Re: question

[Guest guest]

yes darlingpaypal will send you a notice that a payment has been madedid it so long ago that I can't remember if I had to set it up that way for notification or if it does it automatically.To: From: jnantonucci@...Date: Sat, 10 Jul 2010 11:08:17 -0400Subject: question

do any of you have patients paying through a website wheer the web site or the pay pay or some other thing like that TELLS YOU that a paymetn came in?or do all these sites/ mechanisms depend on you going IN to t he site to check your accounts?

thanksJeancan answer off list of you do not want to clutter the list serv.

-- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax

impcenter.org

The New Busy is not the too busy. Combine all your e-mail accounts with Hotmail. Get busy.

[Guest guest]

perhaps you should not be calling me  darling in front of 899 other people. Sweetie...thanks!

 

yes darlingpaypal will send you a notice that a payment has been madedid it so long ago that I can't remember if I had to set it up that way for notification or if it does it automatically.

To: From: jnantonucci@...Date: Sat, 10 Jul 2010 11:08:17 -0400

Subject: question

 

do any of you have patients  paying through a website wheer the web site  or the pay pay or some other thing like that  TELLS YOU that a paymetn came in?or do all these sites/ mechanisms  depend on you going IN to t he site to  check your accounts?

thanksJeancan answer off list of you do not want to  clutter the list serv.

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)Email is best used for appointment making and  brief  questions

Email replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD          ph    fax

impcenter.org

The New Busy is not the too busy. Combine all your e-mail accounts with Hotmail. Get busy.

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)

Email is best used for appointment making and  brief  questionsEmail replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD    

     ph    fax impcenter.org

[Guest guest]

We have a few patients who pay us via

Paypal. I get an email notice when we get paid. I either use Paypal to

purchase supplies for the office, or I go in and transfer the funds directly to

our checking account when it gets to be enough.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ] On

Behalf Of

Sent: Saturday, July 10, 2010 8:08

AM

To:

Subject:

question

do any of

you have patients paying through a website wheer the web site or

the pay pay or some other thing like that TELLS YOU that a paymetn came

in?

or do all these sites/ mechanisms depend on you going IN to t he site

to check your accounts?

thanks

Jean

can answer off list of you do not want to clutter the list serv.

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart (

be careful what you say!)

Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

[Guest guest]

thanks

 

We have a few patients who pay us via

Paypal.  I get an email notice when we get paid.  I either use Paypal to

purchase supplies for the office, or I go in and transfer the funds directly to

our checking account when it gets to be enough.

 

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ] On

Behalf Of

Sent: Saturday, July 10, 2010 8:08

AM

To:

Subject:

question

 

 

do any of

you have patients  paying through a website wheer the web site  or

the pay pay or some other thing like that  TELLS YOU that a paymetn came

in?

or do all these sites/ mechanisms  depend on you going IN to t he site

to  check your accounts?

thanks

Jean

can answer off list of you do not want to  clutter the list serv.

--

PATIENTS-please remember  that email may not be entirely secure, and that

Email is part of the medical  record and is placed into your  chart (

be careful what you say!)

Email is best used for appointment making and  brief  questions

Email replies can be expected within 24 hours-Please CALL  if the 

matter is more urgent .

     MD

     115 Mt Blue

Circle

     Farmington

ME 04938

ph    fax

impcenter.org

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)

Email is best used for appointment making and  brief  questionsEmail replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD    

     ph    fax impcenter.org

[Guest guest]

What does PayPal charge your office, charge the patient, for this service?We may have kicked this around before, but I can't find it in my notes or bookmarks.Thanks,Kathleen thanks On Sat, Jul 10, 2010 at 1:54 PM, Pratt <karen.oaktreecomcast (DOT) net> wrote: We have a few patients who pay us via Paypal. I get an email notice when we get paid. I either use Paypal to purchase supplies for the office, or I go in and transfer the funds directly to our checking account when it gets to be enough. PrattOffice ManagerOak Tree Internal Medicine P.Cwww.prattmd.info From: [mailto: ] On Behalf Of Sent: Saturday, July 10, 2010 8:08 AM To: Subject: question do any of you have patients paying through a website wheer the web site or the pay pay or some other thing like that TELLS YOU that a paymetn came in? or do all these sites/ mechanisms depend on you going IN to t he site to check your accounts? thanks can answer off list of you do not want to clutter the list serv. -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org

[Guest guest]

I am interested in the answer to this as well.  C

 

do any of you have patients  paying through a website wheer the web site  or the pay pay or some other thing like that  TELLS YOU that a paymetn came in?or do all these sites/ mechanisms  depend on you going IN to t he site to  check your accounts?

thanksJeancan answer off list of you do not want to  clutter the list serv.

