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SAN FRANCISCO (AP) — Authorities in California took the unusual step of jailing and charging a tuberculosis patient who they say refused to take medication to keep his disease from becoming contagious.
Health officials said Armando Rodriguez, 34, of Stockton, has active pulmonary tuberculosis, which can include coughing up blood or phlegm and can spread through the air.
Rodriguez has been noncompliant with his treatment and could become contagious as a result, Ginger Wick, nursing director for San Joaquin County, said in a letter requesting a warrant for Rodriguez’s arrest.
After failing one time to give himself the drugs, Rodriguez told a nurse he had gone on an alcohol binge and taken methamphetamine and didn’t want to hurt his liver, Wick said in her letter.
Rodriguez was arrested Tuesday and is expected to be arraigned Thursday on two misdemeanor counts of refusing to comply with a tuberculosis order to be at home at certain times and make appointments to take his medication.
He will likely be appointed a public defender.
Tuberculosis is a bacterial infection that usually attacks the lungs. Many people have a latent form, and the active form usually only affects adults whose immune systems are compromised, which can happen from drug use.
Public health experts are divided on the issue of mandatory treatment and criminal charges for patients who don’t comply with treatment orders.
Many of those who do support criminal prosecution in the rarest of cases when public health is in jeopardy oppose the jailing of patients.
“I think it’s an error to confine someone in the criminal justice system for a public health crime,” said Lawrence Gostin, a Georgetown University public health law professor who drafted a model law adopted by several states struggling with the issue. “The whole intention is to protect the public’s health. It’s not to lay blame on someone.”
Implementing mandatory treatment should be a last resort, and prosecuting someone for disobeying a public health order is unhelpful and sends the wrong message if protecting public health is the intent, Gostin said.
Instead, the afflicted should be given incentives such as transportation to and from treatments rather than punishment as an incentive to take their medicine, he said.
The Centers for Disease Control and Prevention said laws to control the spread of tuberculosis have been in use for more than a century, though regulations differ in each state.
As many as 12,000 new cases of tuberculosis are reported in the country each year, the CDC reported. California recorded 2,317 new cases in 2011, a low since records have been kept.
Nonetheless, officials throughout the nation continue to struggle to stop the spread of tuberculosis, with several drug-resistant strains emerging in recent years.
Federal and state officials don’t keep records of the number of people prosecuted for refusing to take their medicines. But some say it’s exceedingly rare to file criminal charges in such cases.
San Joaquin County has had more than 30 tuberculosis prosecutions since 1984, prosecutor Stephen Taylor said, noting the county is more aggressive than other jurisdictions in prosecuting patients to get them to take their medication.
“The criminal cases we’re dealing with generally involve drug users who are harder to treat and manage because the TB medicines conflict with street drugs,” he said. “We have to throw these people in jail and treat them as in-patients. They don’t cooperate as out-patients.”
Karen Furst, San Joaquin County public health officer, said the county arranges transportation and other services to help patients stick to their drug regimen and turns to the legal system only as a last resort.
“I have to make sure that if I’m aware that somebody is in a position that could possibly be spreading a disease to another person, that I take steps that are necessary to prevent that from happening,” she said.
Rodriguez was discharged in March from San Joaquin General Hospital with four medications for active tuberculosis and agreed to take the drugs under observation by a county health official on weekdays and on his own on weekends, authorities said.
He allegedly refused to take the drugs on another day and then was not at home on three occasions and missed an appointment.
Each charge against Rodriguez carries a maximum penalty of a year behind bars. In her letter, Wick said Rodriguez would need nine months of treatment.
As the largest segment of the population of the United States, the generation of baby boomers born around the end of the Second World War, the medical industry has seen a corresponding increase in the need for medical professionals to treat aging of this community. With doctors, nurses and assistants, there is the demand for specialists in medical billing. And medical billing is more conducive to working from home. The work can be done easily from home, in some cases it may also be more profitable for health professionals to outsource this work at home medical billing specialists.
There was a time of working as a medical billing specialist, you were advised to go through a college program and obtain certification. Now with the advent of technology and ease of use of the Internet, it became easier for the medical billing specialist at home with a variety of medical billing software online to provide the necessary service.
Online Medical Billing software is used to enter all necessary data on the forms of insurance claims, the public and private companies including insurance, social security, Medicaid and Medicare, and Workers Compensation. Then, using this software they submit claims through a clearinghouse that spreads the claims of all institutions and enterprises correct. Billing software will find errors, making the work easier and allowing far fewer errors which saves your and your clients’ time and money.
There are many packages of online medical billing software available for use, and you can find more information on GuideToMedicalBilling.com. Some specialize in very large heath care centers, and some are created specifically for the home based business. It is important to give new software a test run, and try several before making a decision on what is right for you.
Online software is a great step forward for the largest billing specialist, making the whole process much easier and simpler than ever. However, before purchasing any software or service, take the time to do the research to be sure you choose the plan that works best for you and your business.
