Seniors Health all 1

medical practitioners doctors specialists listings by Location alphabetical

Doctors4U® - Listing In Adelaide . Brisbane . Cairns . Canberra . Darwin . Gold Coast . Hobart . Launceston . Melbourne . Perth . Sydney

Managing vertebral fractures - with cement!
With compliments of ACA Channel 9
19 August 2003
Reporter: Jane Hansen

Vertebral fractures are common among severe osteoporosis sufferers but up until recently there have been few alternatives to manage the pain. Now, as ACA reports, a procedure known as vertebroplasty - which involves an injection of concrete into the fracture - is giving patients new hope of an improved quality of life.

It's hard to believe but just 24 hours ago, Marie Englund could barely move after a fall fractured her spine and she says the pain was agonising.

"I couldn't even talk, it crossed under my chest, it was agony," she says. "It's the most terrible pain and I can't describe it."

Within hours, Marie's fracture was pinpointed and treated with an injection of cement by specialist Dr William Clark, which he says stops the movement in the broken bone and abolishes the pain almost immediately.

Sydney-based Professor Terry Diamond says the treatment is a remarkable improvement on traditional therapies, which have largely been ineffective for many years.

"Bracing of the spine is very difficult to do so treatment has centred on heat and cold packs and analgesia with rehabilitation," he says. "Six to six months is the natural history for how long spinal fractures take to heal."

For Margaret McGuiness, who fractured her spine just a few days ago, undergoing vertebroplasty seems a little daunting but she fears the alternative.

"There's no alternative really," she says. "Only sitting in a chair with painkillers."

According to Dr Clark, Margaret's spine actually looks as though there is a fracture right through the middle of the vertebral body and these types of injury tends to be very painful. That's why this procedure - which involves the same cement orthopaedic surgeons have been using for many years to glue hip joints - is so appealing.

"We mix up the cement by adding some liquid to some powder and we have a working time of about three to four minutes to inject the cement," explains Dr Clark.

An hour later, the local anaesthetic has worn off and Margaret is resting more comfortably.

The therapy is by no means a cure for osteoporosis but it's an effective treatment that returns the quality of life to the elderly and in some cases saves lives. Without the procedure, 90-year-old World War II veteran Gordon McIlvene may not have survived after fracturing his back two years ago.

Professor Diamond says Gordon's severe back pain began when he got off the bus he'd caught into town. The pain ended up getting much worse.

"[He] was eventually wheelchair-bound and started to get secondary infection in his lungs because of the pain," says Professor Diamond. "He's the classic patient who is at risk of pneumonia, ending up in hospital, getting clots in the legs and dying from a pulmonary event - in this group, the therapy is amazing."

For Gordon, he's back to his cheeky self, ready and looking forward to marching at next year's ANZAC Day parade.

"They [surgeons] do things behind your back, you know?" he jokes. "I still don't know what they actually did but I've been alright ever since.

back to top

Percutaneous vertebroplasty: what is it?
With Compliments of ACA Channel 9
19 August 2003

Information in the following fact sheet has been provided by Associate Professor of Medicine, Terry Diamond.

What is a vertebral fracture?

The spinal column comprises a number of vertebral bodies (cervical, thoracic and lumbar). With severe osteoporosis, a vertebral body can fracture either spontaneously following a cough, sneeze or with minimal trauma such as lifting a small shopping bag.

The fracture is associated with severe, excruciating back pain, requiring narcotic analgesia and hospitalisation. Patients are usually elderly and may develop significant complications following fracture, such as pneumonia, blood clots and even death (increased by as much as eight-fold).

Until recently, analgesia, bracing, heat packs and physiotherapy offered some benefit.

What is vertebroplasty?

Vertebroplasty or cementoplasty is a technique whereby liquid cement is injected through a fine needle into a vertebrae body under careful X-ray screening.

The cement is injected in liquid form and rapidly undergoes a thermal reaction and solidifies. When the liquid substance is injected, it first dissipates throughout the fine fractured trabecular network of the vertebral body and then solidifies, acting as a solid support for the pain-sensitive vertebral endplates and the spinal column above. This process results in dramatic pain relief.

Who can benefit from this treatment?

Vertebroplasty was first developed in 1987 for the treatment of spinal tumours. It is now recognised as a very effective modality for treating acute painful vertebral fractures in elderly osteoporotic patients. This procedure is predominantly of benefit in individuals who have MRI evidence of acute vertebral fractures.

