- American Medical Technologists

SPRING/SUMMER 2014
Vol 27 / NO 3
Journal of Allied Health Professionals
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Lubbock TX
Permit No. 49
Articles
Texas State Society of American
Medical Technologists
Basal Cell Carcinoma
6
Munchausen and
“by Proxy” Syndrome
8
Necrotizing Enterocolitis
9
CE #31-306-14
by Donna Concidine
Angelina College
Spring/Summer 2014
Vol 27 / No 3
TABLE OF
CONTENTS
Features
Calendar of Events
5
by Melissa Blight
Angelina College Phlebotomy Student
Photos10-11
Fall Registration
18
Hotel Registration
20
Departments
Officer’s Page
3
A Message from the President
4
District Councilor’s Message
4
Kimberly’s Corner
5
by Rebecca Fontenot
Angelina College Phlebotomy Student
Rabies Updated
13
Spontaneous Cerebrospinal
Fluid Leak
16
CE :31-307-14
by Taffy K. Durfee
Editorial opinions in articles printed in The New Texan
are those of the author, and are not the official policy of
the society.
The Editor reserves the right to edit all articles where
necessary.
Manuscripts submitted for publication should be
typewritten, double spaced with wide margins. No
manuscript will be returned unless specifically requested
by the author.
Changes of address of subscribers to The New Texan
must be in the hands of the editor one month before the
issuance of each number. Your old and new address
should be given. Advertising correspondence, requests
for information or other correspondence concerning
advertising may be addressed to Kim Meshell, P.O. Box
152023, Lufkin, Texas 75915
by Melva Morrison
Angelina College Student
Home Office
American Medical Technologists
10700 W. Higgins Rd., Rosemont, IL 60018
847-823-5169
1-800-ASK-1AMT
(1-800-275-1268)
www.americanmedtech.org
2
The New TexaN
Spring/Summer 2014 / TxSSAMT
TxSSAMT Officers 2013-2014
President
VICE-President/editor
Secretary
Norma “Taffy” Durfee, MT
P.O. Box 432 • Iola, Texas 77861
Work (936) 661-5140
Nkd003@shsu.edu
Kim Meshell, CAHI, COLT, RMA, RPT
P.O. Box 152023 • Lufkin, Texas 75915
Home (936) 831-3729
Work (936) 633-5459
Cell (936) 465-2222
kim8569@hotmail.com
Katrina Fryar, MT
9338 FM 2549 • Bryan, Texas 77808
Cell (979) 777-7030
ag3kat@yahoo.com
chairman of the
board/Co-Editor
MT Board Member
Convention coordinator
Michelle Jenkins, MT
1100 Carrington Court • Irving, Texas 75060
Home (972) 986-5133
Work (972) 518-6293
dimitrimj@netzero.net
David Finch, MT
1901 FM 2088 • Gilmer, Texas 75644
Home (903) 762-2419
Cell (903) 841-1884
Vernell Boyd, MT
36119 B FM 149 • Pinehurst, Texas 77362
(281) 259-2548
Cell (713) 826-3772
mamadowser@aol.com
Treasurer
Jean Palmer, CAHI, RMA
260 Willow Springs Drive • Coppell, Texas 75019
Home (972) 462-7826
Work (469) 499-5440
jeangonshpn@hotmail.com
Committee Chairs
employment chair
Pat Westbrook, MT
14330 Hollypark Drive
Houston, Texas 77015
Home (713) 453-2075
Work (713) 330-3000
pwest1@hal-pc.org
HISTORIAN/Hall of fame
Vernell Boyd, MT
36119 B FM 149
Pinehurst, Texas 77362
(281) 259-2548
Cell (713) 826-3772
mamadowser@aol.com
Spring/Summer 2014 / TxSSAMT
Continuing education
chair
T.J. Weatherly, MT
158 Roucourt Loop
College Station, TX 77845
Cell (979) 255-9301
tjw80@yahoo.com
proctor chair
Jean Palmer, CAHI, RMA
260 Willow Springs Drive
Coppell, Texas 75019
Home (972) 462-7826
Work (469) 499-5440
jeangonshpn@hotmail.com
Legislative Chair
ASSISTANT Editor
Glenda Stephens, MLT
350 High Crest Drive
Point Blank, TX 77365
936-581-4672 or
106 Mineola Ct.
Lakeway, TX 78734
936-581-4672
Miranda Lankford
490 Joe Bailey Road
Apple Springs, Texas 75926
936-465-8984
Audit
Awards/membership
David Finch, MT
1901 FM 2088
Gilmer, Texas 75644
Home (903) 762-2419
Cell (903) 841-1884
Norma “Taffy” Durfee, MT
P.O. Box 432
Iola, Texas 77861
Work (936) 661-5140
Nkd003@shsu.edu
The New TexaN
3
A Message
from the
President
I
can’t believe it is already 2014.
This is election year for the
board members of the Texas State
Society of American Medical Technologist. Nominations
for the Fall 2014 election will be made at the Austin Spring
business meeting so plan to attend. We will also be
taking names for the delegates list for the national AMT
convention held in Chicago this year.
Taffy K. Durfee
The Spring meeting at the National American University
will be hosted by Viviana Pelton and it will include a
Knowledge Bowl competition. We will be dedicating this
convention to the Registered Medical Assistants. Their
numbers are growing as well as the demand for these
individuals in the work force. We are lucky to get such
a great hotel nearby. They are offering us suites, which
have two beds in the bedroom as well as a fold out sofa in
the living area. Hot breakfast is also offered at the hotel.
The Fall meeting will be held in Mount Pleasant and I
believe it is a first for this location. David Finch has already
lined up a list of speakers and is working on the program.
District
Councilor’s
Message
A
MT is 75 years old. Welcome
as we celebrate this accomplishment together. If our AMT
founders could see us now; I wonder what their thoughts
would be. First of all I think they would be “staggered” at
the Technological changes that have taken place.
Randy Swopes
We have come a long ways in that area, as we who have
been in the field a long time can also attest to. But most
of all, I think they would be blown away with how AMT
has grown in membership.
