30 Aug 2014

TORONTO STAR: OTTAWA LAWYER MICHAEL CRYSTAL $412-million class action against Scarborough ROUGE VALLEY CENTENARY HOSPITAL for disclosing details of 8,300 patients to local BABY PHOTOGRAPHER (2009-2014)

Disclosures by two hosp  employees included:
\
name, room number, length of stay, type of room accomodation, reason for admission.

Lawsuit has not yet been certified.




25 Aug 2014

Two-day OMA COLLABORATIVE SESSION ON MENTAL HEALTH: Ont. Med. Review July/Aug 2014 26-28 (Ms B KLICH-)

(BLOG COMMENT)
OHIP (Ont.Health Ins.Plan) does not pay for PhD CLINICAL PSYCHOLOGISTS . OHIP pays GPs who do "GP-psychotherapy"  $125.50/ 50 minutes.. No time limit for treatment. No specific training required.. Any GP can bill for Primary Mental Health. or GP-psychotherapy. Public Health doctors with limited clinical experience can add to their retirement pension working for Psychiatrists who have a Psych clinic. The GP-psych takes 70% of the OHIP fee. The Psychiatrist can have a "stable" of GPs paying 30% for office and overheads.. Research of the four main Toronto clinics show that patients are not screened for organic disease. Many have simple social problems more suitable for a Social worker. GPs working in the clinics are expected to extend treatment to at least 12 treatments a= $1500+..In Ontario the Psychologists do not object. They can bill Private Insurers or the patient directly. Avoiding OHIP fee control.

24 Aug 2014

UK SPINAL NEWS Editorial Board member:: Toronto University Prof.KIERAN MURPHY



Kieran Murphy, MD (Ireland 86), FACR, FRCP(C) (1994)


Murphy_hs Toronto Western Hospital
McLaughlin Pavilion
3rd Floor Rm 433, 399 Bathurst St.
Toronto, ON M5T 2S8
Phone: 416.603.5800 x2393
Email: kieran.murphy@uhn.ca




Affiliation in the Department of Medical Imaging of the University of Toronto
Radiologist, Professor, Toronto Western Hospital
Research Interests
• Osteoporosis
• Spine
• Neurovascular imaging
Current funding for CIP residents' salary & projects: 2 years
Possibility of accommodating CIP residents
Number of residents per year: a maximum of 3 per year
Laboratory infra-structure (physical area): wet lab, collaborations at UHN
Office infra-structure: Yes at university
Experience in multi-disciplinary research: Yes

22 Aug 2014

UK: MEDICAL SCREENING SOCIETY

 
 
 
    

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The Society

In November 2002 a new international society was set up to provide a forum for the disparate groups involved in medical screening. The Medical Screening Society will provide a forum for people interested in screening to discuss their ideas and problems, to debate controversial topics in a friendly and constructive way, and to share their experiences. The Journal of Medical Screening will be the journal of the Society.
The Society will:
  • Set up working groups to look at problems and controversies in medical screening.
  • Produce scientific reports that would be published in the Journal of Medical Screening.
  • Hold periodic scientific meetings on screening.
  • Have a page in each issue of the Journal of Medical Screening
  • Download the rules of the society
    June 2013
    Professor Jacob (Jack) Canick
    Medical Screening Society founding member Jack Canick died on 19 May 2013. As a tribute to him and his teaching a new page provides downloads of many of his talks.
     
