Tuesday, April 30, 2013

Germ-zapping 'robots': Hospitals combat superbugs

NEW YORK (AP) ? They sweep. They swab. They sterilize. And still the germs persist.

In U.S. hospitals, an estimated 1 in 20 patients pick up infections they didn't have when they arrived, some caused by dangerous 'superbugs' that are hard to treat.

The rise of these superbugs, along with increased pressure from the government and insurers, is driving hospitals to try all sorts of new approaches to stop their spread:

Machines that resemble "Star Wars" robots and emit ultraviolet light or hydrogen peroxide vapors. Germ-resistant copper bed rails, call buttons and IV poles. Antimicrobial linens, curtains and wall paint.

While these products can help get a room clean, their true impact is still debatable. There is no widely-accepted evidence that these inventions have prevented infections or deaths.

Meanwhile, insurers are pushing hospitals to do a better job and the government's Medicare program has moved to stop paying bills for certain infections caught in the hospital.

"We're seeing a culture change" in hospitals, said Jennie Mayfield, who tracks infections at Barnes-Jewish Hospital in St. Louis.

Those hospital infections are tied to an estimated 100,000 deaths each year and add as much as $30 billion a year in medical costs, according to the Centers for Disease Control and Prevention. The agency last month sounded an alarm about a "nightmare bacteria" resistant to one class of antibiotics. That kind is still rare but it showed up last year in at least 200 hospitals.

Hospitals started paying attention to infection control in the late 1880s, when mounting evidence showed unsanitary conditions were hurting patients. Hospital hygiene has been a concern ever since, with a renewed emphasis triggered by the emergence a decade ago of a nasty strain of intestinal bug called Clostridium difficile, or C-diff.

The diarrhea-causing C-diff is now linked to 14,000 U.S. deaths annually. That's been the catalyst for the growing focus on infection control, said Mayfield, who is also president-elect of the Association for Professionals in Infection Control and Epidemiology.

C-diff is easier to treat than some other hospital superbugs, like methicillin-resistant staph, or MRSA, but it's particularly difficult to clean away. Alcohol-based hand sanitizers don't work and C-diff can persist on hospital room surfaces for days. The CDC recommends hospital staff clean their hands rigorously with soap and water ? or better yet, wear gloves. And rooms should be cleaned intensively with bleach, the CDC says.

Michael Claes developed a bad case of C-diff while he was a kidney patient last fall at New York City's Lenox Hill Hospital. He and his doctor believe he caught it at the hospital. Claes praised his overall care, but felt the hospital's room cleaning and infection control was less than perfect.

"I would use the word 'perfunctory,'" he said.

Lenox Hill spokeswoman Ann Silverman disputed that characterization, noting hospital workers are making efforts that patients often can't see, like using hand cleansers dispensers in hallways. She ticked off a list of measure used to prevent the spread of germs, ranging from educating patients' family members to isolation and other protective steps with each C-diff patient.

The hospital's C-diff infection rate is lower than the state average, she said.

Westchester Medical Center, a 643-bed hospital in the suburbs of New York City has also been hit by cases of C-diff and the other superbugs.

Complicating matters is the fact that larger proportions of hospital patients today are sicker and more susceptible to the ravages of infections, said Dr. Marisa Montecalvo, a contagious diseases specialist at Westchester.

There's a growing recognition that it's not only surgical knives and operating rooms that need a thorough cleaning but also spots like bed rails and even television remote controls, she said. Now there's more attention to making sure "that all the nooks and crannies are clean, and that it's done in as perfect a manner as can be done," Montecalvo said.

Enter companies like Xenex Healthcare Services, a San Antonio company that makes a portable, $125,000 machine that's rolled into rooms to zap C-diff and other bacteria and viruses dead with ultraviolet light. Xenex has sold or leased devices to more than 100 U.S. hospitals, including Westchester Medical Center.

The market niche is expected to grow from $30 million to $80 million in the next three years, according to Frost & Sullivan, a market research firm.