I urge all who are reading my spring 2014 message to
gather in Chicago at our National Convention. It is scheduled to take place in July from the 6 to the 11 at the Drake
Hotel. The room rates are only $125.00 per day. Help us
celebrate this important milestone in AMT. You will meet
a lot of great people who are friends of mine and will soon
become your friends. You will obtain the needed CEU’s
for recertification. Then we will continue our birthday celebration by attending each of your local respective State
Society meetings when they are scheduled.
I am looking forward to seeing each of you at the Austin
meeting. Start thinking about attending a national meeting.
If you have never attended one of these meetings, it is a
great experience. There are a lot of educational offerings
and you will meet people from all over the world who work
in your field. Remember, this year’s national convention
will be held in Chicago and next year’s convention will be
held in Hawaii.
So excited to tell you as you probably already know where
our 2015 National Convention will take place. Drum roll,
please. It will be in June from the 21st to the 26 on the
big island in Hawaii. Start planning to attend this convention, I think it will be a most memorable 5 days. Watch for
more to come about this fantastic meeting
For Employment Information
I look forward to visiting with you at your perspective
states throughout the year. I will let you know which
states I will be able to travel to.
Contact:
Pat Westbrook
14330 Hollypark Drive
Houston, Texas 77015
713-453-2075
4
The New TexaN
I would also like to extend a personal invitation to all of
you to join me in Gatlinburg TN, for the Magnolia Conference. It is scheduled to take place on Oct. 17th and
18th. Watch your AMT publication and Websites for more
information about this meeting.
Until then be blessed and safe and enjoy being a part of
our 75 year old organization.
Respectfully,
Randy Swopes, MT, AMT
Central District Councillor
Spring/Summer 2014 / TxSSAMT
Kimberly’s
Corner
Kimberly Meshell
Hello Texas!
H
ope everyone is enjoying this crazy weather we are
having. We have had two snow days in Lufkin and
then a couple of days later it was in the 70's and I wonder
why I still have the sniffles. Crazy!
I hope everyone is having a blessed start of the new year
and may you have many more to come.
Now, we have lots of exciting things coming up. We have
our meeting in Austin March 28-29th. There will be lots of
great speakers that I am looking forward to hearing. We will
have a student quiz bowl, I am hoping some of my students
will come and participate. Then for the National meeting
we will be going to the windy city of Chicago; I'm looking
forward to that, except for the plane ride of course. If you
wish to go to the National meeting as a delegate, and are
eligible, be sure to attend the spring meeting to get signed
up. For the fall we will be going to Mt. Pleasant where our
host David Finch has some awesome speakers lined up.
We also have the elections this fall so if you would like to
run for an office make sure you attend the Spring meeting
to get nominated. If you would like more information about
an officer's position and responsibilities, I will be glad to help
out so just contact me.
We also want to recognize all of our medical assistants out
there and we are trying to get more lectures for you to hear.
Don't forget Medical Laboratory Professionals Week is April
20-26, so remember all of your hard working Laboratory
Personnel!
If you have an article you would like to submit, please email
it to me and I will make sure it gets into the journal. I love
getting new articles from students and members.
I'm looking forward to seeing everyone in Austin at the
meeting.
Happy Spring Y'all!
Kimberly
Spring/Summer 2014 / TxSSAMT
Calendar
of
Events
Meetings or Conventions
Spring Meeting
March 28-29,2014
Austin,Texas
Summer 2014
July 6-11
AMT National and Program Meeting
Chicago, IL
Fall 2014
September 19-20, 2014
LaQuinta Inn
Mt.Pleasant,Tx
Recipe of the Day!!!
Chicken Salad and Waffle Bites
1 c. diced cooked chicken
1 stalk of celery chopped
2 scallions chopped
2 Tbs. cilantro
1 tsp. grated lime zest
1/8 tsp.salt
1/4 c. ranch dressing
16 mini waffles frozen
In bowl, combine chicken, celery, scallions, cilantro,
lime zest, and stir in dressing. Just before serving,
prepare the waffles by heating them up. Top each waffle
with 1Tbs. chicken salad.
Serving: 16
Calories: 58
Protein: 3
Fat: 4g
Trans fat: 0
Chol: 11mg
Carbs: 4g
Sodium: 95mg
Sugar: 0
The New TexaN
5
CE #31-306-14
Basal Cell
Carcinoma
B
asal cell carcinoma constitutes 80 percent of the skin
cancers not including the most serious skin cancer,
melanoma. Basal cell carcinoma is the most common form
of cancer, with about a million new cases estimated in the
U.S. each year. Basal cells line the deepest layer of the
skin. Basal cell carcinomas are malignant growth-tumor that
arise in a particular area. Basal cell carcinoma can usually
be diagnosed with a simple test and is easy to treat when
detected early. However, 5 to 10 percent of basal cell carcinoma can be resistant to treatment, damaging the skin
around them, and sometimes invading bone and cartilage.
When not treated quickly, they can be difficult to eliminate.
Fortunately, however, this is a cancer that has an extremely
low rate of matastasis, and although it can result in scars
and disfigurement, it is not life threatening.
As the tumor grows, it destroys health
structures in its path, including nerves,
muscles, and blood vessels.
The Cause
The cause is intense intermittent exposure to sun during
adolescence- the kind of exposures that bring on sunburn.
The sun is responsible for over 90 percent of all skin cancers, including basal cell carcinoma, which occurs most frequently on the sun-exposed areas of the body; face, ears,
neck, scalp, shoulder, and back.
6
The New TexaN
by Donna Concidine
Angelina College
Am I at Risk?
Anyone with a history of frequent or intermittent intense sun
exposure can develop Basal cell carcinoma, but a number
of factors increase risk:
Time Spent Outdoors
People who work outdoors- construction workers, groundskeepers, lifeguards, etc.-are at greater risk than people who
work indoors, as are those who spend their leisure hours in
the sun.
Skin Type
Fair-skinned individuals who sunburn easily and tan minimally, or not at all, have a higher incidence of skin cancer
than dark-skinned individuals.
Hours of Sunlight
The more hours of sunlight in the day, the greater the incidence of skin cancer. For example, there are more cases
in Arizona, Texas and Florida-- states that are closer to the
equator and get more sun-than in more northern states of
Maine, Oregon, and Washington.
