Sunday, September 30, 2012

Dissolvable Medical Devices

Electronic Implant Dissolves in the Body  by Susan Young.  Technology Review.  September 27, 2012.

Researchers at the University of Illinois, Tufts, and others have developed sensors and drug delivery devices that dissolve after they are no longer needed.  The researchers tested the concept on a device that heated a surgical cut area in order to prevent bacterial growth.  Materials are being tested to speed the dissolving process.

Key Molecule in Autoimmune Disease

Scientists Find a Molecule That Puts the Brakes on Inflammation  Science Daily.  September 28, 2012.

Autoimmune disease are increasingly prevalent.  So, the findings of researchers at the University of Pennsylvania School of Veterinary Medicine are significant.  Regulatory t cells function to check an immune system out of control, the definition of autoimmune disease.  The molecule call IL-27 has been identified by the researchers as the check needed to control the immune system.  This molecule may have potential for developing treatments for inflammatory bowel disease, multiple sclerosis, colitis, Crohn's disease, rheumatoid arthritis, and in lupus.

Type of SARS Virus Appears Not Easily Spread

Potentially Deadly Virus Related to SARS Appears Not Easily Spread  by Marc Santora.  The New York Times.  September 30, 2012.

While a newly discovered strain of a virus related to SARS has been discovered, public health officials have indicated that it seems not easily spread from person to person.  World Health Officials are pressing to develop a diagnostic test which they advise to be used only in the case of severely ill patients so as to not overload the healthcare system.  SARS is an disease of concern after a 2002 outbreak in China that affected 8,000 and killing one in ten victims.  However that variant of the SARS virus differs from the new discovered strain.

Transition for the Developmentally Disabled

After Decades in Institutions, a Bumpy Journey to a New Life  by Rachel L. Swarns.  The New York Times.  September 30 2012.

In response to Justice Department pressure, states are integrating the developmentally disabled into society.  The Department's view is that these individuals are needlessly segregated from society in public hospitals, nursing homes, and day programs.  Georgia has been, as a result, releasing hundreds of back into society mostly into small group homes with up to 4 residents.  This article traces the family and personal transitions of one developmentally disabled resident of Central State Hospital in Milledgeville, GA.  which is now mostly empty after housing up to 13,000 patients in the 1950's.

Thursday, September 27, 2012

Georgia Ranks 44th

Georgia Ranks Low In Health Coverage by Orlando Montoya.  GPB News.  August 20, 2012.

Key Ideas/Summary.  Georgia ranks 44th in overall coverage with approximately 25% of adults between 18 and 64 uncovered.

Pain Killer Restrictions Impact Doctors, Patients, Pharmacists

Making the "Pharmacy Crawl"  by Timothy W. Martin.  The Wall Street Journal.  September 27, 2012.

Key Ideas/Summary.  Several states now make doctors criminally liable and revoke their licenses for writing prescriptions for painkillers that lead to overdoses.  As a result some physicians do not write such prescriptions at all.  These laws arose as a result of the skyrocketing number of deaths by prescription drugs which in 2011 exceeded death from heroin and cocaine combined (Centers for Disease Control).  As a results of restrictive laws some pharmacies have stopped carrying pain-killers or limited their supply, sometimes forcing patients to "crawl" from pharmacy to pharmacy to fill their prescription.

Venture Capital Healthcare Firms Ranked

Looking for the Next Big Thing? Ranking the Top 50 Start Ups  by Zoran Basich and Emily Maltby.  The Wall  Street Journal.  September 27 2012.

Key Ideas/Summary.  The Wall Street Journal ranks annually start-up firms backed by venture capital.  The purpose of this ranking is to identify trends and emerging areas.  While healthcare firms faded somewhat this year in the ranking, there were several firms of interest:  Glaukos Corp, has developed a device to treat glaucoma;  NeuroPace Inc.  specializes in implantable devices treating neurological disorders;  PatientSafe Solutions develops patient-safety systems for hospitals;  Achaogen Inc.  focuses on antibiotics for multi-drug resistant  bacterial infections;  Acceleron Pharma Inc.  Drugs to treat cancer and rare diseases

Big Firms Revamp Health Coverage

Big Firms Overhall Health Coverage  by Anna Wilde Mathews.  The Wall Street Journal.  September 27, 2012.

Key Ideas/Summary.  In what may be a trend, two large firms are giving employees a fixed sum of money and allowing them to choose their medical coverage and insurance from an online marketplace.  The two firms, Darden Restaurants Inc. (Olive Garden, Red Lobster) and Sears Holdings Corp. aim to increase employee control of health benefits.  A concern for employees may be that the money provided may not be sufficient and adequate to keep up with premium inflation though the companies assert that the amount provided will increase with premium inflation.   The hope is that increased competition for employee dollars will lower overall health cost.  Overall , U.S. employers and workers are estimated to spend over $15,000 a year on medical insurance premiums.

