Thursday, September 22, 2016

Trial helps doctors tell Lewy body dementia from Alzheimer's, Parkinson's

Researchers at The Ohio State University Wexner Medical Center set out to develop a clinical profile for these patients. The study compared 21 patients with Lewy body dementia to 21 patients with Alzheimer's disease and 21 patients with Parkinson's disease.

 "Many clinicians find it difficult to diagnose Lewy body dementia patients, often confusing them and misdiagnosing them as Alzheimer¹s disease or Parkinson¹s disease patients. Our study findings showed that the clinical profiles of Lewy body dementia patients can be differentiated from Alzheimer's and Parkinson's patients," said Dr. Douglas Scharre, director of the division of cognitive neurology at Ohio State's Wexner Medical Center and principal investigator of the study. "Since treatments and prognosis differ between these conditions, it's important to correctly diagnose the patient from the start."

Lewy body dementia is characterized by Parkinsonism (stiffness and trouble with gait), memory loss, and visual processing difficulties. Fluctuations and visual hallucinations are not uncommon. Mental degradation progresses as in people with Alzheimer's disease. The disease usually appears after age 60. Lewy bodies are collections of proteins (alpha-synuclein) that accumulate abnormally in the brain, that are not typically seen in Alzheimer's, and are deposited in different parts of the brain than in Parkinson's. These toxic alpha-synuclein proteins accumulate gradually, impact specific brain regions leading to its unique clinical symptoms and disease course, and need to be treated and managed differently than those with Alzheimer's or Parkinson's.

The diagnosis is likely Lewy body dementia if the patient is characterized by a specific cognitive profile (retrieval memory disturbance and deficits in visuospatial and executive domains), along with axial (trunk/body) posture impairments & gait/balance instability. Compared to Alzheimer's patients, Lewy body dementia patients have more executive and visuospatial deficits and less amnesia and disorientation, and also show more daytime sleepiness, cognitive/behavioral fluctuations, hallucinations and obstructive sleep apnea than either Alzheimer's or Parkinson's patients.

"It's vitally important that patients are correctly diagnosed so that they can be prescribed the proper medications that may help slow down the course of the disease or improve symptoms," Scharre said. The correct diagnosis of Lewy body dementia will prompt evaluation and treatment for commonly co-existing associated conditions such as autonomic conditions, sleep apnea, REM sleep behavior disorder, fluctuations of attention and alertness, gait disturbance and fall risk.

Read more about this at The Ohio State University Wexner Medical Center. "Trial helps doctors tell Lewy body dementia from Alzheimer's, Parkinson's." ScienceDaily. ScienceDaily, 21 September 2016. <www.sciencedaily.com/releases/2016/09/160921151916.htm>.


William Wombacher, your Central Illinois Certified Elder law Attorney (CELA) and Social Security Disability Specialist. I'll help you! www.wombacherlaw.com

Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.
 

Thursday, July 21, 2016

Get a little Gold in your knee or hip replacement

Titanium is the leading material for artificial knee and hip joints because it’s strong, wear-resistant, and nontoxic, but adding gold might make implants even better.
Because titanium and gold by themselves are among the most biocompatible metals and are often used in medical implants, the team believed titanium-3-gold would be comparable. They were surprised.
“It is about 3-4 times harder than most steels,” says Emilia Morosan, the lead scientist of a new study in Science Advances that describes the properties of a 3-to-1 mixture of titanium and gold with a specific atomic structure that imparts hardness. “It’s four times harder than pure titanium, which is what’s currently being used in most dental implants and replacement joints.”
The researchers decided to do tests to determine exactly how hard the compound was, and while they were at it, they also decided to measure the hardness of the other compositions of titanium and gold that they had used as comparisons in a previous study.
What they didn’t know at the time was that making titanium-3-gold at relatively high temperature produces an almost pure crystalline form of the beta version of the alloy—the crystal structure that’s four times harder than titanium. This was much strong than making them at lower temperatures which produced a different structure.
In fact, tests determined that the new alloy was even more biocompatible than pure titanium. The story proved much the same for wear resistance: Titanium-3-gold also outperformed pure titanium.
Read about this at http://www.futurity.org/knees-hips-gold-titanium-1208232-2/  of the work of Emilia Morosan of Rice University.
William Wombacher, your Central Illinois Certified Elder law Attorney (CELA) and Social Security Disability Specialist. I'll help you! www.wombacherlaw.com
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Friday, July 15, 2016

