement has a strong impact on the procedure’s success,” says Will Mauldin, Chairman and CEO of Rivanna Medical. “Today, anesthesiologists rely on spinal palpation and their knowledge of spinal anatomy to determine the appropriate injection site and depth. Depending on the patient condition and physician skill, up to 80% of first attempt epidural needle placements fail. Obesity and atypical spinal characteristics such as scoliosis place patients significantly at failure risk.”

Repeated epidural needle insertions can negatively impact the patient with ongoing headaches, bleeding, back pain and possibly paralysis. Failed epidurals cost the medical system more than $1.5 billion annually.

Mauldin notes that ultrasound is the imaging modality of choice for epidurals because most are administered to expectant mothers who must avoid the radiation involved in other imaging procedures.

Significant research shows that ultrasound guidance of epidural and other neuraxial anesthesia significantly improves efficacy and patient safety. However, performing and interpreting ultrasound requires specialized training not typically in the anesthesia provider’s skillset.

Accuro’s SpineNav3D™ computerized ultrasound image guidance eliminates the steep ultrasound learning curve, making it simple and practical for anesthesiologists and other medical professionals not trained in the modality.

“This study published in a respected anesthesiology publication underscores the device’s precision in providing physician guidance,” says Mauldin.

In addition to innovative image guidance, RIVANNA Accuro also incorporates BoneEnhance® technology, which optimizes the device for visualization of bony spinal anatomy. Accuro delivers a five- to 10-fold increase in bone-to-tissue contrast compared to traditional ultrasound, which is generally preferred for soft tissue imaging. The pocket-sized, wireless device is simple and practical to use in a wide range of settings where traditional large, unwieldy systems can be a problem.

“Accuro is designed to eliminate the risks of multiple needle placement attempts, increasing patient satisfaction while supporting anesthesiology workflow,” notes Mauldin. “A growing number of studies underscore the device’s success in meeting these goals.”

A recent randomized trial at University of Virginia Medical Center found that for residents with prior spinal anesthesia experience, Accuro improved first-attempt needle placement by more than 100% in patients with a high body mass index. Appropriate needle placement in these patients is particularly difficult. The average number of needle redirections to achieve placement using Accuro was almost half that of the same sub-group using conventional placement methods.

* ANESTHESIA & ANALGESIA is the official journal of the International Anesthesia Research Society.

About Accuro® and Rivanna Medical, LLC
RIVANNA® Accuro is the world’s first ultrasound-guidance system designed to effortlessly enhance spinal and epidural anesthesia placement accuracy. The revolutionary platform features BoneEnhance®, which optimizes ultrasound for the visualization of bony vs. soft tissue anatomy, and SpineNav3D™, which automates measurements of the spinal midline, epidural depth and trajectory. Accuro was engineered and commercialized by RIVANNA, an innovative medical device company headquartered in Charlottesville, VA. The proprietary device is FDA 510(k)-cleared for a variety of imaging applications. For anesthesia providers, certainty can be effortless with Accuro. For more information, visit http://www.rivannamedical.com.

Copyright © by Rivanna Medical, LLC. All rights reserved. RIVANNA® and Accuro® are registered trademarks of Rivanna Medical, LLC.

Media Contact:
HealthFlash Marketing
Jeanne-Marie Phillips, 203-977-3333
jphillips@healthflashmarketing.com

The ‘Sweet Season’ in Coming Up, But with Good Habits and Careful Monitoring, Teeth Problems can be Avoided, According to Gilroy Dentist

Candy is harder to avoid on Halloween than pumpkin spice and spooky ghosts and witches, but according to Gilroy dentist Dr. Jernell Escobar, teeth problems can be avoided with some good habits and monitoring the amount of candy children eat.

Gilroy, CA, Sept 28, 2017 — Candy is harder to avoid on Halloween than pumpkin spice and spooky ghosts and witches, but according to Gilroy dentist Dr. Jernell Escobar, teeth problems can be avoided with some good habits and monitoring the amount of candy children eat.

“It really can be quite a challenge for parents to let children enjoy Halloween, but still maintain the health of their teeth,” says Dr. Escobar. “But the solution isn’t to ban all candy, which is an impossible, but to closely monitor their intake of candies and other sweets.”

Halloween is the start of the “sweet season,” which includes Thanksgiving, Christmas and New Year’s Eve, the time of the year that is taken up with holiday parties, family celebrations, school activities and community events. Parents have to be extra attentive during this time of the year because many of these events feature cookies, cakes, pies, brownies, and other sweet treats.

Dr. Escobar wants people to be aware that there are good sweets and bad sweets, much as there are good habits and bad habits when it comes to the health of their teeth.

Sweets such as taffy and hard candies that can sit on or stuck between teeth for long periods of time actually increases the risk of tooth decay. Bacteria feeds on the sugar on the teeth, producing acid that causes tooth decay.

