How One Health System is Demonstrating the Right Way to Build a Smart Growth Strategy.

SUMMARY: Across the United States, health system growth has been tied to significant investments in physical growth such as the build-out of large, traditional hospitals. Concurrent with this infrastructure investment, value frequently has been sought by cost cutting and large-scale closures of lower-margin facilities.At Froedtert Health, a philosophy of providing the right care at the right time in the right place is driving new growth. As the demand for unique tertiary services at its academic medical center has surged, Froedtert Health is leveraging and enhancing a new community hospital strategy while investing in new capability platforms to complement the health network's care model across Wisconsin.

Evaluation of Cannabidiol in Animal Seizure Models by the Epilepsy Therapy Screening Program (ETSP).

Cannabidiol (CBD) is a cannabinoid component of marijuana that has no significant activity at cannabinoid receptors or psychoactive effects. There is considerable interest in CBD as a therapy for epilepsy. Almost a third of epilepsy patients are not adequately controlled by clinically available anti-seizure drugs (ASDs). Initial studies appear to demonstrate that CBD preparations may be a useful treatment for pharmacoresistant epilepsy. The National Institute of Neurological Disorders and Stroke (NINDS) funded Epilepsy Therapy Screening Program (ETSP) investigated CBD in a battery of seizure models using a refocused screening protocol aimed at identifying pharmacotherapies to address the unmet need in pharmacoresistant epilepsy. Applying this new screening workflow, CBD was investigated in mouse 6 Hz 44 mA, maximal electroshock (MES), corneal kindling models and rat MES and lamotrigine-resistant amygdala kindling models. Following intraperitoneal (i.p.) pretreatment, CBD produced dose-dependent protection in the acute seizure models; mouse 6 Hz 44 mA (ED50 164 mg/kg), mouse MES (ED50 83.5 mg/kg) and rat MES (ED50 88.9 mg/kg). In chronic models, CBD produced dose-dependent protection in the corneal kindled mouse (ED50 119 mg/kg) but CBD (up to 300 mg/kg) was not protective in the lamotrigine-resistant amygdala kindled rat. Motor impairment assessed in conjunction with the acute seizure models showed that CBD exerted seizure protection at non-impairing doses. The ETSP investigation demonstrates that CBD exhibits anti-seizure properties in acute seizure models and the corneal kindled mouse. However, further preclinical and clinical studies are needed to determine the potential for CBD to address the unmet needs in pharmacoresistant epilepsy.

Planning during turmoil: credit challenges and healthcare finance. Interview by Carole J. Bolster.

The crisis in the financial markets is having a major impact on hospitals' ability to access capital. Providers are seeking longer-term fixed-rate debt rather than shortterm debt. Hospital management teams and their boards need to understand the upside and downside of variable-rate debt and interest rate derivatives.