Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Press release] The future of fighting disease could be glycans (video) | EurekAlert! Science News

N-linked protein glycosylation (N-glycosylatio...

N-linked protein glycosylation (N-glycosylation of N-glycans) at Asn residues (Asn-x-Ser/Thr motifs) in glycoproteins. (Photo credit: Wikipedia)The future of fighting disease could be glycans (video)|EurekAlert! Science News.

 

From the 28 January 2015 press relase

WASHINGTON, Jan. 28, 2015 — Like the candy shell on an M&M ®, every cell on the planet has a carbohydrate coating that holds special information. But decoding these coatings has proven elusive. Now Laura Kiessling, Ph.D., and her team at University of Wisconsin-Madison are trying to unlock the mystery of these coatings, known as glycans. In the latest episode of Prized Science, Kiessling explains how glycans could hold the key to new antibiotics and other disease treatments. The video is available at http://youtu.be/D-9utC2fY0k.

Comparative overview of the major types of ver...

Comparative overview of the major types of vertebrate N-glycan subtypes and some representative C. elegans N-glycans. (Photo credit: Wikipedia)

January 30, 2015 Posted by | Medical and Health Research News | , , | Leave a comment

Schoolgirl comment points to antibiotics as new cancer treatments | EurekAlert! Science News

Schoolgirl comment points to antibiotics as new cancer treatments 

From the 28 January 2015 University of Manchester press release

A way to eradicate cancer stem cells, using the side-effects of commonly used antibiotics, has been discovered by a University of Manchester researcher following a conversation with his young daughter.

Professor Michael P. Lisanti
Professor Michael P. Lisanti

Professor Michael P. Lisanti, Director of the Breakthrough Breast Cancer Unit, led the research.  He was inspired to look at the effects of antibiotics on the mitochondria of cancer stem cells by a conversation with his daughter Camilla about his work at the University’s Institute of Cancer Sciences. Camilla is currently a student at the Moor Allerton Preparatory School.

His new paper, published in Oncotarget, opens up the possibility of a treatment for cancer, which is highly effective and repurposes drugs which have been safely used for decades.

Mitochondria are the ‘engine’ parts of the cells and are the source of energy for the stem cells as they mutate and divide to cause tumours. Cancer stem cells are strongly associated with the growth and recurrence of all cancers and are especially difficult to eradicate with normal treatment, which also leads to tumours developing resistance to other types of therapy.

Professor Lisanti said: “I was having a conversation with Camilla about how to cure cancer and she asked why don’t we just use antibiotics like we do for other illnesses.  I knew that antibiotics can affect mitochondria and I’ve been doing a lot of work recently on how important they are to the growth of tumours, but this conversation helped me to make a direct link.”

Professor Lisanti worked with colleagues from The Albert Einstein College of Medicine, New York and the Kimmel Cancer Centre, Philadelphia.  The team used five types of antibiotics – including one used to treat acne (doxycycline) – on cell lines of eight different types of tumour and found that four of them eradicated the cancer stem cells in every test. This included glioblastoma, the most aggressive of brain tumours, as well as lung, prostate, ovarian, breast, pancreatic and skin cancer.

Mitochondria are believed to be descended from bacteria which joined with cells early on in the evolution of life.  This is why some of the antibiotics which are used to destroy bacteria also affect mitochondria, though not to an extent which is dangerous to people. When they are present in stem cells, mitochondria provide energy for growth and, crucially, for division, and it is this process going wrong which leads to cancer.

In the lab, the antibiotics had no harmful effect on normal cells, and since they are already approved for use in humans, trials of new treatments should be simpler than with new drugs – saving time and money.

Professor Lisanti said: “This research makes a strong case for opening new trials in humans for using antibiotics to fight cancer.  Many of the drugs we used were extremely effective, there was little or no damage to normal cells and these antibiotics have been in use for decades and are already approved by the FDA for use in humans. However, of course, further studies are needed to validate their efficacy, especially in combination with more conventional therapies.”