Mark Stibich, Xenex's chief scientific officer, said client hospitals sometimes call them robots and report improved satisfaction scores from patients who seem impressed that the medical center is trotting out that kind of technology.

At Westchester, workers still clean rooms, but the staff appreciates the high-tech backup, said housekeeping manager Carolyn Bevans.

"We all like it," she said of the Xenex.

At Cooley Dickinson Hospital, a 140-bed facility in Northampton, Mass., the staff calls their machines Thing One, Thing Two, Thing Three and Thing Four, borrowing from the children's book "The Cat in the Hat."

But while the things in the Dr. Seuss tale were house-wrecking imps, Cooley Dickinson officials said the ultraviolet has done a terrific job at cleaning their hospital of the difficult C-diff.

"We did all the recommended things. We used bleach. We monitored the quality of cleaning," but C-diff rates wouldn't budge, said nurse Linda Riley, who's in charge of infection prevention at Cooley Dickinson.

A small observational study at the hospital showed C-diff infection rates fell by half and C-diff deaths fell from 14 to 2 during the last two years, compared to the two years before the machines.

Some experts say there's not enough evidence to show the machines are worth it. No national study has shown that these products have led to reduced deaths or infection rates, noted Dr. L. Clifford McDonald of the Centers for Disease Control and Prevention.

His point: It only takes a minute for a nurse or visitor with dirty hands to walk into a room, touch a vulnerable patient with germy hands, and undo the benefits of a recent space-age cleaning.

"Environments get dirty again," McDonald said, and thorough cleaning with conventional disinfectants ought to do the job.

Beyond products to disinfect a room, there are tools to make sure doctors, nurses and other hospital staff are properly cleaning their hands when they come into a patient's room. Among them are scanners that monitor how many times a health care worker uses a sink or hand sanitizer dispenser.

Still, "technology only takes us so far," said Christian Lillis, who runs a small foundation named after his mother who died from a C-diff infection.

Lillis said the hospitals he is most impressed with include Swedish Covenant Hospital in Chicago, where thorough cleanings are confirmed with spot checks. Fluorescent powder is dabbed around a room before it's cleaned and a special light shows if the powder was removed. That strategy was followed by a 28 percent decline in C-diff, he said.

He also cites Advocate Christ Medical Center in Oak Lawn, Ill., where the focus is on elbow grease and bleach wipes. What's different, he said, is the merger of the housekeeping and infection prevention staff. That emphasizes that cleaning is less about being a maid's service than about saving patients from superbugs.

"If your hospital's not clean, you're creating more problems than you're solving," Lillis said.

___

Online:

CDC: http://www.cdc.gov/hai/

Source: http://news.yahoo.com/germ-zapping-robots-hospitals-combat-superbugs-140922678.html

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Why isn't chronic Lyme disease covered by health insurance ...

Nick DiUlio

The weather is warming across the country, which means that tick season is fast approaching. And with ticks comes the ever-growing threat of Lyme disease, a bacterial infection transmitted by ticks that causes flu-like symptoms such as chills, fever, swollen lymph nodes, headaches and joint pain. Even if you think you know all there is to know about this insidious illness, one fact may surprise you: most insurance companies will not pay for long-term Lyme treatment.

?There are countless people out there just like me who have been living with this disease for decades with no relief in sight,? says Terri Reagan, 55, a New Jersey resident who was first infected with Lyme disease 20 years ago after being bitten by a deer tick while walking her dog.

One woman: Health insurance didn?t cover chronic Lyme treatment

In 1993, Reagan first came down with the flu-like symptoms that signify Lyme disease. She suspected that it was Lyme and was diagnosed by a doctor who immediately gave her a standard two-week regimen of oral antibiotics. Her symptoms dissipated, but not entirely, and she was ?down and out? for nearly two months after being bitten.

lyme-disease-health-insuranceSince then Reagan?s life has been punctuated by long, arduous relapses, with symptoms including nausea, extreme fatigue, short-term memory loss, depression and debilitating joint pain, just to name a few.

?For the last two years in particular, I have had no quality of life,? Reagan says.