Warning Signs
Basal cell carcinoma sometimes resembles noncancerous skin conditions such as psoriasis and eczema. Only a
trained physician can decide for sure. If you observe any
of the warning signs, consult your physician immediately.
Basal cell carcinoma is just about always curable, but if not
treated early it can bore deeply into tissues and cause local
destruction.
Spring/Summer 2014 / TxSSAMT
Types of Basal Cell Carcinomas
Questions
Nodular basal cell carcinoma is the most common type. This
tumor usually resembles a smooth, round waxy pimple, yellow or pearl gray and may vary in size from a few millimeters
to 1 centimeter. Often, the skin covering the nodule is so thin
that the slightest injury will cause it to bleed. These tumors
are often depressed in the middle. As the tumor grows, it destroys health structures in its path, including nerves, muscles,
and blood vessels. Large tumors are easily diagnosed, but
smaller ones are often difficult to tell from noncancerous skin
conditions, such as warts, seborrheic keratoses or psoriasis.
Basal Cell Carcinoma - CE Article #31-306-13
Superficial. This is less common form of basal cell carcinoma. It is progressively spreading, slow-growing cancer
that differs greatly from other types. The tumor is red, with a
slightly raised, ulcerated or crusted surface, often bordered
with pearly or threadlike formations. Tumors usually appear
as patches on the torso, but can develop more extensively on
the face and neck. This is often mistaken for other skin conditions such as fungal infections, eczema, or psoriasis.
3. Fibrosing is also called
_______ _______
_______.
Sclerosing or Fibrosing. Fibrosing basal cell carcinoma is
also called morphea-like carcinoma. This fibrosing type
tumor begins as a flat or slightly depressed, shiny, hard,
yellow-white patch with irregular border. Sometimes, it may
present for years without growing or being recognized.
More often, though, it grows quickly, reaching a diameter
of several centimeters within a few months. This is a fairly
uncommon type of skin cancer, and can be difficult to eradicate because of invisible root-like extensions of the tumor
that reach into the underlying tissue.
1. T/F Eczema is easily
mistaken for melanoma
cancer.
2. _______ _______
_______ _______ is
the most common type
of skin cancer.
4. _______ is a rare type
of basal cell carcinoma.
5. T/F Squamous and
Superficial can coexist
as one tumor as it
grows at the same
time.
6. T/F Sunlight is the
major cause in
adolescents for skin
cancer.
7. T/F Texas, Arizona,
Maine, Oregon are
closer to the equator
and get more sun
which can be the cause
of skin cancer.
8. _______ to _______
can be resistant to
treatment, which
damages the skin
around them and
invades _______ and
_______.
9. _______ _______
individuals who
burn easily and tan
minimally are at
a higher risk than
_______ _______
individuals.
10. T/F Basal cell
carcinoma will
metastasize quickly if
not treated.
Pigmented. Pigmented basal cell carcinoma is similar to
nodular basal cell carcinoma, but is more likely to appear in
people with dark hair or dark eyes. As its name implies, this
growth is almost black and can easily be mistaken for more
aggressive melanoma.
Please do not send money, these are free CEUs.
Send a copy of your answers and the identification form below to:
Fibroepithelioma. This rare type of basal cell carcinoma
appears as one or more slightly elevated, reddish lesions.
Usually they arise on the back.
158 Roucourt Loop
College Station, TX 77845
Basosquamous carcinoma. Squamous and basal cell carcinoma can coexist as one tumor growth at the same time.
Clinically, it can look like a basal cell or squamous cell carcinoma. Basosquamous cell carcinomas are believed by some
researchers to have a greater tendency to metastasize.
These tumors require immediate and aggressive treatment.
Consult your physician to seek treatment with any of these
types. n
References:
1. Basal Cell Carcinoma Skin Cancer is Curable; Dr. Paul G. Donahue;
Beaumont Enterprise; October 2005.
2. The Skin Cancer Foundation-Basal Cell Carcinoma; Rogers, B.G.
September 2006.
Spring/Summer 2014 / TxSSAMT
T.J. Weatherly
American Medical Technologists Institute for Education
Reporting form for Continuing Education Hours
(Please print all information)
Last Name: ________________________________
First Name:________________________________
E-mail:____________________________________
Check AMT Certification:
q MT
q MLT
q COLT
q RMA
q RDA
q CLC
q RPT
q CAHI
AMT I.D. Number___________________________
(Do not put social security number on form)
The New TexaN
7
“by Proxy”
Munchausen and “by Proxy” Syndrome
by Melissa Blight
Angelina College Phlebotomy Student
M
unchausen syndrome is a
serious mental disorder in
which a person repeatedly, and
factiously, acts as if he or she is sick.
They do this by self-inflicting their
injuries, or claiming to have a selfchosen mental disorder, all to gain
sympathetic attention that an actual
sick person would receive. Individuals
with this disorder will go as far as tampering
with laboratory tests to try and authenticate their
fictitious illness. They prevent wound healing, by
reopening or reinjuring the wound, and are willing
to undergo risky tests and major surgeries if the
claimed illness, self-inflicted injury, or chosen
disorder calls for it. Munchausen is a difficult
disorder to identify, because that person will go to great
lengths to cover up the fact that they themselves are the
ones causing the problem. Munchausen has an old history in
hospitals, but only a few of the patients are diagnosed with
the disease, due to the elaborate and well thought up stories.
Munchausen was named in 1951 by Richard Asher, after
Karl Friedrich Hieronymus, Baron Munchausen (17201797). Baron Munchausen, and 18th Century German officer, was known for his false and ridiculously exaggerated
NATIONAL AMERICAN UNIVERSITY
National American University’s Austin campus is seeking
applications for adjunct faculty positions to teach Medical
Laboratory courses, Anatomy & Physiology, and other
Medical Assisting courses
• Applicants must be able to teach 1-2 days/wk in the evenings
• 3-5 years teaching experience preferred
• Minimum qualifications include a bachelor’s degree in a related field
(MD, PA, NP required to teach A&P)
• Certification and licenses must be current or able to reinstate
(ie, CMA, RMA, MT, RN)
To apply:
• Applicants invited to interview will need to prepare a 15 minute
teaching demonstration to a small panel of staff/faculty
• Textbooks and instructor resources provided.