Is Alzheimer's A Type of Diabetes?

Is Alzheimer's Type 3 Diabetes?  by Mark Bittman.  The New York Times.  September 25, 2012.

Key Ideas/Summary.  Bittman cites scientific research for the connection between poor diet and Alzheimer's.  The idea that Alzheimer's is Type 3 diabetes has been around since 2005.  However the link between poor diet and Alzheimer's  is becoming more convincing.  When brain cells do not take adequate blood sugar because of insulin resistance they lose function and the person can lose memory and become disoriented and most severely lose their personal sense of self.  While Alzheimer's is not "caused" by diabetes the two conditions have the same root, the consumption of hyperprocessed foods that interfere with insulin's many vital functions.  The implications are alarming:  With the rise of diabetes in lockstep with Alzheimer's,  costs for obesity related diseases will rise over the next 40 years by one trillion dollars.

Wednesday, September 26, 2012

Personal Avatars For Fighting Cancer

Mice as Stand-Ins in the Fight Against Disease  by Andrew Pollack.  The New York Times.  Wednesday, September 26, 2012

Key Ideas/Summary:  Researchers have begun implanting tumors from patients into mice so that various  drugs can be tried to determine the most effective drug or drugs to treat the tumor.  Using mice as "avatars" can perhaps avoid side effects and ineffective treatments.  However, researchers realize that  a tumor implanted under a mouse's skin may not behave as it does in a human.  Also, the time involved in raising enough mice with the tumor so that an array of drugs can be tested sometimes results in the cancer patient dying before a treatment can be determined.  Genetic testing of tumors for mutations is an alternative to this approach.  However the "avatar" approach has sometimes been more effective

Tuesday, September 25, 2012

Trending Health Habits

Bad Health Habits On the Rise  by Mark Fischetti.  Scientific American.  October 2012

Key Ideas/Summary.  A graphic presentation of trends in health behaviors including heavy drinking, binge drinking, tobacco use,  obesity, and exercise.  We learn for example that Georgia got significantly worse from 1995-2010 in obesity but also got significantly better in exercise.  Getting on the trend mill and rewarding yourself with a Diary Queen Blizzard.

Trends Impacting Physician Choice and Utilization

Finding the Best Doctor for You by Anna Wilde Mathews.  The Wall Street Journal.  September 24, 2012.

Key Ideas/Summary.  Things are changing at the doctor's office.

(1)  Primary-care physicians are increasingly aiming to be in the role of overseeing all aspects of a patients health.  With the assistance of nurses and physicians assistants, physicians are increasingly adopting the concept of "medical home" is growing.  The primary-care physician coordinates with specialists and ensures that patients get preventive tests.

(2)  Some primary-care physicians are a abandoning solo/small practices for employment by hospitals or medical groups.  Access to resources is a key reason

(3)  Some doctors are refusing to accept insurance requiring the patients to pay them directly.  Sometimes this payment is in the form of a monthly fee.  Others may charge up to $20,000 or more for services such as house calls, cellphone access, and other personalized services.

(4)  Workplace clinics are becoming increasingly common.

Mirrors As Medical Diagnostic Devices

Article:  Mirrors That Double as Computers  by Daisuke Wakabayashi.  The Wall Street Journal.  September 24, 2012.

Key Ideas/Summary.  Mirrors are merging with digital components to become health monitoring devices.  For example, a person's pulse rate can be monitored by the slight variations in brightness of the face as the heart pumps.  The commercialization of the medical mirror faces the cost obstacle.  Most individuals will probably resist a mirror that costs as much as a television.  Businesses therefore are the target of Panasonic Corp. new  digital mirror.  Rehabilitation centers also are being targeted by other produces of digital mirrors.

Monday, September 24, 2012

States React to Health Reform

Article:  Liking It or Not, States Prepare for Health Law by Abby Goodnough.  New York Times.  September 23, 2012.

Key Ideas:  States are required  to make a decision by November 16  to  either operate an insurance exchange required by President Obama's health care law or leave the creation of the exchange to the federal government.  These exchanges will provide online marketplaces for individuals and businesses to shop for private insurance which will be required.  The law requires that states have an exchange by January 2014.

Several states who have Republican governors who oppose the health care law are quietly making preparations to implement an exchange even as they hope that the law will be eliminated with the election of Mitt Romney.  13 states with Democratic or independent governors are committed to creating exchanges.   7 states (6 Republicans and 1 Democrat) have indicated that they will not create an exchange.  Nevada has already created an exchange.

