Story first appeared on Med Page Today -
Failure rates for hip implants were 29% higher for women than men in a large U.S. registry study after controlling for a variety of factors including device type, researchers said.
With a total of 35,140 patients undergoing primary total hip arthroplasty followed for a median of 3 years, the crude all-cause rate of failure (defined as subsequent revision surgery) was 2.3% for women (95% CI 2.1% to 2.5%) compared with 1.9% for men (95% CI 1.6% to 2.1%), according to Maria C.S. Inacio, MS, of the Southern California Permanente Research Group in San Diego, and colleagues.
After adjustments for age, body mass index, diabetes status, degree of pre-surgical symptom severity, implant fixation method, device category, and femoral head size, the authors calculated a hazard ratio (HR) for revision of 1.29 for women versus men (95% CI 1.11 to 1.51), they reported online in JAMA Internal Medicine.
The risk appeared most prominent for aseptic revision (HR 1.32, 95% CI 1.10 to 1.58) compared with septic failure (HR 1.17, 95% CI 0.81 to 1.68), the researchers found.
Larger femoral head sizes appeared especially problematic for women. For head sizes of 36mm or more, the adjusted HR for failure in women versus men was 1.49 (95% CI 1.14 to 1.95), whereas differences in revision rates for smaller head sizes were not significant after adjustment.
Much of the increased risk for women also seemed concentrated in metal-on-metal implants, with a doubling in risk for women versus men (adjusted HR 1.97, 95% CI 1.29 to 3.00).
But that was primarily because of reduced risk of failure with metal-on-metal devices in men (adjusted HR 0.68 versus highly cross-linked polyethylene, 95% CI 0.45 to 1.02), whereas in women, the adjusted failure rates for metal-on-metal versus cross-linked polyethylene were similar, adjusted HR 1.07, 95% CI 0.72 to 1.60).
Clinical Implications?
In an accompanying commentary, Diana Zuckerman, PhD, of the National Research Center for Women and Families in Washington, D.C., suggested that the study's clinical implications were relatively trivial.
She noted that most patients considering hip replacement are already suffering pain and limited mobility and have few other options.
"Knowing that their chances of success are lower than men's is not helpful to women who are unable to perform many activities of daily living," Zuckerman argued.
Instead, she said, what is needed is "long-term comparative effectiveness research based on large sample sizes, indicating which total hip arthroplasty devices are less likely to fail in women and in men, with subgroup analyses based on age and other key patient traits, as well as key surgeon and hospital factors."
But Glenn Don Wera, MD, of UH Case Medical Center in Cleveland, told MedPage Today that the study provided valuable insights into the reasons for higher failure rates in women.
He noted that the higher rate of revision in women was already known from Medicare data. In the current study, however, "they were able to control for a number of clinical factors, including the kind of prosthesis the patient had, the experience level of the surgeon, and the different institutions and the different prostheses they were using."
That the increased risk in women was still evident despite adjusting for those factors indicates that something else, such as women's generally smaller stature, is responsible, Wera suggested.
Revision Rate: Beyond Infection
Data for the current study came from the Kaiser Permanente system's registry of total joint replacements from 2001 to 2010. Procedures were performed at 46 hospitals in California, Hawaii, Oregon, Washington, and Colorado by 319 different surgeons.
The registry is the largest of its type in the U.S., the authors said and includes data on surgeons' and hospitals' arthroplasty procedure volumes; the patients and the implants they received (cemented, uncemented, or hybrid); and implant bearing surface, such as metal on metal, metal or ceramic on highly cross-linked polyethylene, or ceramic on ceramic. The researchers put the DePuy metal-on-metal hip resurfacing monoblock device into its own category.
Only patients undergoing unilateral procedures were included in the analysis.
About 58% of the 35,140 procedures were performed in women (mean age 65.7 versus 63.8 for men). Just over 60% of both sexes had scores of 1 or 2 on the American Society of Anesthesiologists index, with nearly all of the remainder having scores of 3 or more.
The age difference between men and women was statistically significant. In addition, women in the cohort tended to be slightly more likely to be white or Asian and to have osteoarthritis, rheumatoid arthritis, or dysplasia. They were less likely to be diabetic or obese and to have osteonecrosis or post-traumatic arthritis.
Not surprisingly, women were much less likely to have implant femoral head sizes of 36mm or more (32.8% versus 55.4% for men, P<0 .001="" 9.6="" about="" as="" bearings="" br="" ceramic="" cross-linked="" female="" for="" had="" highly="" many="" men="" metal-on-metal="" metal="" more="" on="" or="" patients="" polyethylene="" popular="" twice="" versus="" were="" whereas="" women="">
The DePuy resurfacing implant was used in 1.3% of women versus 2.6% of men (P<0 .001="" br="">
Preferences for fixation types also differed between men and women, with hybrid methods more common in the women and cementless fixation more common in men.
Mean surgeon and hospital volumes did not differ between sexes.
The authors noted that with no significant increase in risk of septic failure for women, their results mean that "factors other than infection" are responsible for the higher overall revision rate.