For some medical procedures and conditions, your doctor may prescribe a short-term diet of clear liquids. This does not have to be a deadly-dull ordeal if you include flavorful alternatives to the usual bland fare and try these clear liquid diet food ideas.
A clear liquid diet includes plain water, clear juices, broth or bouillon, tea or coffee (WITHOUT cream or creamers but can be sweetened with honey or sugar), gelatin, clear sodas like ginger ale, and ice pops or other frozen products made from pure juice that contain no pulp, pures or chunks of fruit. The goal, after all, is to keep food residues out of your digestive system long enough so that your doctor can perform tests such as a colonoscopy, or until your body can begin to digest food on its own again after surgery or an illness. This diet sounds pretty miserable, yes? Not necessarily.
Drinking plain water can get old really fast on this diet, even if you normally love it. Jazz it up with flavorings like Crystal Light or a splash of clear fruit juice like cranberry, apple or grape.
It’s not exactly soup, but clear broth can be an important part of the short time you’re on a clear liquid diet. First, it provides electrolytes like salt and potassium that you’re not getting from your regular diet. Second, since it’s hot and you sip slowly, it can feel like you’re eating something more substantial than the other components of this diet. But before you grab that can or box of broth from the supermarket shelf, consider that making your own broth is much cheaper, does not contain chemicals like MSG, and can be tailored to fit your tastes. And it’s easy. Add a quartered onion, a couple of stalks of celery, a couple of carrots, salt and pepper to taste (fresh, coarsely ground pepper works best), and your own bouquet garni – a combination of herbs and spices tied in a little cheesecloth bag – to four to six cups of water in a pot. Bring to a boil, lower the heat and simmer for about 30 minutes. Strain the broth twice to make sure all particles are removed, and enjoy as frequently as you desire.
Who says gelatin has to be boring? Why not make non-alcoholic “Jell-O shots” and pretend it’s a little more interesting? Just follow the package directions, but pour the hot, dissolved gelatin mixture into shot glasses. After it has set, loosen the edges with a popsicle stick or a butter knife and enjoy. Or, while making the gelatin, replace some of the water with clear fruit juice to your preference. Cranberry/lime, anyone?
Sorry, no ice cream on this diet. But the “treat” feeling of an ice pop can help with the monotony. Sure, you can buy commercially-available ice pops, and some commercially-prepared Italian ices are allowed (check labels carefully to make sure no fruit solids or pures are included), but to avoid artificial colors that may not be advisable in some conditions, for example, in colonoscopy prep, make your own frozen goodies. For ice pops, all you need is an ice pop form – available from companies like Tupperware or at stores like Target – and a selection of clear fruit juices like apple, grape or cranberry. You can also use lemonade or fruit punch as long as you carefully strain to remove any pulp. Either using individual flavors or a combination (apple/cranberry is nice), pour into molds and freeze. If you’re feeling ambitious and want to make your own lemon Italian ice, bring to a boil 2 cups of water, 3/4 pounds of granulated sugar and 1/2 teaspoon of grated lemon zest. Simmer for 10 minutes, strain out the zest and let cool. Then add the strained juice of three lemons. Adjust the balance of sweet/tart to your preference by adjusting the amount of sugar or the amount of water. Churn in an ice cream maker until slushy. This can also be made without an ice cream maker. Just pour the cooled mixture into an airtight container, put into your freezer and stir about every half hour until it reaches the desired consistency.
Yes, coming up with clear liquid diet food ideas can be a trial, and yes, being on the diet can be unsatisfying and tedious, but if you plan ahead and use some creativity, you can make the very short time you or a loved one is on a clear liquid diet go faster.
NOTE: Using a clear liquid diet for weight loss can be dangerous. This diet should only be undertaken under a doctor’s supervision and for no more than a few days, as this type of diet does not contain adequate nutrition or calories.
Do you suffer from not seeing very well? Does this happen when you’re driving? When you’re reading? When you’re looking at the board in class? Does it happen 24 hours of the day, 7 days a week? You are probably a candidate for, or have already discovered, corrective contact lenses. Commonly known as “contacts,” corrective contact lenses are used to improve vision and eyesight. People turn to contact lenses for many reasons: their practical purpose, appearance over eye glasses, and for other reasons that outweigh wearing eye glasses.
Corrective Contact Lenses for Sight Contacts have been used for quite some time. They are used all over the world, and in the United States alone, over 20 million people wear them. Contacts are basically therapeutic lenses to cover the cornea of the eye. They are worn to improve vision. Many people, as evidenced by the astonishing number above, have a mismatch between the refractive power of the eye and the length of the eye; this is known as a refraction error. The corrective contact lens, for all intents and purposes, acts like a buffer by neutralizing this disparity and promoting the correct focusing of light on the retina, which is the part of the eye that receives images. There are a number of conditions for which corrective contact lenses are suitable:
- Myopia: near or short sightedness.
- Hypermetropia: far or long sightedness.
- Astigmatism: blurry vision.