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)Email is best used for appointment making and  brief  questions

Email replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD          ph    fax

impcenter.org

[Guest guest]

i have a paypal account set up that emails to the email account of my choice when a payment comes in

 

do any of you have patients  paying through a website wheer the web site  or the pay pay or some other thing like that  TELLS YOU that a paymetn came in?or do all these sites/ mechanisms  depend on you going IN to t he site to  check your accounts?

thanksJeancan answer off list of you do not want to  clutter the list serv.

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)Email is best used for appointment making and  brief  questions

Email replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD          ph    fax

impcenter.org

[Guest guest]

thanks

 

i have a paypal account set up that emails to the email account of my choice when a payment comes in

 

do any of you have patients  paying through a website wheer the web site  or the pay pay or some other thing like that  TELLS YOU that a paymetn came in?or do all these sites/ mechanisms  depend on you going IN to t he site to  check your accounts?

thanksJeancan answer off list of you do not want to  clutter the list serv.

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)Email is best used for appointment making and  brief  questions

Email replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD          ph    fax

impcenter.org

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)

Email is best used for appointment making and  brief  questionsEmail replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD    

     ph    fax impcenter.org

[Guest guest]

The last time I read up on this was when the recommendation changed a year or 2

ago to include people with h/o shingles. There was no new evidence. Those with

h/o shingles still had not been studied. But the thinking changed to: 1)some

people didn't really have shingles and 2)maybe it prevents recurrences.

Haresch

>

> I am really busy and too lazy..

> anyone know whether there has been testing or evidcen of efficacy to give

> zostavax to people who have already had shingles?

> A few yers ago I though it was that the thing is only 50% useful anyway in

> people who are um shingles-naiive but there had been no testing on folks

> who'd already had zoster.

> I s ee a recommendation somewhere to give it to folks who had have

> shingles but I cannot tell if it is worth the expense and troubel to people,

> and what usefulness it is to them thanks

> Sorry about being lazy

> Jean

>

> --

> PATIENTS-please remember that email may not be entirely secure, and that

> Email is part of the medical record and is placed into your chart ( be

> careful what you say!)

> Email is best used for appointment making and brief questions

> Email replies can be expected within 24 hours-Please CALL if the matter is

> more urgent .

>

>

> MD

>

>

> ph fax

> impcenter.org

>

[Guest guest]

Give the patient the choice. Having had shingles before is not a contraindication. But who knows the benefit. Recurrent shingles is pretty rare. The vaccine helps reduce incidence by 50% but post herpetic neuralgia by 80% so actually that is where the benefit is. I don't know if there would be a benefit in those who have had shingles. Logically I would say "no". If they don't mount a decent immune response to the actually disease, is their immune response to the vaccine going to be any better? How common is recurrent shingles? To me this is the manufacturer trying to sell more.

Kathy Saradarian

question

I am really busy and too lazy..anyone know whether there has been testing or evidcen of efficacy to give zostavax to people who have already had shingles?A few yers ago I though it was that the thing is only 50% useful anyway in people who are um shingles-naiive but there had been no testing on folks who'd already had zoster. I s ee a recommendation somewhere to give it to folks who had have shingles but I cannot tell if it is worth the expense and troubel to people, and what usefulness it is to them thanksSorry about being lazyJean

-- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org

[Guest guest]

from the CDC:  useful info for teaching re Zoster.

 

 

Prevention of Herpes Zoster

Recommendations of the Advisory Committee on Immunization Practices (ACIP)

NOTE: A Continuing Education Activity has been approved for this report and will be included in the print and electronic format on June 06, 2008, in Vol. 57, No. RR-5. The credits awarded are as follows: CME, 2.75; CNE, 2.75; CEU, .25; and CHES, 3.0.

Prepared by Harpaz, MD, Ismael R. Ortega-, PhD, Jane F. Seward, MBBS, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases

The material in this report originated in the National Center for Immunization and Respiratory Diseases, Anne Schuchat, MD, Director; and the Division of Viral Diseases, Larry , MD, Director.

Corresponding preparer: Harpaz, MD, National Center for Immunization and Respiratory Diseases, CDC, 1600 Clifton Rd., NE, MS A-47, Atlanta, GA 30333. Telephone: ; Fax: ; E-mail: rzh6@....