Limitations to the analysis include its observational design, the relatively short follow-up period, lack of data on some potential confounding factors, and the use of revision surgery as the definition of implant failure. Also, the researchers used relatively broad categories of implant type, conceding that design variations within these categories could have influenced the results.
The study was funded by the FDA.
Study authors and Zuckerman declared no relationships with commercial entities. Several study authors were Kaiser Permanente employees.
19 February 2013
Nurse Sues Hospital for Supporting Discrimination
Story first appeared on Detroit Free Press -
An African-American nurse who is suing a Flint hospital because she said it agreed to a man's request that no African-American nurses care for his newborn recalled Monday that she was stunned by her employer's actions.
"I didn't even know how to react," said Tonya Battle, 49, a veteran of the neonatal intensive care unit and a nearly 25-year employee of the Hurley Medical Center.
Battle's lawsuit states a note was posted on the assignment clipboard reading "No African American nurse to take care of baby," according to the eight-page complaint against the medical center.
Hurley, which according to its website was founded in 1908 and is a 443-bed teaching hospital, released a brief statement Monday, saying that it "does not comment on past or current litigation."
Battle said she was working as a registered nurse in Hurley's neonatal intensive care unit Oct. 31, when a man walked into the NICU, where Battle was at an infant's bedside. He reached toward the child, according to the lawsuit filed in Genesee County Circuit Court last month.
"I introduced myself to him. 'Hi, I'm Tonya and I'm taking care of your baby. Can I see your (identification) band?' " Battle said, referring to the hospital-issued identification used to identify infants' parents. "And he said in return, 'And I need to see your supervisor.' "
Perplexed by his curtness, she asked for the charge nurse, who spoke separately to the man.
When the charge nurse returned, she told Battle that the father didn't want African Americans to care for his child. Further, the charge nurse told Battle that he had rolled up his sleeve to expose what appeared to be a swastika.
"I felt like I froze," Battle said. "I just was really dumbfounded. I couldn't believe that's why he was so angry (and) that's why he was requesting my charge nurse. I think my mouth hit the floor. It was really disbelief."
The charge nurse passed the request to her supervisor, and Battle was reassigned, according to the complaint.
Even after hospital officials removed the sign that had been placed for a short time on the assignment chart, Battle and other black nurses were not assigned to care for the baby for about a month "because of their race," according the lawsuit. Battle is seeking punitive damages for emotional stress, mental anguish, humiliation and damage to her reputation.
Battle said colleagues have told her they were surprised at the hospital's stand and they have been supportive. But she said she felt the issue was important enough to pursue the matter legally because she expected Hurley to have turned down such a request.
"What flashed in my mind is, 'What's next? A note on the water fountain that says 'No blacks? Or a note on the bathroom that says 'No blacks'?" she said.
Larry Dubin, a law professor at University of Detroit Mercy's School of Law, called the hospital's actions, if true, "morally repugnant."
"The patient's father has the right to select the hospital to treat the child. The father does not have the right to exercise control over the hospital in discrimination of its employees," he said.
The case "puts into tension two different facets of the law," said Lance Gable, an associate professor specializing in health law at the Wayne State University Law School.
Patients choose their doctors, he said. Some women prefer to see female gynecologists, for example.
"But there are also laws prohibiting discrimination," he added, citing the 1964 Civil Rights Act, among others.
"The bottom line is that the law is not clear about this, although I suspect the nurse will have a pretty strong case," Gable said.
One in 3 doctors in a 2007 survey said they felt patients believed they got better care if they matched their doctor's race. Patients' requests were more likely to be honored if the request came from someone who was female, non-white or Muslim, according to a report on the survey written in part by a University of Michigan researcher.
But just how often hospitals receive requests based on race is unclear.
Vickie Winn, spokeswoman for Children's Hospital of Michigan, said the hospital may try to accommodate a patient's request for providers with a certain religion or gender, but a request for a doctor based on race is different, she said.
"It has come up in the past, but generally speaking, we don't accommodate that. ... We have a very diverse population, and we just don't feed into those kinds of beliefs," Winn said.
Beaumont Health System, likewise, does not accommodate requests based on race, said spokesman Bob Ortlieb.
Julie Gafkay, an employment discrimination and civil rights lawyer in Frankenmuth who is representing Battle, said medical personnel might receive such requests from time to time, but employers must guard against racial discrimination.
"I don't doubt that people have made requests like this in the past. You're not going to control the prejudices and biases of people. That's not my client's issue. The problem she has ... is that her employer of 25 years granted" the request.
She added: "We made a decision in this country that, that kind of discrimination is wrong."
An African-American nurse who is suing a Flint hospital because she said it agreed to a man's request that no African-American nurses care for his newborn recalled Monday that she was stunned by her employer's actions.
"I didn't even know how to react," said Tonya Battle, 49, a veteran of the neonatal intensive care unit and a nearly 25-year employee of the Hurley Medical Center.
Battle's lawsuit states a note was posted on the assignment clipboard reading "No African American nurse to take care of baby," according to the eight-page complaint against the medical center.
Hurley, which according to its website was founded in 1908 and is a 443-bed teaching hospital, released a brief statement Monday, saying that it "does not comment on past or current litigation."