Last August, Reagan experienced her worst relapse ever. So she searched for a nearby physician who specializes in Lyme disease (often known as a ?Lyme literate doctor?).

The doctor put Reagan on an aggressive IV antibiotic treatment schedule in November that should?ve lasted six months. But after just one month of treatment her health insurance provider, United Healthcare, stopped paying, informing her that further treatment was deemed experimental and would not be covered. For the next two months Reagan spent more than $6,000 out of pocket for her treatment, but eventually the money ran out. She had no option but to stop.

?The bottom line is if you suffer from chronic Lyme disease and don?t have the money for treatment, you?re screwed,? Reagan says.

The Lyme controversy

The heart of this issue stems from a debate about what exactly Lyme disease is. According to Patricia Smith, president of the nonprofit Lyme Disease Association Inc., the problem boils down to two schools of thought.

?According to the Infectious Disease Society of America (IDSA), the Centers for Disease Control (CDC) and most insurance companies, Lyme disease is hard to catch and easy to cure,? Smith says. ?They believe that a few weeks of antibiotics are enough to cure the disease and that?s that.?

However, hundreds of Lyme disease sufferers and Lyme-literate physicians claim Lyme bacteria survive in the body long after treatment is completed. This results in what?s known as persistent Lyme disease, or Lyme disease treatment syndrome.

The IDSA doesn?t buy it. A review panel met in 2010 to examine 2006 IDSA guidelines for treatment of Lyme. The panel concluded that there?s no evidence for the existence of chronic Lyme disease and that long-term antibiotic treatment is ?unproven and unwarranted.?

Why insurance won?t cover treatment

Most insurance companies base their coverage criteria on guidelines set forth by groups like the CDC and IDSA. That means if the CDC and IDSA don?t recognize chronic Lyme disease as a legitimate, long-term illness, neither does your health insurance provider.

Consider the case of Jim Kosal. Two years ago Kosal was misdiagnosed with ALS (a degenerative neurological disease that affects the spinal chord and nerve cells in the brain). By the time doctors figured out that he actually had Lyme disease, it was too late. The disease had progressed to a chronic stage, and his insurance provider wasn?t going to pay for treatment.

?First they said the therapy was ?investigational,?? recalls Jim?s wife Erica. ?Even after we demonstrated that it wasn?t, they questioned whether or not Jim even had Lyme, even though he had multiple diagnoses.?

The Kosals have spent more than $30,000 since Jim first became ill, and even after two rounds of appeals their insurance company doesn?t appear to be budging on reimbursement.

?(Insurers) think there?s a one-size-fits-all approach to treating Lyme,? says Jennifer Reid, co-chair of the Ridgefield Lyme Disease Task Force, a nonprofit educational and advocacy group based in Connecticut.

But, she adds, Lyme is a very complex disease, and a lot more research is required to understand it.

When it comes to Lyme disease, the language of most insurance policies is fairly straightforward. For instance, Aetna?s policy clearly states that it will pay for a four-week regimen of antibiotic treatment. However, Aetna considers additional antibiotic therapy for so-called chronic Lyme disease experimental and investigational, claiming that treatment for this condition has not been proven effective.

?Most people don?t read their policies, so it comes as a shock when they get sick (from Lyme disease),? Reid says. ?I know people?who have lost their homes, their insurance, even their jobs. The potential for financial disaster is tremendous.?

Is change coming?

Make no mistake?Lyme disease isn?t going anywhere.

According to the CDC, this nasty and debilitating illness is America?s fastest-growing vector-borne disease (a disease carried by birds, animals or insects). In 2002, there were nearly 25,000 reported cases of Lyme disease nationwide. By 2011, that figure jumped to about 35,000 cases.

And yet the medical and insurance communities remain tight-lipped about the whole ordeal. Over the course of reporting on this story, all messages to health insurance representatives and doctors went unreturned.

?That?s because they?re afraid to talk about this too openly,? Smith says.