Study shows Brand-Name Drugs’ High Copays Stick it to Medicare Part D Patients

A new study takes a fresh measure of generic drugs’ price advantages, revealing how much more Medicare Part D patients shelled out in co-payments for two popular brand-name drugs in 2013.
The result: 10.5 times more.
Copayments averaged $42 for both Crestor, a cholesterol medication, and Nexium, taken for acid reflux, according to researchers whose study was published in Health Affairs.
The consumers’ cost for generic therapeutic equivalents was $4, they said.
In 2013, the top 10 drugs in Part D, ranked by claims, were all generics, accounting for $4.1 billion in expenses. But ranked by total spending, the top 10 most expensive drugs were all brand names, representing $19.8 billion in spending, CMS said. Nexium was No. 1 — at $2.5 billion — and Crestor was No. 3 at $2.3 billion.
Had generic equivalents been prescribed in 2013 instead, the government, patients and insurance companies could have saved a combined $870 million for omeprazole in place of Nexium and $1.2 billion for atorvastatin instead of Crestor, researchers estimated. Dr. Nicole Gastala, the study’s lead author, said certain aspects of medical culture steer patients toward brand-name drugs.
Patients are frequently biased toward brand names by the power of advertising, and doctors’ interactions with pharmaceutical representatives have the same effect on them, said Gastala, who practices family medicine in Iowa and was a former visiting scholar at the Robert Graham Center for Policy Studies in Washington, D.C.
The cost of a drug is often unknown to both patients and doctors and physicians may have no idea how expensive a copay is.  When doctors prescribe a brand-name, patients rarely second-guess the choice, Gastala said.
Read about this at http://khn.org/news/study-brand-name-drugs-high-copays-soak-medicare-part-d-patients/  in an article written by Rachel Bluth at Kaiser Health news.

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   http://www.wombacherlaw.com

Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.
 

Myths about Mental Illness

As common as mental illness is, though, certain myths are surprisingly persistent and prejudice continues to be widespread. Here are common beliefs debunked.
 MYTH #1
You can “snap out of” mental health problems.
The facts: You can’t just magically think your way out of a mental illness, whether it’s mild or severe. This idea is pervasive — and damaging, because it creates unreasonable expectations for the person who is suffering from the illness, says Nelson Freimer, psychiatry professor at the University of California, Los Angeles.Some may regard mental illness as a personality or character flaw, but that simply isn’t the case. Researchers have found many factors that contribute to and influence whether someone will develop mental illness, including genetics, biochemical imbalances in the brain, childhood abuse and the hormonal changes that come with pregnancy.
MYTH #2
Mental health problems breed violence.
The facts: There’s a big disconnect between our perceptions and the evidence, says Jeffrey Swanson, a psychiatry and behavioral sciences professor at Duke University School of Medicine. It is hard to escape the headlines about mass shootings committed by someone with a history of mental illness, and polls show that a majority of people believe that the mentally ill are more likely to be violent.
But the truth is, the vast majority of people with mental illness are not violent, says Swanson. Although people with severe mental illness are up to three times more likely to be violent than those who are mentally healthy, they contribute to just a small part of violence in society, he says. And only about 3 percent to 5 percent of violent acts can be attributed to mental illness. In fact, researchers have found that people with mental illness are about 10 times more likely to be victimized by violence than the general population.
MYTH #3
You can’t recover from mental illness.
The facts: Many people do make it through mild or moderate episodes of mental illness and never experience them again. Others with more serious conditions are able to successfully control them and live the life they want, just like people with such chronic diseases as diabetes.
Recovery often depends on the type of mental illness, how old you are when diagnosed and other health conditions. The good news is that recovery rates are generally high: up to 50 percent for schizophrenia, 70 percent for panic disorder and 80 percent for bipolar disorder.
Recovery can feel different to different people, but it’s helpful to think of it as an ongoing process of regaining control over your life after a diagnosis, says 63-year-old Susan Noonan, a Boston physician and author who suffers from depression herself. Recovery doesn’t necessarily mean being the person you were before you got sick — that’s likely not realistic. “But it doesn’t mean you can’t enjoy your life,” says Noonan. “Living in recovery means being able to handle tough days, and it looks different for everyone.” The challenge lies in setting realistic expectations for what recovery means to you. “Mental illness changes how my life goes, but it doesn’t dictate. It’s not the decider,” says Noonan.
Read more about this at http://khn.org/news/busting-myths-about-mental-illness/  in an article written by Barbara Feder Ostrov at Kaiser health News.