“Candies” such as sugar-free gum can prevent cavities by dislodging food particles and increasing saliva, which helps to neutralize acids in the mouth and prevent tooth decay.

“We can’t avoid all sweets, of course, but by being smart with our choices, going for healthy alternatives and promoting a healthy oral routine with our kids, we can all keep our families happy and healthy during the holiday season,” says Dr. Escobar.

The American Dental Association, on its website mouthhealthy.org, offers 10 easy-to-follow tips to help your children maintain a healthy mouth and teeth:

1. Eat Halloween candy and other sugary foods with meals or shortly after mealtime. Saliva production increases during meals and helps cancel out acids produced by bacteria in your mouth and helps rinse away food particles.

2. Avoid hard candy and other sweets that stay in your mouth for a long time. Besides how often you snack, the length of time sugary food is in your mouth plays a role in tooth decay. Unless it is a sugar-free product, candies that stay in the mouth for a long period of time subject teeth to an increased risk for tooth decay.

3. Avoid sticky candies that cling to your teeth. The stickier candies, like taffy and gummy bears, take longer to get washed away by saliva, increasing the risk for tooth decay.

4. Drink more water. Drinking optimally fluoridated water can help prevent tooth decay. If you choose bottled water, look for kinds that are fluoridated.

5. Maintain a healthy diet. Your body is like a complex machine. The foods you choose as fuel and how often you “fill up” affect your general health and that of your teeth and gums.

6. Avoid beverages with added sugar such as soda, sports drinks or flavored waters. When teeth come in frequent contact with beverages that contain sugar, the risk of tooth decay is increased.

7. Chew sugarless gum. Chewing sugarless gum for 20 minutes after meals helps reduce tooth decay, because increased saliva flow helps wash out food and neutralize the acid produced by dental plaque bacteria.

8. Brush your teeth twice a day with a fluoride toothpaste. Replace your toothbrush every three or four months, or sooner if the bristles are frayed. A worn toothbrush won’t do a good job of cleaning your teeth.

9. Clean between teeth daily with floss. Decay-causing bacteria get between teeth where toothbrush bristles can’t reach. Flossing helps remove plaque and food particles from between the teeth and under the gum line.

10. Visit your dentist. Regular visits to your dentist can help prevent problems from occurring and catch those that do occur early, when they are easy to “treat.”

About Dr. Jernell Escobar DDS

Dr. Jernell Escobar and her staff are dedicated to providing patients with a pleasant visit and results that they are proud to show off. Her administrative staff is ready to help with questions about scheduling, financial policy and insurance, to make that part of the process as simple as possible.

Dr. Escobar’s offers advanced dental treatments and materials that can give patients a healthier, more complete smile that can last a lifetime, including TMJ (temporomandibular joint disorders), Fillings / Restorations, Dental Sealants, Dentures, Bridges, Dental Implants, Crowns, Tooth Extractions and Non-Surgical Root Canal.

Cosmetic treatments offered by Dr. Escobar and her staff include Bonding, Porcelain Veneers, Inlays & Onlays, Teeth Whitening, Zoom Whitening, Laser Smile and Clear Braces.

They can also answer questions about the different dental specialties and explain the meaning of dental terms, including in areas of Oral Hygiene, Child Dentistry, Prophylaxis (Teeth Cleaning), Periodontal Maintenance and Arestin.

Born and raised in Southern California, Dr. Escobar became interested in healthcare while serving her country as a Public Health technician for the United States Air Force. After seven years of military service, Dr. Escobar was honorably discharged from the Air Force, having garnered multiple awards and service commendations.

Upon completion of her military service, Dr. Escobar received a bachelor’s degree in biology with a minor in chemistry from San Jose State University, graduating with honors. She earned a Doctor of Dental Surgery degree in 2006.

After completion of dental school, Dr. Escobar continued her education at the University of the Pacific School of Education and earned a master’s degree in Dental Education in 2009.

Dr. Escobar has been practicing dentistry in the bay area since 2006. She is passionate about providing exceptional oral health care in a patient-centered environment. In addition, Dr. Escobar enjoys spending time with her two children. Some of her favorite activities include travel, boating, running marathons, triathlons, wakeboarding and yoga.

Contact:

Marci Bracco Cain

Chatterbox PR

Salinas, CA 93901

(831) 747-7455

http://mouthhealthy.org/

Progressive Bay Area Executive Protection Teams Incorporate Medical Component to Enhance Protection of Their Principals

Bay Area Emergency & EP Professionals to Present, “Emerging Trends in Executive Protection Medical Programs” at ASIS International 2017.