8
Submit an employment application (http://www.national.edu/careers-nau),
letter of interest, current resume, and a copy of your college transcripts to:
Medical Assisting Program Coordinator
13801 Burnet Rd., Ste. 300
Austin, TX 78727
Fax/Email resumes to (512) 651-4705 or vvera@national.edu
EEO
The New TexaN
stories of his travels and triumphs
around the world. Although people lie all the time; adding things
to a story to make it more appealing to the viewer or listener is to
most people, just an art of storytelling. However, to lie about your health
and actually putting your life at risk for the attention and concern of others is, as they say, “going
a little too far”. The person with Munchausen syndrome
physically only hurts themselves, but unfortunately, it can
emotionally affect family members that know the truth about
the situation, and can’t stand to see that person hurt themselves. So they do something about it.
But what if that person is the caretaker or a parent with this
disease, and the person physically and emotionally affected
is a child? Munchausen by Proxy is a form of child abuse,
known as “medical child abuse”, in which the caretaker or
parent of a child creates false accusations of illnesses and
symptoms to the child’s doctor. This mental disorder in the
adult can cause very serious and sometimes fatal injuries to
the child by poisoning, suffocation, or physical abuse. The
adult will give false information to authority figures, such as
the child’s school representatives, police and physicians.
They will fabricate medical records that are required for the
child’s school, stating that the child has a disease, but in
fact does not. Symptoms or illnesses to the child’s doctor
are exaggerated so that different tests and treatments will
be done to the child. This disorder is also hard to identify,
due to the constant lies and cover-ups. Although doctors
may sometimes suspect the parent, it’s difficult for police
and doctors to determine what is actually real or fake, that
would allow for a prosecution.
These disorders are very real and very dangerous, for the
person that is causing harm to his or her self, or the child involved. If there is any knowledge of this disorder occurring,
it must be reported. Both diseases require psychological
treatment for the patient themselves, and for the abused
child, as well. However, if the person involved doesn’t admit
the wrongdoing, treatment might not be effective in stopping the problem. In some cases, if the patient is suspected, but not convicted, they will move or switch caregivers
to then continue the behavior. If the case involves a child,
the pattern continues, and with adequate evidence the child
may be removed from the home. Recognizing and reporting
this disorder may save the life of the patient, or patients,
involved. n
Spring/Summer 2014 / TxSSAMT
Necrotizing
Enterocolitis
by Rebecca Fontenot
Angelina College Phlebotomy Student
N
ecrotizing Enterocolitis usually called NEC, is a condition where the intestinal tissue becomes infected and
can begin to die. This disease usually affects premature babies, but can also affect term babies. This condition could
require surgery and has a high morbidity rate. What can
cause NEC? Although doctors are unsure of what causes
NEC, the biggest risk factor is prematurity, due to the immature intestines. Doctors are unsure of what causes NEC,
but do know that the majority of infants who get NEC have
already begun breast or formula milk feedings. Delaying
the feedings do not reduce the incidence of the disorder. It
is known that the reduced blood flow to the intestines play
an important factor. Babies with a heart condition, such as
patent ductus arteriosis (PDA) are also at a higher risk for
developing necrotizing enterocolitis.
There are many symptoms in the early stages, one of which
is the baby’s belly appearing bloated or distended. When
this happens, the intestinal infection has caused the movement of food and air through the intestines to slow or stop
completely. It is common for preemies to have a NG-tube
or G-tube to check for gastric residuals. Gastric residuals
are undigested feedings which remain in the stomach at the
start of the next feeding. If the residuals look healthy, it is
returned to the stomach after discarding the air. If green or
bloody residuals are seen, then it may be a sign of Necrotizing Enterocolitis. When too much food and air become
trapped in the intestines, the bowel loops may be visible
on the baby’s swollen, and painful belly. Sometimes this
causes the baby to start vomiting bile or having bile-tinged
residuals. Blood will also be present in the stools and the
abdominal bloating may cause less urine output. Some late
symptoms of NEC are apnea, bradycardia, and an inability
to regulate temperature. If the bowel ruptures, the infection
spreads and respiratory distress sets in. Early treatment for
NEC is very important, and all feedings must be stopped.
Then the gas is relieved from the bowels by inserting the
small tube into the stomach. The intravenous fluids are
given to replace the formula or breast milk and to let the
bowels rest. The IV will also be a great benefit for an acSpring/Summer 2014 / TxSSAMT
cess to give antibiotics that will treat the infection. If medical
treatment does not work then surgery is required. Surgery
will consist of removing any dead section(s) of the bowel
and any other infected areas. There are possibilities that the
bowel will reattached after surgery. If not, it will be diverted
to the abdomen through a stoma and medical treatments
will continue until the disease is resolved. About 25% of infants diagnosed with NEC that recover will need long-term
treatments. Infants that are treated have a great possibility
of growth-delays, trouble absorbing nutrients, liver and gallbladder problems. Infants who have had surgery for NEC
may show developmental delays and have an increased
risk of cerebral palsy as well as epilepsy. Preventing premature birth is the best way to prevent NEC. n
References:
Preemies.about.com/ua/preemiehealthproblems/UANE.htm.
Medical Laboratory
Personnel Week
Make sure you celebrate all
of your lab personnel!
April 20-26TH
Clinical Laboratory & Diagnostic Services
Stephen R. Harlow, PhD, MT, ASCLS
Certified Laboratory Consultant
Managing Director
201 Laurence #108 • Heath, TX 75032
(214) 577-9311 • (972) 771-4588 FAX
sharlowphd@roninclinlab.com
The New TexaN
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5
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The New TexaN
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1Members enjoying the
lecture at the fall meeting
2Stephen with Viviana
during the lecture
3Taffy and her daughters in
Pennsylvania
4 Pat and Jean at national's.
5Chuck French-guest
speaker giving a lesson
on fire extinguishers
6Hunter, Colton and other
students listening to a
lecture
7What a beautiful building
in Pennsylvania
8Students-We welcome all
our students
9Tonya LaForge-guest
speaker
10Great pics from National
meeting
11TJ and Katrina having fun
at the fall meeting
12Juan Reyes-guest speakerexcellent lecture
13Vernell and David in
Pennsylvania
14What a beautiful church
15Members listening in
16 Pic of Taffy at national
meeting in Pennsylvania.