Battle said she was working as a registered nurse in Hurley's neonatal intensive care unit Oct. 31, when a man walked into the NICU, where Battle was at an infant's bedside. He reached toward the child, according to the lawsuit filed in Genesee County Circuit Court last month.
"I introduced myself to him. 'Hi, I'm Tonya and I'm taking care of your baby. Can I see your (identification) band?' " Battle said, referring to the hospital-issued identification used to identify infants' parents. "And he said in return, 'And I need to see your supervisor.' "
Perplexed by his curtness, she asked for the charge nurse, who spoke separately to the man.
When the charge nurse returned, she told Battle that the father didn't want African Americans to care for his child. Further, the charge nurse told Battle that he had rolled up his sleeve to expose what appeared to be a swastika.
"I felt like I froze," Battle said. "I just was really dumbfounded. I couldn't believe that's why he was so angry (and) that's why he was requesting my charge nurse. I think my mouth hit the floor. It was really disbelief."
The charge nurse passed the request to her supervisor, and Battle was reassigned, according to the complaint.
Even after hospital officials removed the sign that had been placed for a short time on the assignment chart, Battle and other black nurses were not assigned to care for the baby for about a month "because of their race," according the lawsuit. Battle is seeking punitive damages for emotional stress, mental anguish, humiliation and damage to her reputation.
Battle said colleagues have told her they were surprised at the hospital's stand and they have been supportive. But she said she felt the issue was important enough to pursue the matter legally because she expected Hurley to have turned down such a request.
"What flashed in my mind is, 'What's next? A note on the water fountain that says 'No blacks? Or a note on the bathroom that says 'No blacks'?" she said.
Larry Dubin, a law professor at University of Detroit Mercy's School of Law, called the hospital's actions, if true, "morally repugnant."
"The patient's father has the right to select the hospital to treat the child. The father does not have the right to exercise control over the hospital in discrimination of its employees," he said.
The case "puts into tension two different facets of the law," said Lance Gable, an associate professor specializing in health law at the Wayne State University Law School.
Patients choose their doctors, he said. Some women prefer to see female gynecologists, for example.
"But there are also laws prohibiting discrimination," he added, citing the 1964 Civil Rights Act, among others.
"The bottom line is that the law is not clear about this, although I suspect the nurse will have a pretty strong case," Gable said.
One in 3 doctors in a 2007 survey said they felt patients believed they got better care if they matched their doctor's race. Patients' requests were more likely to be honored if the request came from someone who was female, non-white or Muslim, according to a report on the survey written in part by a University of Michigan researcher.
But just how often hospitals receive requests based on race is unclear.
Vickie Winn, spokeswoman for Children's Hospital of Michigan, said the hospital may try to accommodate a patient's request for providers with a certain religion or gender, but a request for a doctor based on race is different, she said.
"It has come up in the past, but generally speaking, we don't accommodate that. ... We have a very diverse population, and we just don't feed into those kinds of beliefs," Winn said.
Beaumont Health System, likewise, does not accommodate requests based on race, said spokesman Bob Ortlieb.
Julie Gafkay, an employment discrimination and civil rights lawyer in Frankenmuth who is representing Battle, said medical personnel might receive such requests from time to time, but employers must guard against racial discrimination.
"I don't doubt that people have made requests like this in the past. You're not going to control the prejudices and biases of people. That's not my client's issue. The problem she has ... is that her employer of 25 years granted" the request.
She added: "We made a decision in this country that, that kind of discrimination is wrong."
18 February 2013
Alcohol Raises Risk of Cancer
Story first appeared on SFGate -
Even moderate alcohol use may substantially raise the risk of dying from cancer, according to a study released Thursday offering the first comprehensive update of alcohol-related cancer deaths in decades.
"People don't talk about the issue of alcohol and cancer risk," said Dr. David Nelson, director of the Cancer Prevention Fellowship Program at the National Cancer Institute and lead author of the study.
"Alcohol has been known to be related to causing cancer for a long period of time. We talk about cancer prevention, screenings and tests. This is one of those things that seems to be missing in plain sight."
Alcohol use accounts for about 3.5 percent of all U.S. cancer deaths annually, according to the study. The majority of deaths seemed to occur among people who consumed more than three alcoholic drinks a day, but those who consumed 1.5 beverages daily may account for up to a third of those deaths, the researchers found.
In 2009, 18,000 to 21,000 people in the United States died of alcohol-related cancers, from cancer of the liver to breast cancer and other types, the researchers said. That's more than the number of people in the United States who die every year of melanoma (9,000 in 2009) or ovarian cancer (14,000 in 2009).
Reasons Unclear
How alcohol contributes to cancer is not fully understood, the study notes. Previous research has shown alcohol appears to work in different ways to increase cancer risk, such as affecting estrogen levels in women and acting as a solvent to help tobacco chemicals get into the digestive tract.
The study, published in the American Journal of Public Health, is the first major analysis of alcohol-attributable cancer deaths in more than 30 years. Researchers said the lack of recent research on the subject may contribute to a lack of public awareness of cancer risks.