Dr Matthew Lam, Senior Research Officer at Breakthrough Breast Cancer, said: “The conclusions that the researchers have drawn, whilst just hypotheses at this stage, are certainly interesting. Antibiotics are cheap and readily available and if in time the link between their use and the eradication of cancer stem cells can be proved, this work may be the first step towards a new avenue for cancer treatment.

“This is a perfect example of why it is so important to continue to invest in scientific research. Sometimes there are answers to some of the biggest questions right in front of us but without ongoing commitment to the search for these answers, we’d never find them.”

Importantly, previous clinical trials with antibiotics – intended to treat cancer-associated infections, but not cancer cells – have already shown positive therapeutic effects in cancer patients.  These trials were performed on advanced or treatment-resistant patients.

In the lung cancer patients, azithromycin, the antibiotic used, increased one-year patient survival from 45% to 75%. Even lymphoma patients who were ‘bacteria-free’ benefited from a three-week course of doxycycline therapy, and showed complete remission of the disease. These results suggest that the antibiotic’s therapeutic effects were actually infection-independent.

“As these drugs are considerably cheaper than current therapies, they can improve treatment in the developing world where the number of deaths from cancer is predicted to increase significantly over the next ten years,” said Dr Federica Sotgia, another leader of the study.

The research was published in the journal Oncotarget and part-funded by Breakthrough Breast Cancer.

The paper is available here.

January 30, 2015 Posted by | Uncategorized | , , , , , | Leave a comment

[Issue Brief] The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect – The Commonwealth Fund

The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect – The Commonwealth Fund.

From the January 2015 Issue Brief

Overview

New results from the Commonwealth Fund Biennial Health Insurance Survey, 2014, indicate that the Affordable Care Act’s subsidized insurance options and consumer protections reduced the number of uninsured working-age adults from an estimated 37 million people, or 20 percent of the population, in 2010 to 29 million, or 16 percent, by the second half of 2014. Conducted from July to December 2014, for the first time since it began in 2001, the survey finds declines in the number of people who report cost-related access problems and medical-related financial difficulties. The number of adults who did not get needed health care because of cost declined from 80 million people, or 43 percent, in 2012 to 66 million, or 36 percent, in 2014. The number of adults who reported problems paying their medical bills declined from an estimated 75 million people in 2012 to 64 million people in 2014. Read the brief.

View interactive
 

 

health insurance survey Publication Date:

January 15, 2015
Authors:
Sara R. CollinsPetra W. Rasmussen,Michelle M. DotySophie Beutel
Contact:
Sara R. Collins, Vice President, Health Care Coverage and Access, The Commonwealth Fund
E-mail: src@cmwf.org
Citation:
S. R. Collins, P. W. Rasmussen, M. M. Doty, and S. Beutel, The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect, The Commonwealth Fund, January 2015.

January 30, 2015 Posted by | Uncategorized | , , , , , | Leave a comment

[Reblog] New technology makes tissues, someday organs – Science360 News Service | National Science Foundation

New technology makes tissues, someday organs – Science360 News Service | National Science Foundation.

From the 28 January 2015 post

A new device for assembling large tissues from living components could someday be used to build replacement human organs the way electronics are assembled today: with precise picking and placing of parts.
[Go to the above link for the 1 minute, 23 second video]

Provided by Brown University
Runtime: 1:23

January 30, 2015 Posted by | Medical and Health Research News | , , , | Leave a comment

[Press release] Among gut microbes, strains, not just species, matter

From the 29 January 2015 University of Washington press release

First large-scale analysis completed of intra-species genetic variation in gut’s resident organisms

By Leila Gray  |  HSNewsBeat  |  Updated 9:00 AM, 01.29.2015

Posted in: Research

  • Gut microbiomes from different people can contain similar microbial species, but different strains, as this cartoon illustrates.Dana C, Thomas

A large community of microorganisms calls the human digestive tract home.  This dynamic conglomerate of microscopic life forms – the gut microbiome – is vital to how people metabolize various nutrients in their food, how their immune systems react to infection, and how they respond to various medications.  Moreover, imbalances in the microbiome are thought to play a significant role in many human diseases.

