Wednesday, February 29, 2012

Epocrates EHR Too Late For the Show and Looking to Sell Their Mobile Medical Records System

This is kind of too sad as I have used Epocrates for years on my cell phone andimage PDA before that to look up formularies.  Even on this blog I put a courtesy search box for their web services to make it easy to look up a drug. The problem here is that they have way too much competition and the late start didn’t help them out a bit.

Epocrates Entering the Mobile EHR Market

This is just yet one more merging or selling of software as it’s happening all over and I can’t even keep up with it, especially on the insurer side of payor software.  BD 

The San Mateo, Calif.-based company acknowledged that building the EHR has hindered its ability to pursue other ways to expand its portfolio. “As a result, we are exploring strategic alternatives for our EHR offering,” according to a statement. The company noted it needed to focus more “on the natural extension of our core business.”

The company had high hopes for the EHR, as it counts 340,000 physicians on its network. But the product, which is mobile-device friendly, was coming late into a saturated market. A first-phase version of the software was not available until August 2011 and the product did not receive Complete EHR meaningful use certification until February 2012.

http://www.healthdatamanagement.com/news/epocrates-stock-ehr-electronic-health-records-44090-1.html?ET=healthdatamanagement:e2388:120588a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_022912

Judge Says No to Cardinal–Suspension Remains on Shipping Drugs from Florida Facility–Where Were The Algorithms/Analytics To Find This?

As you read on here and with the way we use business intelligence for everything and even abuse it today in some areas, here’s a case to where the CVS pharmacy would have stuck out like a sore thumb if the average store dispenses 69,000 a year and this store dispenses 1.8 million pills.  I know any intelligence report of course would have caught that in a heartbeat but the problem is, someone has to look at it as well and bring it to the forefront.  I think the judge making this ruling is being tough as the numbers are so very far out of whack here with normal and customary numbers.   image

DEA Raids 2 CVS Stores in Florida and Suspends License of Drug Distributor Cardinal Health–Lots of Oxycodone

Then you have the other side of the coin with making sales numbers too so perhaps in the name of sales and marketing this little observation here was perhaps not that important?  BD 

WASHINGTON – Cardinal Health, a Fortune 500 drug distribution company accused by the Drug Enforcement Administration of selling excessive amounts of prescription painkillers to Florida pharmacies, must stop shipping drugs from its Lakeland, Fla., distribution center, U.S. District Judge Reggie Walton ruled Wednesday.

The DEA says the Lakeland distribution center posed a danger to public health. A DEA investigation found Cardinal shipped 50 times as much oxycodone to its four top pharmacies in Florida as to its other retail customers. In 2011, a CVS pharmacy in Sanford, Fla., purchased 1.8 million pills from Cardinal, DEA records show.

An average U.S. pharmacy dispenses 69,000 a year, the DEA said.

http://www.usatoday.com/news/nation/story/2012-02-29/cardinal-health-painkillers-florida/53307498/1

FDA Approves First 4 in 1 FluMist Vaccine For Ages 2 to 49

We get some extra vaccine power in this FluMist vaccine it appears so I guess might as well get all you can at once and you inhale it.  Strains of two types of both strains A and B are included.  BD

image

WASHINGTON (AP) — Federal health officials have approved the first vaccine that protects against four strains of the common flu, offering one additional layer of protection against the influenza virus that affects millions each year.

The FluMist Quadrivalent vaccine from AstraZeneca's MedImmune unit protects against two strains of influenza A and two strains of influenza B. The Food and Drug Administration approved the spray-based vaccine for people ages 2 to 49.

Previously all vaccines contained two strains of influenza A and one strain of influenza B, chosen annually by medical experts based on their potential to spread the virus. Having an extra strain of influenza B increases the likelihood that the vaccine will protect against illness, the FDA said in a statement.

http://www.google.com/hostednews/ap/article/ALeqM5ibXE85rONseljFyN9twquE_-qoSw?docId=0f1bacee0d3d4d109f2cde74ead44952

Feds Bust Doctor in Dallas, Texas Area for Medicare Fraud–No Yacht and No Escape from the US Now… Biggest MD Fraud Case in History

When you read through this he had it all pretty well planned out so this was not an “accidental” case of errors with medical billing by any means.  Getting busted one and then going around to create another company to keep functioning is like really asking to be caught and there’s greed in fraud for sure.  What is also kind of funny is the book that they found that evidently was his business plan to make all the money and run, "Hide Your A$$ET$ and Disappear."image

Also too using folks from shelters and giving them grocery money and so forth was not a good idea either and if the folks were hungry well they maybe got some food out of the deal and probably had no idea as to the big over all scheme that was taking place.  Stories like this are just amazing as honest doctors fight, dig and scratch at times to get what’s owed and then you have this one who figured out how to work the system for $360 million.  Everyone got certified for care and a boiler room the article stated was in place to handle the paper work.  BD 

Federal officials say they have taken down the largest Medicare fraud scheme investigators have ever discovered: a $375 million dollar home healthcare scam operating in the Dallas, Texas area.

The alleged "mastermind" of the fraud, Dr. Jacques Roy, is charged with certifying hundreds of fraudulent claims for Medicare reimbursement, and pocketing millions in payments for services not needed, or never delivered. Prosecutors say the 54-year-old Dr. Roy, who was arrested today and could be sentenced to life in prison, operated a "boiler room" to churn out thousands of phony Medicare claims and recruited homeless people as fake patients.

The government charges that Dr. Roy was planning to take the money and run. He allegedly hid much of his Medicare money in an offshore account in the Cayman Islands, and in documents filed in court today, the government charges that Dr. Roy was planning to change his identity and flee the country to avoid prosecution. In a motion opposing bail for Dr. Roy, prosecutors claim that he had created a false Canadian identity under the name Michel Poulin, had a copy of a book called "Hide Your A$$ET$ and Disappear," and a guide to yacht registration in the Caymans.

In some cases, the indictment charges, Medicare patients were recruited by offering cash and groceries in return for signing up for home health care. These fraudulent "patients" were then allegedly certified by Dr. Roy for services. Some of those recruits didn't even have a home to visit, according to sources close to the investigation: they were recruited from homeless shelters.

http://abcnews.go.com/Blotter/biggest-medicare-fraud-history-busted-feds/story?id=15809129#.T08VuHlXWSo

United Healthcare Buys Two HMOs in Florida–More Cheap or Free Hearing Aids for Seniors Perhaps–Subsidiary Watch

Not too long ago the cheap and free hearing aides were in the news.  These are distributed through yet another United Healthcare subsidiary, of which there are many, more than any other health insurer has.  As you can read below the bonus was a free hearing aid for those in Miami Dade county who enrolled in their plans, to include HMOs and Medicare Advantage. 

UnitedHealthCare Throws in Free Hearing Aids for Those Who Enroll In AARP Medicare Advantage, HMO & POS Plans in Miami-Dade County From Their New Subsidiary

Maybe this is yet one more way to capture more market with United.  If you read the link below you can read up on some of their other subsidiaries and again they have a ton and you might be surprised as this is not the same company it was a few years ago as some investments are outside of healthcare.  With so many subsidiaries they are in every nook and cranny of healthcare today, whether it be owning an IPA, an HMO, their Optum Bank with deposits of over a billions, to all types of Health IT groups and they sell on heck of a lot of data for profit too from some of these divisions.  The more HMOs they buy, the more control they get on paying doctors and contracts for reimbursement. 

United Healthcare Preparing to Roll Out New Contracts To Pay Doctors& Hospitals For Meeting Goals and Keeping Costs Down– Plenty of Subsidiaries to Provide Some of the Technology And/Or Products & Generate Income–Subsidiary Watch

With all these varied subsidiaries, no wonder they hired former US Attorney General in Minnesota for their general counsel as I too sometimes wonder when the “conflicts of interests” or those of a monopoly of business sector questions will arise. They are also duking it out in Kansas and Nebraska for state and employee managed care contracts In Kansas, Blue Cross who is the largest in that state decided not to even bid, and again when up against the mighty subsidiary powers Untied has being being  able to bring in profit dollars from so many different areas from introducing a drug to the FDA all the way down to physician reimbursement, I do wonder how they compete not to mention the draw of the crowd for those cheap hearing aides in some areas.  image

Blue Cross and United Healthcare Duking It Out In Nebraska Over State Health Insurance Contract–We Have More Subsidiaries My Cost Algorithms Are Better Than Yours?