What are the benefits?

Vertebroplasty results in prompt pain relief and allows for the rapid rehabilitation of patients, thereby preventing hospital admission and fracture-related complications.

The procedure is performed on a day-only outpatient service. The overall reduction in costs and bed days associated with acute vertebral fractures treated by successful vertebroplasty may have significant savings on the ailing health economy.

Are there any drawbacks?
· Not all patients are suitable for vertebroplasty. This technique is indicated for treating patients with acute severe osteoporotic vertebral fractures. It is not a technique for treating chronic vertebral deformities.

· Vertebroplasty is contraindicated in individuals who are on blood thinners (anti-coagulants) and those in whom the fracture deformity impinges on the spinal cord.

· It is not without risk. Complications may be related to cement allergy, bleeding from the procedure and leakage of cement into surrounding structures and blood vessels.

· Vertebroplasty should currently be reserved for the elderly patient (60+), since the long-term risks of increased spinal stiffness associated with recurrent fractures remains unknown.

Is there any other treatment required after vertebroplasty?

It is important to note that vertebroplasty only treats the symptoms. Most patients have severe underlying osteoporosis placing them at high risk of recurrent fractures. Treatment with appropriate anti-osteoporotic drug therapies is indicated. Moreover, an optimal rehabilitation program with hydrotherapy is indicated after the procedure, so as to allow the individual to return to his/her pre-fracture lifestyle.

Who performs this procedure?

Complications are very rare but can be significant. Vertebroplasty is very much operator-dependent. It is imperative that vertebroplasty only be undertaken in tertiary care referral centres with highly trained and skilled radiologists with optimal radiological imaging equipment.

How effective is it?

Recent research (Diamond et al, American Journal of Medicine 2003) indicates when compared to conservative therapy, vertebroplasty results in prompt pain relief and rapid rehabilitation. In experienced hands, it is considered a safe and effective procedure for treating acute osteoporotic vertebral fractures.

The two articles above are from ACA Channel 9.
www.ninemsn.com/aca

A special thank you to Channel 9 & ACA.

Parkinson's Disease - Want to know more about this disease? Here is a great site that provides links to State organisations, support groups as well as the latest in research.
www.parkinsons.org.au

The is an American Web site on the same subject which also offers various information on the disease and its treatments.
www.parkinsons.org

back to top

back to main home page

Anti - Alzheimer's day

DO a crossword puzzle, play a board game and then go dancing - this could be the agenda for an anti-Alzheimer's day.

A study recently published in the New England Journal of Medicine has suggested that brain exercise extends functional brain life. New York's Albert Einstein College of Medicine neurologist Joe Verghese said it was not clear whether using the grey matter actually slowed the degeneration process or increased the number of brain cells that could later be lost. But either way, the result was a significant reduction in dementia.

The study found that those who regularly challenged themselves mentally through such activities as reading, playing board games, doing crossword puzzles or playing a musical instrument reduced their chances of developing dementia by about two-thirds.

Verghese and his team have followed hundreds of elderly volunteers for more than 20 years and believe they have collected sufficient information to confirm the 'use it or lose it' theory.

One specific finding of the study was that people who did crossword puzzles four days a week had only half the risk of dementia when compared to those who did the puzzles one day a week.

Physical activity seemed to have little effect, except for dancing. Those who frequently danced lowered their risk by 76 per cent.

Knees up: a radical procedure for replacements

Australian surgeons have pioneered a radical procedure for knee replacements, which for the first time can be done using keyhole surgery.

According to medical professionals, it lessons the impact of surgery and dramatically improves the recovery time. Douglas Blanchonette is one of 20,000 Australians undergoing knee replacements each year, a legacy of plenty of sport and age-related arthritis. "I thought I was bulletproof when I was young," the knee replacement patient said. In recent years, a trend to do partial knee replacements has resulted in smaller and smaller incisions.

But now, Australian surgeon Ray Randle has developed a world first. Using virtually a keyhole surgery technique, assisted by a camera on what's called an arthroscope, a hole about two centimetres is all that is needed to insert the partial knee replacement. "By using this technique we don't disturb any deep soft tissues or muscle and that means there's less swelling and that the patient's recovery is much faster," said orthopaedic surgeon, Dr Ray Randle.