The collection of species occupying the gut is known to be quite personalized, and people may differ considerably in the set of species they harbor. Now new research suggests that the differences between people may go even deeper. In a paper published Jan. 29 in Cell, researchers at the University of Washington show that even when people share microbes in common, the exact strains each carries might be very different.

“Knowing more about these strain-level variations,” said Elhanan Borenstein, the senior author of this paper and an associate professor of genome sciences at the University of Washington, “is crucial for understanding the complex relationship between the composition of the community of microbes living in the human gut and its influence on health and disease.”

January 30, 2015 Posted by | Medical and Health Research News | , , , , , , , , , , | Leave a comment

[Reblog] Use of Social Media Across US Hospitals: Descriptive Analysis of Adoption and Utilization

English: Infographic on how Social Media are b...

English: Infographic on how Social Media are being used, and how everything is changed by them. (Photo credit: Wikipedia)

Use of Social Media Across US Hospitals: Descriptive Analysis of Adoption and Utilization,January 29, 2015

From the post at Full Text Reports
Source: Journal of Medical Internet Research

Background:
Use of social media has become widespread across the United States. Although businesses have invested in social media to engage consumers and promote products, less is known about the extent to which hospitals are using social media to interact with patients and promote health.

Objective:
The aim was to investigate the relationship between hospital social media extent of adoption and utilization relative to hospital characteristics.

Methods:
We conducted a cross-sectional review of hospital-related activity on 4 social media platforms: Facebook, Twitter, Yelp, and Foursquare. All US hospitals were included that reported complete data for the Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems survey and the American Hospital Association Annual Survey. We reviewed hospital social media webpages to determine the extent of adoption relative to hospital characteristics, including geographic region, urban designation, bed size, ownership type, and teaching status. Social media utilization was estimated from user activity specific to each social media platform, including number of Facebook likes, Twitter followers, Foursquare check-ins, and Yelp reviews.

Results:
Adoption of social media varied across hospitals with 94.41% (3351/3371) having a Facebook page and 50.82% (1713/3371) having a Twitter account. A majority of hospitals had a Yelp page (99.14%, 3342/3371) and almost all hospitals had check-ins on Foursquare (99.41%, 3351/3371). Large, urban, private nonprofit, and teaching hospitals were more likely to have higher utilization of these accounts.

Conclusions:
Although most hospitals adopted at least one social media platform, utilization of social media varied according to several hospital characteristics. This preliminary investigation of social media adoption and utilization among US hospitals provides the framework for future studies investigating the effect of social media on patient outcomes, including links between social media use and the quality of hospital care and services.

January 30, 2015 Posted by | health care | , , , , , | Leave a comment

[Reblog] Medical Necessity and Unnecessary Care

Medical Necessity and Unnecessary Care

From the 29 January 2015 post at The Health Care Blog

Paul KeckleyUnnecessary care that’s not evidence-based—usually associated with excess testing, surgical procedures or over-prescribing—accounts for up to 30% of what is spent in healthcare. In recent months, enforcement actions against physicians and hospitals have gained increased attention. But unnecessary care and over-utilization is not a new story or one that’s easy to understand.

Background

Medical necessity means something slightly different in every part of the healthcare industry. Varied definitions and interpretations are used by providers, physicians, courts, pharmacy benefits managers, government insurers, private insurers, and consumers. Perhaps the two most important are from the largest and most influential payer, Medicare, and the industry’s most important clinical authority, the American Medical Association (AMA).

 

The AMA defines medical necessity as: “Healthcare services or products that a prudent physician would provide to a patient for the purpose of preventing, diagnosing or treating an illness, injury, disease or its symptoms in a manner that is: (a) in accordance with generally accepted standards of medical practice; (b) clinically appropriate in terms of type, frequency, extent, site, and duration; and (c) not primarily for the economic benefit of the health plans and purchasers or for the convenience of the patient, treating physician, or other healthcare provider.” “Statement of the American Medical Association to the Institute of Medicine’s Committee on Determination of Essential Health Benefits,” American Medical Association, January 14, 2011

So based on these definitions, the application of “medical necessity” leaves lots of room for variation in how doctors and hospitals determine what’s done, and how payers (Medicare, Medicaid, employers, individuals) assess the appropriateness of their activities and costs. Therein is the conundrum about medical necessity and unnecessary care and the need for fresh thinking about the issue.

