American Health Care: Curbing Costs and Increasing Access

A recent Wall Street Journal article reported that, facing increasing health care costs and higher insurance company  premiums, Americans are patronizing more affordable and convenient retail clinics.  At the same time, Drug Store News disclosed a 36% rise in visits to MinuteClinics last year.

Quick-Care Clinics
The first CVS owned MinuteClinic opened in the Twin Cities in 2000 and now number 560 units in 25 states.  Service is on a walk-in, non-appointment basis, and is administered by family nurse practitioners and physician assistants.  The staff is trained to diagnose and treat common illnesses, minor injuries, and skin conditions deliver health screenings and vaccinations.

Mass Market Retailers Offering Medical Care
Retailers such as Target, Walmart, and ShopKo have joined the express-clinic trend with in-store facilities.  Walmart has gone the route of partnering with local hospitals and leasing out space to medical clinic companies such as Saltanic, which has doctors on staff and offers a wider range of services including x-rays.

Target has taken a slower, more experimental approach after closing the MinuteClinics it had opened in a limited number of stores. This year, the Minneapolis-based retailer undertook the greatest expansion in in-store clinics since 2007, opening eight new Target Clinics – five in Chicago and three in Palm Beach, FL.  Previously the company had operated 28 clinics in just two states: Minnesota and Maryland.

Risks and benefits
Many in the American health care industry worry that offering medicine on a retail basis will result in the commoditization of health care.  However, the upside may be worth the risk.  The reality is that increasing competition by adding another channel of distribution may provide convenience and access to more people.  And that is what is currently missing from health care delivery in America, namely the typical convenience of other services that are subject to free-market forces.

Abbott Baxter Infus O.R IV infusion pump (pre-owned) Call Us at 800-522-5909, ext. 104 for a price quote.
Modify dose without multiple reprogramming steps; adjust settings easily at any time during infusion; change dial settings with a single hand for an immediate response; save calculation time; minimize risk of calculation error.  Read more.

Abbott Baxter Plum 6200 IV infusion pump (pre-owned) Call Us at 800-522-5909, ext. 104 for a price quote.
Baxter 6200 infusion pumps are capable of delivering a wide variety of fluids, including blood, over a broad range of infusion rates.  The 6200s are easy to load, spill resistant pumping mechanisms with occlusion sensors that detect both upstream and downstream restrictions. Read more.

Alaris Asena Tiva IV infusion pump (pre-owned) Call Us at 800-522-5909, ext. 104 for a price quote.
Infusion rates 0.1-1200ml/h; medical device interface (MDI); pole clamp; real-time clock; syringe sizes 5, 10, 20, 30 & 50ml; event log. Read more.

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New Victory in the War against Cancer

Amazing progress has been made this year toward prolonging the lives of patients with advanced skin cancer.  In March the U.S. Food and Drug Administration approved Bristol-Myers Squibb’s injectable drug Yervoy, which was found to extend the lives of end-stage melanoma patients an average of 10 months.  In a study which was presented on June 5 at a meeting of the American Society of Clinical Oncology, another drug, vemurafenib, was revealed to have a 63% reduction in the risk of death compared to patients given the chemotherapy drug dacarbazine.

Unlike chemotherapy, which attacks cancer cells with chemicals, Yervoy belongs to a novel class of immuno-therapy drugs that work by mobilizing the body’s immune system to destroy the cancer. Vemurafenib is a so-called targeted therapy which counteracts the effect of a mutation in a gene called B-RAF that causes tumors to grow and spread.

More than life extension
Some observers believed that prolonging the life of patients with metastatic melanoma as much as two years is not significant.  “Two years is nothing when you’re 30,” said Dr. Anna C. Pavlick, head of the melanoma program at New York University.

However, many doctors and patient groups welcomed the progress because until now treatment of melanoma that had spread beyond the skin to other organs was uncontrollable.  “Late-stage melanoma is devastating, with very few treatment options for patients, none of which previously prolonged a patient’s life,” Richard Pazdur, MD, director of the FDA’s cancer drugs office, said in a news release.

The number of melanoma cases has been rising steadily, unlike for many other types of cancer.  Doctors say this is because of unprotected sun exposure and the proliferation of tanning salons.  More than 68,000 people in the United States and 160,000 worldwide are diagnosed with melanoma each year, according to the American Cancer Society.  The five-year survival rate for the aggressive cancer is just 15%.

First in a Series
These two new drugs, with possible rare exceptions, do not cure melanoma.  More than half of patients with the disease will not be helped much or at all by either drug.  Experts say more needs to be done, especially since melanoma affects more young adults than many other types of cancer.