If they don’t get a contract then there’s always a lawsuit like the Tri-Care situation which as far as I know has not yet been resolved, so again with all the might legal powers and a new general counsel is maybe why Blue Cross gave up in Kansas?  I guess time will tell.  BD 

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?

UnitedHealthcare, the giant nationwide insurer, is making a major move in South Florida by announcing Tuesday it has agreed to purchase two Miami-Dade based Medicare and Medicaid insurance plans that have more than 100,000 members and eight clinics.

Terms of the two deals were not announced.

Preferred Care Partners has 55,000 Medicare members in its health maintenance organization in South and Central Florida and another 5,000 members in its Medicaid HMO. It has six clinics in Miami-Dade.

Medica Healthcare Plans has 35,000 Medicare HMO members and 7,200 Medicaid beneficiaries in Miami-Dade and Broward. It has two clinics, in Coral Gables and Hialeah.

“This is certainly a bold move by United,” said Joseph Caruncho, founder and chief executive officer of Preferred Care. “It shows their commitment to become involved in South Florida and immediately become a major player.”

http://www.miamiherald.com/2012/02/28/2665453/unitedhealthcare-buys-preferred.html

Tuesday, February 28, 2012

Zinc Deficiency and Children with Autism

Thanks to a commenter for pointing me to a newish study (open access):  Infantile zinc deficiency: Association with autism spectrum disorders.

I see Paul Whiteley already covered it here.  If you are interested in the autism spectrum disorders, I very highly recommend his blog.  Paul is very sober and clear-sighted about the limitations of the research information but has an open mind about what might be clues to the pathophysiology of these disorders.  Since it is a long paper, and Paul and I have quite different styles, I think there is plenty of room for my own thoughts.

Atlas Genius:  Trojans (right click to open in new tab)

In this study, nearly 2000 children with autistic disorders had hair tested for zinc deficiency.  584 (29.6%) subjects had levels lower than two standard deviations below the mean of the reference range.  43.5% of the male children ages 0-3 and 52.5% of the female children 0-3 in the sample were zinc deficient.  Older children with autism in the study had a lower incidence of zinc deficiency, which continued to decrease with the age of the subject sample, to the point where autistic children over the age of 10 had normal zinc levels.  Normal hair zinc in healthy children appears to be around 130 ppm, and one autistic 2 year old in the study had a level of 10.7 ppm.

However you slice it (and let's take into account the limitations of a strictly observational study), that is an impressive finding.  The authors speculate that epigenetics could be a factor in the pathophysiology of autism.  Epigenetics is the alteration of gene expression by environmental influences.  Mineral deficiencies could certainly alter gene expression and perhaps cause an epigenetic disorder.  The other side of the argument is that active inflammation and stress causes us to waste zinc (and other minerals) as part of the inflammatory process.  Since we know autistic spectrum disorders are related to inflammation, it would make perfect sense that babies and toddlers with autism would have low zinc levels.  Low serum zinc also seems to be associated with heavy metal toxicity, which is also associated with autistic spectrum disorders (more often cadmium and aluminum, according to the study authors, than mercury).

But measuring a mineral deficiency is more tricky than it might appear.  Zinc can be sequestered in the bones or liver and bound up by protein in the serum.  Zinc levels can vary considerably based on infection, stress, low protein levels in the blood, and even time of day.  Hair levels could perhaps be considered a more reliable indicator of full-body zinc stores, so may be a more useful measure for these sorts of studies.

Zinc deficiency could very plausibly be part of what causes the symptoms of autism.  Zinc plays an important role in protein synthesis, cell growth and repair, and levels need to be super topped off in pregnant women and infants where all these processes are occurring at a more rapid rate than any other time in one's life.  Also, we know that a "leaky gut" has been associated with autism in a rather well-designed study, and with leaky guts there is malabsorption of nutrients and minerals.  Many children with autism have signs from birth (when everyone has a leaky gut, up through 6 months of age when there is no argument that exclusive breastmilk is best, period), but some children seem to develop normally and do not exhibit symptoms until later.  Could leaky guts leading to toxin exposure, and micronutrient deficiency have something to do with these cases?  Seems a plausible theory.

In addition, in the setting of zinc deficiency, the intestinal zinc importer (the awesomely named Zip4) is upregulated, sensibly enough.   Increasing Zip4 can increase the absorption of toxic heavy metals such as cadmium and lead.  Therefore an early zinc deficiency could plausibly lead to more absorption of toxic metals.   (Creepy fact from the article:  soy-based infant formulas have 6 times higher cadmium levels than cow's milk formulas, and cereal-based formulas 4-21 times higher levels (1).)

I don't think there is any argument that we all need sufficient zinc, particularly pregnant women and babies.  As far as I know, there are no controlled studies of zinc supplementation in pregnant women and babies and autism risk, so we really can't make any conclusion or recommend any sort of increased zinc supplementation in babies at this point.  There is more data in ADHD and I should probably pull those papers myself (some of them are too old to pull easily) and do a post on it.  Super-high zinc intake has killed older people who used zinc-based denture cream by causing copper deficiency and heart arrhythmia, and babies and little children (like the elderly) will be more vulnerable to these sorts of insults.

More data please!  Researchers, rescue us from the rocky shoals of the unknown.

(Hmmm.  My favorite diaper cream is zinc-based.  I wonder how much is absorbed and if that has any bearing on zinc levels, zinc deficiency, etc.)




Gordon Gekko Comes Back to Help the FBI With A Public Service Announcement to Help Fight Financial Crime On Wall Street

This is a little off topic but interesting that Michael Douglas, who played the role, twice, was asked to do a public service video but I guess it gets attention as he played a pretty ruthless character and I watched both movies myself just as like movies.  What’s interesting is when you read his comments below that people used to come up and congratulate him on being the bad guy, he doesn’t even get where that comes from as it was a movie.  BD 

“The movie was fiction, but the problem is real,” Douglas says in the announcement. “Our economy is increasingly dependent on the success and integrity of the financial markets. If a deal looks too good to be true, it probably is. For more information on how you can identify securities fraud, or to report insider trading, contact your local FBI.”

Douglas’s spot is the latest element of “Perfect Hedge,” an initiative begun by the FBI New York’s office to combat insider trading at hedge funds, said FBI Special Agents David Chaves and Richard Jacobs, supervisors in the bureau’s New York’s securities and commodities fraud squads

Douglas told agents that decades after the movie that won him an Oscar for best actor, he’s frequently stopped and greeted as a hero and not a Wall Street villain.

Douglas said he was “startled over the positive response he received as Gordon Gekko,” Chaves said. He quoted Douglas saying, “I don’t know what’s wrong with Wall Street but I would be approached all the time, people would ‘high-five’ me or shake my hand for being this terrible man who stole people’s money. Where are the values? The culture has to change.”

http://bottomline.msnbc.msn.com/_news/2012/02/27/10519206-gordon-gekko-changes-sides-works-for-fbi

Monday, February 27, 2012

More Birth Control Pill Recalls–Patient Found This Error with Pills in Bubble Pack in Reverse Order–The “Shitty Deal” With No Bar Codes to Make Them Easier to Find…

I goes pay to ask questions and look around anymore as you never know what you might find and obviously this woman knew her pills enough to the fact that she was able to recognize that the wrong colors for the wrong weeks were in the wrong places.  This time it’s generic pills on the hook.