    Medical Screening Society, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ

    18 Aug 2014

    USA NIH: Diagnostic brush test for sporadic CJD using nasal neurones and urine test for prions in variant CJD

    • New tests can rapidly and accurately diagnose Creutzfeldt-Jakob disease, an incurable and ultimately fatal neurodegenerative disorder.
    • Early diagnoses of prion diseases could help prevent their spread and aid in the development of experimental treatments.
    Prion diseases originate when, for reasons not fully understood, normally harmless prion proteins become abnormal, clump together, and accumulate in the brain. The diseases are characterized by sponge-like holes in brain tissue. They are notoriously difficult to diagnose, untreatable, and ultimately fatal.
    Brain tissue of a CJD patient
    Sponge-like lesions in the brain tissue of a CJD patient. Image courtesy of CDC.
    Human prion diseases include sporadic, familial, and variant Creutzfeldt-Jakob disease (CJD). Sporadic CJD is the most common, affecting an estimated 1 person per million worldwide each year. Sporadic CJD is caused by the spontaneous transformation of normal prions into abnormal ones. Other prion diseases include scrapie in sheep and bovine spongiform encephalopathy (BSE), or mad cow disease, in cattle.
    Previously, a definitive CJD diagnosis could only be made by testing brain tissue after death or by biopsy in living patients. In the August 7, 2014, issue of the New England Journal of Medicine, researchers at NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and Italian colleagues described a less invasive test.

    Dr. Gianluigi Zanusso and scientists at the University of Verona in Italy developed a way to collect olfactory neurons connected to the brain. The technique involves inserting a rigid fiber-optic rhinoscope into the patient’s nasal cavity. A sterile brush is then inserted alongside the scope. The brush is gently rolled along the mucosal surface to collect the neurons.
    The scientists tested for the presence of prions using a technique called real-time quaking-induced conversion—or RT-QuIC. Dr. Byron Caughey’s group at NIAID, with collaborators at Nagasaki University, had previously developed the method to test cerebrospinal fluid for the presence of prions.
    The researchers tested nasal samples from 31 people with sporadic CJD, 12 who had other neurologic diseases, and 31 with no neurologic disorder. The test correctly identified 30 of the 31 CJD patients (97% sensitivity) and correctly showed negative results for all 43 of the non-CJD patients (100% specificity). By comparison, tests using cerebral spinal fluid were 77% sensitive and 100% specific, and took twice as long to complete.
    “This exciting advance, the culmination of decades of studies on prion diseases, markedly improves on available diagnostic tests for CJD that are less reliable, more difficult for patients to tolerate, and require more time to obtain results,” says NIAID Director Dr. Anthony S. Fauci. “With additional validation, this test has potential for use in clinical and agricultural settings.”
    Another NIH-funded team, led by Dr. Claudio Soto of the University of Texas Health Science Center at Houston Medical School, developed a method for detecting prions in urine. They described the technique, called protein misfolding cyclic amplification, in an accompanying paper in the same journal. The test detected prions in 13 of 14 urine samples from patients with variant CJD—a type of CJD caused by exposure to BSE. The test didn’t detect prions in urine samples from healthy controls or from patients with other neurologic disorders, including sporadic or familial CJD. These results suggest that prions in urine are an exclusive feature of variant CJD.
    The researchers will continue to develop and assess these tests in patients with CJD and other prion diseases.

    15 Aug 2014

    Toronto Mt. SINAI HOSPITAL NURSES TO REPLACE MDs for PRE-OP. MEDICAL ASSESSMENT

    Mt Sinai Hospital plans to replace Physician pre-op medical examination by using Nurses. (No comment by
    Ont.Medical Association)

    13 Aug 2014

    NOTARISED STATEMENT REFUSING NO CODE STATUS on any Hospital admission.

    Important to have notarized statement absolutely refusing "NO CODE" status (aka "Do Not Resuscitate").
    If not in place in the chart and copy given to Specialists(s) concerned there can be pressure from overworked Hospital juniors to persuade relatives to agree to DNR if patient is costing too much time and money..

    10 Aug 2014

    UK DAILY MAIL:: Potential Private patients.

    Billionaire Square: In the most exclusive address in London, only three of 30 owners are British. Meet the new exotic super-rich neighbours (and find out how they afford to live in houses worth up to £60million)

    Belgarve Behind the opulent facades of Belgrave Square, a quiet social revolution has been taking place: most of the square’s grand mansions have now been bought by foreign multi-millionaires and billionaires. The the international super-rich have been discreetly acquiring the capital’s trophy assets – making this, in the process, the richest

    (COMMENT) The gated gardenis are PRIVATE for those who live around the square.. 