"People are well aware of other risks, like the impact of tobacco on cancer, and are not as aware alcohol plays quite a bit of a role," said Thomas Greenfield, one of the study's authors and scientific director of Public Health Institute's Alcohol Research Group in Emeryville.
Researchers examined seven types of cancers known to be linked to alcohol use: cancers of the mouth and pharynx, larynx, esophagus, liver, colon, rectum and female breast. To link the cancer to alcohol use, they relied on surveys of more than 220,000 adults, 2009 U.S. mortality data, and sales data on alcohol consumption.
Breast cancer accounted for the most common alcohol-related cancer deaths among women, with alcohol contributing to 15 percent of all breast cancer deaths. Among men, cancers of the mouth, pharynx, larynx and esophagus accounted for the most alcohol-linked cancer deaths.
The study drew some criticism. Dr. Curtis Ellison, professor of medicine and public health at Boston University School of Medicine, said the study failed to take into account several important factors, such as the pattern of drinking rather than just the amount of alcohol consumed. He said consuming small, consistent amounts of alcohol is much healthier than occasional binge drinking.
Individualized Advice
"They're mixing alcohol abuse, which leads to all of these cancers as they've clearly shown, with the casual drinker, where the risk is very small," said Ellison, also co-director of the International Scientific Forum on Alcohol Research.
Dr. Arthur Klatsky, adjunct investigator at the Kaiser Permanente Northern California Division of Research, said many studies have shown moderate drinkers in older age groups may be healthier than those who abstain. Klatsky has long researched the effects of alcohol on health but declined to comment directly on the study because he had not yet read it.
"Advice needs to be individualized," Klatsky said. "The advice one would give to 60-year-old man who has no problem with alcohol but is at high risk of heart disease due to family history is quite different than the advice we give to a 25-year-old woman whose mother died of breast cancer."
The study's authors acknowledged alcohol can have health benefits but said alcohol causes 10 times as many deaths as it prevents. There's no known safe level of drinking, they said.
"The safest level for cancer prevention is that people don't expose themselves to any potential risk," said Nelson of the National Cancer Institute. "The bottom line means for people who choose to drink, their cancer risk will be lower if they drink lower amounts."
Alcohol Use Tied To Deaths
A study released Thursday by the American Journal of Public Health found:
Even moderate alcohol use may substantially raise the risk of dying from cancer, according to a study released Thursday offering the first comprehensive update of alcohol-related cancer deaths in decades.
"People don't talk about the issue of alcohol and cancer risk," said Dr. David Nelson, director of the Cancer Prevention Fellowship Program at the National Cancer Institute and lead author of the study.
"Alcohol has been known to be related to causing cancer for a long period of time. We talk about cancer prevention, screenings and tests. This is one of those things that seems to be missing in plain sight."
Alcohol use accounts for about 3.5 percent of all U.S. cancer deaths annually, according to the study. The majority of deaths seemed to occur among people who consumed more than three alcoholic drinks a day, but those who consumed 1.5 beverages daily may account for up to a third of those deaths, the researchers found.
In 2009, 18,000 to 21,000 people in the United States died of alcohol-related cancers, from cancer of the liver to breast cancer and other types, the researchers said. That's more than the number of people in the United States who die every year of melanoma (9,000 in 2009) or ovarian cancer (14,000 in 2009).
Reasons Unclear
How alcohol contributes to cancer is not fully understood, the study notes. Previous research has shown alcohol appears to work in different ways to increase cancer risk, such as affecting estrogen levels in women and acting as a solvent to help tobacco chemicals get into the digestive tract.
The study, published in the American Journal of Public Health, is the first major analysis of alcohol-attributable cancer deaths in more than 30 years. Researchers said the lack of recent research on the subject may contribute to a lack of public awareness of cancer risks.
"People are well aware of other risks, like the impact of tobacco on cancer, and are not as aware alcohol plays quite a bit of a role," said Thomas Greenfield, one of the study's authors and scientific director of Public Health Institute's Alcohol Research Group in Emeryville.
Researchers examined seven types of cancers known to be linked to alcohol use: cancers of the mouth and pharynx, larynx, esophagus, liver, colon, rectum and female breast. To link the cancer to alcohol use, they relied on surveys of more than 220,000 adults, 2009 U.S. mortality data, and sales data on alcohol consumption.
Breast cancer accounted for the most common alcohol-related cancer deaths among women, with alcohol contributing to 15 percent of all breast cancer deaths. Among men, cancers of the mouth, pharynx, larynx and esophagus accounted for the most alcohol-linked cancer deaths.
The study drew some criticism. Dr. Curtis Ellison, professor of medicine and public health at Boston University School of Medicine, said the study failed to take into account several important factors, such as the pattern of drinking rather than just the amount of alcohol consumed. He said consuming small, consistent amounts of alcohol is much healthier than occasional binge drinking.
Individualized Advice
"They're mixing alcohol abuse, which leads to all of these cancers as they've clearly shown, with the casual drinker, where the risk is very small," said Ellison, also co-director of the International Scientific Forum on Alcohol Research.