No bar bodes yet to make the recalled lots easy enough to find so worth a mention again so I can sound like a 3 years old broken record here as that’s how long my campaign has been going to get the drug, device companies and the FDA to collaborate and get this going.  A few weeks ago Pfizer had their recalls with birth control pills.

Pfizer Recalls 1 Million Birth Control Packs–Where’s the Bar Codes to Help Consumers Identify? Yet One More Big Example of the “Shitty Deal” American Consumers Get

Glenmark Generics is issuing a nationwide recall of seven lots of birth control pills. The pills are labeled "norgestimate and ethinyl estradiol tablets."

Because of a packaging error, some of the pills were placed in the wrong order within the packs, according to a statement from the Food and Drug Administration. The packs contain three types of pills with varying levels of hormones, designed to be taken at different times during a woman's cycle.

Lot numbers of affected packs are as follows: 04110101, 04110106, 04110107, 04110114, 04110124, 04110129 and 04110134. The packs were distributed nationwide between Sept. 21 and Dec. 30, 2011. The complete name of the product is norgestimate and ethinyl estradiol tablets USP, 0.18 mg/0.035 mg, 0.215 mg/0.035 mg, 0.25 mg/0.035 mg (Generic).

The error was discovered when a consumer complained she received a pack in which the tablets were packaged in reverse order, the FDA said.

http://www.foxnews.com/health/2012/02/27/more-birth-control-pills-recalled/?test=latestnews

Blue Cross and United Healthcare Duking It Out In Nebraska Over State Health Insurance Contract–We Have More Subsidiaries My Cost Algorithms Are Better Than Yours?

Ok so the title got your attention but gee if you have followed news about insurers then you do know that United has tons of subsidiary companies and Blue Cross doesn’t even come close in number and as you have read too they are not all insurance companies.  We have all different types to include hearing aids, FDA consultants, Wellness and so on.  They have truckload of data too.image

The person making the decision says it will save around $8 million a year and again you wonder do subsidiary companies figure in here somewhere along the line?  We have the China Gate subsidiary that works to promote more drugs and devices for approval worldwide and in the US for one.  I don’t know if Blue Cross has an equivalent of that type of subsidiary or not but have not read about one.  Here’s the real back breaker is that the state of Nebraska has a contract with Express Scripts and we know what happened there with Blue Cross as of the first of the year so perhaps this enters in here as I’m sure there’s many Walgreen stores throughout the state. 

Anthem Blue Cross Members Will No Longer Be Able to Fill Prescriptions at Walgreens After January 1, 2012

Well we know what happens if a rebid takes place though with government contracts, like this lawsuit they filed against Tri-Care over losingimage the bid, if you remember this, so here we go again, all about contracts. 

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?

They own enough companies to do all the analytics that one could desire I think and even said they would not stop short of legal action.  The Tri-Care contract for the south includes Alabama, Arkansas, Florida, Georgia, part of Kentucky, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee and most of Texas.”  BD

LINCOLN, NE – Blue Cross Blue Shield of Nebraska is challenging the state's decision to switch insurance companies for state employees to UnitedHealthcare - a decision worth $184 million annually.

On Feb. 15, the state announced that it is awarding UnitedHealthcare with a contract to administer a health plan for state employees, which will take effect July, 1 2012.

"We made this decision because United is going to save us a significant amount of money each year," said Department of Administrative Services Director Carlos Castillo. "It's about five percent, $8 million a year on average. We also looked into comparing some of the programs each company could provide to us to help make a decision to switch."

http://www.healthcarefinancenews.com/news/nebraska-drops-bcbs-state-health-insurance-provider?topic=05,19

Sunday, February 26, 2012

Thyrotropin Day to Night

It's a chilly Sunday morning.  More plowing away at the endocrine system, and now I remember why endocrinologists can be cranky sometimes.  Gads it is complicated, but beautiful.

Two music selections, one for those who prefer a xanthine alkaloid jolt of rock:

Kasabian Reason is Treason

The other for those who like to let Sundays wake them up, sunshine through the window style:

Dance of the Blessed Spirits (from Orpheus and Eurydice)

I don't recommend listening to these simultaneously.

Oh, in the northern hemisphere we've been having a lovely show of the planets the past couple days.  They are exceptionally bright, with reports of seeing Venus in broad daylight.  (Here is a picture from @BadAstronomer through his binoculars).  Last night, just after sunset (lower right), I snapped this picture with my phone of the crescent moon and Venus (through the trees) with Jupiter above to the left:




All right.  Enough putting off the inevitable.  Endocrinology!  As we know from a previous post, thyroid hormone secretion is regulated (to some extent) by a classic negative feedback mechanism.  Thyrotropin (TSH) is released from the anterior pituitary and then travels down to the thyroid to stimulate the TSH receptor (TSH-R).  This action leads to the release of thyroid hormones, mostly T4 but some T3, which toodle on up to the pituitary and inhibit the production of TSH.  We also learned in previous posts there is other master regulation via the hypothalamus and TRH as well as regulation at the tissue level by how readily the prohormone T4 is made into the active hormone T3.

In the serum, T4 and T3 levels remain relatively stable during the course of 24 hours.  However, at a cellular/nuclear level it is hard to say what is happening at any given time.

TSH secretion from the pituitary, on the other hand, varies considerably, as demonstrated by a graph from this paper which is available free full text on Pubmed (showing some differences in TSH secretion variation between lean and obese women):


In fact, TSH is one of the well-known hormones, such as cortisol, melatonin, prolactin, etc. that change as part of the daily circadian rhythm.  TSH peaks during the night and remains lower during the day.  The fact that serum T4 and T3 levels remain relatively constant despite this change is intriguing, though again, there is likely a good deal of regulation we don't understand and that is difficult to measure at an intracellular level, and it may have to do with some of the regulation I talk about in a couple of paragraphs.

A bit of a side note but one that may be of interest for the future when we take a peek at the alternative medicine diagnosis of "adrenal fatigue," the circadian rhythm peaks seem to be delayed by an hour or two in folks with seasonal depression, premenstrual dysphoric disorder, and major depressive disorder.  Treating the depression with late sleep deprivation (i.e. going to bed at 9 or 10 and waking up at 1am) seems to jerk the cortisol portion of the rhythm back to normal, and in some studies, the TSH and prolactin as well (I'll discuss these and link the reference studies in the future posts).

Here is where we get to an even more complicated part.  TSH is not just "TSH."  As TSH is created and as it is secreted, we add various numbers and types of carbohydrate molecules to the protein hormone to make a glycoprotein (p 84-6).   These carbohydrate molecules help with the creation and proper folding of the protein into its final active shape.  TSH is then a group of "isohormones" with different carbohydrate compositions.  People with hypothyroidism have an increase in sialylated TSH which decreases when the hypothyroidism is treated with T4 hormone. (Sialylate is one type of  carbohydrate molecule that can be plopped onto TSH.  Sulfated carbohydrate is another).  Higher sialylation is also seen in the nocturnal surge of TSH in normal patients compared with the daytime circulating TSH in the same person.  In mice, as the hypothalamic-pituitary-thyroid axis develops and matures, there are higher proportions and more complex carbohydrate molecules on the TSH backbone.

Phew.  Cowboy Junkies:  I'm So Open

What are all these carbohydrates doing?  Besides helping out with the folding and secretion of the protein, they also seem to modify the biologic activity of TSH.  If we take TSH and apply enzymes to it to clean off the carbohydrate molecules, TSH will still bind to its receptor, but its activity is very much reduced.  Increased sialylation seems to moderately reduce the activity of TSH at the receptor as well, at least in the test tube.  In the body, the highly sialylated TSH lasts longer than the less sialylated versions, so overall the sialylated form will cause more receptor activation (though it is less potent, it lasts longer).  High-mannose versions of TSH seem to be more aggressive about stimulating messaging through the cell after alighting upon the TSH receptor and activating it.