Summary

These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a live attenuated vaccine for the prevention of herpes zoster (zoster) (i.e., shingles) and its sequelae, which was licensed by the U.S. Food and Drug Administration (FDA) on May 25, 2006. This report summarizes the epidemiology of zoster and its sequelae, describes the zoster vaccine, and provides recommendations for its use among adults aged >60 years in the United States.

Zoster is a localized, generally painful cutaneous eruption that occurs most frequently among older adults and immunocompromised persons. It is caused by reactivation of latent varicella zoster virus (VZV) decades after initial VZV infection is established. Approximately one in three persons will develop zoster during their lifetime, resulting in an estimated 1 million episodes in the United States annually. A common complication of zoster is postherpetic neuralgia (PHN), a chronic, often debilitating pain condition that can last months or even years. The risk for PHN in patients with zoster is 10%--18%. Another complication of zoster is eye involvement, which occurs in 10%--25% of zoster episodes and can result in prolonged or permanent pain, facial scarring, and loss of vision. Approximately 3% of patients with zoster are hospitalized; many of these episodes involved persons with one or more immunocompromising conditions. Deaths attributable to zoster are uncommon among persons who are not immunocompromised.

Prompt treatment with the oral antiviral agents acyclovir, valacyclovir, and famciclovir decreases the severity and duration of acute pain from zoster. Additional pain control can be achieved in certain patients by supplementing antiviral agents with corticosteroids and with analgesics. Established PHN can be managed in certain patients with analgesics, tricyclic antidepressants, and other agents.

Licensed zoster vaccine is a lyophilized preparation of a live, attenuated strain of VZV, the same strain used in the varicella vaccines. However, its minimum potency is at least 14-times the potency of single-antigen varicella vaccine. In a large clinical trial, zoster vaccine was partially efficacious at preventing zoster. It also was partially efficacious at reducing the severity and duration of pain and at preventing PHN among those developing zoster.

Zoster vaccine is recommended for all persons aged >60 years who have no contraindications, including persons who report a previous episode of zoster or who have chronic medical conditions. The vaccine should be offered at the patient's first clinical encounter with his or her health-care provider. It is administered as a single 0.65 mL dose subcutaneously in the deltoid region of the arm. A booster dose is not licensed for the vaccine. Zoster vaccination is not indicated to treat acute zoster, to prevent persons with acute zoster from developing PHN, or to treat ongoing PHN. Before administration of zoster vaccine, patients do not need to be asked about their history of varicella (chickenpox) or to have serologic testing conducted to determine varicella immunity.

Introduction

Infection with varicella zoster virus (VZV) causes two distinct clinical conditions. Primary VZV infection causes varicella (i.e., chickenpox), a contagious rash illness that typically occurs among children. A vaccine for preventing initial VZV infection has been available in the United States since 1995, and the Advisory Committee on Immunization Practices (ACIP) recommends routine varicella vaccination for all persons aged >12 months who lack evidence of immunity (1--3). Varicella vaccination has dramatically reduced chickenpox cases among children (3).

VZV can reactivate clinically decades after initial infection to cause herpes zoster (zoster) (i.e., shingles), a localized and generally painful cutaneous eruption that occurs most frequently among older adults. Approximately 1 million new cases of zoster occur in the United States annually. Approximately one in three persons in the general population will develop zoster during their lifetime. A common complication of zoster is postherpetic neuralgia (PHN), a chronic pain condition that can last months or even years. In May 2006, a live, attenuated vaccine for prevention of zoster (ZOSTAVAX®, manufactured by Merck & Co., Inc.) was licensed in the United States for use in persons aged >60 years. This report provides recommendations for use of zoster vaccine for prevention of zoster and its sequelae.

 

 

 

[Guest guest]

thankstwo things1 last week someone had  zoster( I see it alot I guess becasue I have alot of older folks  and I always  likeit  when i  can predict it  from the pain.hyperesthesia before the rash is out Mildy fun heh hehe) So- I could not get acyclcovir I  gave famvir  and she got comatose and delusional!

sigh2 event this nice thing  Carolyn and thank you- does not give me  ammunition to say how likley it is to help at 150.00 or whatever I was hoping ot give my  patients information to make an informed choice thanks I mean Saradarian's point i s good- if you do not get immune response form the   reactivated  virus--zoster- why would  you ge t  it from the vaccine.. Hmmm

thanks guys

 

from the CDC:  useful info for teaching re Zoster.

 

 

Prevention of Herpes Zoster

Recommendations of the Advisory Committee on Immunization Practices (ACIP)

NOTE: A Continuing Education Activity has been approved for this report and will be included in the print and electronic format on June 06, 2008, in Vol. 57, No. RR-5. The credits awarded are as follows: CME, 2.75; CNE, 2.75; CEU, .25; and CHES, 3.0.