In recent years, state medical boards across the country have reprimanded dozens of Lyme-literate doctors for treating long-term Lyme patients with extended antibiotic regimens, sometimes going so far as to suspend their licenses. The claim is that these doctors are not following standard guidelines for Lyme treatment and are, in essence, being irresponsible practitioners of medicine.

This threat is so real and present that four states?Rhode Island, Connecticut, New Hampshire and Massachusetts?recently passed laws allowing doctors to prescribe long-term antibiotic treatment for Lyme patients without fear of losing their licenses or being dropped by certain health insurance providers.

?It?s all well and good that you can now get treated in Connecticut for chronic Lyme, but it doesn?t change the fact that insurance won?t pay for it,? Reid says. ?And that has to change.?

Source: http://www.insurancequotes.com/lyme-disease-health-insurance/

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New stats: Plastic surgery trend has women armed for spring and summer

New stats: Plastic surgery trend has women armed for spring and summer [ Back to EurekAlert! ] Public release date: 29-Apr-2013
[ | E-mail | Share Share ]

Contact: Shannon McCormick
shannon@mediasourcetv.com
614-477-2719
American Society of Plastic Surgeons

Inspired by strong-armed celebrities, upper arm lifts jump 4,378% since 2000, new ASPS statistics show

ARLINGTON HEIGHTS, Ill., April 29, 2013 New statistics released by the American Society of Plastic Surgeons (ASPS) show that arm lifts in women have skyrocketed more than 4,000 percent in just over the last decade. It is a trend fueled, in part, by sleeveless fashions for women and more focus on strong-armed celebrities. In 2000, more than 300 women got upper arm lift procedures. Last year, more than 15,000 did.

Arm Lifts By The Numbers:

Procedures in 2012


  • Overall: 15,457 up 3% since 2011 / 4,473% since 2000
  • Women: 15,136 up 4,378% since 2000
  • 98% of arm lift patients were women
  • Most popular with patients over 40. The majority, 43%, of patients were ages 40 and 54, 33% were over age 55.
  • Average surgeon fee: $3,939 / total spent on arm lifts: $61 million

Upper arm lifts can include liposuction or a surgical procedure known as brachioplasty, in which loose skin is removed from the back of the arms.

"Women are paying more attention to their arms in general and are becoming more aware of options to treat this area," said ASPS President Gregory Evans, MD. "For some women, the arms have always been a troublesome area and, along with proper diet and exercise, liposuction can help refine them. Others may opt for a brachioplasty when there is a fair amount of loose skin present with minimal elasticity."

Doctors say there is no single reason behind the increase, though celebrities from the White House to the red carpet may be having an influence. A recent poll* conducted on behalf of ASPS found that women are paying closer attention to the arms of female celebrities.

According to the poll, women most admire the arms of first lady Michelle Obama, followed closely by Jennifer Aniston. Actresses Jessica Biel and Demi Moore, and daytime TV talk show host Kelly Ripa also got votes for their toned arms.

"I think we are always affected by the people that we see consistently, either on the big screen or on TV," said ASPS Public Education Committee Chair David Reath, MD, based in Knoxville, Tenn. "We see them and think, 'yeah, I'd like to look like that'."

That's just what happened to 24-year-old Natalie Robinson of Knoxville, who says she was inspired by the arms of the first lady. "I looked at Michelle Obama and said 'Oh my gosh, I want her arms. When I first started losing weight and started to tone up, I had her image in my head."

That was three years ago. Today, Robinson has lost more than 170 pounds and continues an amazing transformation through diet and exercise. But for all the weight she'd lost, Robinson says she still wasn't entirely happy.

"I had a lot of excessive skin around my upper arms," she said. "Every time I looked in the mirror there was a reminder of a heavier person and I just couldn't get rid of it."

That's when Robinson contacted Dr. Reath, who performed her brachioplasty. "Natalie had the perfect arms for this procedure," said Dr. Reath, "but it's not for everybody."