However, Tim Turnham, director of the Melanoma Research Foundation told the Associated Press, “Clearly this is not a home run, but it’s a solid base hit, and because we see other things in the pipeline, we think this is the first in a series of important new therapies for melanoma.”


Brand-new Schiller AT-2 Plus EKG at an amazing price of $1,999.00 – while supplies last. 
Alphanumeric keyboard 6/12 channel representation of all 12 simultaneously acquired leads; large, high resolution backlit monitor for easy preview of ECG quality; automatic and manual mode; fullsize 8 ½” x 11” reports; integrated rechargeable battery lasts up to 3 hours or normal use.  Read more.

GE MAC 1200 EKG machine (pre-owned) $2,200
Resting ECG system whose true one-button operation makes it especially suitable for routine use in private practice, emergency medicine or hospitals; standard, built-in battery; independent battery operation together with the electrode application system KISS with device-integrated suction pump (optional); brilliant graphic display where 12 leads can be displayed quickly in 3-lead sequences. Read more.

Burdick ATIRA 3100 EKG machine (pre-owned) $3,500
Automatic, manual or 12-lead rhythm operation for maximum flexibility; advanced functionality in a compact package; easy-to-use keyboard and menu driven interface; optional, powerful interpretation algorithm based on five clinically significant criteria, as well as pediatric analysis and pacemaker enhancement.  Read more.

Unusual Medical Treatments: Part II

If you thought that the extreme medical treatments involving urine, heroin and cigarette smoking were unbelievable, wait until you read this follow-up piece… except that one of the cures is still being used.

Psychic surgery
Actually used by the comedian, Andy Kaufmann in 1984, as a treatment for lung cancer, psychic surgery first came on the scene in the 1940s and 50s in Brazil and the Philippines.  Self-proclaimed healers often appear to remove ugly black leaves and other gruesome objects from the bodies of the ill.  While slight of hand is generally used to create the effect of spiritual intervention, the theoretical premise is that these objects were implanted as the result of dark magic or sorcery.

These cases of psychic surgery center around healers whose talents are said to be guided by powerful spirits.  Operations are performed without the benefit of anesthesia or antisepsis, under unsterile conditions, often without even the benefit of a knife. Blood appears. Tissue is removed. And yet, when the procedure is completed there is often no trace of a wound or an opening.

Early hemorrhoid suppository treatments
In 400 BC Hippocrates composed a treatise on the treatment of hemorrhoids.  In it he suggests a fanciful suppository concoction which he described this way, “the shell of the part fish a third part of plumbago, bitumen, alum, a little of the flos aeris, galls, a little verdigris; having poured a small quantity of boiled honey on these, and formed an oblong suppository, apply until you remove them.”

Medieval physicians used cautery irons to treat the problem.  Read more.

Maggot therapy
Maggots have been known for centuries to help heal wounds. Military surgeons noted that soldiers whose wounds became infested with maggots had better outcomes than those not infested. William Baer, while at Johns Hopkins University in the 1920s may have been the first in the Northern Hemisphere to have intentionally applied larvae to wounds in order to induce wound healing.

In many cases, the maggots can help treat festering wounds that have been open for weeks, even years, within only a day or two. While the treatment is pretty disgusting looking, patients rarely feel anything and when they do, it’s generally an itching or tickling sensation and nothing more. In January 2004, the U.S. Food and Drug Administration (FDA) began regulating medicinal maggots, and allowed the production and marketing of one particular strain of Phaenicia sericata larvae marketed under the brand name Medical Maggots (TM)

Malaria therapy
Until the early 1900s, there was no treatment for the sexually transmitted disease (STD) when Viennese neurologist Wagner-Jauregg had the idea to treat syphilis patients with malaria-infected blood. The patients would then develop malaria, which would cause an extremely high fever that would destroy the syphilis bacteria. When that happened, they would be treated with the malaria drug quinine and cured of both ailments.

Of course, there were the side effects–such as the high fever, but they were worth the outcome, especially without any other options. Wagner-Jauregg even won the Nobel Prize for malaria inoculation in 1927, and the treatment was common until the development of penicillin came along and doctors had a safer and more efficient cure for the STD.

21st-Century Medical Equipment from Ganim Medical

This week we are featuring some great deals on ultrasounds.

Aloka SSD 500 ultrasound (pre-owned)  Click here to make an offer.
Applications include general abdominal, obs/gynae & surgical; convex sector/inear scanner; outstanding image quality; extensive measurement & calculation package; annotation function with full alpha-numeric keyboard. Read more.