    4 Aug 2014

    British Colombia,: TEKMIRA Pharm TKM-EBOLA


    About Investigational TKM-Ebola Therapeutic

    For many years, the Zaire species of Ebola virus (ZEBOV), a highly contagious and lethal human infectious disease, has been associated with periodic outbreaks of hemorrhagic fever in human populations with mortality rates reaching 90%.

    In May 2010, a series of studies demonstrating the ability of an RNAi therapeutic utilizing Tekmira’s LNP technology to protect non-human primates from the Ebola virus were published in The Lancet. Tekmira conducted the studies in collaboration with infectious disease researchers from Boston University and the United States Army Medical Research Institute for Infectious Diseases (USAMRIID). These studies were funded in part by the U.S. Department of Defense’s (DoD) Joint Project Manager Transformational Medical Technologies (JPM-TMT) Office. The results of these preclinical studies demonstrated that when siRNA – delivered by Tekmira's LNP technology – targeted the Ebola virus to treat previously infected non-human primates, the result was 100 percent protection from an otherwise lethal dose of Zaire Ebola virus (Geisbert et al., The Lancet, Vol 375, May 29, 2010).

    In 2010, Tekmira signed a $140-million contract with the DoD to advance an RNAi therapeutic, which utilized our LNP technology, to treat Ebola virus infection. In 2013, the collaboration was expanded to include significant advances in LNP formulation technology, including a new LNP formulation that was more potent, the ability to be able to lyophilize (freeze-dry) LNP formulations and an LNP formulation that can be administered subcutaneously.

    In March 2014, we were granted a Fast Track designation from the U.S. Food and Drug Administration (FDA) for the development of TKM-Ebola, our anti-Ebola viral RNAi therapeutic. The FDA's Fast Track is a process designed to facilitate the development and expedite the review of drugs in order to get important new therapies to the patient earlier.

    Human Clinical Trial of TKM-Ebola

    In January 2014, Tekmira commenced a Phase I clinical trial using TKM-Ebola. The TKM-Ebola Phase I clinical trial is a randomized, single-blind, placebo-controlled study involving single ascending doses and multiple ascending doses of TKM-Ebola. The study will assess the safety, tolerability and pharmacokinetics of administering TKM-Ebola to healthy adult subjects.

    About BioDefense Therapeutics (BD Tx)

    This work is being conducted under contract with the US Department of Defense's (DoD) BioDefense Therapeutics (BDTX), a Joint Product Manager within the Medical Countermeasure Systems (JPM-MCS) Joint Project Management Office. A component of the Joint Program Executive Office for Chemical and Biological Defense, JPM-MCS aims to provide U.S. military forces and the nation with safe, effective and innovative medical solutions to counter chemical, biological, radiological and nuclear threats. JPM-MCS facilitates the advanced development and acquisition of medical countermeasures and systems to enhance our nation's biodefense response capability. For more information, visit www.jpeocbd.osd.mil.

    Read recent news on TKM-Ebola in press releases by clicking here.

    3 Aug 2014

    Harvard ProMed: PHARYNGEAL GONORRHOEA.(NG-MAST genogroup 1407) resistant to monotherapy


    GONOCOCCAL DISEASE - SWEDEN: PHARYNX, TREATMENT FAILURE, 2013-2014
    ******************************************************************
    A ProMED-mail post
    <http://www.promedmail.org>
    ProMED-mail is a program of the
    International Society for Infectious Diseases
    <http://www.isid.org>

    Date: Thu 31 Jul 2014
    Source: Eurosurveillance Edition 2014, 19(30) [edited]
    <http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20862>


    Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500
    mg) or cefotaxime (500 mg), Sweden, 2013 and 2014
    ----------------------------------------------------------------------
    [Authors: Golparian D, Ohlsson AK, Janson H, Lidbrink P, Richtner T,
    Ekelund O, Fredlund H, Unemo M]

    Abstract
    --------
    We describe 4 cases in Sweden of verified treatment failures of
    pharyngeal gonorrhoea with ceftriaxone (500 mg; n=3) or cefotaxime
    (500 mg; n=1) monotherapy [2013-2014]. All the ceftriaxone treatment
    failures were caused by the internationally spreading
    multidrug-resistant gonococcal NG-MAST genogroup 1407 clone. Increased
    awareness of treatment failures is crucial particularly when
    antimicrobial monotherapy is used. Frequent test of cure and
    appropriate verification/falsification of suspected treatment
    failures, as well as implementation of recommended dual antimicrobial
    therapy are imperative.

    _Neisseria gonorrhoeae_ has developed resistance to all antimicrobials
    previously used as 1st-line treatment for gonorrhoea [1-4]. Clinical
    resistance is now emerging to the extended-spectrum cephalosporins
    (ESCs), that is, cefixime (oral) and the more potent ceftriaxone
    (injectable). Many treatment failures with cefixime have been verified
    in Japan, Europe, Canada, and South Africa. No failure to treat
    urogenital gonorrhoea with ceftriaxone (250 mg-1 g), the last
    remaining option for 1st-line empiric antimicrobial monotherapy, has
    been detected as yet. However, some few failures to treat pharyngeal
    gonorrhoea with ceftriaxone have been verified in Japan (n=1),
    Australia (n=3), Sweden (n=1) and Slovenia (n=1) [4-10]. In recent
    years, extensively drug-resistant (XDR) gonococcal strains with
    high-level ceftriaxone resistance were also reported from Japan,
    France and Spain [2,9-11].

    Case descriptions
    -----------------
    >From February to May 2013, 3 cases of suspected failure to treat
    pharyngeal gonorrhoea with ceftriaxone 500 mg intramuscularly were
    reported from 2 clinics for sexually transmitted infections (STIs) in
    Sweden (Table). All 3 patients reported having had unprotected oral
    and vaginal sex with heterosexual contacts in Stockholm. Case A was a
    woman in her 30s, with pharyngeal symptoms including pharyngitis.
    Cases B and C, both in their 50s, were asymptomatic. Pharyngeal and
    urogenital samples were taken and all patients had a positive
    gonococcal pharyngeal culture. Furthermore, the urogenital samples
    from the Cases B and C were positive in a nucleic acid amplification
    test (NAAT) (BD ProbeTec GC Qx Amplified DNA Assay, Becton Dickinson).
    All 3 patients were administered a single dose of 500 mg ceftriaxone
    intramuscularly (Day 1). When returning for follow-up after 7 to 22
    days, all patients were asymptomatic but had persistent positive
    gonococcal pharyngeal cultures. All urogenital samples were negative.
    Finally, all 3 patients were successfully treated with a single dose
    of 1 g ceftriaxone intramuscularly between Day 7 and 27, which was
    confirmed at follow-up visits with negative pharyngeal cultures
    between Day 22 and 48 (Table).

    In May 2014, 1 case of suspected failure to treat pharyngeal
    gonorrhoea with cefotaxime 500 mg intramuscularly was reported from an
    STI clinic in Karlskrona, Sweden. This patient (Case D), a man in his
    30s, attended the clinic because he had had unprotected oral and
    vaginal sex with a woman diagnosed with gonorrhoea. On Day 1, the
    patient was asymptomatic and sampled from the pharynx, urethra, and
    rectum. The pharyngeal sample was positive for gonococci in culture
    and he was treated with a single dose of 500 mg cefotaxime
    intramuscularly. At the follow-up visit (Day 7), the patient was still
    asymptomatic, however, a pharyngeal sample remained positive in
    culture. The patient was treated with a single dose of 250 mg
    ceftriaxone intramuscularly plus a single oral dose of 1 g
    azithromycin (day 14). On Day 26, the patient returned for test of
    cure and the pharyngeal culture was negative for gonococci (Table).