A brachioplasty requires an incision from the elbow to the armpit, generally on the back of the arm, leaving a visible and permanent scar. For Robinson, the scar was much easier to deal with than the excessive skin, but Dr. Reath cautions patients to carefully consider the pros and cons before having an upper arm lift, particularly a brachioplasty.

"It's a trade off. We get rid of the skin, but we leave a scar," he said. "So, as long as there's enough improvement to be made in the shape of the arm to justify the scar, then it's a great procedure."

Dr. Reath stresses the importance of proper diet and exercise as part of a healthy lifestyle to all his patients, but says some women simply can't achieve the look they want on their own. Many who simply want to tighten and tone their upper arms, but don't have a lot of excess skin, opt for liposuction instead of a brachioplasty.

"We are genetically programmed to have different accumulations of fat in different areas, and for some women the arms can be a problem area," said Dr. Reath. "The arms are a very noticeable area and if excessive fat and skin are an issue, they tend to look more out of proportion than the rest of the body."

That was certainly the case for Robinson, but not anymore. Robinson says she never expected surgery to make her arms perfect, just more normal. "Well-proportioned is what I was going for, and I'm very happy. It was well worth the investment," she said. "I would do it again."

###

For more new statistics on trends in plastic surgery including gender, age, regional, national average fees and other breakouts, refer to the ASPS 2012 National Clearinghouse of Plastic Surgery Procedural Statistics report at http://www.plasticsurgery.org/news-and-resources/2012-plastic-surgery-statistics.html. (Stats on this site will be updated with the specific demographics and trends when embargo lifts on 4/29/13). Information about procedures and referrals to ASPS Member Surgeons can be found at http://www.PlasticSurgery.org.

* This poll was conducted online within the United States by Harris Interactive on behalf of the American Society of Plastic Surgeons from March 28-April 1, 2013 among 1,219 women ages 18 and older. This online poll is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. For complete poll methodology, including weighting variables, please contact Shannon McCormick.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at PlasticSurgery.org or Facebook.com/PlasticSurgeryASPS and Twitter.com/ASPS_News.

Broadcast quality multimedia elements at: http://bit.ly/14STmA2

(Multimedia Newsroom is password protected until embargo lifts. Please contact media relations representative listed below for password prior to embargo.)

Media Contacts: Shannon McCormick, 614-932-9950 (ext. 14) shannon@mediasourcetv.com or ASPS: 847-228-9900, media@plasticsurgery.org


[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


New stats: Plastic surgery trend has women armed for spring and summer [ Back to EurekAlert! ] Public release date: 29-Apr-2013
[ | E-mail | Share Share ]

Contact: Shannon McCormick
shannon@mediasourcetv.com
614-477-2719
American Society of Plastic Surgeons

Inspired by strong-armed celebrities, upper arm lifts jump 4,378% since 2000, new ASPS statistics show

ARLINGTON HEIGHTS, Ill., April 29, 2013 New statistics released by the American Society of Plastic Surgeons (ASPS) show that arm lifts in women have skyrocketed more than 4,000 percent in just over the last decade. It is a trend fueled, in part, by sleeveless fashions for women and more focus on strong-armed celebrities. In 2000, more than 300 women got upper arm lift procedures. Last year, more than 15,000 did.

Arm Lifts By The Numbers:

Procedures in 2012


  • Overall: 15,457 up 3% since 2011 / 4,473% since 2000
  • Women: 15,136 up 4,378% since 2000
  • 98% of arm lift patients were women
  • Most popular with patients over 40. The majority, 43%, of patients were ages 40 and 54, 33% were over age 55.
  • Average surgeon fee: $3,939 / total spent on arm lifts: $61 million

Upper arm lifts can include liposuction or a surgical procedure known as brachioplasty, in which loose skin is removed from the back of the arms.

"Women are paying more attention to their arms in general and are becoming more aware of options to treat this area," said ASPS President Gregory Evans, MD. "For some women, the arms have always been a troublesome area and, along with proper diet and exercise, liposuction can help refine them. Others may opt for a brachioplasty when there is a fair amount of loose skin present with minimal elasticity."