Aloka Alpha 7 ultrasound (pre-owned)  Click here to make an offer.
Broadband harmonics imaging; reduced side lobes and multiple echoes; higher penetration in deeper areas; directional eFLOW; enhanced spatial and time resolutions.  Read more.

Aloka SSD 1000 ultrasound (pre-owned)  Click here to make an offer.
Employs super high-density transducers; convex sector & linear scanning as standard; dynamic frequency scanning; swivel operation panel and monitor; ABC (Automatic B-gain Control).  Read more.

Unusual Medical Treatments: Part I

Have you ever wondered about the validity of a treatment when a doctor orders a test or medication for your recovery from an illness?  Today we trust our doctors and modern medical science to prescribe the correct treatment, but health care in the past was often based upon superstition, or whatever was at hand that seemed to make sense.

Urotherapy
During Roman occupation of what is today France, there was a tradition among the Gauls to use urine to whiten teeth.  In China, the urine of young boys has been regarded as a curative.  Later in history, the French regularly soaked stockings in urine and wrapped them around their necks to cure strep throat.

Scientifically speaking, here is no evidence of a therapeutic benefit of urine.  The bodily fluid does contain Vitamin C and other beneficial substances, but most of what makes up urine has been excreted by the body because it is harmful or present in excess.  Re-ingesting these substances will just result in re-excretion.  The most direct physiological effect of drinking urine, is diarrhea due to the laxative action of hypertonic solution of urea.

Heroin as cough medicine
First developed by Bayer Pharmaceutical in Germany around 1900, heroin was marketed by Bayer, and other companies for various medicinal uses including cough suppression.  Glyco-Heroin manufactured by Martin H. Smith Company, New York, was widely used not only as an analgesic but also as a remedy for asthma, coughs, and pneumonia.  Combining heroin with glycerin and often adding sugar or spices made the bitter-tasting opiate more palatable for oral consumption.

Ironically, heroin was also sold as a treatment for morphine addiction, but shortly afterwards the Smith Company faced an embarrassment when it was found that heroin is actually metabolized into morphine in the human body, therefore making the product a faster-acting form of morphine.

Today, under the chemical name diamorphine, heroin is available for prescription to long-term users in the Netherlands, United Kingdom, Switzerland, Germany, and Denmark.

Smoking
Nineteenth-century doctors often prescribed cigarettes and pipes packed with tobacco as a cure to patients with asthma.  According to the strange logic of old-time medicine, patients could breathe easier if they got enough healing smoke in their lungs.

In the 21st century, evidence suggests that the risk of developing Parkinson’s disease or Alzheimer’s disease might be 50% lower in smokers, compared to non-smokers.  Nicotine has also been found to improve ADHD symptoms and appears to have effects in the brain that are similar to those of stimulants.

These findings have not led physicians to encourage anyone to smoke, but some studies are focusing on benefits of nicotine therapy in adults with ADHD.  Risk of ulcerative colitis has been frequently shown to be reduced by smoking on a dose-dependent basis.  Curiously, the effect is eliminated if the individual stops smoking.

21st-Century Medical Equipment from Ganim Medical

This week we are featuring some great deals on pre-owned otoscopes/ophthalmoscopes.

Welch-Allyn 74710 with heads (pre-owned) $400
Handle-based rheostats for quick light-intensity adjustments; comfortable, contoured handles, easy to hold and maneuver; high-impact ABS housing that is durable and easy to clean;OptiSense Sensor automatically turns handles on when they are removed from the cradles and off when they are replaced; Halogen HPX lamp that provides 30% more light output; 74710 transformer.  Read more.

Welch-Allyn 76710 with heads (pre-owned) $650
The instrument you will need to perform a complete diagnostic examination; handle-based rheostats for quick light-intensity adjustments; comfortable, contoured handles easy to hold and maneuver; durable, easy-to-clean, high-impact ABS housing; OptiSense Sensor automatically turns handles on when they are removed from the cradles and off when they are replaced; choose one of four halogen ophthalmoscopes, including the innovative PanOptic.

From Opium to Ether: The Evolution of Anesthesia

Have you ever heard the comment “I don’t mind, as long as they put me under?”  Today, when we think of potentially painful surgery we immediately assume we’ll have the use of anesthesia on our side to get us through with little or no pain.  Surgeons perform amazing and intricate surgeries – heart bypasses, transplants, brain surgery – but would find it difficult without anesthesia.

