The Jaker

Mostly rational politics, with occasional rants about how a few crazy Republicans are ruining the country.


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Monday, January 31, 2005
Can we trust them?
So now Bush & Co. are trying to push ownership into healthcare as well.

My initial thought? How can we be expected to trust them? They have clearly shown that their process is: Idealogy first, Plan second. In Iraq they disseminated wrong or exaggerated evidence to justify a war they'd already decided to wage. With Social Security, they decided it had to be changed because Republicans hate government programs, and then set about instilling a sense of impending crisis in the public. Even with Prescription Drugs in Medicare, they took a solid Democratic idea and turned it into a huge payoff for their drug company CEO friends.

Now, with healthcare, can we really expect them to have the people's best interests in mind? Why should we not believe this is simply part of a larger idealogy to create more Republicans, rather than something that will really be better for the average person.

The problem is when you only interact with rich corporate executives you only hear a single side - that the cost to a company of providing health insurance to its employees is rising. So what do they do - they try to relieve their friends of that cost.

I undestand the idea of rationalizing healthcare costs by giving the consumer some of the burden of decision-making. I just don't trust this administration to do it fairly.
posted by CB @ 6:44 PM  
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  • At 9:17 PM, Anonymous Anonymous said…

    Mesothelioma is a form of
    cancer that is almost always caused by previous exposure to Asbestos.
    In this disease, malignant cells develop in the mesothelium, a
    protective lining that covers most of the body's internal organs. Its
    most common site is the pleura (outer lining of the lungs and internal
    chest wall), but it may also occur in the peritoneum (the lining of
    the abdominal cavity), the heart, the pericardium (a sac that
    surrounds the heart) or tunica vaginalis.

    Most people who develop Mesothelioma have worked on
    jobs where they inhaled Asbestos particles, or they
    have been exposed
    to Asbestos dust and
    fiber in other ways. Washing the clothes of a
    family member who worked with asbestos can also put a person at risk
    for developing mesothelioma. Unlike lung cancer, there is no
    association between Mesothelioma and smoking.
    Compensation via Asbestos
    funds or lawsuits is an important issue in
    mesothelioma (see Asbestos and the law).

    The symptoms of Mesothelioma include
    shortness of breath due to pleural effusion (fluid between the lung
    and the chest wall) or chest wall pain, and general symptoms such as
    weight loss. The diagnosis may be suspected with chest X-ray and CT
    scan, and is confirmed with a biopsy (tissue sample) and microscopic
    examination. A thoracoscopy (inserting a tube with a camera into the
    chest) can be used to take biopsies. It allows the introduction of
    substances such as talc to obliterate the pleural space (called
    pleurodesis), which prevents more fluid from accumulating and pressing
    on the lung. Despite treatment with chemotherapy, radiation therapy or
    sometimes surgery, the disease carries a poor prognosis. Research
    about screening tests for the early detection of mesothelioma is
    ongoing.
    Symptoms of Mesothelioma
    may not appear until 20 to 50 years after exposure to Asbestos.
    Shortness of breath, cough, and pain in the chest due to an
    accumulation of fluid in the pleural space are often symptoms of
    pleuralMesothelioma

    Symptoms of peritoneal Mesothelioma include weight
    loss and cachexia, abdominal swelling and pain due to ascites (a
    buildup of fluid in the abdominal cavity). Other symptoms of
    peritoneal Mesothelioma
    may include bowel obstruction, blood clotting abnormalities, anemia,
    and fever. If the cancer has spread beyond the mesothelium to other
    parts of the body, symptoms may include pain, trouble swallowing, or
    swelling of the neck or face.

    These symptoms may be caused by Mesothelioma or by other,
    less serious conditions.

    Mesothelioma that affects
    the pleura can cause these signs and symptoms:

    chest wall pain
    pleural effusion, or fluid surrounding the lung
    shortness of breath
    fatigue or anemia
    wheezing, hoarseness, or cough
    blood in the sputum (fluid) coughed up (hemoptysis)
    In severe cases, the person may have many tumor masses. The individual
    may develop a pneumothorax, or collapse of the lung. The disease may
    metastasize, or spread, to other parts of the body.