Redwood City, CA, USA — Emergency University, the industry leader in corporate Emergency Response system design, emergency medical training and state-of-the-art response and collaborative technologies announced today that Dr. Odelia Braun, Medical Director of Emergency University, Eric Powell, Chief Security Officer of Bayshore Global Management, and William Killgallon, Head of Security and Crisis Management, GE Digital will lead an Impact session on, “Emerging Trends in Executive Protection Medical Programs” at the upcoming ASIS International Conference at the Kay Bailey Hutchison Convention Center in Dallas on September 26, 2017.

As Executive Protection models evolve, EP professionals are increasingly aware of the importance of integrating medical capabilities into their security protection models to reflect the needs of their principals. The panel will address the critical components to consider when designing EP Medical Programs.

After studying the challenges faced in designing these complex Executive Protection Programs, the panel of EP professionals and experienced emergency physicians developed a standardized process to evaluate the status of their current teams, and set short-term and long-term goals. They designed and implemented a coordinated program of medical protocols, targeted training programs, equipment and technology, designed to orient and prepare security teams to effectively respond to medical issues while ensuring that the solutions emphasized security first.

“Medical capability in the executive/dignitary protection arena is a critical resource. Having medical care on hand dramatically increases the probability of mission success,” Killgallon remarked. “For example, one of the primary reasons the murder rate has decreased in the last 30 years in the US is not because of less violence – there is actually more – or better law enforcement; it is because of better, faster, and closer emergency medical care – people are surviving things that used to kill them.”

A well-prepared medical program ensures the best clinical outcome for protectees experiencing medical emergencies. The presenters will emphasize due diligence, ways to minimize risk and assemble vital components into a cohesive system that predictably achieves effective medical protection.

About Emergency University: For more than 20 years, Emergency University has assisted national and global corporations and government agencies in the development of effective internal emergency response system planning and design, provided comprehensive emergency response preparedness training, as well as researched, developed and implemented Executive Protection Medical program solutions with cutting-edge technological support – ensuring their clients are 100% prepared! Emergency University’s clients enjoy an outstanding 100% response rate versus the national average of 2%. EU’s educational methodology prepares students to respond while offering its clients a one-stop solution for emergency response system design, compliance and training. Additional information on Emergency University is available at: http://www.emergencyuniversity.com.

Media Contact:
T. Farina
Emergency University
866-233-4357
tfarina@emergencyuniversity.com
http://www.emergencyuniversity.com

Finding Temporary Care for Seniors Displaced by Disaster

Many Seniors Displaced by Hurricane Harvey – How Local Senior Communities are Helping.

Dallas, TX, USA — We have all seen the horrific images of flooding and disaster along the gulf in Texas and Louisiana. This event has left thousands homeless and helpless, lacking basics as well as medical equipment, medication and help. Times like these leave the vulnerable, especially seniors, at a greater risk.

This is when neighboring communities open their doors to help those in need. From the mega-shelters, to churches, and small owner run assisted living homes, all are willing to help neighbors in need.

NewLifeStyles.com named as a Top Senior Living Website by Top5Reviewed.com, is a free, comprehensive guide to senior communities and care providers, not just in the Houston and Rockport areas, but nationwide. Where you can find senior homes offering respite, or temporary help for those displaced by the storm.

NewLifeStyles.com is a “one stop shop” where people can find and compare senior living communities & care providers across the country, from nursing homes in Texas, to assisted living and memory care in the Heartland, retirement communities in the New York and Boston, and even hospice providers in Alaska. You can find all licensed senior communities and care providers and more, including some pictures, videos, email forms, etc. The “robust blog content” contains tips for choosing a provider, moving, downsizing, caretaking and more.

We are receiving emails and notices from communities in Texas with openings, offering to take in seniors needing help. Let us help you find the help you need, rather that is temporary or long-term.

New LifeStyles is The Source for Senior Living and Care, providing free, comprehensive, quality information on senior communities and care providers nationwide. New LifeStyles offers free print guides covering many areas across the country, as well as a website and mobile site, reducing the frustration of trying to find information from multiple sources, agencies, or organizations. Whether looking for a nursing home, memory care, assisted living, independent living, home care or something else, New LifeStyles can help seniors and their loved ones make the best decisions to fit their needs.

If you would like more information about this topic, please contact at 1-800-869-9549 or jennifer@newlifestyles.com.

Media Contact:
Jennifer Campbell
New LifeStyles
800-975-9439
jennifer@newlifestyles.com
http://www.newlifestyles.com

The Drop4 Diet: Revolutionary #NEW Low Carb High Fat Diet to Drop up to 4 Dress Sizes

Targets how Stress Makes us Fat and tackles the Big ‘4’ to Fast-track Weigh Loss

Perth, WA, Australia, August 24th, 2017 — Released this week, the Drop4 Diet is the revolutionary science based, natural eating program that balances blood sugars, improves cell health and resets the body’s own appetite thermostat. It looks at how stress makes us fat and tackles the Big ‘4’ – it’s low carb, high fat, no sugar and reduced dairy formula fast-tracks weight loss for women.