The Australian team developed special instruments to make the new procedure possible, recently demonstrated at the biggest orthopaedic conference in America. Here, surgeons were so impressed that they have ordered the first run of instruments. However, they, and Australian surgeons, will need special training before the procedure is generally available. "There's no doubt it's technically more difficult than doing it through an open cut, but it is certainly a win for the patient," said Dr Randle.

Patient Lorraine Leuckel was mobile just 48 hours after surgery. "It's all fixed, none of the dramatic pain compared to the heartache that I thought I was going to be going through," she said.

Contact
Keyhole-arthroscopically assisted partial knee replacement:
Gold Coast Surgeon Dr Ray Randle
Ph: 1800 21 22 00 (only for Queensland)
Interstate: (02) 66 21 2200
Source: A special thank you to National Nine News for this article.

Remember, any articles on any of our pages are for reference purposes only. Please, we urge you to always seek the advice of your Health Professional for diagnosis and treatment and answers to any questions you are seeking.

back to top

Right to life fears over Victorian ruling

Critically-ill patients being tube-fed can now choose to end their lives after a Victorian court ruled such feeding was medical treatment, not palliative care.

Right to life groups claimed the landmark ruling by the Supreme Court would lead to the deaths of vulnerable people who were not imminently dying. But medical and legal experts said it finally clarified a "grey" area of Victoria's Medical Treatment Act and there were safeguards in place to protect the lives of patients.

The court made its ruling in the case of a 68-year-old woman who has been unconscious in a nursing home for three years. The woman, known only as BWV, is suffering from a rare form of dementia known as Pick's disease and has been kept alive by being fed through a stomach tube.

Justice Stuart Morris found the artificial feeding was a medical procedure under the Act, rather than palliative care, and as such could be refused. He said the ruling would enable the Public Advocate, Julian Gardner, "to decide on behalf of BWV whether it is now time to allow her to die with dignity".

Mr Gardner said the decision made it clear that everyone had a right to refuse medical treatment and it would not endanger the lives of other tube-fed patients.

"This decision relates to people who made their wishes known while they were competent and if those wishes were not made known or they didn't ever have any wishes, then if I for example were their guardian, I would fight to continue to get the medical treatment," he said. "This case is about someone who, while they were competent, made their views and wishes about medical treatment clearly known. "What the decision does is to respect that and mean that they will now be allowed the same rights as the rest of us. They will not be treated as second-class citizens." Mr Gardner would not say when BWV's treatment would cease.

The woman's family said they were grateful for the court's decision.
"The family feel that the court has considered the best interests of BWV and know that this is the outcome she would have wanted," they said in a statement. "The primary concern is that BWV receives the best care possible and the family are sympathetic to others in the same situation."

But Right to Life Australia president Margaret Tighe said it was "not an act of love to kill somebody by dehydration and starvation". Mrs Tighe said the ruling could result in the untimely deaths of other tube-fed people. "I do feel fearful for the lives of many people who will be considered expendable," she said. "There will be lives that are lost, lives that should never have been lost, simply because the nutrition and hydration will have been removed, and even though that patient might well have recovered.

"Some people would say it's not euthanasia, but clearly it's a decision to end a person's life by an act of omission."

©AAP 2003
A special thank you to AAP & Channel 9 news for this article.

Australian Council for Safety and Quality in Health Care
19 December 2003

Consumers now have easy access to advice about adverse drug reactions and medication errors following the recent launch of Australia's first Adverse Medicine Events consumer reporting hotline.

The hotline, which operates Monday to Friday from 9am to 6pm (AEST), is part of an 18-month trial by The Australian Council for Safety and Quality in Health Care to track people's adverse medicine experiences in order to improve medication safety.

Safety and Quality Council Chair, Professor Bruce Barraclough, says the hotline allows people to report any adverse reactions, medication errors or 'near misses' with prescription medicines, over the counter drugs, and complementary medicines.

Brisbane's Mater Health Services is conducting the trial, following a successful two-year pilot of the concept in Queensland. The Adverse Medicine Events Line is staffed by pharmacists with specialist training in drug information.

Professor Barraclough says one woman found that taking a cranberry tablet was causing her insomnia. "She was taking the tablets for her bladder while on the anti-depressant medication, dothiepin, when she started having trouble sleeping," he says. "A call to the hotline and the pharmacist was able to pinpoint how the herbal preparation was likely to be lowering the dose of her anti-depressant medication and reducing the effectiveness of her medication - thereby stopping her from getting a good night's sleep."