    Tumors that affect the abdominal cavity often do not cause symptoms
    until they are at a late stage. Symptoms include:

    abdominal pain
    ascites, or an abnormal buildup of fluid in the abdomen
    a mass in the abdomen
    problems with bowel function
    weight loss
    In severe cases of the disease, the following signs and symptoms may be present:

    blood clots in the veins, which may cause thrombophlebitis
    disseminated intravascular coagulation, a disorder causing severe
    bleeding in many body organs
    jaundice, or yellowing of the eyes and skin
    low blood sugar level
    pleural effusion
    pulmonary emboli, or blood clots in the arteries of the lungs
    severe ascites
    A Mesothelioma does not
    usually spread to the bone, brain, or adrenal glands. Pleural tumors
    are usually found only on one side of the lungs.
    Diagnosing Mesothelioma
    is often difficult, because the symptoms are similar to those of a
    number of other conditions. Diagnosis begins with a review of the
    patient's medical history. A history of exposure to Asbestos may
    increase clinical suspicion for mesothelioma. A physical examination
    is performed, followed by chest X-ray and often lung function tests.
    The X-ray may reveal pleural thickening commonly seen after asbestos
    exposure and increases suspicion of Mesothelioma A CT (or CAT)
    scan or an MRI is usually performed. If a large amount of fluid is
    present, abnormal cells may be detected by cytology if this fluid is
    aspirated with a syringe. For pleural fluid this is done by a pleural
    tap or chest drain, in ascites with an paracentesis or ascitic drain
    and in a pericardial effusion with pericardiocentesis. While absence
    of malignant cells on cytology does not completely exclude
    mesothelioma, it makes it much more unlikely, especially if an
    alternative diagnosis can be made (e.g. tuberculosis, heart failure).

    If cytology is positive or a plaque is regarded as suspicious, a
    biopsy is needed to confirm a diagnosis of Mesothelioma A doctor
    removes a sample of tissue for examination under a microscope by a
    pathologist. A biopsy may be done in different ways, depending on
    where the abnormal area is located. If the cancer is in the chest, the
    doctor may perform a thoracoscopy. In this procedure, the doctor makes
    a small cut through the chest wall and puts a thin, lighted tube
    called a thoracoscope into the chest between two ribs. Thoracoscopy
    allows the doctor to look inside the chest and obtain tissue samples.

    If the cancer is in the abdomen, the doctor may perform a laparoscopy.
    To obtain tissue for examination, the doctor makes a small incision in
    the abdomen and inserts a special instrument into the abdominal
    cavity. If these procedures do not yield enough tissue, more extensive
    diagnostic surgery may be necessary
    The mesothelium consists of a single layer of flattened to cuboidal
    cells forming the epithelial lining of the serous cavities of the body
    including the peritoneal, pericardial and pleural cavities. Deposition
    of asbestos fibres in the parenchyma of the lung may result in the
    penetration of the visceral pleura from where the fibre can then be
    carried to the pleural surface, thus leading to the development of
    malignant mesothelial plaques. The processes leading to the
    development of peritoneal Mesothelioma remain
    unresolved, although it has been proposed that Asbestos fibres from
    the lung are transported to the abdomen and associated organs via the
    lymphatic system. Additionally, Asbestos fibres may be
    deposited in
    the gut after ingestion of sputum contaminated with Asbestos fibres.