17First timers at the meeting,
love our members!
18Ginell Agnew-speaker
19Ms.Miranda's corrigan
phlebotomy students
Spring/Summer 2014 / TxSSAMT
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19
21
20
23
22
24
27
28
26
25
29
20Vernell Boyd and kidsCandy & David Boyd from
Texas who came to National
to surprise their Mom when
she received the GEM award
21Kim presenting a speaker
gift to Tonya LaForge
Stephen Williamson-speaker
22
at the Fall Tx meeting
23Scholarship winner,
Kimberly Derschuck
24Christopher with his
daughter Kourtnie
25Monument in Pennsylvania
26Juan and Viviana during
his lecture
27Kourtnie listening in on
a lecture
31
30
28Megan, Joseph, Josie at
the meeting
29Vernell
30Ms.Sybil looking lovely as
ever enjoying the lectures
31Vernell involving the
students in the lectures
32Viviana Vera- guest speaker
33Kourtnie Dickensscholarship winner
34Patti Reyes-guest speaker
35Christopher Dickens
listening to the lectures
36Candy Vantilborg and
David Boyd from Texas
37Sandra Patterson-guest
speaker at the meeting
Spring/Summer 2014 / TxSSAMT
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35
34
33
36 37
The New TexaN
11
Tidbits on
Health......
Happiness in a cup!
According to a new study in the journal of
Biological Psychiatry, coffee isn't just an
easy quickness for energy, it also reduces
depression to about 45%. The antioxidants in the coffee,
as well as its caffeine, rev the production of the brain’s
natural antidepressant compounds such as dopamine and
noradrenaline says Dr.Lucas, Ph.D who is the author.
Are you a worry wart?
Turn it off with hibiscus tea! Whether you
fret about something in the future or on
a day-to-day concern, this fruity drink
can calm your nerves fast. The flower
contains flavonoids and anthocyanins that
prompt the brain to release calming GABA, relaxing you in
minutes, reveals the researchers at India Central Institute of
Medicinal and Aromatic Plants. So to get those serotonins
surging, enjoy a cup or two a day......
Stressed out?
Drink a cup of hot cocoa every day! An experiment done at The University of Technology in Australia’s Swineburne found that
stressed out folks who did this significantly
was calmer and happier after a month. The antioxidants in
dark chocolate target the same anxiety activating brain receptors that Xanax and Valium do according to the studies.
So pick up a cup of hot cocoa and relax........
Re-energize with
peppermint tea...
The Journal of the International
Society of Sports Nutrition reports
that peppermint tea will boost
oxygen levels by relaxing smooth
muscles in the lungs and reduces the buildup of the waste
compound in your muscles that bring on the fatigue burning
sensation when working out.
12
The New TexaN
Beat the 4pm blahs
by taking a break
A study by Louisiana State University
says that folks who work at computers all day found that workers
who took a 30 second break,
four times each hour plus a
14 minute breather every two
hours solved problems faster
and more accurately.
Maybe I need to take more
breaks.....hmmm that's a thought
to increase my brain activities.
You already know that keeping your stress level low can
make you feel less worn out, tense and irritable-but did you
know it can also cut your risks of colds, chronic headaches
and joint pain, indigestion by 50% according to a German
research.
Creating calm by popping B vitamins each day could help
your brain produce more calming serotonin-enough to cut
your risk of chronic tension and edginess as much as half.
Eat peanut butter
to clear arteries
People that eat 2 tbs. of sugar free peanut butter daily are 41% less likely to
develop the clogged brain blood vessels
that can lead to Alzheimers according to
recent studies.
So take care of yourself and get energized.........
Spring/Summer 2014 / TxSSAMT
CE # 31-307-14
Rabies
Updated
by Taffy K. Durfee
R
abies is a zoonotic viral disease
that is transferred to humans
from other species of animals. The
word rabies is from the Latin word that
means “madness”. It was often referred to as “hydrophobia” or the fear
of water. Worldwide, it caused about
26,000 deaths in 2010, which was
down from 54,000 deaths in 1990. (1)
Most of these deaths, about 95%, occur in Africa and Asia, but the country
with the highest rate of human rabies
in the world is India. A form of delusion
associated with rabies, called puppy
pregnancy syndrome, occurs in India
where people believe that puppies
are growing inside of them and they
rely on faith healers to save their lives.
Because of this, people arrive at the
hospitals after their symptoms have
escalated and the doctors are unable
to save them. Vietnam has the second
highest rate of human rabies and it is
followed by Thailand, with the third
highest rate. Many of the areas where
death occurs is in countries without
access to adequate health care facilities. In the United States, preventative
measures, especially in dog vaccinations, cost more than $300 million per
year. (2) The death rate in the United
States has dropped from 100 or more
a year to only one or two a year due
to the vaccination of pets. The virus
is found worldwide except in Australia
and New Zealand.
The rabies virus is of the genus Lyssavirus and the family Rhabdoviridae. It contains an envelope and a single strand RNA. Once inside the muscle or nerve cell,
the virus travels along the neural pathways to the central nervous system. There
are high concentrations of the virus in the salivary glands. Once the virus reaches
the brain, it causes encephalitis and the symptoms begin. In the early stages, the
symptoms include headache, fever, malaise and pain. Later, violent movements
begin along with mania, lethargy, coma and finally respiratory failure and death.
The time period between infection and the first symptoms is usually 2 to 12 weeks.
Death is usually between 2 and 10 days after the first symptom occurs.