    Characterisation of _N. gonorrhoeae_ isolates
    ---------------------------------------------
    The pre- and post-treatment gonococcal isolates were species-confirmed
    by sugar utilisation test, Phadebact Monoclonal GC Test (Pharmacia
    Diagnostics), and MaldiTOF MS (Bruker Daltonics). The paired isolates
    from each case were indistinguishable using _N. gonorrhoeae_
    multi-antigen sequence typing (NG-MAST [12]) and the isolates from
    Cases A, B, and C belonged to the NG-MAST genogroup 1407 clone [4,13]
    (Table). Using Etest (AB bioMerieux), the isolates from Cases A, B,
    and C (ceftriaxone treatment failures) showed elevated minimum
    inhibitory concentrations (MICs), that is, 0.064-0.125 mg/L, which is
    equal to the European resistance breakpoint (greater than 0.125 mg/L)
    [14]. In Case D (cefotaxime treatment failure), according to the
    European resistance breakpoints [14], the paired isolates were
    resistant to cefotaxime (MIC: 0.5 mg/L) and the pre-treatment isolate
    also to ceftriaxone (MIC: 0.25 mg/L) (Table).

    Sequencing of ESC resistance determinants [1,3,4,6,9,10,15] showed
    that all the paired isolates belonging to Cases A, B and C contained
    the penA mosaic allele XXXIV, which has been correlated with NG-MAST
    genogroup 1407, decreased susceptibility or resistance to ESCs and ESC
    treatment failures [1,4-6,9,11]. The isolates from Case D contained
    the penA mosaic allele XIII [10]. In addition, all isolates contained
    mtrR and penB alterations that further increase the ESC MICs
    [1,3-6,9-11,15].

    Discussion
    ----------
    This paper reports 4 cases of verified pharyngeal gonorrhoea treatment
    failure in Sweden using injectable ESCs, that is, ceftriaxone (n=3)
    and cefotaxime (n=1). The failures were verified in accordance with
    international recommendations [2,4], that is, clinical records were
    obtained, reinfection was excluded, pre- and post-treatment isolates
    were identical using highly discriminatory molecular epidemiological
    typing, and the isolates had elevated ESC MICs and well recognised ESC
    resistance determinants. Reinfection was considered to be excluded as
    much as possible for all cases. Accordingly, all patients were
    strongly advised to abstain from any sexual contacts before their
    follow-up visit and all 4 patients repeatedly assured that they had
    not had any unprotected sexual contacts between the
    ceftriaxone/cefotaxime treatment and test of cure. Furthermore, Case D
    was infected by a casual sexual contact.

    In the current emergent situation of fear that gonorrhoea may become
    untreatable [1-3,10], recommendations of using dual antimicrobial
    therapy (mainly ceftriaxone plus azithromycin) have been introduced in
    the United States [16] and Europe [17]. No appropriate well-designed
    international study has yet assessed the implementation of dual
    antimicrobial therapy. However, as observed by the authors in many
    international projects the implementation of these guidelines appears
    suboptimal in several European countries and monotherapy with
    ceftriaxone remains frequently used.