    Pleural contamination with Asbestos or other mineral
    fibres has been
    shown to cause cancer. Long thin asbestos fibers (blue Asbestos,
    amphibole fibers) are more potent carcinogens than "feathery fibers"
    (chrysotile or white asbestos fibers).[6] However, there is now
    evidence that smaller particles may be more dangerous than the larger
    fibers. They remain suspended in the air where they can be inhaled,
    and may penetrate more easily and deeper into the lungs. "We probably
    will find out a lot more about the health aspects of Asbestos from
    [the World Trade Center attack], unfortunately," said Dr. Alan Fein,
    chief of pulmonary and critical-care medicine at North Shore-Long
    Island Jewish Health System. Dr. Fein has treated several patients for
    "World Trade Center syndrome" or respiratory ailments from brief
    exposures of only a day or two near the collapsed buildings.

    Mesothelioma development
    in rats has been demonstrated following intra-pleural inoculation of
    phosphorylated chrysotile fibres. It has been suggested that in
    humans, transport of fibres to the pleura is critical to the
    pathogenesis of mesothelioma. This is supported by the observed
    recruitment of significant numbers of macrophages and other cells of
    the immune system to localised lesions of accumulated asbestos fibres
    in the pleural and peritoneal cavities of rats. These lesions
    continued to attract and accumulate macrophages as the disease
    progressed, and cellular changes within the lesion culminated in a
    morphologically malignant tumour.

    Experimental evidence suggests that asbestos acts as a complete
    carcinogen with the development of Mesothelioma occurring in
    sequential stages of initiation and promotion. The molecular
    mechanisms underlying the malignant transformation of normal
    mesothelial cells by Asbestos fibres remain
    unclear despite the
    demonstration of its oncogenic capabilities. However, complete in
    vitro transformation of normal human mesothelial cells to malignant
    phenotype following exposure to asbestos fibres has not yet been
    achieved. In general, asbestos fibres are thought to act through
    direct physical interactions with the cells of the mesothelium in
    conjunction with indirect effects following interaction with
    inflammatory cells such as macrophages.

    Analysis of the interactions between Asbestos fibres and DNA has
    shown
    that phagocytosed fibres are able to make contact with chromosomes,
    often adhering to the chromatin fibres or becoming entangled within
    the chromosome. This contact between the Asbestos fibre and the
    chromosomes or structural proteins of the spindle apparatus can induce
    complex abnormalities. The most common abnormality is monosomy of
    chromosome 22. Other frequent abnormalities include structural
    rearrangement of 1p, 3p, 9p and 6q chromosome arms.
    Asbestos has also been shown to mediate the entry of foreign DNA into
    target cells. Incorporation of this foreign DNA may lead to mutations
    and oncogenesis by several possible mechanisms:

    Inactivation of tumor suppressor genes
    Activation of oncogenes
    Activation of proto-oncogenes due to incorporation of foreign DNA
    containing a promoter region
    Activation of DNA repair enzymes, which may be prone to error
    Activation of telomerase
    Prevention of apoptosis
    Asbestos fibers have been shown to alter the function and secretory
    properties of macrophages, ultimately creating conditions which favour
    the development of mesothelioma. Following asbestos phagocytosis,
    macrophages generate increased amounts of hydroxyl radicals, which are
    normal by-products of cellular anaerobic metabolism. However, these
    free radicals are also known clastogenic and membrane-active agents
    thought to promote Asbestos carcinogenicity.
    These oxidants can
    participate in the oncogenic process by directly and indirectly
    interacting with DNA, modifying membrane-associated cellular events,
    including oncogene activation and perturbation of cellular antioxidant
    defences.

    Asbestos also may possess
    immunosuppressive properties. For example,
    chrysotile fibres have been shown to depress the in vitro
    proliferation of phytohemagglutinin-stimulated peripheral blood
    lymphocytes, suppress natural killer cell lysis and significantly
    reduce lymphokine-activated killer cell viability and recovery.
    Furthermore, genetic alterations in asbestos-activated macrophages may
    result in the release of potent mesothelial cell mitogens such as
    platelet-derived growth factor (PDGF) and transforming growth factor
    which in turn, may induce the chronic stimulation and proliferation of
    mesothelial cells after injury by Asbestos fibres