There is expense involved in creating an exchange including web site, creating a call center, and outreach and information programs.  Conservative groups such as the Tea Party and Americans for Prosperity are engaged in efforts to block state administered exchanges.

Sunday, September 23, 2012

Constant Training Needed: The Medical Field Too

Article:  To Stay Relevant In a Career, Workers Train Nonstop by Shaila Dewan.  New York Times.  September 21, 2012.

Key Ideas.  The world of learning is changing.  "Car mechanics, librarians, doctors, Hollywood special effects designers--everyone whose job is touched by computing--are being forced to find new, more efficient ways to learn as retooling becomes increasingly important not just to change careers, but to stay competitive on their chosen path.

The article states that the number of doctors participating in continuing education has more than doubled over the last decade.  The vast majority of this increase has come from Internet-based activities.

Genetics Redefines Disease

Article:  Genetic Study Divides Breast Cancer Into 4 Distinct Types by Gina Kolata.  New York Times.  September 23, 2012.  

Breast cancer has now been shown to in fact be four genetically distinct types of cancer which have much in common with other types of cancer.  Drugs approved for cancers in other parts of the body may now be evaluated to treat breast cancers since the underlying genetic processes for the cancers are similar.  Additional drugs may now be developed to precisely target the underlying conditions giving rise to breast cancer.  Developing and evaluating these treatments may take years.  Even though there are 4 distinct types of cancer, individual tumors may have individual genetic changes  thus complicating the development of clinical tools.

However some immediate therapeutic implications are available.  For example certain drugs for ovarian cancer may now be tried to treat breast cancer.  These cancers are basal-like cancers for the basal layer of the skin.

Luminal A and Luminal B type breast cancers seem to be often so closely associate with specific genetic aberrations that some scientists think that they may be the actual cause of the cancer.

The analysis of the fourth type of cancer, HER2-enriched, shows that the current drug to may be effective for some tumors and not for others.  Extensive clinical trials will be required to determine the most effective treatment for specific HER2-enriched tumors

Cancer Centers Seeks to Build on Scientific Advances

Article:  Cancer Center Sets $3 Billion Program by Ron Wilslow.  Wall Street Journal September 21, 2012  

The M.D. Anderson Cancer Center in Houston TX is one of the world's leading cancer treatment and research centers, treating about 117,000 patients in 2011 and conducting some 1,000 clinical trials involving around 11,000 patients.  Its $3 billion program is aimed at reducing cancer deaths over the next decade

The Center sees great opportunities for advancements in cancer treatment due to the plummeting cost of gene sequencing enabling precise targeting of genetic aberrations with specific drugs to address those aberrations.  Also important will be vastly more powerful computers to analyze genomic data and enhanced ability to manipulate genes in laboratory experiments to understand the relationship of genes to tumors.

Surgeon Speaks on Medical Errors

Article:  How to Stop Hospitals From Killing Us  by Marty Makary.  The Wall Street Journal.  September 21, 2012.

Key Ideas:  Medical mistakes kill enough people each week to fill four jumbo jets.  As often as 40 times a week a surgeon operates on wrong body part.  20-30% of all medications, tests, and procedures are unnecessary.  So states the author, a surgeon at Johns Hopkins Hospital.

To confront this situation the he proposes five reforms  (1)  An informational dashboard including infections, readmission rates, and the volume of the type of surgery performed.  (2)  Anonymous surveys of doctors, nurses, and technicians at hospitals  (3)  Cameras to record procedures  (4)  Doctor's notes that are open to patients.  (5)  Elimination of the increasingly common requirement that patients agree to refrain from saying anything negative about the physician.

Least Educated Whites Suffer Lifespan Decline

Article:  Life Spans Shrink for Least-Educated Whites in the U.S.  New York Times  September 20, 2012.
Key Ideas:  Life expectancies for the least educated whites has fallen by four years between 1990 and 2008.  The fall of white women was 5 years during the same time period.  The dramatic fall rivals the catastrophic seven year decline among men after the fall of the Soviet Union.  

While reasons remain unclear, possible explanations include prescription drug overdoses, increased smoking among women. rising obesity, rising prevalence of risky behavior, and lack of health insurance.  Those without health insurance rose from 35% in 1993 to 43% in 2008.

Increased pressure on women from childbirth outside of marriage, single parenthood, , and the fact that women in this group tend to marry men with a similar profile thus concentrating the disadvantages. Also possibly important is the lack of flexibility in low paying jobs and fertility levels about those found in European countries.

Some experts state that the significance of these findings could be overstated because the group of individuals without a high school education has been declining.  However those who remain seem to be dying more quickly.

The study was headed by S. Jay Olshansky, a public health professor at the University of Illinois at Chicago.