    No failure to treat urogenital gonorrhoea with ceftriaxone (250 mg-1
    g) monotherapy has been verified to date. However, the observed
    initial accumulation of failures treating pharyngeal gonorrhoea was
    not unexpected, because these infections are substantially harder to
    eradicate with most antimicrobials than urogenital gonorrhoea
    [1-4,6,18]. As shown in the present study, ceftriaxone 500 mg
    monotherapy can be sufficient to eradicate urogenital gonorrhoea but
    not the concomitant pharyngeal gonorrhoea in the same patient. The
    pharyngeal gonorrhoea of the patients was instead successfully treated
    with 1 g ceftriaxone monotherapy or 250 mg ceftriaxone plus 1 g
    azithromycin. Unfortunately, 1 g ceftriaxone monotherapy may only
    provide a short-term solution [1,2,4,19,20] judging from the failure
    to treat the pharyngeal gonorrhoea caused by the 1st gonococcal XDR
    strain with 1 g ceftriaxone [10], ceftriaxone MICs of all the
    identified gonococcal XDR strains [9-11], emergence of ceftriaxone
    resistance and its anticipated trend, and
    pharmacodynamic/pharmacokinetic simulations showing that the benefits
    of increasing the ceftriaxone dose from 500 mg to 1 g are limited when
    taking into account the high ceftriaxone MICs detected recent years
    [19]. Consequently, dual antimicrobial therapy, such as 500 mg
    ceftriaxone intramuscularly plus 2 g azithromycin orally, as
    recommended by the European gonorrhoea guideline [17], should ideally
    be implemented. It remains unknown if ceftriaxone and azithromycin act
    synergistically in vivo. However, most importantly, there are no
    indications, in vitro or in vivo, that they act antagonistically.
    According to a review from 2010, 99 percent of urogenital and 98
    percent of pharyngeal gonorrhoea cases may be treatable with 2 g
    azithromycin monotherapy [21]. Consequently, nearly all gonorrhoea
    cases (ceftriaxone-resistant or not) are treatable with even 2 g
    azithromycin monotherapy. Nevertheless, azithromycin monotherapy is
    not recommended due to the spread of gonococcal strains with
    high-level resistance to azithromycin and the anticipated rapid
    selection of azithromycin resistance [1,17,20].

    All ceftriaxone treatment failures in the present study (Cases A, B,
    and C) were caused by the internationally spreading
    multidrug-resistant gonococcal NG-MAST genogroup 1407 clone, which has
    caused many ESC treatment failures internationally [4-6,9,15].
    However, the cefotaxime treatment failure was caused by the unrelated
    NG-MAST ST4539, which shows that clinical resistance to injectable
    ESCs is emerging also in other gonococcal clones.

    In conclusion, increased awareness of treatment failures particularly
    with antimicrobial monotherapy, improved implementation of recommended
    dual antimicrobial therapy (such as 500 mg ceftriaxone plus 2 g
    azithromycin [17]), frequent test of cure (ideally for all cases, and
    at least for all cases of pharyngeal gonorrhoea), and appropriate
    verification/falsification of suspected treatment failures (including
    subsequent tracing of sexual contacts of the index case with the
    treatment failure) are essential internationally. An enhanced focus on
    pharyngeal gonorrhoea is also crucial, with increased sampling and
    prevention, such as promotion of condom use also when practising oral
    sex. Ultimately, novel options for effective treatment of gonorrhoea
    are imperative.

    [Table and references can be accessed at the source URL
    <http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20862>.]

    --
    Communicated by:
    ProMED-mail
    <promed@promedmail.org>

    [In 2012 US CDC updated its recommendations for treatment of
    uncomplicated urogenital, anorectal, and pharyngeal gonorrhea to
    combination therapy with a single intramuscular dose of ceftriaxone
    250 mg plus either a single dose of azithromycin 1 g orally or
    doxycycline 100 mg orally twice daily for 7 days
    (<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm>). The CDC
    considers that the 250 mg dose of ceftriaxone is sufficient to treat
    gonococcal infection at all anatomic sites caused by strains currently
    circulating in the United States
    (<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm>).

    The updated European gonorrhea guideline, however, recommends a 500 mg
    intramuscular dose of ceftriaxone plus azithromycin 2 g oral dose for
    uncomplicated gonorrhea
    (<http://dx.doi.org/10.1177/0956462412472837>).