Doctors say there is no single reason behind the increase, though celebrities from the White House to the red carpet may be having an influence. A recent poll* conducted on behalf of ASPS found that women are paying closer attention to the arms of female celebrities.

According to the poll, women most admire the arms of first lady Michelle Obama, followed closely by Jennifer Aniston. Actresses Jessica Biel and Demi Moore, and daytime TV talk show host Kelly Ripa also got votes for their toned arms.

"I think we are always affected by the people that we see consistently, either on the big screen or on TV," said ASPS Public Education Committee Chair David Reath, MD, based in Knoxville, Tenn. "We see them and think, 'yeah, I'd like to look like that'."

That's just what happened to 24-year-old Natalie Robinson of Knoxville, who says she was inspired by the arms of the first lady. "I looked at Michelle Obama and said 'Oh my gosh, I want her arms. When I first started losing weight and started to tone up, I had her image in my head."

That was three years ago. Today, Robinson has lost more than 170 pounds and continues an amazing transformation through diet and exercise. But for all the weight she'd lost, Robinson says she still wasn't entirely happy.

"I had a lot of excessive skin around my upper arms," she said. "Every time I looked in the mirror there was a reminder of a heavier person and I just couldn't get rid of it."

That's when Robinson contacted Dr. Reath, who performed her brachioplasty. "Natalie had the perfect arms for this procedure," said Dr. Reath, "but it's not for everybody."

A brachioplasty requires an incision from the elbow to the armpit, generally on the back of the arm, leaving a visible and permanent scar. For Robinson, the scar was much easier to deal with than the excessive skin, but Dr. Reath cautions patients to carefully consider the pros and cons before having an upper arm lift, particularly a brachioplasty.

"It's a trade off. We get rid of the skin, but we leave a scar," he said. "So, as long as there's enough improvement to be made in the shape of the arm to justify the scar, then it's a great procedure."

Dr. Reath stresses the importance of proper diet and exercise as part of a healthy lifestyle to all his patients, but says some women simply can't achieve the look they want on their own. Many who simply want to tighten and tone their upper arms, but don't have a lot of excess skin, opt for liposuction instead of a brachioplasty.

"We are genetically programmed to have different accumulations of fat in different areas, and for some women the arms can be a problem area," said Dr. Reath. "The arms are a very noticeable area and if excessive fat and skin are an issue, they tend to look more out of proportion than the rest of the body."

That was certainly the case for Robinson, but not anymore. Robinson says she never expected surgery to make her arms perfect, just more normal. "Well-proportioned is what I was going for, and I'm very happy. It was well worth the investment," she said. "I would do it again."

###

For more new statistics on trends in plastic surgery including gender, age, regional, national average fees and other breakouts, refer to the ASPS 2012 National Clearinghouse of Plastic Surgery Procedural Statistics report at http://www.plasticsurgery.org/news-and-resources/2012-plastic-surgery-statistics.html. (Stats on this site will be updated with the specific demographics and trends when embargo lifts on 4/29/13). Information about procedures and referrals to ASPS Member Surgeons can be found at http://www.PlasticSurgery.org.

* This poll was conducted online within the United States by Harris Interactive on behalf of the American Society of Plastic Surgeons from March 28-April 1, 2013 among 1,219 women ages 18 and older. This online poll is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. For complete poll methodology, including weighting variables, please contact Shannon McCormick.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at PlasticSurgery.org or Facebook.com/PlasticSurgeryASPS and Twitter.com/ASPS_News.

Broadcast quality multimedia elements at: http://bit.ly/14STmA2

(Multimedia Newsroom is password protected until embargo lifts. Please contact media relations representative listed below for password prior to embargo.)

Media Contacts: Shannon McCormick, 614-932-9950 (ext. 14) shannon@mediasourcetv.com or ASPS: 847-228-9900, media@plasticsurgery.org


[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Source: http://www.eurekalert.org/pub_releases/2013-04/m-nsp_1042313.php

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Video: "House of Cards" spoof at WH Correspondents' Dinner (cbsnews)

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