    Incidence
    Although reported incidence rates have increased in the past 20 years,
    mesothelioma is still a relatively rare cancer. The incidence rate is
    approximately one per 1,000,000. The highest incidence is found in
    Britain, Australia and Belgium: 30 per 1,000,000 per year.[7] For
    comparison, populations with high levels of smoking can have a lung
    cancer incidence of over 1,000 per 1,000,000. Incidence of malignant
    Mesothelioma currently
    ranges from about 7 to 40 per 1,000,000 in industrialized Western
    nations, depending on the amount of asbestos exposure of the
    populations during the past several decades.[8] It has been estimated
    that incidence may have peaked at 15 per 1,000,000 in the United
    States in 2004. Incidence is expected to continue increasing in other
    parts of the world. Mesothelioma occurs more
    often in men than in women and risk increases with age, but this
    disease can appear in either men or women at any age. Approximately
    one fifth to one third of all mesotheliomas are peritoneal.

    Between 1940 and 1979, approximately 27.5 million people were
    occupationally exposed to asbestos in the United States [4]. Between
    1973 and 1984, there has been a threefold increase in the diagnosis of
    pleural Mesothelioma in
    Caucasian males. From 1980 to the late 1990s, the death rate from Mesothelioma in the USA
    increased from 2,000 per year to 3,000, with men four times more
    likely to acquire it than women. These rates may not be accurate,
    since it is possible that many cases of Mesothelioma are
    misdiagnosed as adenocarcinoma of the lung, which is difficult to
    differentiate from mesothelioma.

    Risk factors
    Working with Asbestos is
    the major risk factor for Mesothelioma A history of
    Asbestos exposure exists
    in almost all cases. However, Mesothelioma has been
    reported in some individuals without any known exposure to asbestos.
    In rare cases, Mesothelioma has also been
    associated with irradiation, intrapleural thorium dioxide
    (Thorotrast), and inhalation of other fibrous silicates, such as
    erionite.

    Asbestos is the name of a
    group of minerals that occur naturally as
    masses of strong, flexible fibers that can be separated into thin
    threads and woven. Asbestos has been widely
    used in many industrial
    products, including cement, brake linings, roof shingles, flooring
    products, textiles, and insulation. If tiny Asbestos particles float
    in the air, especially during the manufacturing process, they may be
    inhaled or swallowed, and can cause serious health problems. In
    addition to Mesothelioma,
    exposure to Asbestos
    increases the risk of lung cancer, Asbestos (a
    noncancerous, chronic lung ailment), and other cancers, such as those
    of the larynx and kidney.

    The combination of smoking and Asbestos exposure
    significantly
    increases a person's risk of developing cancer of the airways (lung
    cancer, bronchial carcinoma). The Kent brand of cigarettes used
    asbestos in its filters for the first few years of production in the
    1950s and some cases of Mesothelioma have resulted.
    Smoking modern cigarettes does not appear to increase the risk of
    mesothelioma.

    Some studies suggest that simian virus 40 (SV40) may act as a cofactor
    in the development of Mesothelioma
    Exposure
    Asbestos was known in
    antiquity, but it wasn't mined and widely used
    commercially until the late 1800s. Its use greatly increased during
    World War II. Since the early 1940s, millions of American workers have
    been exposed to Asbestos
    dust. Initially, the risks associated with
    Asbestos exposure were
    not publicly known. However, an increased risk
    of developing Mesothelioma was later found
    among shipyard workers, people who work in asbestos mines and mills,
    producers of Asbestos
    products, workers in the heating and
    construction industries, and other tradespeople. Today, the U.S.
    Occupational Safety and Health Administration (OSHA) sets limits for
    acceptable levels of Asbestos exposure in the
    workplace, and created
    guidelines for engineering controls and respirators, protective
    clothing, exposure monitoring, hygiene facilities and practices,
    warning signs, labeling, recordkeeping, and medical exams. By
    contrast, the British Government's Health and Safety Executive (HSE)
    states formally that any threshold for Mesothelioma must be at a
    very low level and it is widely agreed that if any such threshold does
    exist at all, then it cannot currently be quantified. For practical
    purposes, therefore, HSE does not assume that any such threshold
    exists. People who work with asbestos wear personal protective
    equipment to lower their risk of exposure. Recent findings have shown
    that a mineral called erionite has been known to cause genetically
    pre-dispositioned individuals to have malignant Mesothelioma rates much
    higher than those not pre-dispositioned genetically. A study in
    Cappadocia, Turkey has shown that 3 villiages in Turkey have death
    rates of 51% attributed to erionite related mesothelioma.