Dr. Arthur Klatsky, adjunct investigator at the Kaiser Permanente Northern California Division of Research, said many studies have shown moderate drinkers in older age groups may be healthier than those who abstain. Klatsky has long researched the effects of alcohol on health but declined to comment directly on the study because he had not yet read it.
"Advice needs to be individualized," Klatsky said. "The advice one would give to 60-year-old man who has no problem with alcohol but is at high risk of heart disease due to family history is quite different than the advice we give to a 25-year-old woman whose mother died of breast cancer."
The study's authors acknowledged alcohol can have health benefits but said alcohol causes 10 times as many deaths as it prevents. There's no known safe level of drinking, they said.
"The safest level for cancer prevention is that people don't expose themselves to any potential risk," said Nelson of the National Cancer Institute. "The bottom line means for people who choose to drink, their cancer risk will be lower if they drink lower amounts."
Alcohol Use Tied To Deaths
A study released Thursday by the American Journal of Public Health found:
- Total deaths: Alcohol use accounts for 3.5 percent of all U.S. cancer deaths, or between 18,000 and 21,000 deaths a year.
- Lost years: About 18 years of potential life are lost per cancer death. That means a person who died at age 60 from alcohol-related cancer would have otherwise probably lived to 78.
- Number of drinks: The majority of alcohol-related cancer deaths occurred among those who drank more than three alcoholic beverages a day, but about 30 percent occurred in those who drank less than 1.5 drinks a day.
Lung Transplant Program beginning at Spectrum
Story first appeared on WoodTV10 Grand Rapids -
Hospital did first West Michigan heart transplant
Spectrum Health announced today that it has hired Reda Girgis, MD, to serve as medical director for its lung transplant program.
Girgis comes from the Johns Hopkins School of Medicine and started last week as a member of the Spectrum Health Medical Group.
Girgis will head a multidisciplinary team that will evaluate recipients for lung transplantation, and provide preoperative and follow-up care.
The hiring comes as Spectrum Health begins to establish its lung transplant program.
Currently there are only two hospitals in Michigan that conduct lung transplants.
Both Henry Ford Hospital and the University of Michigan Medical Center are on the east side of the state.
Spectrum will be the first hospital in West Michigan to join as a lung transplant center.
"We are fortunate to have a physician of Dr. Girgis' ability and stature to head our latest transplant endeavor," said Matthew Van Vranken, executive vice president, Spectrum Health Delivery System. "He will build another critical service we can provide to the people of West Michigan. His arrival is an important step as we build a regional transplantation program."
According to the U.S. Department of Health and Human Services there are currently more than 1,600 people waiting for lung transplants, 80 here in Michigan.
One of Girgis' primary tasks this summer will be completing applications for both a lung and combined heart-lung transplant program to the United Network for Organ Sharing (UNOS), a private, non-profit organization that manages the U.S. organ transplant system. Once the programs receive UNOS approval, Spectrum Health can begin listing patients for these transplants.
Girgis grew up in Grand Blanc, Michigan, and earned his medical degree at the University of Cairo in his native Egypt.
Girgis completed both his internal medicine residency and pulmonary and critical care fellowship at Henry Ford Hospital in Detroit.
In addition, he obtained advanced fellowship training in heart-lung and lung transplantation at Stanford University Medical Center in California.
He is board certified in internal medicine, pulmonary medicine and critical care medicine.
"I am extremely excited to return to my home state and help build a new lung transplant program for the residents of Western Michigan and beyond," said Girgis. "Spectrum Health is a state-of-the-art health care institution with all the necessary elements for a successful program."
Girgis has been at Johns Hopkins since 2000, where he served as associate medical director of lung transplantation and co-director of the pulmonary hypertension program.
Back in 2010 Spectrum Health preformed the first heart transplant in West Michigan.
Hospital did first West Michigan heart transplant
Spectrum Health announced today that it has hired Reda Girgis, MD, to serve as medical director for its lung transplant program.
Girgis comes from the Johns Hopkins School of Medicine and started last week as a member of the Spectrum Health Medical Group.
Girgis will head a multidisciplinary team that will evaluate recipients for lung transplantation, and provide preoperative and follow-up care.
The hiring comes as Spectrum Health begins to establish its lung transplant program.
Currently there are only two hospitals in Michigan that conduct lung transplants.
Both Henry Ford Hospital and the University of Michigan Medical Center are on the east side of the state.
Spectrum will be the first hospital in West Michigan to join as a lung transplant center.
"We are fortunate to have a physician of Dr. Girgis' ability and stature to head our latest transplant endeavor," said Matthew Van Vranken, executive vice president, Spectrum Health Delivery System. "He will build another critical service we can provide to the people of West Michigan. His arrival is an important step as we build a regional transplantation program."
According to the U.S. Department of Health and Human Services there are currently more than 1,600 people waiting for lung transplants, 80 here in Michigan.
One of Girgis' primary tasks this summer will be completing applications for both a lung and combined heart-lung transplant program to the United Network for Organ Sharing (UNOS), a private, non-profit organization that manages the U.S. organ transplant system. Once the programs receive UNOS approval, Spectrum Health can begin listing patients for these transplants.
