Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Reblog] SurroundHealth – 2015 Top 10 Predictions in Public Health

SurroundHealth – 2015 Top 10 Predictions in Public Health.

Excerpt from the 6 January 2015 post

Ready or not, the Affordable Care Act (ACA) is once again heading to the Supreme Court. At stake is whether the law allows consumers purchasing insurance through the Federal portal to extend the same discounts that states provide. Eliminating the discount could gut the exchange’s value to federal consumers. In the meantime, it’s enrollment as usual for 2015. Share this this updated ACA enrollment guide from the IOM.

2. Defending Safety Net and Programs and Regulations

  • Medicare Private voucher program proposal. With a new GOP majority, I expect to revisit proposals to privatize Medicare. The American Public Health Association (APHA) is on record opposing such a policy move as undermining the foundation of Medicare’s guaranteed coverage. Brace yourselves for some ideological power-plays over health care access for seniors.
  • Access to Abortion Services. APHA supports Access to abortion and ensuring the availability of qualified practitioners. The access to safe and legal abortion services at the state level has narrowed rapidly across the majority of US states since 2013. Now, this sharply partisan issue is likely provoke both Congressional challenges and more states to seeking to restrict these services, especially for low-income women.
  • Environmental Protections. Expect attacks on environmental regulations and the Environmental Protection Agency (EPA). Republicans are candid that their goal is to end the EPA. Clean air standards and more may be threatened.

3. New Vaccines

  • Ebola Vaccine. Likely the most fast-tracked vaccine trials ever, I’m not the only one predicting that we’ll see an ebola vaccine in 2015. Together with infection control protocols established for the affected West African countries, this will hasten the end to what had seemed an intractable crisis—though we’re not likely to snuff out ebola completely within the year.
  • HPV Nonavalent Vaccine. Merck’s nine-valent HPV vaccine received FDA approval in 2014. It’s very likely that this will replace, or partially replace, their current quadrivalent (4-valent) version. The newer vaccine will increase the percentage of cancer-causing HPV types prevented from 70% to 90% and potentially prevent tens of thousands of cancers per year. It may only need 2 doses instead of the current 3. The Advisory Committee on Immunization Practices (ACIP) should make a recommendation in the first half of 2015 with rollout later in the year.

4. National Policy on Police Violence in Communities of Color

January 27, 2015 Posted by | Public Health | , , , , | Leave a comment

George W. Bush’s angioplasty: Did he receive the best care? (With Lively Discussion on Pros/Cons of Medical Screening)

 

Polygon Medical Animation - Angioplasty Procedure

Polygon Medical Animation – Angioplasty Procedure (Photo credit: Polygon Medical Animation)

 

 

 

 

 

 

 

From the 19 August 2013 Kevin MD article by 

…..

The press coverage of Bush’s angioplasty had frequent questions about the necessity of the angioplasty and the cost of such a procedure. That is precisely not the point, and gives the public the incorrect idea that angioplasties are expensive and beneficial luxuries. BMWs, after all, are unnecessary and expensive, but very nice. And if a VIP gets something unnecessary and expensive, shouldn’t I want one too? The point of the evidence about angioplasties is that in most patients they have no benefit. Focusing on “necessity” misses that point.

It is entirely possible that Bush’s care was flawless. One possibility was that his stress test was extremely abnormal. Such very abnormal tests were excluded from the COURAGE trial, and we have no definitive evidence whether medications or stenting is best in those cases.

The important thing for the public to understand is that VIPs sometimes get terrible care. I’ve personally seen that myself. Physicians often over-test and over-treat celebrities, wrongly thinking that this will protect them from blame for any adverse outcome later. It’s much easier to tell a prominent patient that we will fix your problem with a high-tech and very expensive solution, rather than taking the time to educate the patient that we should start a few very old and very inexpensive medicines which have been proven to save lives. Paradoxically, we’re frequently much more comfortable doing the right thing for patients who will not draw public attention.

……

Read the entire article here

The comments section was very interesting and lively.
Pap testing was one topic.  An excerpt

For those women interested, in my opinion, the best screening program in the world for cervical cancer is the new Dutch program. They’ll scrap their 7 pap test program, 5 yearly from 30 to 60, and offer instead 5 hrHPV primary tests at ages 30,35,40,50 and 60 and ONLY the roughly 5% of women who are HPV+ and at risk will be offered a 5 yearly pap test. (until they clear the virus) This will save more lives and take most women out of pap testing and harms way. (damage to the cervix can mean miscarriages, premature babies, c-sections etc.)

Those HPV- and no longer sexually active or confidently monogamous might choose to stop all further testing. Dutch women are already using a HPV self-test option/device, the Delphi Screener. (also, available in Singapore and elsewhere)
I’ve also, declined breast screening even though that cancer is far more common. Weighing up the risks and actual benefits, it doesn’t get over the line for me. (The Nordic Cochrane Institute brochure on breast screening and Professor Michael Baum’s informative articles and lecture helped me make an informed decision to decline testing)

Speaking generally:

We need to stop telling women what to do and start respecting informed consent. Give women real information on risk and ACTUAL benefit, respect them as competent adults/individuals and offer evidence-based testing that focuses on what’s best for them AND, leave the final decision to women, to accept or decline screening as they see fit.

Related Resources (just a few from many!)

systematic reviews of primary research in human health care and health policy, and are internationally recognised as the highest standard in evidence-based health care. They investigate the effects of interventions for prevention, treatment and rehabilitation. They also assess the accuracy of a diagnostic test for a given condition in a specific patient group and setting. They are published online in The Cochrane Library.

Example of a free summary
Screening for breast cancer with mammography (2013) –[scroll down for link to abstract]

August 26, 2013 Posted by | health care | , , , , , | Leave a comment

HPV vaccine myths put health, lives at risk, say health leaders: Airing the facts

HPV vaccine myths put health, lives at risk, say health leaders: Airing the facts.

Excerpts from this blog item from the American Public Health Association

HPV vaccine myths put health, lives at risk, say health leaders: Airing the facts

Vaccination rates for human papillomavirus are lagging for teens, and a complicated web of confusion and misinformation may be to blame, according to public health leaders.

Several strains of HPV can cause cervical cancer, and two vaccines, Gardasil and Cervarix, have been shown conclusively to defend against those strains. The Food and Drug Administration recommended in 2006 that girls receive the vaccine before they become sexually active so that they are protected at the outset. In 2009, FDA approved the use of the vaccine for boys as well.

According to the Centers for Disease Control and Prevention, about 6 million people in the U.S. become infected with HPV each year and each year about 12,000 women are diagnosed with cervical cancer, leading to about 4,000 deaths.

Studies have shown the vaccine to be overwhelmingly safe, CDC said. As of June 2011, about 35 million doses of Gardasil had been distributed in the United States. CDC’s adverse event tracking mechanisms reported about 18,000 adverse events, 92 percent of which were nonserious events, such as fainting, swelling at the injection site and headache. Sixty-eight deaths were reported, but there is “no unusual pattern or clustering to the deaths that would suggest that they were caused by the vaccine, and some reports indicated a cause of death unrelated to vaccination,” CDC said.

And yet, fed perhaps by misinformation or squeamishness about the idea of their children becoming sexually active, some parents are opting not to vaccinate, and the vaccination rates are lagging, according to CDC.

Figure

Lauren Fant receives an HPV vaccination from nurse Stephanie Pearson at a doctor’s office in Marietta, Ga., in 2007.

Photo by John Amis, courtesy AP Images

November 20, 2011 Posted by | Consumer Health, Health Education (General Public) | , , , , , | 1 Comment

   

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