Vaccines to the rabies virus was developed in 1885 by Louis Pasteur and Emile
Roux, but it must be administered before the symptoms occur. The disease is
almost always fatal if the post exposure prophylaxis is not given promptly. After
the onset of symptoms, the result is usually death within days. The original vaccine developed by Pasteur and Roux was grown in the nerve tissue of infected
rabbits. In 1967, the human diploid cell vaccine was put into use. A recombinant
vaccine, V-RG is used in the case of undomesticated animals. Treatment should
begin within 10 days of infection. The Centers of Disease Control recommends one
dose of Human Rabies Immunoglobulin followed by four doses of rabies vaccine
over a 14 day period. (3)
Below is a list of Rabies Vaccines and Immunoglobulins Available in the United
States, according to the Centers for Disease Control and Prevention (4):
TYPE
NAME
ROUTE GIVENINDICATIONS
Human Diploid Cell Imovax RabiesIntramuscular
(HDC) Vaccine
Preexposure or
Post exposure
Purified Chick RabAvert
Intramuscular
Embryo Cell (PCEC) Vaccine
Preexposure or
Post exposure
Human RabiesImogam Rabies-HTLocal infusion at
Immune Globulin wound site, additional
(RIG)Intramuscular
Post exposure
Human RabiesHyperRab TM S/DLocal infusion at
Immune Globulin wound site, additional
(RIG)Intramuscular
Post exposure
continued on next page
Spring/Summer 2014 / TxSSAMT
The New TexaN
13
continued from page 13
Any time
bats are found in
the home, it is a
cause for alarm.
TREATMENT REGIME:
1. T
he wound should be cleaned immediately with soap
and water or a virucide if available.
2. T
he full dose of RIG should be given at wound site and
remaining given intramuscular at a distant location
The vaccines, HDCV or PCECV 1.0 mL, intramuscular in
the deltoid region should be given on days 0, 3, 7, and 14.
Animals which often carry rabies include domesticated dogs
and cats, farm animals, bats, raccoons, foxes, skunks, coyotes, wolves, monkeys, to name a few. Small rodents such
as squirrels, rats, chipmunks and hamsters almost never
become infected with the virus. The Virginia opossum is resistant but not immune. (5)
In Texas, according to the Texas Department of Health, a
2012 summary listed Williamson County having the most
cases of positive rabid animals, 89. Of those positive cases,
88 were found in bats. The second highest number of positive rabies cases was found in Travis County with a total
of 76 positives. Once again, the largest number of positives in Travis County was 74 cases found in bats with 2
positive skunks. The county with the third highest number
of positives was Hays County with a total of 32 positives,
all found in bats. (6) In 2012, positive rabies cases in Texas
were found to be 273 in skunks, 13 in foxes, 331 in bats, 2 in
coyote, 19 in raccoons, 16 in dogs, 14 in cats, 9 in bovine, 4
equine, 1 goat, and 1 deer for a total of 683 positive cases.
Any time bats are found in the home, it is a cause for alarm.
The bite of the bat may go unnoticed while the victim is
asleep. Bats are most active at night and may dine on an
un-expecting victim. On Dec. 3, 2011, a 46 year old woman was admitted to an emergency facility with shortness
14
The New TexaN
of breath, sweating, and tingling sensations of her hands.
Blood tests and scans revealed nothing but within 12 hours
she stopped breathing on her own. Her organs began to
fail and by Dec. 19th, she died. Family members reported
to the physician that the woman had told them that she had
removed a bat from her house but she did not get bitten.
Doctors sent specimens to the CDC which confirmed that
she had rabies. This disease is so rarely found in humans
that it is difficult to diagnose. (7)
In 2013, the Maryland Department of Health reported that
a patient who had an organ transplant more than a year
before had died of rabies, contracted from the donor. The
organ recipient had no known animal exposures but the
donor and recipient had both had the same type of rabies
virus, a raccoon type.(8) The incubation period was much
longer than the typical time. Rabies transmission had been
reported previously through cornea transplants. The first
reported cases of rabies transmission through organ transplants was confirmed by the CDC in 2004, when one of four
organ recipients had died during surgery but the other 3
recipients died later of rabies. Friends of the donor reported
that the donor had told them that he had been bitten by a
bat. (8) In 2005, in Germany, 6 people received organs or
tissues from a donor with rabies. Two recipients were not
infected after their grafts were removed, another had previously received rabies vaccination and lived, but the other
recipients died from rabies. (8) Some organ organizations
now have added screening questions about rabies but in
the previous situations, there seemed to be no risk.
There is now hope for rabies victims who have presented
with symptoms. It is called the “Milwaukee Protocol” and it is
called an unorthodox treatment developed by Rodney Willoughby, an infectious disease specialist at the Children’s
Hospital of Wisconsin. In 2004, a 15 year old girl survived
an infection of unvaccinated rabies. After she was admitted to the hospital with symptoms, she was placed in an
induced coma and given ketamine, midazolam, ribavirin,
and amantadine. The doctors proposed to stop the dysfunctions of the brain caused by the rabies by halting the brain
function, while in a coma, and giving the immune system
time to combat the virus. (9) After 76 days of hospitalization,
she was released from the hospital. She survived with the
higher level of brain functions but had to learn to walk again.
The treatment has been repeated but without the drug ribavirin. In 2008, an 11 year old boy survived rabies with the
Milwaukee Protocol without ribavirin and had no noticeable
brain damage. An 8 year old girl from California became
the third person in the United States to recover from rabies
using the Milwaukee Protocol. (10) This new treatment plan
offered hope to those who either did not know they were
exposed to rabies or failed to get treatment. Up until now,
if the symptoms appeared, there was virtually no hope to
save the patient. n
Spring/Summer 2014 / TxSSAMT
Questions
Rabies Updated - CE Article #31-307-13
1. W
hat country in the world has the
highest number of human rabies
cases?
a. Australia
b. India
c. Vietnam
d. Thailand
2. W
hat is the reason for the sharp
decline in the number of human
rabies cases in the United States?
a. Pet vaccinations
b. An improved type of post
exposure prophylaxis
c. Better hygiene
d. Improved health care facilities
3. W
hat is the pathway for the rabies
virus, once inside the human
body?
a. By way of the blood stream
b. Within the central nervous
system
c. By way of the salivary glands
d. Through the epidermis
4. Who discovered the first rabies
vaccine?