I know.  See how one can be led down the garden path with respect to understanding something about hormonal regulation, but then you find a whole 'nother layer of complexity that boggles the mind.  Sialylation to sulfation ratios of circulating TSH affect metabolic activity and clearance, but these activities are also dependent upon the location on the TSH where the carbohydrate molecules are added (they can be added at all sorts of different places on the various protein subunits and frequently are).

These hormonal systems have developed over thousands of millennia of evolution, and it is only in the very recent past that we have understood much of any of it.  The spectacular dance of molecules and the exquisite microregulation is humbling, to say the least.  How much is changed by nighttime lighting, by inflammatory signals, by activity and rest?  Appreciation of the complexity is what makes me try, in a practical fashion, to emulate the diet and lifestyle of the paleolithic past, as it seems likely the best way to keep the system acting at optimal capacity.  That's just a hunch, but I think the null hypothesis that begs to be disproven.

Thursday, February 23, 2012

HHS Facebook Application Winners Announced for the Lifeline Challenge–But Are Any Privacy Policies/Protections Included?

This is just my personal opinion but I think these are nuts and could not for the life of me figure this contest out and the press release says nothing about privacy so again we know who mines data on the web and who sells data so that is my first question here in wondering why privacy was not mentioned.

Sure the intentions here are good but again in case of a hurricane for example if I were a victim, imagewould I find my home owners insurance going up quickly and would I be receiving FEMA contractor coupons?  These are not dumb questions as that’s kind of how things work out there today with everything being connected.  On the other hand if privacy is not protected here would someone be out there ready to vandalize my house too?  When earthquakes occur Twitter is the one that seems to be all over disasters quickly and I’ve watched that many times.

HHS Seems To Be Confused on Social Networks–Facebook for Disaster Support Contest, Give Me a Break Use Twitter Like Everyone Else Does

Secondly how many folks at HHS will be role models and use this application?  We don’t seem to have any role models around that talk about how social networks or any mHealth applications work for them and it’s always for “those guys over there” with experts telling us how great the apps are.  It’s nice that the developers got something for their work but with privacy out there today, I would rather not chance it with Facebook, but I also shut my page down about a year ago as it became a nuisance with taking too much time away from what I need to do.  Let’s see if Ms. Sebelius talks about how she uses the apps in the future, bet we’ll never hear anything on that topic <grin>.

Again my question here is are we putting too much out there for data mines to scrape and make billions in profits as many US Corporations do?  I think we need to license and tax the data sellers myself as even companies such as Walgreens for an example stated on their SEC form that they made under $800 million in selling data, sounds like a good number to tax and just thing when you add all the other big corporations and bank and others in here, they make billions mining “free taxpayer data” so that’s one more reason for me not to contribute to corporate profits in areas as such.  BD 

Start Licensing and Taxing the Data Sellers of the Internet Making Billions of Profit Dollars Mining “Free Taxpayer Data”–Attack of the Killer Algorithms Chapter 17 - “Occupy Algorithms”– Help Stop Inequality in the US

Three Facebook applications designed to help people prepare for emergencies and get support from friends and family in an emergency – from personal medical emergencies or car accidents to natural or man-made disasters – are winners of a Facebook application challenge sponsored by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR).

ASPR’s Facebook Lifeline Application Challenge called on software application developers to design new Facebook applications that could enhance individual and community resilience by establishing social connections in advance of an emergency.

Two recent Brown University graduates, Evan Donahue and Erik Stayton, partnered as Team ALP to win first place with their application, named Lifeline. The Las Vegas team JAMAJIC 360 with David Vinson, Erick Rodriguez, Gregg Orr, and Garth Winckler came in second with an app also named JAMAJIC 360. Third place was awarded to AreYouOk? developed by TrueTeamEffort, a team of 11 University of Illinois students led by Alex Kirlik

Although these top three applications differ in how users interface with the app, all three allow users to designate three lifelines -- Facebook friends the person can count on and who agree to check on them in an emergency, supply them with shelter, food, and other necessities, and provide the person’s social network with an update about their wellbeing. Facebook users could use the lifeline app to create disaster readiness plans and share the plans with their emergency contacts, and provide users with news.

The lifeline app is anticipated to be launched in the coming months, prior to the start of hurricane season. The team also receives $10,000 and complimentary passes from Health 2.0 to attend the spring Health 2.0 conference in Boston. JAMAJIC 360 receives $5,000 for second place, and TrueTeamEffort receives $1,000 for third place.

http://www.hhs.gov/news/press/2012pres/02/20120223b.html

Meatless = Less Tense in the Short Term

Hi!  Back to the thyroid in a bit… but I've had a few questions about a study that came out earlier this week so I thought I would do a quick post.

Restriction of meat, fish, and poultry omnivores improves mood: a randomized controlled trial

The Strokes: 12:51 (video starts with an ad.  Sorry!)

This pilot study was small and interesting and embarked upon to try to answer some questions about diet and mood.  Hooray! Specifically the authors speculate that the arachidonic acid (AA) in meat could impact how we feel, and that restricting AA could make us feel better.   AA (which is a highly unsaturated omega 6 fatty acid) is situated in the biochemistry to be pro-inflammatory (though WAPF has some issues with this characterization).  Specifically, AA eaten directly competes with the desaturating enzymes for EPA (a long chain omega 3 fish oil constituent), so AA could potentially increase pro-inflammatory cytokines such as TNFalpha which are known to have mood altering effects.  One question is does fish consumption ameliorate the affects of pro-inflammatory AA, and is that why populations who eat fish tend to have better moods than those who don't?  Hey, let's whip up a little experiment and get informed consent and run it by the IRB and test it.

So… 39 adults who ate meat or poultry once daily (thus omnivorous) with no major psychiatric problems, substance abuse, or health problems were randomized to three groups for two weeks.  One group was told not to change their diets (OMN).  Another group was told to avoid meat and poultry but to eat fish 3-4 times a week (FISH).  The last group was told to avoid all animal products except dairy (VEG).  (Traditionally in the US eggs are considered dairy for whatever reason but I'm assuming they were left out as the yolks have a nice dose of AA).   Diets before and after were assessed by a "validated food frequency questionnaire."  The participants were also given a bunch of mood, anxiety, and depression rating scales before and after.

The results!  OMN and FISH groups were about the same with no change from baseline, but the VEG group showed a decrease in the psychological ratings scores with respect to tension and stress (anxiety and depression scores were not significantly changed).  Dietarily, if one can truly believe a report to a hundredth of a gram of dietary fatty acids based on food frequency questionnaires, EPA and DHA and AA dropped considerably in the VEG group, OMN group was unchanged, and the FISH group managed to increase their dietary long chain omega 3 fatty acid consumption by 100%.  They also successfully raised the O6/O3 ratio by 60% in the diet of the vegetarians, which I'm not enthusiastic about long term, by any means.

Hooray!  A result.  Decreased tension and stress.  But what does it mean?  I'm hoping this pilot trial is used as evidence to recruit funding for a bigger and more ambitious trial, because what these researchers did not measure is pretty much everything that would tell us anything about what actually happened to decrease those stress scores.  There were no measures of tissue fatty acids to tell us how the ratios changed in the body relative to these dietary changes, and no "after" measures of weight.   Losing weight from a diet is associated with improved psychological scores, and since vegetarian-geared fare is often healthier than the regular SAD meaty counterparts (tofurky and cheese pizza excepted), I wouldn't be surprised if the most dramatically altered diet caused more weight loss than the others.  Or it might have to do with changes in AA.  The Seventh Day Adventists study (which the authors if this study did as well!!) showed that "Vegetarian Diets Are Associated with Healthy Mood States."

(My critique of the SDA studies are that being part of a close-knit community that is very pro-vegetarianism is a HUGE confounder when it comes to mood and stress, and boy, it sure would be nice to know the tissue levels of fatty acids because that would tell us a lot more than just food frequency questionnaires and psych scales.)