The basic facts:

Over-utilization and unnecessary care is prevalent and costly: Several reputable studies point to systemic over-utilization costing the U.S. system up to 30% more than what’s necessary (Exhibit A). The U.S. health system is the world’s most expensive, and health costs, per the Congressional Budget Office, will continue to increase at least 2-3% faster than the overall economy for the next decade. The costs associated with unnecessary care (a.k.a. medical necessity) are significant and growing. “The 2014 Long-Term Budget Outlook,” Congressional Budget Office, July 2014.

The government is cracking down on unnecessary care: Hospitals are increasingly being held accountable for the practice patterns of the physicians on their medical staff via the False Claims Act. Enforcement actions against both are on the rise and financial penalties harsh (see Exhibit B for recent cases).

Media attention is sparking public attention to unnecessary care: The Wall Street Journal calls its series, “Secrets of the System.” National broadcast and print news organizations have increased coverage of healthcare including its tendencies around medical necessity and unnecessary care. And social media is a hotbed for anecdotal assessments of “medical necessity”—some supported with objective data, most supported by personal experience, and a few judiciously studied and reported.

So if health costs are a looming problem in U.S. healthcare, and lack of consistency around the delivery of medically-necessary care is a systemic challenge that’s increasingly transparent, why isn’t more done? Most industry insiders offer these reasons:

The body of scientific evidence about what works best is expanding and changes fast. There are 20,000 medical journals. Keeping track of the latest innovations is almost impossible without using a clinical knowledge management software program that captures and filters relevant information useful to making patient diagnostic treatment decisions.
The strength of evidence about what works best and why is often weak. As more information about a patient’s signs, symptoms, risk factors and co-morbidities are factored into a treatment determination, the less likely it is that a clear “medical necessity” directive is found. Ironically, the more information (data) a clinician has about a specific patient, the less likely it is that a “medically necessary service” is dictated through a clinical algorithm or guideline.

Most consumers assume everything recommended is “medically necessary.” The majority of consumers assume that what their physician recommends is evidence-based, and few feel confident to challenge their view. Therefore, consumers want MORE not less in the majority of cases. And social media and media coverage is complicating matters as treatments-de jour become more widely known to consumers searching the latest and best treatments. The burden to stay abreast about traditional and nontraditional methods for diagnosing and treating is daunting, especially if reimbursements are cutting into time spent with patients.

Most providers necessarily err on the side of over-treatment. The majority of physicians and the institutions that credential them to practice tend to over-treat fearing liability exposure or the possibility of an inaccurate diagnosis. It’s precautionary and a business imperative (discounting it can be lucrative at the same time).

The health information technology tools that allow for real-time, accurate matching of a patient’s signs, symptoms, risk factors and co-morbidities to the latest and best evidence don’t exist or are too expensive. The integration of smart medical record systems shared by clinically-integrated networks and with their patients is still aspirational in most communities. These systems are expensive. Clinicians doubt that these systems will pay for themselves in improved efficiency (less paperwork), nor do they trust that payers will pay them more if they make the investment. And most consumers aren’t demanding them to make the investment. Instead, basic access, convenient locations and an assuring experience with doctor are of higher importance.

These views provide a defensible rationale as to why medical necessity and unnecessary care is a systemic challenge in our system, but in coming months, they may be seen more as lame excuses. The spotlight on unnecessary care and medical necessity is likely to shine brighter because:

Unnecessary care contributes significantly to the impressive profitability in many parts of the health system.


Unnecessary care can be harmful to consumers.
The data and sophisticated analytic tools upon which determinations of medical necessity and unnecessary care are increasingly available. Defaults that “my patients are different” and “we don’t have the data” will fall on deaf ears.