a. Willoughby
b. Koch
c. Watson
d. Pasteur and Roux
5. In Texas, in 2012, what type of
animal had the most positive
cases of rabies?
a. Dogs
b. Skunks
c. Bats
d. Foxes
6. C
urrently, where are most rabies
vaccines administered?
a. In the gut
b. Intravenously
c. Subcutaneously
d. Intramuscularly
9. T
he Milwaukee Protocol is a type
of rabies therapy that is different
from conventional therapy in what
way?
a. It can be used after symptoms
appear
b. It must be given on day 14 after
the animal bite
c. It can only be used on patients
who have previously been
vaccinated
d. It is not approved for use in the
United States
7. T
he first rabies vaccine, developed in 1885, was grown in what
animal tissue?
a. Bats
b. Dog
c. Rabbit
d. Sheep
10. What type of warm blooded
animal is resistant to the rabies
virus?
a. The 3 lined skunk
b. The south Texas coyote
c. The Mexican free tailed bat
d. The Virginia opossum
References:
1. Lozano, R (Dec 15, 2012). “Global and regional mortality from 235
causes of death for 20 age groups in 1990 and 2010,” Lancet 380:2095128.
2. Saving Lives, Protecting People, Centers for Disease Control and
Prevention, CDC 24/7.
3. “Use of a Reduced (4-Dose) Vaccine Schedule for Post exposure
Prophylaxis to Prevent Human Rabies”, Centers for Disease Control
and Prevention.
4. “Rabies Vaccines and Immunoglobulin Available in the United States”,
Centers for Disease Control and Prevention.
5. McRuer, DL; Jones, KD (May 2009), “Behavioral and nutritional aspects
of the Virginia opossum (Didelphis virginiana)”. The veterinary clinics of
North America, animal practice 12(2): 217-236.
6. “Zoonosis Control Branch”. Rabies Summary by County, 1/1/201212/31/2012. Texas Department of State Health Services.
7. “Rabies case in SC illustrates bat-bite concerns”. The State, Sept. 2,
2013.
8. “Human Rabies Due to Organ Transplantation, 2013”. Centers for
Disease Control and Prevention News, March 15, 2013.
9. “Hope for Rabies Victims: Unorthodox Coma Therapy Shows Promise”.
Nov. 21, Scientific American.
10. “ UC Davis Children’s Hospital patient becomes third person in US to
survive rabies”. Health News. 2011-06-12.
Spring/Summer 2014 / TxSSAMT
8. Imogram Rabies HT is what type
of vaccine?
a. Human Diploid Cell Vaccine
b. Purified Chick Embryo Cell
Vaccine
c. Human Rabies Immune Globulin
d. PCECV
Please do not send money, these are free CEUs.
Send a copy of your answers and the identification form below to:
T.J. Weatherly
158 Roucourt Loop
College Station, TX 77845
American Medical Technologists Institute for Education
Reporting form for Continuing Education Hours
(Please print all information)
Last Name: ________________________________
First Name:________________________________
E-mail:____________________________________
Check AMT Certification:
q MT
q MLT
q COLT
q RPT
q RMA
q RDA
q CLC
q CAHI
AMT I.D. Number___________________________
(Do not put social security number on form)
The New TexaN
15
Spontaneous Cerebrospinal
S
Fluid Leak
pontaneous Cerebrospinal Fluid Leak (SCSFL),
also known as “Intracranial Hypotension”, is a medical condition
that is caused by Cerebrospinal Fluid
(CSF), which is a clear, colorless liquid that circulates within
the cavities surrounding the brain and spinal cord, to leak
out through the dura, a touch inflexible tissue that is the
outermost part of the meninges. The incidence has been
estimated at 5 per 100,000 year, with a peak around age
of 40. Women are affected more commonly than men. The
cause for SCSFL are certain head, brain, or spinal surgeries, placement of tubes for epidural anesthesia or pain
medications, spinal tap or unknown causes. Symptoms for
SCSFL are headaches that improve while you are sitting or
lying down, light sensitivity, nausea, neck stiffness, cranial
nerve dysfunction and drainage from the nose/ and or ear.
There are numerous tests that can be done to diagnose
SCSFL. The most common tests are CT (computed tomography), MRI (Magnetic Resonance Imaging), Radioisotropic
Test, and CT myelogram.
by Melva Morrison
Angelina College Student
Depending on the cause of the leak, many cases go away
on their own after a few days. Complete bed rest for several
days is usually recommended. Drinking increased fluids, especially drinks with caffeine, can help slow or stop the leak
and may help ease the headache pain. Fibrin Glue and Nasal Packing has also been used. Pain relievers can be given for the headache as directed by the doctor or instruction
for use. Always consult your doctor first before starting any
pain relievers. Symptoms of infection include fever, chills,
and change in mental status and can happen after surgery,
which they will need to be treated with antibiotics. Complications may occur if the cause is surgery or trauma. Infections
after surgery or trauma can lead to meningitis and serious
complications can be swelling of the brain. If there is still a
problem with leakage then a blood patch procedure can be
performed. A blood patch procedure is a patch that acts as a
blood clot to stop the leakage and helps to repair the damage
that caused the leakage. n
References: www.webmd.com, www.mayoclinic.com, http://
my.clevelandclinic.org/head-neck/diseases-conditions/cerebrospinal-fluidleak.aspx, http:/m.hopkinsmedicine.org/sinus/sinus conditions/csf leaks.htm.
CongratA New Way to Track Your
Continuing Education!
ulations!!
AMTrax is AMT's newest online CE tracking system. Simply
log in as a member on the AMT website (www.amt1.com)
and click on AMTrax under the Continuing Education tab.
Benefits of AMTrax include:
wO
ne easy and convenient place to track your CE and
related activities
w T rack AMT as well as non-AMT activities
w Print
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licensing agency
w Easy way to demonstrate CCP compliance (for those
certified after 1/1/06)
w Passing scores on AMT online CE tests, like STEP Online,
automatically populate AMTrax
w It's FREE!
16
The New TexaN
Taffy Durfee giving Katrina Fryar her
Distinguished Achievement Award
Spring/Summer 2014 / TxSSAMT
a
&
Cold Versus Flu
What is the difference between
a cold and the flu?