Girgis grew up in Grand Blanc, Michigan, and earned his medical degree at the University of Cairo in his native Egypt.
Girgis completed both his internal medicine residency and pulmonary and critical care fellowship at Henry Ford Hospital in Detroit.
In addition, he obtained advanced fellowship training in heart-lung and lung transplantation at Stanford University Medical Center in California.
He is board certified in internal medicine, pulmonary medicine and critical care medicine.
"I am extremely excited to return to my home state and help build a new lung transplant program for the residents of Western Michigan and beyond," said Girgis. "Spectrum Health is a state-of-the-art health care institution with all the necessary elements for a successful program."
Girgis has been at Johns Hopkins since 2000, where he served as associate medical director of lung transplantation and co-director of the pulmonary hypertension program.
Back in 2010 Spectrum Health preformed the first heart transplant in West Michigan.
14 February 2013
Lady Gaga Needs Surgery, Cancels Remaining Tour Dates
Story first appeared on USA Today -
Mother Monster tore the muscle that helps hold the hip joint, forcing her to cancel shows.
Get well soon, Mother Monster!
Tests revealed Wednesday that Lady Gaga tore her labrum -- a layer of muscle that helps hold the hip joint in place -- requiring her to undergo surgery and cancel the rest of her tour dates.
Little Monsters who had tickets for the 21 dates remaining in the Born This Way Ball tour will get a refund beginning Thursday.
Earlier, when the tour was merely postponed, Gaga revealed her injury to fans via a tweet.
"I've been hiding a show injury and chronic pain for sometime now, over the past month it has worsened," Gaga shared Tuesday afternoon. "I've been praying it would heal."
The injury is a synovitis, a severe inflammation of joints, she said, adding, "I hid it from my staff, I didn't want to disappoint my amazing fans. However after last night's performance I could not walk and still can't."
She went on to say, "To the fans in Chicago Detroit & Hamilton I hope you can forgive me, as it is nearly impossible for me to forgive myself. I'm devastated & sad."
Mother Monster tore the muscle that helps hold the hip joint, forcing her to cancel shows.
Get well soon, Mother Monster!
Tests revealed Wednesday that Lady Gaga tore her labrum -- a layer of muscle that helps hold the hip joint in place -- requiring her to undergo surgery and cancel the rest of her tour dates.
Little Monsters who had tickets for the 21 dates remaining in the Born This Way Ball tour will get a refund beginning Thursday.
Earlier, when the tour was merely postponed, Gaga revealed her injury to fans via a tweet.
"I've been hiding a show injury and chronic pain for sometime now, over the past month it has worsened," Gaga shared Tuesday afternoon. "I've been praying it would heal."
The injury is a synovitis, a severe inflammation of joints, she said, adding, "I hid it from my staff, I didn't want to disappoint my amazing fans. However after last night's performance I could not walk and still can't."
She went on to say, "To the fans in Chicago Detroit & Hamilton I hope you can forgive me, as it is nearly impossible for me to forgive myself. I'm devastated & sad."
Heart Attack's Emotional Toll Higher for Women
Story first appeared on USA Today -
A new Gallup poll is based on interviews with heart attack survivors about their well-being.
Women who survive heart attacks may suffer even greater emotional fallout than men who do, a new Gallup Poll suggests.
Heart attack survivors of both genders report more sadness, worry and stress and less enjoyment in life than people who have not had heart attacks, but the gaps are bigger for women, according to results from 353,492 interviews conducted in 2012. The interviews were part of an ongoing, daily poll, the Gallup-Healthways Well-Being Index, which tracks the nation's emotional temperature.
More than 11,000 male heart attack survivors and 6,000 female survivors answered questions about how they felt and what they experienced the day before they were polled, says Lauren Besal, a Gallup research analyst.
Those survivors scored significantly lower than other adults on a 100-point scale of emotional well-being — with male survivors scoring 77 and female survivors scoring 73, compared with 81 for other men and women. The gaps were bigger for women than for men when it came to sadness, worry, stress, pain and diagnosed depression (with 35% of female survivors and 24% of male survivors reporting a diagnosis). These happiness gaps existed for women at every income level, but not for men making more than $90,000 a year.
The poll had a margin of error of about 1 percentage point.
The results do not prove that heart attacks cause more emotional upheaval in women. It's possible that women who have heart attacks and survive them are even more likely than men to have had emotional problems before their heart problems began, Besal says. "Whether one came before the other we cannot tell."
But the findings might mean that "social support as a part of treatment may be especially important for women," she says.
Suzanne Steinbaum, a cardiologist at Lenox Hill Hospital in New York, agrees: "This could be a crucial wake-up call."
The relationship between emotional and heart health is complex, she says, but research shows that "when people have heart disease, and they have depression on top of this, they don't do as well."
Women who survive heart attacks may be more despondent because "a lot of times, women are sicker after they have a heart attack," she says, possibly because they wait longer than men to get medical help for warning signs such as chest pain and shortness of breath.