    Occupational
    Exposure to Asbestos
    fibres has been recognised as an occupational
    health hazard since the early 1900s. Several epidemiological studies
    have associated exposure to Asbestos with the
    development of lesions
    such as Asbestos bodies
    in the sputum, pleural plaques, diffuse
    pleural thickening, asbestosis, carcinoma of the lung and larynx,
    gastrointestinal tumours, and diffuse Mesothelioma of the pleura
    and peritoneum.

    The documented presence of Asbestos fibres in water
    supplies and food
    products has fostered concerns about the possible impact of long-term
    and, as yet, unknown exposure of the general population to these
    fibres. Although many authorities consider brief or transient exposure
    to asbestos fibres as inconsequential and an unlikely risk factor,
    some epidemiologists claim that there is no risk threshold. Cases of
    Mesothelioma have been
    found in people whose only exposure was breathing the air through
    ventilation systems. Other cases had very minimal (3 months or less)
    direct exposure.

    Commercial asbestos mining at Wittenoom, Western Australia, occurred
    between 1945 and 1966. A cohort study of miners employed at the mine
    reported that while no deaths occurred within the first 10 years after
    crocidolite exposure, 85 deaths attributable to Mesothelioma had occurred by
    1985. By 1994, 539 reported deaths due to mesothelioma had been
    reported in Western Australia.

    Paraoccupational secondary exposure
    Family members and others living with Asbestos workers have an
    increased risk of developing Mesothelioma and possibly
    other Asbestos related
    diseases. This risk may be the result of
    exposure to Asbestos dust
    brought home on the clothing and hair of
    asbestos workers. To reduce the chance of exposing family members to
    asbestos fibres, Asbestos
    workers are usually required to shower and
    change their clothing before leaving the workplace.

    Asbestos in buildings
    Many building materials used in both public and domestic premises
    prior to the banning of Asbestos may contain
    asbestos. Those
    performing renovation works or DIY activities may expose themselves to
    asbestos dust. In the UK use of Chrysotile asbestos was banned at the
    end of 1999. Brown and blue Asbestos was banned in the
    UK around 1985.
    Buildings built or renovated prior to these dates may contain Asbestos
    materials.
    Environmental exposures
    Incidence of mesothelioma had been found to be higher in populations
    living near naturally occurring asbestos. For example, in Cappadocia,
    Turkey, an unprecedented Mesothelioma epidemic caused
    50% of all deaths in three small villages. Initially, this was
    attributed to erionite, however, recently, it has been shown that
    erionite causes mesothelioma mostly in families with a genetic
    predisposition
    Treatment of malignant Mesothelioma using
    conventional therapies in combination with radiation and or
    chemotherapy on stage I or II Mesothelioma have proved on
    average 74.6 percent successful in extending the patients life span by
    five years or more [commonly known as remission][this percentage may
    increases or decrease depending on date of discovery / stage of
    malignant development] (Oncology Today, 2009). Treatment course is
    primarily determined by the staging or development. This is unlike
    traditional treatment such as surgery by itself which has proved only
    be 16.3 percent likely to extend a patients life span by five years or
    more [commonly known as remission]. Clinical behavior of the
    malignancy is affected by several factors including the continuous
    mesothelial surface of the pleural cavity which favors local
    metastasis via exfoliated cells, invasion to underlying tissue and
    other organs within the pleural cavity, and the extremely long latency
    period between Asbestos
    exposure and development of the disease

     
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