We need more info to make anything of this little study.  I also think the title is misleading (and is leading to misleading news reports, as is typical), as actual mood and anxiety scores were unchanged, only the tension and stress scores (though certainly over the long term tension and stress are associated with more depressed and anxious mood states).  Whatever gets you funding, I suppose…



Wednesday, February 22, 2012

The “Shit” Cancer Patients Say–Five Time Cancer Survivor and the Best Looking Amputee in Denver – Woody Roseland

This is quite the video and being he’s a five time survivor he knows the chemo imageroutine and you have have to admire his humor and going though a day in the chemo session here and making the best of it. 

He has a website you can visit to hear his story.  The cancer came back 4 times! 

Shit Cancer Patients Say

Here’s a second video and this guy has been through hell and back and is able to talk and inspire others and have a sense of humor at the same time.  The cancer even took his knee and he’ so young and started when he was 17 years old.  He gives chemo a real face and what patients endure, and he even talks about the “beep” of the machine.  Hope this is the last chemo he has go through as it was a long regimen.  BD

His Story

http://woodyroseland.com/index.php/videos/player

FDA Finds 14 Additional Chinese Companies That Supplied Contaminated Raw Materials Used to Make Heparin And Puts Out Alert –Time To Start Raising More Pigs in the US?

We all remember the Baxter incident from a few years ago.  The FDA has put out a warning list with additional companies listed and they did not know or state if they were current distributors of the raw material that makes the blood thinning drug.  Back in October of 2010 it was back in the news again with another recall. 

B. Braun Recalls Seven Lots of Heparin–Potential Contamination–FDA States Not a Signification Public Health Threat

Despite Tainted Heparin, US Drug and Medical Device Companies Still Like China

We need more home grown pigs intestines from the US is appears as that is one of the raw materials that goes into the drug.  BD 

The Food and Drug Administration said Wednesday it found 14 additional Chinese companies supplied contaminated raw material to make heparin, a widely used blood thinner.

The companies supplied the materials in 2008, when the FDA found a link between contaminated heparin marketed by Baxter International Inc. to some Chinese suppliers of the active ingredient used in heparin. The contamination was linked to 80 deaths in U.S. patients and hundreds of allergic reactions. The same contamination was found in heparin sold by other pharmaceutical companies in other countries.

The 14 companies were put on a so-called import alert list that allows the FDA to stop shipments at the U.S. border. The companies are being added to a list that already included eight other Chinese suppliers.

The contaminated heparin contained oversulfated chondroitin sulfate, an altered version of chondroitin sulfate that is used as a dietary supplement and is typically made from animal cartilage. Oversulfated chondroitin sulfate is chemically similar to the active ingredient in heparin, which is derived from pig intestines. Federal health officials have said it is cheaper to make than the active ingredient in heparin. It still remains unknown how the heparin became contaminated and who might be responsible, although FDA is still investigating.

http://online.wsj.com/article/SB10001424052970203960804577239624228625522.html

Tuesday, February 21, 2012

Closed Hospitals in the Los Angeles Area Get a Second Life for Television and Movie Filming as Turn Key Sets

Some facilities are better than others but when you stop and think of the shows we imagesee on television, hospitals are all over the place as someone is always getting shot, or something along that line.  The location though formerly used for Scrubs though was not as nice as some of the other locations used.

Scrubs Television Show Hospital Filming Site Filled with Rats

The one I remember though was the Bucket List which I believe used the closed Century City hospital for it’s set.  BD 

Bucket List

The scene, for an upcoming episode of the CBS crime drama “Criminal Minds,” actually unfolded last week on the former Sherman Way campus of Northridge Hospital Medical Center, which solely serves as a location backdrop for shows that have included such dramas such as TNT’s “Rizzoli & Isles” and "Hawthorne."
The Northridge facility is among a dozen current and onetime medical centers and hospitals represented by Real to Reel Inc., a 30-year-old Van Nuys location agency that has built a successful niche supplying location managers with something they frequently seek: film-ready hospital settings.
“Hospitals are a staple of crime dramas. Someone’s always getting shot, so we’re always going to the hospitals,” said Jeffrey Spellman, location manager for “Criminal Minds,” which plans to shoot its next episode at another closed hospital, St. Luke Medical Center in Pasadena. “To have a facility like this makes our job much easier.”

Reel to Reel’s clients include St. Luke Medical Center in Pasadena, used in Clint Eastwood’s Oscar-winning boxing drama “Million Dollar Baby” and HBO’s vampire series “True Blood,” and St. Vincent Medical Center, the working hospital in downtown Los Angeles often used by crime dramas such as “CSI,” “The Closer” and “Southland.”

The former Northridge medical center, for example, has gimbal windows that can swing open to make it easier to shoot inside rooms. The nurse’s station table was lowered to improve camera angles.
"These properties are affordable, they’re turn-key and they’re ready to go and directors love them because they offer a variety of looks," Onyshko said.

http://latimesblogs.latimes.com/entertainmentnewsbuzz/2012/02/criminal-minds-other-shows-turn-to-hospitals-for-filming.html

Foundation Medicine - Personalized Medicine for Biopsy DNA Studies - Will Cost $5000 for the “Pan-Cancer” Test - Any Oncologist Will Be Able To Use The Center For Testing

This is very interesting article and goes in depth to discuss how running the DNA on a biopsy can help doctors with prescribing cancer drugs and many of which are still in early testing stages.  It could also lead to more patients in that respect being referred to a clinical trial. image

The big problem here cited with this article is the same old same old with insurance reimbursement and the fact that some of the genes have patents like the HER2 gene which has really been scrutinized by insurance carriers with Myriad.  This however is going to be the way treating cancer will be in a few years as it makes sense rather than guessing.  Of course with reimbursements we have the generic versus the name brand costs to look at too.  Right now the clients are mostly drug companies and of course they want to know where their products would line up as far as treatments as well and really that part of the entire scenario too.  The company also is getting some investments and mentoring from Google.  image

Foundation Medicine too has been rushing to file their patents as well and again we have this same question as to whether or not a gene should be patented. 

“The company also scours the medical literature to provide doctors with the latest information on how genetic changes influence the efficacy of specific drugs.”

“Molecular testing by Foundation Medicine provides precise genomic information about your cancer in a way never before available.”

The commercial end is due to be launched soon and the website has a page of patient stories” available to read.  BD

Michael Pellini fires up his computer and opens a report on a patient with a tumor of the salivary gland. The patient had surgery, but the cancer recurred. That's when a biopsy was sent to Foundation Medicine, the company that Pellini runs, for a detailed DNA study. Foundation deciphered some 200 genes with a known link to cancer and found what he calls "actionable" mutations in three of them. That is, each genetic defect is the target of anticancer drugs undergoing testing—though not for salivary tumors. Should the patient take one of them? "Without the DNA, no one would have thought to try these drugs," says Pellini. 

Starting this spring, for about $5,000, any oncologist will be able to ship a sliver of tumor in a bar-coded package to Foundation's lab. Foundation will extract the DNA, sequence scores of cancer genes, and prepare a report to steer doctors and patients toward drugs, most still in early testing, that are known to target the cellular defects caused by the DNA errors the analysis turns up. Pellini says that about 70 percent of cases studied to date have yielded information that a doctor could act on—whether by prescribing a particular drug, stopping treatment with another, or enrolling the patient in a clinical trial.

So far, most of Foundation's business is coming from five drug companies seeking genetic explanations for why their cancer drugs work spectacularly in some patients but not at all in others. The industry has recognized that drugs targeted to subsets of patients cost less to develop, can get FDA approval faster, and can be sold for higher prices than traditional medications. "Our portfolio is full of targets where we're developing tests based on the biology of disease," says Nicholas Dracopoli, vice president for oncology biomarkers at Janssen R&D, which is among the companies that send samples to Foundation. "If a pathway isn't activated, you get no clinical benefit by inhibiting it. We have to know which pathway is driving the dissemination of the disease."