“What’s most exciting about the Drop4 Diet is there’s no counting calories, no complicated diet program or food deprivation. We introduce foods that satisfy you more and balance your blood sugars to reduce the psycho-emotional connection to food’ said Drop4 Diet’s founder, Rose Burnett.

The Drop4 Diet, part of the Mind Body Soul Balance Program for Women is being officially launched by founder, Rose Burnett on Friday, August 25th at Earthwise, Rokeby Rd Subiaco. Tickets are available from Eventbrite

The Drop4 Diet looks at the underlying cause of being overweight which is often traced back to our blood sugar levels and how much stress we have in our life. When experiencing high levels of stress, a number of stress hormones are released into our bloodstream that can affect cell health, blood pressure and sugar levels.

Leading to sugar spikes in blood glucose levels and a vicious cycle of sugar cravings, sugar highs and dips. This can wreak havoc with the natural appetite thermostat that lets us know when we’ve had enough to eat.

The Drop4 Diet started with Burnett’s own amazing body transformation. “Combined with my Total Body Sculpting Workout for Women’ the Drop4 Diet saw me personally lose 29kgs and Drop 4 Dress Sizes from a Size 14 down to a tiny Size 8.”

“I had struggled with weight loss over the years, trying all sorts of diets which led to long cycle of yo-yo dieting. When I looked at how stress was affecting my cell health and weight, I discovered is that weight loss has nothing to do with dieting or motivation.“

THE FOOD SCIENCE BEHIND THE DROP4 DIET:
Burnett shared “There is a direct link between what you eat and how it makes you feel. And the ‘spike and dip’ crash we can experience from stress hormones being released, significantly increases the driving forces behind our motivation to eat. This constant ‘spike and dip’process affects our endocrine regulators like insulin and our gut, and brain.”

There are a number of foods that we commonly eat that are considered ‘healthy’ but actually turn to simple sugars in our body, elevating blood sugar levels and leading to cravings.

The Drop4 Diet introduces foods that satisfy you more. It eliminates the worst problem foods right from the beginning to start balancing out blood sugars.It resets the appetite thermostat, so you recognize when you are full.

The Drop4 Dietswaps highly processed and packaged foods with naturalorganic foods that are high in antioxidants and more alkaline based. The Drop4 Diet is a low carb, high fat, reduced dairy and no sugar food modification system, supported by food science.

When combined with Burnett’s unique Total Body Sculpting Workout for Women and Cardio Guide, it is possible for women to lose up to 4 Dress Sizes on the Drop4 Diet.

To learn more, visit www.roseburnett.com

About Rose Burnett:
Rose Burnett is Certified Transformational Coach and NLP Practitioner. Yogi, gym junkie and Advanced Usui Reiki Practitioner. Founder of Drop4 Diet, Total Body Sculpting Workout for Women, and Mind Body Soul Balance Program. Organiser of ‘Mind Body Soul Balance’ Meetup Group for Women in Perth.

Rose has 20+ years business experience as an Entrepreneur, digital marketer, web developer and Project Management Professional. A passionate start-up promotor, presenter, interviewer, blogger and Organizer of the ‘Grow Your Business Online’ Meetup Group for Small Business Owners in Perth with 305+ Members.  Rose lives in Perth, Western Australia with her two grown up sons. Living each day in alignment with spirit and nature.

Press & Media Contact:
Rose Burnett
Rosemary Burnett Consulting
Perth, WA – Australia
0426 096 091
info@roseburnett.com

Drop4 Diet

Finally an Answer for the National Opioid Crisis

An at home program for curing opioid addiction with extremely high cure rates is revealed.

Sylva, NC, USA — Dr. Winn Henderson has just released this week his 41st book entitled: “Freedom From Addiction 3” which offers a treatment program which can be accomplished at home to cure opioid addiction. If the addicted individual meets three simple criteria there is a 100% cure rate.

Dr. Winn Henderson is a retired physician with over 20 years of clinical experience. He is the author of 41 books including The Cure of Addiction, The Four Questions, Share Your Mission, The Deposition, The Secret to Happiness, The 12 Steps, and this book, Freedom From Addiction 3. For the last 20+ years, Dr. Henderson has been counseling both in person and by telephone clients from all over the world on issues of addiction and finding one’s purpose in life. He is the host of a 17-year long radio/internet talk show: “Freedom From Addiction/Share Your Mission.” His iTunes podcast: “Freedom From Addiction” can be heard 24/7 all over the world. The doctor is immediately available for national interviews.

Media Contact:
Winn Henderson, M.D.
Freedom From Addiction
828-508-7981
winn@winnhenderson.com
http://www.freedomfromaddictionii.com