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   http://www.wombacherlaw.com


Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Tuesday, July 12, 2016

Retirement plan participants should consult with an experienced attorney about completing beneficiary designation forms!

Retirement plan beneficiary designations are not governed by a will. For retirement plan participants changed circumstances can  affect those beneficiary designations. Those changed circumstances could be a divorce, remarriage, birth or death of a loved one,  or even a pre-nuptial agreement. Make sure that when you consider reviewing your will or trust you also look at the beneficiary designations you have made. They may be out of date. If you are the process of getting a divorce it is especially important to consider changing your will and beneficiary designations in case disaster would strike before the divorce is final.

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   http://www.wombacherlaw.com

Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Tuesday, September 29, 2015

Should I put my money in joint tenancy with my children?

     I can't tell you how many times I have sat down with a potential client to discuss planning their estate upon their death and I find out they have put one or more of their children on their checking account, CDs or investment account as a joint tenant. I ask them if they intend on favoring that child or group of children over the other ones. The answer is almost always, " No!"

   This is done many times because the client is elderly and concerned about someone in the family having access to funds to pay bills if they become sick or incapacitated. This is the wrong way to do things in almost every case. We have Powers of Attorney to accomplish these purposes. An agent under a Power of Attorney has special responsibilities under the law which are known as fiduciary duties. They can not favor themselves and being an agent under a Power of Attorney is not a license to steal. Do agents sometimes do things they shouldn't do --sure. Agents are legally held to a high standard under the law. 

    The problem with making your child or children joint tenants is that it creates a presumption under the law that it is your intention upon your death that the joint tenant should be the sole owner of the account. If you want that account divided equally among all your children you could have big problems.  A joint tenant can also go into the Bank and withdraw all of the money without your knowledge or permission. I had one client that had 3 children and added each child as a joint tenant on each of three different CDs she owned. Now if one CD needs to be cashed in to bill some medical bills who is the odd man out? 

     There are a number of ways to avoid probate that maybe much better than than the do it yourself method of adding your children as joint tenants. I don't want want your children's financial problems to be your financial problems. If the bill collectors are chasing your kids what makes you think they are  going to stop when their research shows up that joint account with you. What about if your kids don't have enough liability coverage and manage to run over an orthopedic surgeon crossing the street in front of the hospital. When you kill someone who makes $900,000 per year in slow year it is going to get expensive. What if one of your kids decides they don't want to be married anymore? Are you going to have prove to some Court that the money in that joint account is not their's? Why in the world would want any of these worries when they could easily be avoided. Discuss your options with a well qualified Elder Law attorney. You will rest easier knowing your approaching this the appropriate way. 


William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   http://www.wombacherlaw.com



Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

A Breast Cancer Surgeon Who Keeps Challenging the Status Quo

Dr. Esserman, 58, is one of the most vocal proponents of the idea that breast cancer screening brings with it overdiagnosis and overtreatment. Her philosophy is controversial, to say the least. For decades, the specter of women dying for lack of intervention has made aggressive treatment a given.
Photo
­ Tissue from a patient with ductal carcinoma in situ. Credit Garry DeLong/Science Source
But last month, her approach was given a boost by a long-term study published in the journal JAMA Oncology. The analysis of 20 years of patient data made the case for a less aggressive approach to treating a condition known as ductal carcinoma in situ, or D.C.I.S., for which the current practice is nearly always surgery, and often radiation. The results suggest that the form of treatment may make no difference in outcomes.

Dr. Esserman, who directs the Carol Franc Buck Breast Care Center, is one of only a few surgeons in the United States willing to put women with D.C.I.S. on active surveillance instead of performing biopsies, lumpectomies or mastectomies. She and other critics of vigorous intervention point to the potential side effects and risks of sometimes disfiguring treatments for premalignant conditions that are unlikely to develop into life-threatening cancers.

Dr. Esserman received national attention five years ago with an innovative, adaptively randomized drug trial called I-SPY 2, aimed at reducing the cost and time required to test new medications for breast cancer. The trial matches drugs with patient subtypes, allowing drugs from different companies to be assessed simultaneously, and much earlier in the disease process, while quickly phasing out those that do not appear to be working.
Trials for drugs to treat other cancers, as well as Alzheimer’s disease and Ebola, have adopted the design, said Donald Berry, a statistician at M.D. Anderson in Houston who designed I-SPY 2 with Dr. Esserman.

Read more about this in an article written by 

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   http://www.wombacherlaw.com

Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.