Women may also face extra stresses "because we are the caretakers of our families," says Amy Heinl a 43-year-old banking executive from Pittsburgh who had a heart attack in June 2010. Heinl, who is a divorced mother of three boys ages 12 to 17, says she "was scared for a year" after her attack, which was especially dangerous because it was caused by a torn artery. "Any pain or tweak I felt, I thought was my heart," she says.
Today, she's optimistic and doing well, but, she says, "I still think about it every day."
Steinbaum and Heinl are spokeswomen for the American Heart Association's Go Red for Women campaign, which raises awareness about heart disease as the No. 1 killer of women.
While women are less likely than men to have heart attacks, they are more likely to die from them, the association says. About 370,000 women and 565,000 men in the United States have heart attacks each year; 26% of women and 19% of men having a first heart attack die within a year. About 4.8 million men and 3.1 million women in the United State are heart attack survivors.
A new Gallup poll is based on interviews with heart attack survivors about their well-being.
Women who survive heart attacks may suffer even greater emotional fallout than men who do, a new Gallup Poll suggests.
Heart attack survivors of both genders report more sadness, worry and stress and less enjoyment in life than people who have not had heart attacks, but the gaps are bigger for women, according to results from 353,492 interviews conducted in 2012. The interviews were part of an ongoing, daily poll, the Gallup-Healthways Well-Being Index, which tracks the nation's emotional temperature.
More than 11,000 male heart attack survivors and 6,000 female survivors answered questions about how they felt and what they experienced the day before they were polled, says Lauren Besal, a Gallup research analyst.
Those survivors scored significantly lower than other adults on a 100-point scale of emotional well-being — with male survivors scoring 77 and female survivors scoring 73, compared with 81 for other men and women. The gaps were bigger for women than for men when it came to sadness, worry, stress, pain and diagnosed depression (with 35% of female survivors and 24% of male survivors reporting a diagnosis). These happiness gaps existed for women at every income level, but not for men making more than $90,000 a year.
The poll had a margin of error of about 1 percentage point.
The results do not prove that heart attacks cause more emotional upheaval in women. It's possible that women who have heart attacks and survive them are even more likely than men to have had emotional problems before their heart problems began, Besal says. "Whether one came before the other we cannot tell."
But the findings might mean that "social support as a part of treatment may be especially important for women," she says.
Suzanne Steinbaum, a cardiologist at Lenox Hill Hospital in New York, agrees: "This could be a crucial wake-up call."
The relationship between emotional and heart health is complex, she says, but research shows that "when people have heart disease, and they have depression on top of this, they don't do as well."
Women who survive heart attacks may be more despondent because "a lot of times, women are sicker after they have a heart attack," she says, possibly because they wait longer than men to get medical help for warning signs such as chest pain and shortness of breath.
Women may also face extra stresses "because we are the caretakers of our families," says Amy Heinl a 43-year-old banking executive from Pittsburgh who had a heart attack in June 2010. Heinl, who is a divorced mother of three boys ages 12 to 17, says she "was scared for a year" after her attack, which was especially dangerous because it was caused by a torn artery. "Any pain or tweak I felt, I thought was my heart," she says.
Today, she's optimistic and doing well, but, she says, "I still think about it every day."
Steinbaum and Heinl are spokeswomen for the American Heart Association's Go Red for Women campaign, which raises awareness about heart disease as the No. 1 killer of women.
While women are less likely than men to have heart attacks, they are more likely to die from them, the association says. About 370,000 women and 565,000 men in the United States have heart attacks each year; 26% of women and 19% of men having a first heart attack die within a year. About 4.8 million men and 3.1 million women in the United State are heart attack survivors.
12 February 2013
Need a Surgery Cost Quote? Good Luck!
Story first appeared on MPR News -
Want to know how much a hip replacement will cost? Many hospitals won't be able to tell you, at least not right away — if at all. And if you shop around and find centers that can quote a price, the amounts could vary astronomically, a study found.
Routine hip replacement surgery on a healthy patient without insurance may cost as little as $11,000 — or up to nearly $126,000.
That's what researchers found after calling hospitals in every state, 122 in all, asking what a healthy 62-year-old woman would have to pay to get an artificial hip. Hospitals were told the made-up patient was the caller's grandmother, had no insurance but could afford to pay out of pocket — that's why knowing the cost information ahead of time was so important.
About 15 percent of hospitals did not provide any price estimate, even after a researcher called back as many as five times.
The researchers were able to obtain a complete price estimate including physician fees from close to half the hospitals. But in most cases, that took contacting the hospital and doctor separately.
"Our calls to hospitals were often greeted by uncertainty and confusion," the researchers wrote. "We were frequently transferred between departments, asked to leave messages that were rarely returned, and told that prices could not be estimated without an office visit."
Many hospitals "are just completely unprepared" for cost questions, said Jaime Rosenthal, a Washington University student who co-authored the report.
Most hospitals aren't intentionally hiding costs, they're just not used to patients asking. That's particularly true for patients with health insurance who "don't bother to ask because they know insurance will cover it," said co-author Dr. Peter Cram, a researcher at the University of Iowa's medical school.
