Gut microbiome controls anti-tumor immune function in liver cells

In a May 24, 2018 NCI (National Cancer Institute) study, scientists found a connection between bacteria in the gut and anti-tumor immune responses in the liver. This effectively changes the composition of immune cells of the liver. Tim Greten, M.D. (NCI) (CCR) Center for Cancer Research, led the study, saying, “This is a great example of how what we learn from basic research can give us insight into cancer and possible treatments.”

Ginger to treat nausea, vomiting and inflammation

NCCIH (National Center for Complementary and Integrative Health) May 2019 report gives fact sheet information on using fresh ginger to assist with pregnancy related symptoms of nausea and vomiting as well as arthritic inflammatory conditions. Cautions are listed for side effects of abdominal discomfort, heartburn, diarrhea and gas (temporary) as well as interactions with blood thinners. Ginger can be added to tea, used in a juicer, or added to cooked vegetables. Cooking may alter the effectiveness, requiring higher doses.

The entire report can be found at:

Immunotherapy treatment leads to complete resolution of metastatic breast cancer

A June 4, 2018 press release from NCI (National Cancer Institute) describes a novel approach to immunotherapy that may apply to all cancer types in the future. Steven A. Rosenberg MD, PhD, chief of Surgery Branch at NCI Center for Cancer Research (CCR), published findings in June 4, 2018 Nature Medicine. The new approach is a modified form of adoptive cell transfer (ACT), which has been effective in treating melanoma, a form of cancer with high levels of somatic or acquired mutations. The new approach has been less effective with epithelial cancers or those starting in the lining of organs, that have lower levels of mutations, such as stomach esophageal, ovarian and breast cancers. However, in phase 2 of human trials, the investigators developed a form of ACT that uses tumor-infiltrating lymphocytes (TILs) that target tumor cell mutations common in epithelial cancers. The selected TILs are grown to large numbers in the laboratory and infused into the patient to create a stronger immune response against the tumor. A patient with metastatic breast cancer came to trial after receiving multiple failed treatments, including chemotherapy and hormonal. After the new immunotherapy treatment this patient’s cancer disappeared and has not returned for more than 22 months.

Emergency preparedness for provider offices

In light of recent natural disasters, now is a good time to review your HIPAA processes and procedures should an emergency arise. The  Department of Health and Human Services has excellent information here: Dept of HHS Emergency Preparedness. The November 2014 Bulletin HIPAA Privacy in Emergency Situations is an older publication but remains a very good resource for understanding HIPAA requirements during an emergency situation (it was written in light of the 2014 Ebola outbreaks). HHS also has excellent Frequently Asked Questions at Dept of HHS Emergency Preparedness FAQ.

Dangers of Colloidal Silver

NCCIH published a July 2018 message with strong warnings for all integrative healthcare providers recommending colloidal silver for patient use. Colloidal silver consists of tiny silver particles in a liquid sometimes promoted as a dietary supplement, however evidence supporting health-related claims is lacking. It can, in fact, be dangerous to health to consume colloidal silver. There are serious side effects including argyria, a permanent, bluish-gray discoloration of the skin; it can also cause poor absorption of thyroid medications and antibiotics. Colloidal silver has not been found to treat any disease condition and is not a nutritionally essential mineral or useful as a dietary supplement. The FDA has warned the public repeatedly about the dangers of ingesting colloidal silver. NCCIH states “However, there are no legally marketed prescription or over-the-counter drugs containing colloidal silver that are taken by mouth.”

Washington State Health Care Authority seeks provider participation in annual value-based payment survey

From the Washington State Health Care Authority:

The Health Care Authority (HCA) is seeking provider participation in its annual value-based payment survey. The survey will assist HCA in tracking progress toward the statewide goal of paying for value-based care, rather than paying for volume of care. Further, this survey will provide valuable insight into the challenges providers face when considering adopting new payment arrangements and inform HCA’s efforts to support the provider community.

HCA invites a variety of providers across Washington State, including hospitals, health systems, clinics, tribal health care, behavioral health care, and others, to participate. The intent is to collect one response per organization and that administrators, rather than individual clinicians, fill out the survey on behalf of their organization.

The survey is open until August 31.

A similar survey was released to health plans. HCA issues this annual value-based payment (VBP) survey to track progress towards our paying for value goals and to identify barriers impeding desired progress.

To learn more, visit the paying for value web page.

Silence is vital for brain health

The importance of asking patients about their home and work environment is important when considering how much noise a patient is exposed to. For most people silence is comforting and nourishes a tired body and mind. Higher decibel sound waves during sleep can disturb vital REM sleep patterns. Exposure to high levels of sound all day can affect the body, leading to a release of stress hormones. The word noise comes from the Latin word, ‘noxia’, meaning hurt, damage or injury. Continual exposure to high decibel sound can cause high blood pressure, heart disease, tinnitus and loss of sleep. In 2011 the World Health Organization reported the root cause of 3,000 deaths was attributed to excessive noise. Professor Gary Evans from Cornell University, published in Psychological Science, charted the effects of airport noise on school children near Munich’s airport. The study showed those children developed a stress response causing them to ignore the noise, which translated to ignoring everyday sounds like speech from others. Silence relieved the stress associated with noise exposure.

Five HIPAA tips for small practices

HIPAA breaches are not limited to large provider organizations such as hospitals or health plans. Small provider practices carry HIPAA compliance concerns, as well, especially when there is staff turnover or a lack of HIPAA knowledge. The Compliance & Ethics Blog lists five areas for small practices to be aware of including staying informed of HIPAA compliance regulations and changes; keeping communications secure; considering physical safeguards, not just digital ones; understanding and using BAA’s; and ensuring mobile devices are protected. Visit their website for more information at

And, don’t forget that CHP offers HIPAA webinars for both privacy and security for integrative healthcare providers! Visit our list of events at

Washington State Health Care Authority announces Interpreter Services for Medicaid and DSHS appointments

From the Washington State Health Care Authority:

Effective July 1, 2018, Universal Language Service (ULS) will be providing  interpreter services for Medicaid and Department of Social and Health Services appointments (DSHS) appointments.

Providers: In order to request interpreters for July 1, 2018 and after, you must register with ULS by contacting

Interpreters: In order to accept requests for Medicaid and DSHS interpreter services for July 1, 2018 and after, you must register with ULS by contacting

Please visit the Health Care Authority Interpreter Services website for more information.

The globalization of inflammatory bowel disease

According a recent article in JAMA, “Inflammatory Bowel Disease Goes Global” (, the rates of inflammatory bowel diseases (IBD) have been increasing in newly industrialized and urbanized countries in Asia, Africa, South America, and the Middle East since 1990.  The findings of this systematic review of 147 observational, population-based studies from 1990 to 2016 indicate a shift in the global patterns of IBD.  The increased incidence of IBD, e.g. ulcerative colitis, Crohn’s disease, in these countries is accelerating similar to that of western countries during the 20th century.  There is still a high prevalence in North America, Oceana, and most European countries but there are some western countries the incidence has begun to stabilize or decrease.

The authors note for these countries with increasing IBD incidence is to “prepare their clinical infrastructure and personnel to manage this complex and costly disease”.