The flu and the common cold are both respiratory illnesses but they are caused by different viruses. Because these two types of illnesses have similar flu-like
symptoms, it can be difficult to tell the difference between
them based on symptoms alone. In general, the flu is worse
than the common cold, and symptoms such as fever, body
aches, extreme tiredness, and dry cough are more common
and intense. Colds are usually milder than the flu. People
with colds are more likely to have a runny or stuffy nose.
Colds generally do not result in serious health problems,
such as pneumonia, bacterial infections, or hospitalizations.
How can you tell the difference
between a cold and the flu?
Because colds and flu share many symptoms, it can
be difficult (or even impossible) to tell the difference
between them based on symptoms alone. Special tests that
usually must be done within the first few days of illness can
be carried out, when needed to tell if a person has the flu.
What are the symptoms of the flu
versus the symptoms of a cold?
In general, the flu is worse than the common cold, and
symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds
are usually milder than the flu. People with colds are more
likely to have a runny or stuffy nose. Colds generally do not
result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.Description expanded
Understanding Influenza Flu Infection: An Influenza Virus
Binds to a Respiratory Tract CellThis image illustrates the
very beginning stages of an influenza (flu) infection. Most
experts think that influenza viruses spread mainly through
small droplets containing influenza virus. These droplets are
expelled into the air when people infected with the flu cough,
sneeze or talk. Once in the air, these small infectious droplets
can land in the mouths or noses of people who are nearby.
Spring/Summer 2014 / TxSSAMT
This image shows what happens after these influenza viruses enter the human body. The viruses attach to cells within
the nasal passages and throat (i.e., the respiratory tract).
The influenza virus’s hemagglutinin (HA) surface proteins
then bind to the sialic acid receptors on the surface of a human respiratory tract cell. The structure of the influenza virus’s HA surface proteins is designed to fit the sialic acid receptors of the human cell, like a key to a lock. Once the key
enters the lock, the influenza virus is then able to enter and
infect the cell. This marks the beginning of a flu infection. n
This information is provided by the CDC. www.cdc.gov/flu
CDC and National Center for Immunization and Respiratory Diseases
(NCIRD)
ELECTIONS
ARE COMING!
At the spring meeting is the meeting for
nominations for President, Vice president,
Treasurer, and Secretary. Elections will be
by ballot via mail, and the results will be
announced at the Fall meeting. So now is
the time to get involved in your state society!
If interested in running for an office be sure
to be at the spring meeting to put your name
out there.........
Happy Elections!!!!!
The New TexaN
17
TxSSAMT Fall
Educational Program
Dates: March 28-29 • Austin, Texas
Pre-Registration Form
Name:_________________________________________________________________________________________
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Address:_______________________________________________________________________________________
City:___________________________________________________State:________________ Zip:_______________
AMT ID#_______________________________________________Phone:__________________________________
GENERAL REGISTRATION (All Seminars) Friday and Saturday (One Day Only) Fri. or Sat.
AMT Members $75.00 ($85.00 at door) ____________ $50.00 ($60.00 at door)
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Make checks payable to TxSSAMT and send registration to:
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(TxSSAMT is not responsible for your personal reservations.)
Holiday Inn Express & Suites
Registration
14620 North IH 35 • Austin, TX
512-251-9110 • 512-251-9112 Fax
Cut off date is March 1, 2014
for room rate of $97.00 + 6% tax.
(72hr cancellation)
After that the rate will go
up to regular price.
18
The New TexaN
Spring/Summer 2014 / TxSSAMT
Our Advertisers
Ronin Clinical Laboratory & Diagnostic Services - page 9
National American University - page 8
The New Texan Publication Committee
Editor: Kim Meshell, AHI, COLT, RMA
936-633-5459 • P.O. Box 152023 • Lufkin, Texas 75915
Assistant Editor: Miranda Lankford
936-465-8984
Co-Editor: Michelle Jenkins
972-518-6293
Graphic Designer: Rebekah Petty
Printer: Branch Media Pro
To Advertisers
The New Texan, Journal of Medical Technology, a publication of
TxSSAMT, is published 2 times a year in one index Volume per year.
Published under the direction of the editor and appointed associates,
the Journal is devoted to the publication of original articles (and review
articles) as well as observations in the fields of interest to medical allied
professionals.
The New Texan, has not only an aim, but a goal which is to serve
both our members and our advertisers through the Journal. We have
over six thousand members in our Texas organization who receive this
publication. Thus it serves as a constant reminder of the products or
articles advertised therein.
We feel that once you advertise in The New Texan, you will reap the
benefits of a close association with our members and will also enjoy the
increased sales of your product(s).
Title of Publication: The New Texan, Journal of Allied
Health Professionals.
Publisher: A publication of the Texas State Society
of American Medical Technologists
Type of Publication: Journal (8½” x 11”)
Issues: First and Second
Advertising Rates Per Issue
One Insertion
All Issues
Full Page $225.00
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Press run 6,000. (b) Circulation to all members of the Texas State Society
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column width. 7 3/8”. (d) Depth of column - 10”. (e) Columns per page - 2.
(f) Column inches per page - 20.
Material requirements: Camera ready positive material.
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Spring/Summer 2014 / TxSSAMT
The New TexaN
19
Austin, TX
March 28-29, 2014
National American University
13801 Burnet Road, Suite 300 • Austin, Texas • 512-651-4700
Program will provide 15 hours Continuing Education with a variety of subjects:
Affordable Care Act, Neuroendocrinology, Pertussis/Whooping Cough, Asepsis,
Medical Massage & Rehabilitation, HIPAA, Sugar Addiction, Knowledge Bowl,
Medical Records Auditing or ICD 10, Food Allergies, Cord Banking.
Programs will be mailed separately!
Reminder: Famous Texas Auction on Friday EVENING at 5:00 p.m.
Bring your donation and your check book!
All Member - First-Time-Attendees will receive a TSSAMT State Society Pin.
NOTICE: TxSSAMT Business Meeting will be held on SATURDAY at 12:15
and will include lunch. REMINDER-this is election year for officers.
Come join us for a fun and educational time!
See inside for registration information.