Professor Barraclough says de-identified data will be collected through the hotline service and fed back to health professionals to assist in changing systems to help prevent the reoccurrence of these adverse events.

"Consumer feedback about the use of medications is an important tool in assisting us to improve our processes regarding medication management," he says.

"Things can go wrong in complex health systems and the important thing is to identify the potential areas of risk, and to change our systems of care to make them safer for patients."

Consumers are encouraged to call the Adverse Medicine Events Line to report or get advice on medication problems on 1300 134 237.

You can see the Safety Council's website at:
www.safetyandquality.org/

More support for the aged to stay at home!

Ms Julie Bishop MP
Minister for Ageing
16 December 2003

Australians will receive increased support to remain in their own homes as they age, following the announcement of 1,345 new aged care places by the Minister for Ageing, Julie Bishop, today.

The places, supported with over $27 million in Australian Government funding, have been allocated to 97 approved providers operating 144 separate services across Australia.

"This latest round of placements form part of the Australian Government's on-going commitment to providing more aged care places for older Australians", Ms Bishop said.

"The new places comprise 906 Community Aged Care Packages (CACP) and 439 Extended Aged Care at Home (EACH)packages, both of which provide aged care to people in their own home.

"Since coming to office in 1996, the Australian Government has increased funding for Community Aged Care Packages by more than 700 per cent. In doing so we have helped fulfil the aspirations of more than 27,000 Australians who wish to remain living independently in their own home and community as they age," she said.

Ms Bishop said the aged care industry sector showed strong interest in working in partnership with the Australian Government by applying for the available places.

Places are allocated to those applicants who have demonstrated they can best meet the care needs of the ageing community within a specified region.

"Two of the key priorities for 2003 were to provide care to people living with dementia and improving access to aged care services for people with special needs," Ms Bishop said.

"The prescribed special needs groups are veterans, including a spouse, widow or widower of a veteran, people in rural and remote Australia, people from Aboriginal and Torres Strait Islander communities, people from non-English speaking backgrounds and people who are financially or socially disadvantaged."

A total of 8,666 places funded with more than $186 million in Australian Government subsidies have been made available in the 2003-04 Aged Care Approvals Program. The allocation of residential aged care places and capital grants is expected to be announced early in the new year.

You may find more information about this subject and others on the Department of Health and Ageing Internet site.
www.ageing.health.gov.au/acar2003/index.htm

Masturbation & Prostate Cancer

New findings on prostate cancer risk and sexual activity
17 July 2003

The Cancer Council Victoria has announced the results of research undertaken into the relationship between prostate cancer and ejaculation in men aged under 70.

A research team led by Professor Graham Giles, Director of the Cancer Council's Cancer Epidemiology Centre, has found that there is evidence that the more frequently men ejaculate between the ages of 20 and 50, the less likely they are to develop prostate cancer.

The researched showed that the protective effect of ejaculation is greatest when men in their twenties ejaculated on average seven or more times a week. This group were one-third less likely to develop aggressive prostate cancer when compared with men who ejaculated less than three times a week at this age.

Professor Giles said, "We looked at a number of different aspects of sexual activity including the number of sexual partners, the frequency of ejaculation, as well as the number of times men ejaculated at different ages, from their twenties through to their fifties.

"The study looked at ejaculation in the context of intercourse with another person, masturbation, nocturnal emissions etc.

"This is a different approach from previous studies which have mostly looked at links between sexual intercourse and prostate cancer.
"Our research indicates that there is no association between prostate cancer and the number of sexual partners, which argues against infection as a cause of prostate cancer in the Australian population."
"We also found no association between maximum number of ejaculations in a 24 hour period and prostate cancer. Therefore, it is not men's ability to ejaculate that seems to be important.
"While it is generally accepted that prostate cancer is a hormone dependent cancer, apart from age and family history, its causes are poorly understood."

"For this reason, our explanations are fairly speculative - one possible reason for the protective effects of ejaculation may be that frequent ejaculation prevents carcinogens building up in the prostatic ducts."
"If the ducts are flushed out, there may be less build up and damage to the cells that line them."

"However, this is only one study and our findings require further corroboration in other studies.