So why pay $5,000 to know the status of only about 200 genes? Foundation has several answers. First, each gene is decoded not once but hundreds of times, to yield more accurate results. The company also scours the medical literature to provide doctors with the latest information on how genetic changes influence the efficacy of specific drugs. As Krenitsky puts it, data analysis, not data generation, is now the rate-limiting factor in cancer genomics.

Although most of Foundation's customers to date are drug companies, Borisy says the company intends to build its business around serving oncologists and patients. In the United States, 1.5 million cancer cases are diagnosed annually. Borisy estimates that Foundation will process 20,000 samples this year. At $5,000 per sample, it's easy to see how such a business could reward investors. "That's ... a $100-million-a-year business," says Borisy. "But that volume is still low if this truly fulfills its potential."

Insurance companies may also be unwilling to pay $5,000 for the pan-cancer test itself, at least initially. Some already balk at paying for well-established tests, says Christopher-Paul Milne, associate director of the Tufts Center for the Study of Drug Development, who calls reimbursement "one of the biggest impediments to personalized medicine."

http://www.technologyreview.com/biomedicine/39707/?mod=chfeatured

Minute Clinics Moving to Allscripts Medical Records System So I Guess E-Clinical Works Who Started With CVS Clinics Is Out the Door? How Do Medium/Small Companies Compete with Huge Corporate Conglomerates

Back in January of 2010 this article was out with the two companies collaborating on e-prescribing so what did Allscripts do, edge out eClincalWorks with a corporate package deal?  I don’t know that’s what occurred but it’s pretty accurate about 85% of the time today with mergers and acquisitions in healthcareeClinical Works is an excellent EHR that is both web and client based and is used all over the US is connects with most hospital medical record systems and they have a big base of business but they are not a “corporate conglomerate” looking to feed hungry shareholders either. 

CVS and AllScripts Collaborating on E-Prescribing – Minute Clinics Get Joint Commission Accreditation Award

We also have Humana in here hawking some software services too for consumers so they can get some data.  I do wonder what CVS makes on selling data as the Walgreens SEC statement for 2010 said they made just under $800 million on selling data, that’s a lot of money. 

Humana and CVS Minute Clinics Partner To Add More Services for Members such as Life Synch and InnoPsych

You can see that eClinical Works is even sold in Sam’s Club for a simple pre-configured system.   

HealthVault Connects with eClinicalWorks EHR, NextGen EHR/EMR Systems and more…Shop Wal-Mart (Sam’s Club) in the Spring

It just kind of looks like 2 big conglomerates that have shareholders here jumping in together and again the medium and smaller companies have no shot here.  Allscripts of course has been a merger and acquisition game too over the years and almost at it during 2008 with the crash.   This merger action took place in June of 2010.  BD 

Misys Sells Allscripts Shares to Enable Eclipsys Merger – Medical Records

CHICAGO and WOONSOCKET, R.I., Feb. 21, 2012 /PRNewswire/ -- CVS Caremark's MinuteClinic, the leading retail health clinic in the United States, will transition from its existing, proprietary Electronic Medical Record system to the AllscriptsMyWay Electronic Health Record. This transition will assist MinuteClinic in its mission of delivering high quality accessible medical care in hundreds of retail clinics across the United States.

"MinuteClinic is partnering with Allscripts to assure that we are utilizing the most advanced electronic health record platform in the market," said Andrew Sussman, M.D., president, MinuteClinic and senior vice president/associate chief medical officer, CVS Caremark. "This will help support our nurse practitioners and physician assistants in continuing to meet and exceed the high standards we have set for quality and adherence to practice guidelines."

http://www.embedded.com/electronics-products/electronic-product-releases/medical-design/4236629/CVS-Caremark-s-MinuteClinic-to-Deploy-Allscripts-EHR-Nationally

AMA Selling Online Physician Portal to AT&T–The Amagine Project, There’s Money in Selling And Aggregating Those Algorithms

I guess if you are attending HIMSS this year you can find out more about it at their booth.  Writing code or in this case having an outsourced company do you development turns into money, right?   The AMA appears to have been just as busy in developing their software house as many vendors have.  Back in July they made the Allscripts e-Prescribing tool available and enhancements and other offerings have proceeded from here. 

Allscripts ePrescribing Tool Will be Offered by AMA

Not too long after the above announcement it was followed with working with HealthVault personal health records for access. 

American Medical Association and HealthVault to Provide Physician’s Portal – Physicians Will be able to access “Patient Shared” Information

Further along in 2010 the AMA announced their own consulting group to help doctors with choosing medical record systems, so they have been busy in the software department with branding their installations and support as well and here’s a little more history on the Amagine project so this kind of gives you an idea as to some of the partnerships that were developed along the way with the Amagine project with large Health IT vendors, one owned by an insurance company,Care Tracker, owned by United.  image

“In addition to agreements with Ingenix for its CareTracker product and with NextGen, the Amagine project has inked deals with DrFirst for e-prescribing; Quest Diagnostics' Care360, a suite that includes lab ordering, e-prescribing and other tools; WellCentive's patient registry; and Dell, which will offer e-mail and data-storage services, as well as discounts for Amagine customers who want to upgrade their hardware.”

AMA and Other Medical Groups Joining Forces with EHR and Health IT Businesses–More Software House/Consulting Choices

Here’s a quick screenshot from the AMAGINE page with some examples of a couple partners in Revenue Cycling and I see NaviNet who was just in the news as being bought by a group of Blue Cross Groups so they all are seeming to mesh together in some fashion or another and no wonder mergers and acquisitions in Healthcare today are so confusing at times.  BD

image

The American Medical Association will combine the platform of its online physician portal, Amagine, with that of AT&T Healthcare Community Online in a deal that would have AT&T owning and operating the combined product. No financial terms were disclosed.

AT&T will lead further development of the platform, though the AMA “will remain actively engaged” in collaborating on business strategies and expanding availability of health IT for physicians, according to a joint AMA-AT&T news release.
Both Amagine and Healthcare Community Online operate on platforms powered by Covisint, a Detroit-based subsidiary of Compuware Corp.

http://www.modernhealthcare.com/article/20120221/NEWS/302219983/

Healthcare Blogger Gets Spammed by Hedge Fund Using Internet “Reputation Restore” With Some Really Bad Algos–Attack of the Killer Algorithms Chapter 20

First of all who was the blogger, it was me of course and this is my story on how this all took place.  If you are not familiar with “Reputation Restore” you can search it on the internet and find many companies who will provide this service for you if you feel you have been slammed with bad publicity on the internet or just want to hide what is out there.  You will find quite a few pages with companies that advertise on the web and run a business to fix your reputation.  Here’s  a screenshot of what a simple search turns up.  As you can see there are a lot of folks out there offering to fix your reputation on the internet.  image

I won’t get into the specifics of it here yet but if you watched 60 Minutes a couple weeks ago and heard the story about the Duke Cancer Clinical Trial, at the very end of the story they mention the doctor who created the false information was found on the internet, practicing in another state and they mentioned “Reputation Restore” was used.  New information about the doctor was created on new websites to show a more favorable side of the doctor.  In case you missed it you can watch the video at the link below where I covered the story and added it to my series on the Attack of the Killer Algorithms as Chapter 15. 

Story of Duke University - The Sad Case of Flawed Data Published in Medical Journals That Was Declared Inaccurate 60 Minutes –Attack of the Killer Algorithms Chapter 15

I’m a Healthcare blogger that has been around for about 5 years now on the internet and the name of the blog, Medical Quack sometimes attracts attention by tags and keywords that may or may not be relative.  This seems to be happening quite frequently today as free text is being mined and searched for words that can bring relative information of value to various posts I have.  Everybody gets this today with search engines and aggregation of data.

Sometimes using such methodologies can create some very surprising results too and in my case with Reputation Restore, it created a ton load of spam.  Anyone who blogs today pretty much uses their “spam” filters, and I do too so spamming comments are not allowed to “auto populate” on my blog posts; however the spammers are still alive and well out there and keep trying.  I get an email notification on every comment so this way I can approve the comments and this is done to keep the spamming commenters out.  When you see such comments you can easily recognize them as they are comments not relative to the topic at all and usually contain a link that advertises something or is a link to promote their own site.