Prepared by Harpaz, MD, Ismael R. Ortega-, PhD, Jane F. Seward, MBBS, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases

The material in this report originated in the National Center for Immunization and Respiratory Diseases, Anne Schuchat, MD, Director; and the Division of Viral Diseases, Larry , MD, Director.

Corresponding preparer: Harpaz, MD, National Center for Immunization and Respiratory Diseases, CDC, 1600 Clifton Rd., NE, MS A-47, Atlanta, GA 30333. Telephone: ; Fax: ; E-mail: rzh6@....

Summary

These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a live attenuated vaccine for the prevention of herpes zoster (zoster) (i.e., shingles) and its sequelae, which was licensed by the U.S. Food and Drug Administration (FDA) on May 25, 2006. This report summarizes the epidemiology of zoster and its sequelae, describes the zoster vaccine, and provides recommendations for its use among adults aged >60 years in the United States.

Zoster is a localized, generally painful cutaneous eruption that occurs most frequently among older adults and immunocompromised persons. It is caused by reactivation of latent varicella zoster virus (VZV) decades after initial VZV infection is established. Approximately one in three persons will develop zoster during their lifetime, resulting in an estimated 1 million episodes in the United States annually. A common complication of zoster is postherpetic neuralgia (PHN), a chronic, often debilitating pain condition that can last months or even years. The risk for PHN in patients with zoster is 10%--18%. Another complication of zoster is eye involvement, which occurs in 10%--25% of zoster episodes and can result in prolonged or permanent pain, facial scarring, and loss of vision. Approximately 3% of patients with zoster are hospitalized; many of these episodes involved persons with one or more immunocompromising conditions. Deaths attributable to zoster are uncommon among persons who are not immunocompromised.

Prompt treatment with the oral antiviral agents acyclovir, valacyclovir, and famciclovir decreases the severity and duration of acute pain from zoster. Additional pain control can be achieved in certain patients by supplementing antiviral agents with corticosteroids and with analgesics. Established PHN can be managed in certain patients with analgesics, tricyclic antidepressants, and other agents.

Licensed zoster vaccine is a lyophilized preparation of a live, attenuated strain of VZV, the same strain used in the varicella vaccines. However, its minimum potency is at least 14-times the potency of single-antigen varicella vaccine. In a large clinical trial, zoster vaccine was partially efficacious at preventing zoster. It also was partially efficacious at reducing the severity and duration of pain and at preventing PHN among those developing zoster.

Zoster vaccine is recommended for all persons aged >60 years who have no contraindications, including persons who report a previous episode of zoster or who have chronic medical conditions. The vaccine should be offered at the patient's first clinical encounter with his or her health-care provider. It is administered as a single 0.65 mL dose subcutaneously in the deltoid region of the arm. A booster dose is not licensed for the vaccine. Zoster vaccination is not indicated to treat acute zoster, to prevent persons with acute zoster from developing PHN, or to treat ongoing PHN. Before administration of zoster vaccine, patients do not need to be asked about their history of varicella (chickenpox) or to have serologic testing conducted to determine varicella immunity.

Introduction

Infection with varicella zoster virus (VZV) causes two distinct clinical conditions. Primary VZV infection causes varicella (i.e., chickenpox), a contagious rash illness that typically occurs among children. A vaccine for preventing initial VZV infection has been available in the United States since 1995, and the Advisory Committee on Immunization Practices (ACIP) recommends routine varicella vaccination for all persons aged >12 months who lack evidence of immunity (1--3). Varicella vaccination has dramatically reduced chickenpox cases among children (3).

VZV can reactivate clinically decades after initial infection to cause herpes zoster (zoster) (i.e., shingles), a localized and generally painful cutaneous eruption that occurs most frequently among older adults. Approximately 1 million new cases of zoster occur in the United States annually. Approximately one in three persons in the general population will develop zoster during their lifetime. A common complication of zoster is postherpetic neuralgia (PHN), a chronic pain condition that can last months or even years. In May 2006, a live, attenuated vaccine for prevention of zoster (ZOSTAVAX®, manufactured by Merck & Co., Inc.) was licensed in the United States for use in persons aged >60 years. This report provides recommendations for use of zoster vaccine for prevention of zoster and its sequelae.

 

 

 

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)

Email is best used for appointment making and  brief  questionsEmail replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD    

     ph    fax impcenter.org