The research was conducted with men who were under the age of 70 when they were diagnosed with prostate cancer, and with a group of similarly aged healthy men. There were 1079 men with prostate cancer and 1259 healthy men in the study. The men were from Melbourne, Sydney and Perth.

The men filled in a confidential questionnaire which sought details of their sexual activity at various times in their life. The results of the survey were treated confidentially.

Professor Giles said, "We believe that the men who participated in the study were likely to have been honest about their sexual activity because of the way the research was conducted, particularly using a questionnaire that men filled out themselves, and respecting their privacy."

"The fact that we did not find any association with the number of sexual partners argues against the possibility of the finding in regard to ejaculation being due to bias, as if this was the case we would have expected both associations to be positive."

The project involved researchers from The Cancer Council Victoria, The University of Western Australia, The European Institute of Oncology and the Dunedin Medical School, University of Otago, New Zealand.
The research was funded by the National Health and Medical Research Council and supported by funding from Tattersall's and The Whitten Foundation, as well as The Cancer Council Victoria.

The research is being published in the British Journal of Urology International
vol 92, p 211.

Media contact: Leigh Raymond 03 9635 5191
Professor Graham Giles is available for interview from 9 am 17 July 2003.

The Australian Cancer Council site is at www.accv.org.au/index.htm

And

The British Journal of Urology article can be seen at:
www.accv.org.au/cancer1/whatsnew/mediareleases/2003/20030717.htm

MEDIA RELEASE

MORE THAN ONE MILLION OLDER AUSTRALIANS
BENEFIT FROM GOVERNMENT REBATE MOVE

The Chief Executive Officer of the Australian Health Insurance Association, Russell Schneider, today applauded the Federal Government's commitment to retain the private health insurance rebate and increase it for older Australians.

"More than 1 million people over 65, many of them on fixed incomes, will benefit directly from the rebate increase," Mr Schneider said. "It will have a very beneficial effect on the whole health care system, both private and public."

"Stresses on the public hospital system will be reduced because the increased rebate will mean more people in this age group will be able to either keep their private health insurance or afford to take out cover."
"People aged more than 65 use more hospital services than any other age group. For more than one million of them, private health insurance is essential. If affordability forced even small numbers to drop their cover, the impact on the public system would be devastating. The 30-percent rebate has made it possible for many older people on fixed or low incomes to remain insured. The increases announced today will make it even more affordable for them."

At June this year 1,054,729 people aged 65 or more had private health insurance. In the year ended June 2004 health funds paid more than $2.2 billion for almost 700,000 hospital episodes involving people over 65, and many hundreds of millions more for a wide range of ancillary health services including dental, optical and physiotherapy.

"This new initiative should be welcomed by all concerned with improving our health system," Mr Schneider said. "It will certainly be strongly welcomed by more than one million people over 65 who are proud of the fact that they are contributing to their own health care needs, and appreciate the Government's recognition of their desire to be able to be treated as private patients.

"In the last few weeks I have been inundated with letters and calls from older people who have been very distressed by ongoing criticism of the rebate and lobbying by some groups to have it removed.

"This announcement will delight more than one million responsible older Australians who want private health care. It unequivocally confirms the Federal Government's commitment to the private health insurance rebate. I would hope all other political parties will similarly indicate their strong support for the rebate and for the extension announced today."

Canberra - 22 August 2004
For further information contact Russell Schneider
on 02 6288 2145 or 02 9286 6000.

back to top

Walking Helps Lower Blood Pressure
Studies Show a Brisk Walk Can Help Improve Heart Health
By Charlene Laino
WebMD Health News
Reviewed by Louise Chang, MD
May 30, 2008 (Indianapolis) --

If you have high blood pressure or are extremely overweight, walking may hold the key to improved heart health.

That's the message from researchers who spoke here this week at the annual meeting of the American College of Sports Medicine (ACSM).
A Korean study shows that walking just 40 minutes a day lowered blood pressure in people with hypertension. A U.S. study suggested that taking a stroll offers cardiovascular benefits for people who are morbidly obese.

The Korean researchers studied 23 men with prehypertension or hypertension. "Normal" blood pressure is a measurement of less than 120/80. Hypertension is defined as a reading of 140 over 90 or greater. Those with blood pressure readings between normal blood pressure and high blood pressure are considered to have prehypertension.