I have other healthcare bloggers who post and have a link back to related material they have, it’s not a problem for me to allow those as it is good sharing of information and I do encourage that; however, when the unrelated and imageeasily recognized spammers hit, again I don’t want those and neither do my readers want to see such clutter either. 

The commenting is also done to create links back for SEO purposes as well and if you read the news last year both JC Penney and Overstock were a couple of the companies busted by Google for using text links to move their ranks up higher in the search engines.  They were both put in the penalty box by Google for a while and then once fixed they were back out again.  What was also interesting about this though was a few months later Google was challenged on their own policy with such links.  The whole idea here is too keep things fair and not allow certain companies and websites to monopolize search engine results and rank at the top unfairly as I see it. 

Now back to the story line here and as a disclosure I don’t’ own any stocks and thus have no ties one way or another to anything in this story other than the fact that I do a website that helps give small cap companies exposure.  I am a 1099 webmaster here and they are a publishing website so I wanted to put this out front so there’s no confusion there with the sponsor of my blog.

Ok so here goes…about a year ago my spam filters and email notifications one day started going crazy.  When you do a blog you have few comments that come in every day and depending on the size and circulation of your blog it varies but when you get about 20-30 from the same source in a matter of 15 minutes coming in, you go look.  My first thoughts were that someone was trying to game the search engines and was placing a number of links on my blog posts.

Again these are all non related topic “generic and canned” comments that an algorithm created.  I have had these before but not quite this heavy as they continued on for a number of days. 20-30 blog comments each time were being sent to my blog.  It would stop for a couple days and then about 2-3 days later, the next rush of spam comments would fill up the spam filter and my inbox notification system.  Well after a few days of this I decided to check into this as I had not seen anything as persistent as this and the fact that every few days more loaded up got my curiosity going. 

In looking at the spam comments I noticed that all of them contained links and they went back to the same 10 to 20 websites and decided to do some looking around.  They were comments all made by Lindsay Rosenwald that had links back to other websites.  Well needless to say I got an education in this process and found some very interesting websites and some that are very quirky, which are known as “splogs”. If you have not heard that term before this is a new word that was created to be a merge of the words spam and blogs which means these are not in fact “real” blogs but rather aggregated material from various sources.  Lindsay Rosenwald is a Biotech related Hedge Fund manager and all of these comment links lead me back to the splogs. 

Now upon finding these “splogs” I decided to do a search to see if they came up in general searches, and guess what, they did.  They are easily recognized as the “splogs” all have very similar names so if you spend time searching the web enough you see patterns.  Here’s an example of one of my notifications I had in my inbox.  You can read the comment and clearly see that it was created by a “bot” just by the content.  I had a bunch of these. 

image

It looks like the “splogs” were updated since the comments in April.  By following the imagelink I find out that he has a hedge fund called OpusPoint Partners.  How does one know this is a “splog”…one look at the blogroll tells all as all the past articles have the same title…his name…

Ok so in searching this link from April of 2011 and finding a link to a September 2011 updates, this tells me the “splogs” and Reputation Restore seems to be alive and well and occasional updates have been made.  The good thing though is that I didn’t get “spammed” again with 20-30 comments this time as back in March and April of 2011 I had over 200 spam comments, all just like the screenshot above. 

image

Ok so looking at this splog a little closer I see several categories here and decided to poke around a bit and see what’s there as we have Mystery, Romance and Adventure posts here to see.  At the bottom of the page is an advertisement stating the page was done by SRS Solutions a marketing firm.  The romance column is hysterical as you can see this is “filler text” and I wonder if anyone else besides me was curious and read this?  Here’s a small preview of the filler text, again all arranged and put in place by some algorithm bots…kind of funny…and I don’t know what novel or book this came from but random text as filler (enjoy) …and see how the algorithms put his name in place in selected tag areas with links back to other “splogs”.  In reading this I am thinking if perhaps his wife saw this?  If she didn’t know a lot of questions could come about <grin>, but we all know this is filler text created by an algorithm. 


“No matter how much she hung around him, she couldn’t help but stare – not at his well toned physique, not at his startlingly blue eyes, not at his near transparent blonde hair – but at his perfectly straight teeth, as bright as polished white marble.  Normally she had to stop herself from watching him quite this intently, but “the guys” (Michael, Ryan, and Wes) were all occupied.  Michael was in the kitchen, where he meticulously topped off three shot glasses with smooth, amber-colored tequila. Meanwhile, Ryan and Wes in the other room.

Stacey pried her eyes away from Lindsay Rosenwald, the man she kept staring at, and looked at the blank white ceiling for a moment, startled to realize that it now seemed off-white compared to Lindsay’s teeth.  The white was a strange contrast to the eight-decade old wood paneling that covered all the walls.  Stacey slouched back into the couch – which was mostly a khaki color, though marked artistically with various chocolate, rum, and soda stains. The couch was easy to sag back into; Stacey gave in to the sensation of being devoured by the plush micro-fiber fabric.

Lindsay Rosenwald took a gulp of his beer then lifted it into the air in a mock salute and said “I’m lame.”  Stacey laughed, and Ryan jokingly flipped Lindsay off.

As the guys started doing shots (yelling inappropriate words before each one) Stacey stood and silently went into the bathroom, turning on the light and closing the door behind her, leaning against the counter.  She started looking herself over in the mirror.

In the back of her mind, she knew she was checking how she looked.  Checking to make sure she looked like the cute girl-next-door that she had always been labeled as.  She knew she was making sure because of the unspoken temptation in the back of her mind.  A temptation she had completely resisted during the two years that Becky Fullmer and Lindsay Rosenwald were together, but that was getting harder and harder to ignore.”


Going back to the home page on this particular “splog” we see that Mr. Rosenwald has his hedge fund discussed and also has some other pretty high credentials to his name as well, such as his involvement with Cougar Biotech and selling the company to Johnson and Johnson last year and this bit of information below. 


“Rosenwald has had an extensive career in managing investment funds, most notably for the Aries Fund (1994 – 2007) and the Orion Fund (2002 – 2006.) Both of which are highly regarded. In the year 2000 under the overseeing of Dr. Rosenwald the Aries Fund invested a substantial one billion dollars into healthcare.”

Dr. Lindsay Rosenwald partakes in many other activities outside of his professional career at OpusPoint Partners, most notably he sits as a member of the Board of Directors in the Republican Jewish Coalition. Though maintaining his thriving business is his main goal, he foresees its continued growth and works diligently to expand and preserve his solid contacts in the biotech and life science financing industry.”


When you follow some of the links, you are lead to even more “splogs” and again you can see where the algorithms mess up with formatting text…like here…you find the same text over and over and again in some areas the algorithm really messed up <grin>.  Utah SEO is another company listed at the bottom of the sites for producing some of these.  I would call this a rogue algorithm here that got a little out of control and we read this happening to in the stock markets and a company called Nanex is very good at reporting these incidents with great images, but this is one little algo who couldn’t spell or follow formatting rules. 

image

Here’s another “splog” page and again all the past articles have all the same titles..wild stuff!

image

Coming back around here I would have probably cared less and never would have seen any of this if it were not for the big spam attack on my blog.  When the company did the “Reputation Restore” process it was probably not a good idea to hit a rather well read healthcare blog like mine, you think?  Did they check that out, obviously not.  Here’s yet another spam comment, again one of a few hundred that infiltrated my blog, so I went to go check out this link that goes way back to the New York Times in 1988 and talks about his Director of Finance appointment at D.H. Blair.  Well before I read this link I didn’t know who or what D.H. Blair was but after reading several of these links I thought this was some of the content that was maybe meant to be hidden or buried?  Keep on reading…

image

Ok so now my curiosity is aroused to find out what is D H Blair since this article was so old and was obviously put in there for folks to read, right?  So let’s go see what a search turns up here.  This is what shows up with a search…OMG Bernie Madoff?   We all know who that is, so I decided to do some reading as I do a lot of that but now I’m curious and boy what a reading file Google pulled up for me.  I also looked at Google images via a search and he was the first picture that came up.  Actually it was a good thing that my spam filter caught a lot of the comments as more of my Medical Quack readers may have done some additional reading. 

image

Ok so now it’s starting to set in as to why this Reputation Restore campaign might exist as I begin reading? From what is published on the web, there’s a lot of players here and again I don’t know any of these folks here and didn’t know any of this, but I do now after being spammed.  Shoot this was more reading than I bargained for in just my small pursuit of finding out who spammed me!  Let’s dig around and check out another spammed comment shall we. 

image

So I followed this link and found yet another so called “splog” and checked it out.  I found out he was a Republican and part of the Republican Jewish Coalition as a member of the Board of Directors and there’s a video at the splog that references the other “splogs”..and it was done in March of 2010 but it looks like they have his age wrong in the comments at stating 76? It was created by this firm it states under the comments.  Looks like a bunch of bad algorithms to me. 