What does it mean?

Documentation is key. Accurate clinical documentation across sites and systems of care is table stakes.

Transparency about medical necessity and unnecessary care is assured. Data about the performance of every practitioner, hospital, and health system will be widely accessible. And the evidence supporting coverage and denial decisions by insurers, formulary design by Pharmacy Business Managers (PBMs) and benefits managers, and the justification for narrow networks will be equally available.

 

January 30, 2015 Posted by | health care | , , , , | Leave a comment

[Reblog] Your Immune System Is Made, Not Born

From the 29 January 2015 post at Scientific American

New research dispels the belief that the strength of the body’s defense system is genetically programmed
Cytomegalovirus

Cytomegalovirus infection.
Credit: Yale Rosen via Wikimedia Commons

Some people seem better than others at fighting the flu, and you might suspect they were born that way. A new study of twins, however, suggests otherwise.

In one of the most comprehensive analyses of immune function performed to date, researchers analyzed blood samples from 105 sets of healthy twins. They measured immune cell populations and their chemical messengers—204 parameters in all—before and after participants received a flu shot. Differences in three fourths of these parameters depended less on genetics than on environmental factors, such as diet and prior infections. Genetics had almost no effect on how well individuals responded to the flu vaccine, judged by antibodies produced against the injected material. And among identical twin siblings, who have the same genome, immune system features differed more strikingly within older twin pairs than in younger sets. The findings, published January 15 in Cell, argue that life habits and experiences shape our body’s defenses more than the DNA passed down from our parents.

Although prior twin studies had hinted that nonheritable factors contribute to some autoimmune disorders, such as multiple sclerosis, the recent analysis was one of the first to quantify genetic and environmental effects on the general immune system. “We were surprised by the degree of environmental influence on so many components,” says Mark Davis of Stanford University School of Medicine, senior author on the new study.

One finding was particularly striking. A single environmental factor—a past infection with common cytomegalovirus—affected 58 percent of the tested parameters. Whereas the results don’t show whether these changes produce an overall stronger or weaker immune response, they do indicate “cytomegalovirus has a really profound effect,” Davis says. The Epstein–Barr virus, another microbe that frequently infects people, had no such effect.

Read the entire article at http://www.scientificamerican.com/article/your-immune-system-is-made-not-born/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Science360NewsServiceComplete+%28Science360+News+Service%3A+Complete%29&utm_content=Netvibes

January 30, 2015 Posted by | Medical and Health Research News | , , , , | Leave a comment

[Reblog] Common Pesticide May Increase Risk of ADHD

Usually I don’t reblog posts with commercial advertising.  Please don’t associate me with any of the products! However, the post cited reputable resources.
On another note, I stopped using pesticides about five years ago.  Don’t get me started on RoundUp, even the least potent versions. Sure, I have more weeds. Corn gluten has eradicated the broadleaf grass. Other weeds I just pull out by hand.

map-ever-diagnosed-2011-550px

 

Percent of Youth 4-17 Ever Diagnosed with Attention-Deficit/Hyperactivity Disorder by State: National Survey of Children’s Health

 

From the undated post at Science Blog

 

A commonly used pesticide may alter the development of the brain’s dopamine system — responsible for emotional expression and cognitive function – and increase the risk of attention deficit hyperactivity disorder in children, according to a new Rutgers study.

The research published Wednesday in the Journal of the Federation of American Societies for Experimental Biology (FASEB), by Rutgers scientists and colleagues from Emory University, the University of Rochester Medical Center, and Wake Forest University discovered that mice exposed to the pyrethroid pesticide deltamethrin in utero and through lactation exhibited several features of ADHD, including dysfunctional dopamine signaling in the brain, hyperactivity, working memory, attention deficits and impulsive-like behavior.
Read more at http://scienceblog.com/76707/common-pesticide-may-increase-risk-adhd/#ZGUbPJch3TbkfGGH.99

 

 

January 30, 2015 Posted by | Medical and Health Research News | , , , , , | Leave a comment

   

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