Needles and soporifics
The Chinese were probably the first to use a form of anesthesia, acupuncture, as a means of relieving pain during surgical procedures.  The earliest text on the medical use of acupuncture, the Yellow Emperor’s Classic of Inner Medicine, dates back to 200 B.C., but the practice itself has its roots to Taosim which originated in the 4th century B.C.

The inventive and industrious Romans pioneered the use of soporifics such as opium and mandrake to perform operations.  Across the Atlantic, Incan shamans had their patients chew coca leaves and drilled holes in their heads to let the bad spirits escape.

Here in the U.S. we’re all fairly familiar with the use of alcohol as an anesthetic, thanks to Gabby Hayes and John Wayne.  Good old whiskey was used around the world in modern times, but side effects of vomiting, addiction, and sometimes death made this method undesirable.

The advent of modern anesthetic practices

Modern techniques to reduce surgical pain began when the English scientist Joseph Priestley (1733-1804) discovered that inhalation of nitrous oxide might relieve pain.  However, the watershed event for medicine and surgery came when William Thomas Green Morton (1819-1868), a Boston dentist, publically demonstrated the application of ether to remove a tumor from the neck of his patient.  Morton had rightly concluded that Priestly’s idea was right, but the gas was wrong.

In the early 20th century ether and chloroform were replaced by halogenated hydrocarbons such as halothane, which is still used.  Today we have a “balanced anesthesia” approach: a “cocktail” of drugs to induce loss of consciousness and eliminate pain.

Save money on Ganim Medical’s selection of pre-owned anesthesia machines

Drager Narkomed 2A Anesthesia Machine (Pre-Owned) $6,995
K-Package: O2 analyzer, tidal volume monitor, alarms; three vaporizers; AVE ventilator; standard hypoxic guard;
standard O2 and N2O; E-cylinder and central gas connections standard; AVE ventilator (electronic) standard; can be configured with ascending (A-of-F style) or descending bellows. Read more.

Drager Narkomed 2B anesthesia machine (pre-owned) $7995
Three 19.1 vaporizers; AVE electronic ventilator; absorber and scavenger; oxygen analyzer;  breathing pressure monitor; respiratory volume; centralized alarm and data; oxygen ratio controller; pressure limit controller; weight: 400 lbs (181.4 kg); max dimensions: 40” L x 68” H x 25” W (101.6 x 172.7 x 63.5 cm); top shelf: 32” L x 52” W (81.3 x 132.1 cm); table top: area 271 in2.  Read more.

Ohmeda Excel 210 SE anesthesia machine (pre-owned) $7,200
Accommodates three gases and two vaporizers; powerful ventilation and monitoring capabilities for secondary anesthetizing locations; integrated oxygen, volume, airway pressure monitoring; enclosed, non-interchangeable pneumatic circuitry; differentiated pipeline, cylinder gauges; master on/off switch activates electronics and pneumatics. Read more.

Ohmeda Modulus 2 Plus Anesthesia Machine (Pre-Owned) $7,000
Comes standard with a 7810 ventilator that integrates oxygen, volume, and pressure monitoring; optional pulse oximetry and endtidal CO2 modules; great for university and research facilities; double-flow meter tubes (O2 & N2O) and flow meter protection shield, link-25 hypoxic guard and touch-coded oxygen knob. Read more.

Visit our web site at:  www.ganimonline.com.  Call us toll free at: 800-522-5909.

Mow Your Lawn while Having an Endoscopy

You can go to work, watch television, or do your gardening while having your small intestine photographed!

Technology revolutionizes healthcare
Capsule endoscopy employs a video capsule that is swallowed and takes photographs of the small intestine.  The procedure is useful when disease is suspected in the small intestine and can sometimes diagnose sources of bleeding visible microscopically only or causes of abdominal pain such as Crohn’s disease, or peptic ulcers. Capsule endoscopy can be used to diagnose problems in the small intestine, but unlike EGD or colonoscopy, cannot treat pathology that may be discovered.  Capsule endoscopy can use bluetooth to transfer the captured images to a computer!

Watch this video to learn more about the procedure:

Limitations
This marvel of modern technology is the best means of viewing the inside of the small intestine but the capsule does not allow for therapy. Other limitations include the inability to detect abnormalities and blurred, uninterpretable photographs in some cases.  At times, transit is so slow that the capsule examines only part of the small intestine before the battery fails.

Camera systems for standard endoscopy
Ganim Medical can save you money with our pre-owned/refurbished line of endoscopic camera systems.  Our price for the units listed here includes both the camera control unit and the camera head with coupler.  For purchase separately, call us at 800-522-5909

Stryker 1088 HD Camera System (Pre-Owned) $4,000
This system features crystal-clear image quality, analog and digital outputs, 220 V or 110 V power rating for international usage, and the ability to send, share, and edit images on most digital devices. This is the longest-lasting, toughest, most rugged camera on the market.