Paramount BioCapital

If you look around under similar videos that appear we seem to have the same video created by SEORouters here and another one here and yet one more here that dates back to the same time when I was being spammed. 

The only half way decent page linked in all of this is Wikipedia but guess what, I found different links  and some other artifacts such as the New York Times paper article from 2008 stating he had been offered $85 million for his penthouse in New York and again the sale of Cougar Biotech to Johnson and Johnson.  What I also found interesting on this page were the “dead” social network links, in other words they don’t work and take you back to the home page. 

image

Needless to say this is the work a a ton of “bots” to say the least.  Anyway getting back to the search I did above now I’m reading Deep Capture, Market Rap and a ton of other archived articles which I probably would not have known existed otherwise:) 

So the question here is what purpose has the Reputation Restore accomplished? Did this Hedge Fund manager get taken for a ride on his money spent?  I am guessing he did spend some money on this project as these folks would not work for free with creating and running these algorithms.  

With all the wealth and money I wonder what he was sold on the job this company did and why the bots used were so “not good” as they connect to “splogs” and when you look at the examples you can see what is out there.  Let’s go one more step and see what Google has for searches that are related…and here it is…

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We come right back around to D H Blair again for one and Madoff, along with a few others added in there.  Guess what, I get a lot of the same “splogs” again and a few other tidbits and this time the Market Rap and Deep Capture results are at the top, (which I am guessing is the portions meant to be buried in searches)  so what is this campaign doing besides making a mess out there?  The You Tube videos in the splogs have little play so hardly anyone is looking at those either.

This even gets better as when you do a search for reputation restoration there’s even a link on the Deep Capture page where a company wrote a story about this and is probably looking for new business.  What I did learn by reading is that Deep Capture did not profile Mr. Rosenwald very favorably and again Deep Capture has their own naked short selling tale to tell and who knows what the whole story is once it all comes together.  Now in my travels around searching Google I ran across a few other blogs with the same “spammed-canned” comments, like this one.  My spam catcher caught mine but no back links from the Quack to the splogs which doesn’t do anything for “splog search engine optimization” <grin>.

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Also this came up in a search, a comment that is exactly the same as the posts on the “splogs”…at a reverse merger page back in 2009…

http://www.reversemergerblog.com/2009/08/08/cougar-biotech-wow/

Here’s yet another one by a blogger called “Noel Vega” and yup it’s all about Mr. Rosenwald and is yet one more splog it appears.  Actually I was not the first site to notice this activity as a site in Germany (which I don’t know if they were spammed or not) figured it all out too.  Below is what that site had to say as he linked right over to the Deep Capture site, which by the way is published by the CEO of Overstock.com.  He did a pretty good job as describing the whole lot of web sites.

Real-Life Reputation Management Example

“These are all simple WordPress installs with a few articles. It’s pretty obvious they’re only here to occupy the first page on Google.
As soon as you dig deeper into the SERPs (search engine results pages) you’ll find tons – and I mean TONS – of web 2.0 properties linking and pushing his WordPress sites and the EDU profile among others”

“Lindsay Rosenwald may be the son-in-law of “the king of stock fraud.” And he was once the vice chairman of D.H. Blair, a firm affiliated with the Mafia – a firm that was run by two former top lieutenants of Michael Milken before it found itself at the center of one of the biggest Mafia investigations in the history of the FBI and on the business end of a 173-count federal indictment.”


In some cases the splogs even spam themselves with comments such as here…

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And there’s some links back to some cached pages of Cougar Biotech floating around out there which we know now was purchased by Johnson and Johnson mainly for their prostate drug which is now on the market. 

It sure looks like he got soaked on this deal on repairing his reputation as with browser and search changes imagemade by Google and others, all it appears to be doing now is stuffing the web full of spam and again I would not even be aware of this if who ever they hired knew what they were doing and wouldn’t have spammed my blog so badly.   You know we hear in the news all the time about money not matching up or they can’t find it, like Corzine and no wonder if the big guys at the the top get sucked in by folks like this who did this some what make shift reputation restore effort which only serves to bring all of the stuff I feel they want to hide out into the forefront. 

How do they make business decisions today one might ask?  Obviously nobody can be an expert in every area but gee to use one of these services that does a job like this?  I would hope they could hire staff that could at least get a quality job done if pursing such a project.

These are a bunch of programmed algorithms that go out and mine the web and relate articles and such on tags, keywords and so on.  I still laugh at the romance section that was just jammed in there as filler.

Mr. Rosenwald got attacked by the very algorithms he hired to help hide him it seems to me. 

I am now much better educated on the past of the financial markets and biotech having been spammed and have passed along some of the articles I found interesting to others to read.  His bot did try to comment on my Happy Doctor’s Day post though to let us know he went to school at Penn State and this was yet another comment that the algorithm was responsible for. 

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I had pages of these comments stacking up and of course when you read them the English is not that good and of course never would been written from a man in his position and education, so maybe “splogs” have a side benefit of not making one look to smart?  Anyway, I wouldn’t want my name attached to such <grin>.

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This page at Google Knol which will end on May of this year even has a Creative Commons License listed, pretty funny as splogs can have those too.  SEO Services of course is one of the commenters here so those are his fans the SEO folks it seems:)  Again I have just never seen anything so extensive and they must be working hard to justify their contract with Mr. Rosenwald.  I have to say the algorithms that created these sure did use and re-use the same text to the maximum!  It’s over here at the Knol site too, so blog platforms were not issue for the algorithms to cross with speed running bots at work. 

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There was actually one “real” press release from PRWeb buried in the splogs and I wonder why he doesn’t use avenues as such to promote himself instead of splogs?  If you publish enough legitimate information out there the other stuff with age will go down the ranks.  Link at the title below from March of 2011. 

Lindsay Rosenwald: Biotechnologies Financial da Vinci

Once more it is amazing that a well known hedge fund manager would not know the difference here and is more comfortable with the Splog efforts. 

One thing too about the web is that what may have been an effective tool yesterday, may not be so today and some Killer Algorithms here appear to be biting the Hedge Fund Manager.   I happen to have a series on the Attacks of the Killer Algorithms that you may want to check out.  I certainly was attacked by the Killer Algorithms here with spamming my blog and Mr. Rosenwald has them biting at his back too as they are getting to be just in the way and not really serving a purpose any longer. 

Attack of the Killer Algorithms–Digest & Links for All Chapters–See How the Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You

Perhaps to his good news or maybe not so good news, this post will now be circulating and searched in Google and other browsers as well and perhaps it may even give Mr. Rosenwald ’s “splogs” some real competition for that top spot:) 

So why did I do this story, that algorithm woke up and snuck in another spam comment!  I was attached by the Killer Spamming Algorithms hired by a Hedge Fund who maybe didn’t have a clue on what he thought he was paying for.  BD