The researchers measured the men's blood pressure following a 40-minute brisk walking session and four, 10-minute brisk walking bouts. What's brisk? About 3 to 4 miles per hour, says Saejong Park, PhD, of the Korea Institute of Sport Science in Seoul.

Blood pressure dropped by similar amounts after each type of exercise session. The top number in the blood pressure reading dropped about 5 points after the 40-minute walk and 3 points after the four 10-minute walks, Park tells WebMD. The bottom number of the blood pressure reading dropped about 2 points for both walking sessions.

While longer studies are needed, "we think the benefits will be sustained over time if the men keep exercising," Park says.

The bottom line, she tells WebMD, is that you have a choice when it comes to exercise. "Some people like to work out all at once, but others say they can't comply with an exercise program because they have no time. These findings suggest people with time crunches and busy schedules can fit bits of exercise in throughout the day and reap the same health benefits."

The findings are in line with ACSM recommendations, which call for healthy adults to engage in at least 30 minutes of moderate physical activity five days a week. The guidelines state that three 10-minute sessions are as effective as one longer session.

Jeffrey A. Ross, DPM, a clinical professor of medicine at Baylor College of Medicine in Houston, recommends alternating walking with other activities.
"Instead of walking seven days a week, take a day off and go swimming or biking. That way you'll work out different muscles and reduce your chance of overuse injuries," Ross says.

We sincerely thank WebMD for this artcile. WebMD is a wonderful American site with much health information and you can see their site by Clicking here

back to top

back to main home page

Walking Helps Morbidly Obese

The U.S. study involved 14 morbidly obese patients who were scheduled to undergo weight loss surgery. Their average body mass index (BMI) was 46; a person with a BMI of 40 or over is considered to be morbidly obese.
Patients were asked to walk 1 mile at as brisk a pace as possible.

They were able to stop and take breaks, but most walked the mile in under 30 minutes, says Thomas Spring, MS, a senior exercise physiologist at William Beaumont Hospital in Royal Oak, Mich.

Results showed that all 14 "got their heart rate up to an adequate level to have benefits in term of cardiovascular health," Spring tells WebMD.

"Walking is a great way for the overweight and obese to begin an exercise program, but always check with your doctor before starting any exercise program."

We sincerely thank WebMD for this article.

Today Tonight has put the call out to help our pensioners. And while the government may be ignoring them - you are not.

An overwhelming response of giving and sharing is going on all around Australia, as ordinary people get behind our campaign and support needy pensioners.
Giveaways

They say winners are grinners. At last our pensioners have something to smile about, as businesses offer a helping hand.
Click here for the list of companies.

New Adopt-A-Pensioner website
Our site is an easy way for both pensioners and potential helpers to meet.

Click here for the Adopt-A-Pensioner website

If you are a pensioner, click on the left and you will be asked to fill in some general details and what you need assistance with.

Alternatively, if you would like to adopt a pensioner, click on the right: fill in your details and where you can help.

You will be matched up with a pensioner in need in your local area and you are guaranteed no personal details will be given out.

If you don't have time to adopt a pensioner: you can make a donation which will be forwarded as a food voucher. To make donations, visit the Combined Pensioners and Superannuants Association website.

* The Adopt-A-Pensioner website requires you to have an email address when you sign up - pensioners and helpers alike. This means personal information, such as real addresses and contact details, is not given out. If you do not have an email account, try asking a neighbour or your local library, who will have internet access and can help you create an email address. If that is not possible, the Combined Pensioners and Superannuants Association may be able to help.

We thank yahoo7, today tonight for the above and congratulate yahoo7 for taking such an initiative to help our Pensioners.

You may see yahoo7 's site by Clicking here

back to top

back to main home page

Disclaimer
The information in any of our Directories or sites is made available for information purposes only, and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Also, the accuracy of the information is not guaranteed. Doctors4U or any of its employers do not accept any liability for any injury, loss or damage incurred by use of or reliance on any such information on any of our sites or in any of our directories Australia.

home | about us | articles

This site is best viewed at 1024 X 768 with I.E 5.+
Disclaimer
PLEASE NOTE: The publisher disclaims any liability arising directly or indirectly from the use
of these pages on our site www.doctors-4U.com or any of its links and advises everyone
using this site and its links to exercise their own informed judgment in the selection of medical care.

Copyright © 2002 - 2008 Doctors 4U®. All rights reserved