Reporting Medical Mistakes: A New Pilot Project

Article:  New System for Patients to Report Medical Mistakes.  National  New York Times  Sunday September 23, 2012

Key Ideas:  The Obama Administration is considering a pilot project to facilitate reporting of medical mistakes and unsafe practices by doctors, hospitals, pharmacists and others who provide treatment.  Patients could have potentially useful information on drug mix-ups, surgery on the wrong body part, radiation overdoses and myriad other problems causing injuries, infections and tens of thousands of deaths each year.  The results of this proposed survey would be analyzed by the RAND Corporation and ECRI Institute.

Up to one-fourth of patients experience "adverse events" associated with their care.  Hospital organizations have indicated that they are receptive to the idea

Sports Injury and Team Psychology

Article:  When a Severe Injury Shakes a Team to Its Heart  Sports New York Times  Sunday September 23, 2012

Key Ideas:  When a sever injury happens to a sports team member, the entire team feels the impact.  The drive to press on, concern about the injured teammate, loss of focus, and worries of personal vulnerability and just some of the reactions.  The article includes a dramatic story of the psychological effects on a team member serving as a mold for a body cast for a injured and paralyzed teammate.  It was for that team member a "glimpse of a life he did not want to know."

Diet for Health, Not Weight

Article: Eating for Health, Not Weight by Dean Ornish Sunday Review New York Times September 24, 2012 Key Ideas: Being thin and being healthy are not the same thing. Loosing weight does not mean that you are eating correctly. Conversely being overweight is not necessarily linked with disease or premature death. Ornish has found numerous benefits to patients who ate mostly plant based meals (black bean vegetarian chili, whole wheat penne pasta, roasted vegetables etc) were able to achieve reversal of severe coronary artery disease and when combined with exercise and stress reduction, effected less inflammation. Beneficial genes were "turned on" and harmful genes were "turned off." Telomere length was increase, a factor thought to control how long we live. A healthy diet is low unhealthful carbs and low in fat as well as in red meat and processed foods. Fruits, vegetables, whole grains, legumes, soy products in natural, unrefined forms and some fish, like salmon. Ornish states about 75 percent of the 2.8 trillion in annual health care costs is the result of diseases that could be reversed with a healthy lifestyle.

Predicting a Pandemic

Article: Anticipating the Next Pandemic by David Quammen Sunday Review New York Times September 23, 2012   Key Ideas: The recent third death of visitors to Yosemite National Park from hantavirus pulmonary syndrome raises the question of how virologists, molecular geneticists, epidemiologists, and disease ecologists are attempting to spot the next big pandemic. There is broad consensus on what will cause the next event: (1) The source will likely be a virus, not a bacterium. Specifically it is likely to be an RNA virus as opposed to a DNA virus. (2) The virus will be zoonotic, spread from nonhuman animals to humans. While the virus that causes hantavirus pulmonary syndrome is common it is not easy to spread and therefore is not likely to evolve into a pandemic. The same is true of Ebola. However a variant of H1N2 flu bug could be an example of an influenza that is "protean and explosive." Among the personal precautions mentioned to avoid zoonotic infection is wearing a mask when you sweep out an old shed.

Rethinking Sleep

Article: Rethinking Sleep by David K Randall Sunday Review New York Times Sunday September 23, 2012 Key Ideas: Rigid and outdated ideas about sleep are creating needless anxiety. For example, the idea that sleep should occur in an eight-hour block is the source of anxiety for many. The historical record and current research are cited by Randall to support the notion of "first sleep" and "second sleep" as being the norm. So-called "split sleep" could provide a middle of the night opportunity for deep thinking, self-reflection or amorous activity and not be a source of "sleep anxiety." Naps during the day prime us for higher levels of mental functioning by helping the brain sort through information to keep or to toss or find connections between recent learning and long-term memory. Employers including Google, the military, and sports times are, as a result of sleep research, beginning to incorporate naps into work to improve creativity, productivity, and performance. Facts for Thought: (1) 41 Million people in the United States get six hours or fewer for sleep a night. (2) 42% of workers in the mining industry are sleep-deprived (3) 27% of financial or insurance industry workers are sleep-deprived

Introduction

This is Joey Freeman introducing you to my new blog. Here I will be summarizing articles of interest in the health and medical field. Of course, the coverage will not be complete, focusing instead on articles that happen to interest me and I feel are significant for the future. This blog may be of interest to anyone who is interested in health and medicine and wants to obtain a quick take of current thinking and events in the field. Presentation of articles here does not represent endorsement of the views presented. While I will on occasion present personal commentary the major emphasis here will be the objective summary of events and opinions of others. Hope you enjoy.