Stryker 1188 HD Camera System (Pre-owned) $7,000
The 1188 HD offers superior picture quality, enhanced clarity, and more intuitive user controls.  Surgical teams will experience unprecedented visibility during endoscopic procedures — visibility that can elevate overall surgical and patient outcomes.

 Stryker 988 Camera System (Pre-Owned/Refurbished) $2,400
Specifications for this system are: imaging system: 1/3” interline transfer, EX view HAD CCD 752 (H) x 582 (V) pixels.  Cameral control unit dimensions: 9.8” / 24.8 cm (w) x 4.0” / 10.1 cm (h) x 15” / 38.1 cm (d).  Enhancement: Switchable to 8 steps.  Cable connector: super lemo gold pin connectors.  Resolution: 950 lines.

Visit our web site at:  www.ganimonline.com.  Call us toll free at 800-522-5909.

Electrosurgical Generator Options

Origins of electrosurgery
Did you know that development of the first commercial electrosurgical device is credited to Dr. William T. Bovie, who worked on it from 1914 to 1927 at Harvard University?  The first use of an electrosurgical generator in operating room occurred on October 1, 1926 in a surgery performed by Dr. Harvey Cushing.

The low-powered hyfrecator, manufactured by the Birtcher Corporation of Los Angeles, for electrosurgery performed on conscious patients in an office setting was in 1940.  The word Hyfrecator® is a brand name derived from “high-frequency eradicator.”  However, a number of manufacturers now produce Hyfrecators and the term, with a lower-case “h,” has since come to be used generically to refer to any dedicated non-ground-return electrosurgical apparatus.

Ganim Medical’s pre-owned and refurbished electrosurgical units
At Ganim Medical, we offer pre-owned and refurbished medical equipment that permits healthcare facilities to use the latest technology for patient treatment, without breaking the bank.  Refurbished medical equipment can be the answer to your needs, instead of making large capital investments in new devices that can become quickly outdated.  Our electrosurgical units come refurbished, rebuilt, and repainted, and include a standard 90-day warranty.

Conmed Excalibur Plus PC Electrosurgical Unit (Pre-Owned) $2,900
This device features the powerful isolated ESU available, allowing the Surgeon to adjust power settings from the surgical field with a standard ES pencil.  The Excalibur Plus PC-patented controlled output voltage in CUT maintains minimum necessary voltage for smooth cutting through various impedance tissues with minimal thermal damage.  This electrosurgical generator includes cut, coag, bipolar and blend.

Conmed Hyfrecator 2000 Electrosurgical Unit (Pre-Owned) $700
Features include a memory to store up to three power settings.  The remote-control, hand- switching pencil can change power settings while maintaining the sterile field and decreasing procedure time.  The dual microprocessors permit (1) controlling the function and output of the hyfrecator, (2) termination activation if a hazard or safety issue is detected.  This device is a cost-effective alternative to various laser procedures.

Conmed Sabre 2400 Electrosurgical Unit (Pre-Owned/Refurbished) $1,800
This high-power electrosurgical unit has a monopolar foot pedal.  The unit is designed to accommodate the needs of all surgical procedures.  It features independent monopolar outputs, enhanced bipolar performance, and can be programmed for standardization.  It also combines automatic feedback circuitry and visual displays to provide the most sensitive contact quality monitoring system available today.

ValleyLab Force 2 Electrosurgical Unit (Pre-Owned/Refurbished) $3,900
The ValleyLab Force 2 electrosurgical generator provides cutting and coagulation in monopolar or bipolar outputs.  The unit offers high-performance capabilities in a multipurpose generator, while featuring flexibility through varying degrees of homeostasis.  The operator can choose one of three preset modes: simultaneous independent coagulation, low-voltage coagulation, and Valleylab REM™ safety, which substantially reduce the risk of patient burns at the return electrode site.

For more information on any of these electrosurgical generators, see our web site or call 800-522-5909.


refurbished anesthesia machine
Ganim Medical's selection of pre-owned and refurbished medical equipment and furniture can save you hundreds, sometimes thousands of dollars over purchasing new. Click on the above image to view our product offer.
Our biomedical engineering technicians are highly skilled specialists who not only repair medical equipment but also take preventive measures to ensure that your equipment doesn't malfunction at critical moments. Click on the above image for more information.