    Pharyngeal gonococcal infections are known to be substantially harder
    to eradicate with most antimicrobials than urogenital gonorrhea (Moran
    JS: Treating uncomplicated _Neisseria gonorrhoeae_ infections: is the
    anatomic site of infection important? Sex Transm Dis. 1995; 22(1):
    39-47;
    <http://journals.lww.com/stdjournal/Abstract/1995/01000/Treating_Uncomplicated_Neisseria_gonorrhoeae.7.aspx>.)
    The Eurosurveillance report above describes 4 cases in Sweden of
    verified treatment failures of pharyngeal gonorrhea with ceftriaxone
    (500 mg; n=3) or cefotaxime (500 mg; n=1) monotherapy.

    Although sufficient to eradicate urogenital gonorrhea in 2 of the 4
    patients, ceftriaxone 500 mg monotherapy failed to eradicate gonococci
    in concomitant pharyngeal gonorrhea in the same patients. The
    ceftriaxone MICs (0.064-0.125 mg/L) of the gonococcal isolates from
    the 3 ceftriaxone pharyngeal gonorrhea treatment failures were
    actually below both the Clinical Laboratory Standards Institute (CLSI)
    resistance breakpoint MIC (equal to or greater than 0.5 micrograms per
    mL) and the European resistance breakpoint MIC (equal to or greater
    than 0.25 micrograms per mL)
    (<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm> and
    <http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/Breakpoint_table_v_4.0.pdf>).

    The cefotaxime MICs (0. 5 micrograms per mL) of the 2 isolates from
    the one cefotaxime pharyngeal gonorrhea treatment failure were above
    the European resistance breakpoint MIC (equal to or greater than 0.25
    micrograms per mL). Thus it seems that gonococci persisted in the
    pharynx despite having MICs in several instances in the susceptible
    range, perhaps because in the doses used, the pharyngeal antibiotic
    concentrations were too low or less active than at other infected
    sites. Pharyngeal gonorrhea in the 4 patients was subsequently
    successfully treated with 1 g ceftriaxone monotherapy or 250 mg
    ceftriaxone plus 1 g azithromycin.

    Most gonococcal infections of the pharynx are asymptomatic and can be
    relatively common in some populations
    (<http://www.cdc.gov/std/treatment/2010/gonococcal-infections.htm>).
    Culture of the pharynx in patients presenting with gonococcal disease,
    even in the absence of pharyngeal symptoms, and, as the authors of the
    Eurosurveillance report emphasize, supplemented by use of recommended
    combined antimicrobial therapy with azithromycin, which might enhance
    treatment efficacy for pharyngeal infection, and test of cure for
    pharyngeal gonorrhea
    (<http://www.cdc.gov/std/treatment/2010/gonococcal-infections.htm>),
    are essential to control the continued spread of this disease. -
    Mod.ML

    1 Aug 2014

    OMA: PHYSICIAN ASSISTANT employment subsidy of $23,000 /year.by MOHLTC

    Funding To Hire 2014 Physician Assistant Graduates Now Available

    The Ministry of Health and Long-Term Care is now accepting funding applications for Physician Assistant (PA) Career Start grants to employ Ontario’s 2014 PA graduates. The application deadline is August 15, 2014.
    Financial support of $46,000 (50:50 cost split with employer) will be provided to help eligible employers provide employment opportunities for PA graduates. An additional $10,000 is being offered as an incentive for PAs who accept positions in rural and/or northern geographies.

    This time-limited financial support is intended to facilitate the transition of Ontario PA graduates into the health care system to help address patient care needs. Opportunities for PA graduates will be supported in settings where the focus will be on meeting the goals of Ontario’s Action Plan for Health Care (Action Plan). Eligible employers must demonstrate a commitment to integrating and sustaining the PA position beyond the Career Start grant funding.
    Prospective employers must apply by August 15, 2014. Once approved, applicants will begin recruitment through the HealthForceOntario Marketing and Recruitment Agency with the requirement that job offers be secured by October 31, 2014.
    Application packages and additional information about available supports are posted at www.healthforceontario.ca/pa