- Presbyopia: this results with age and is marked by a diminished ability to see clearly.
There is also another condition that could possibly be corrected with corrective contact lenses, and it is called color blindness. The lens will allow those with color blindness to distinguish between colors better. It is not a cure, but a corrective measure.
How to Wear Contact Lenses It is important not to keep any type of contact lens in the eye day in and day out. Giving your eyes a break will prevent infection and irritated eyes. Wear the contacts during the day, and either take them out at night or every few days. When you should take them out depends on the specific type of contacts. Daily wear contacts should be only worn for the day and taken out at night. Extended wear contacts can be worn continuously, day and night, for 6 or more days; discard them after the specified amount of time. Another type, made with silicone material, can be worn for up to 30 consecutive days, and are called continuous wear. Both extended and continuous wear contact lenses have high oxygen permeability, allowing the integrity of the eye to remain intact and healthy. Before inserting any type of lens into the eye, wash the hands thoroughly with soap and water to prevent the spread of bacteria. You will need to be taught how to put the lenses in, and remember, practice makes perfect!
Caring for Contact Lenses If the corrective contact lenses aren’t just for single use, they need to be properly cared for; they’ll require regular cleaning and disinfecting. There are different types of cleaners that can be bought for this over-the-counter: multipurpose solutions, hydrogen peroxide, saline solutions, enzymatic cleaner, and more.
Contact Lenses vs. Eye Glasses Both types of eye wear have benefits; mainly that they allow you to see more clearly. Advantages of contact lenses are: they are less affected by damp/wet weather, they don’t steam up, and they provide a wider field of vision than do glasses. Many people simply find them to be more comfortable than wearing eye glasses. However, the choice is yours, and if you find it difficult to wear contact lenses for any reason, that is perfectly okay.
AP Photo/Matt RourkeNEW YORK — Federal regulators filed complaints Monday against the makers of POM Wonderful Pomegranate Juice, saying there’s no science to support claims that the products treat or prevent diseases such as prostate cancer and erectile dysfunction.
The Federal Trade Commission says POM Wonderful LLC, its parent company Roll International Corp., its creators and an executive violated federal law by making false and deceptive claims about disease prevention and treatment.
The agency’s complaint names POM Wonderful President Matthew Tupper and company founders Stewart and Lynda Resnick, a billionaire California couple whose holdings also include florist retailer Teleflora, Fiji Water and companies that produce Wonderful Pistachios and Cuties clementines.
POM Wonderful is seen as starting the pomegranate craze that has spread to everything from tea to smoothies, hitting ice cream, martinis and salad dressings on the way. The company’s health claims are a hallmark of its advertising.
POM Wonderful says on its website that it has spent more than $34 million to support scientific research on POM products since 1998. Study topics include muscle recovery, diabetes, antioxidant potency, heart disease, prostate cancer and erectile dysfunction.
Regulators said the ads were misleading in saying the research shows the juice or related pomegranate supplements prevent or treat certain diseases.
“Any consumer who sees POM Wonderful products as a silver bullet against disease has been misled,” said David Vladeck, director of the FTC’s Bureau of Consumer Protection. He said companies using scientific research in their advertising must have research that supports the claims.
POM and its principals did not immediately respond to a call for comment from The Associated Press.
FTC complaints are not a conclusion or ruling that the law has been violated. The FTC will hold a hearing within eight months before an administrative law judge.
The FTC cited advertisements in national publications including The New York Times and Prevention, on Internet sites run by the company including pomwonderful.com and pompills.com, and elsewhere. Regulators question the scientific methods used and said some studies cited did not show POM Juice to be effective against the diseases.
The claims in POM ads that the FTC cites include:
– “New research offers further proof of the heart-healthy benefits of POM wonderful juice. 30 percent decrease in arterial plaque … 17 percent improved blood flow … promotes healthy blood vessels….”
– “Clinical studies prove that POM Juice and POMx prevent, reduce the risk of, and treat prostate cancer, including by prolonging prostate-specific antigen doubling time.”
– “You have a 50 percent chance of getting (prostate cancer). Listen to me. It is the one thing that will keep your (prostate-specific antigens) normal. You have to drink pomegranate juice. There is nothing else we know of that will keep your PSA in check…. It’s also 40 percent as effective as Viagra.”
The complaint asks that future claims about pomegranate-based products comply with Food and Drug Administration regulations, though that is not typically required for compliance with trade laws. Having the FDA approve claims would give the company more guidance, the FTC said.
The agency also wants to prevent POM and its parents, founders and the executive “from making any other health claim about any food, drug, or dietary supplement without competent and reliable scientific evidence.”
The FTC said it reached a settlement in a related case with Mark Dreher, the former head of scientific research and regulatory affairs for POM Wonderful. He has agreed to a settlement that bars him from making any disease treatment or prevention claims in POM Wonderful advertising unless the claim is backed up.
Dreher also must not make health claims for other products without scientific evidence.
Such settlements do not mean there has been an admission of violating the law, the FTC said.