But he said that's likely to change as employers increasingly force workers to share more health care costs by paying higher co-payments and deductibles, making patients more motivated to ask about costs.
The study was published online Monday in JAMA Internal Medicine. A California study published last year about surgery to remove an appendix found similar cost disparities.
Commenting on the study, American Hospital Association spokeswoman Marie Watteau said hospitals "have a uniform set of charges. Sharing meaningful information, however, is challenging because hospital care is unique and based on each individual patient's needs."
She said states and local hospital associations are the best source for pricing data, and that many states already require or encourage hospitals to report pricing information and make that data available to the public.
U.S. insurance companies typically negotiate to pay less than the billing price. Insured patients' health plans determine what they pay, while uninsured patients may end up paying the full amount.
The study authors noted that Medicare and other large insurers frequently pay between $10,000 and $25,000 for hip replacement surgery.
Sean Toohey, a grains broker at the Chicago Board of Trade, had hip replacement surgery last summer at Loyola University Medical Center in Maywood, Ill. An old sports injury had worn out his left hip, causing "horrendous" pain on the job, where he's on his feet all day filling orders.
Toohey, 54, said his health insurance covered most of the costs, and it didn't occur to him to ask about price beforehand. He was back at work two weeks later and is pain free. That's what matters most to him.
"I never really looked or paid attention" to the cost, he said.
He paid about $7,900, but wasn't sure what the total bill amounted to.
The average charge for hip replacement surgery at Loyola is about $42,000, before the negotiated insurance rates. The most expensive items on a typical hip replacement bill include about $11,000 for the hip implant, said Richard Kudia, Loyola's vice president of patient financial services
Kudia said some patients do ask in advance about costs of surgery and other medical procedures, and those questions require "a little bit of research" to come up with an average estimate. Costs vary from center to center because "there is no standard pricing among hospitals across the country. Each hospital develops its own pricing depending on its market," he said.
An editorial accompanying the hip replacement study said "there is no justification" for the huge cost variation the researchers found.
A few online sites provide price comparisons for common medical procedures, but the editorial said that kind of information "is of almost no value" without information on hospital quality.
A proposed federal measure that would have required states to force hospitals to make their charges public failed to advance in Congress last year but could be revived this year, the editorial says.
"It is time we stopped forcing people to buy health care services blindfolded," the editorial said.
Want to know how much a hip replacement will cost? Many hospitals won't be able to tell you, at least not right away — if at all. And if you shop around and find centers that can quote a price, the amounts could vary astronomically, a study found.
Routine hip replacement surgery on a healthy patient without insurance may cost as little as $11,000 — or up to nearly $126,000.
That's what researchers found after calling hospitals in every state, 122 in all, asking what a healthy 62-year-old woman would have to pay to get an artificial hip. Hospitals were told the made-up patient was the caller's grandmother, had no insurance but could afford to pay out of pocket — that's why knowing the cost information ahead of time was so important.
About 15 percent of hospitals did not provide any price estimate, even after a researcher called back as many as five times.
The researchers were able to obtain a complete price estimate including physician fees from close to half the hospitals. But in most cases, that took contacting the hospital and doctor separately.
"Our calls to hospitals were often greeted by uncertainty and confusion," the researchers wrote. "We were frequently transferred between departments, asked to leave messages that were rarely returned, and told that prices could not be estimated without an office visit."
Many hospitals "are just completely unprepared" for cost questions, said Jaime Rosenthal, a Washington University student who co-authored the report.
Most hospitals aren't intentionally hiding costs, they're just not used to patients asking. That's particularly true for patients with health insurance who "don't bother to ask because they know insurance will cover it," said co-author Dr. Peter Cram, a researcher at the University of Iowa's medical school.
But he said that's likely to change as employers increasingly force workers to share more health care costs by paying higher co-payments and deductibles, making patients more motivated to ask about costs.
The study was published online Monday in JAMA Internal Medicine. A California study published last year about surgery to remove an appendix found similar cost disparities.
Commenting on the study, American Hospital Association spokeswoman Marie Watteau said hospitals "have a uniform set of charges. Sharing meaningful information, however, is challenging because hospital care is unique and based on each individual patient's needs."
She said states and local hospital associations are the best source for pricing data, and that many states already require or encourage hospitals to report pricing information and make that data available to the public.
U.S. insurance companies typically negotiate to pay less than the billing price. Insured patients' health plans determine what they pay, while uninsured patients may end up paying the full amount.
The study authors noted that Medicare and other large insurers frequently pay between $10,000 and $25,000 for hip replacement surgery.
Sean Toohey, a grains broker at the Chicago Board of Trade, had hip replacement surgery last summer at Loyola University Medical Center in Maywood, Ill. An old sports injury had worn out his left hip, causing "horrendous" pain on the job, where he's on his feet all day filling orders.
Toohey, 54, said his health insurance covered most of the costs, and it didn't occur to him to ask about price beforehand. He was back at work two weeks later and is pain free. That's what matters most to him.
"I never really looked or paid attention" to the cost, he said.
He paid about $7,900, but wasn't sure what the total bill amounted to.
The average charge for hip replacement surgery at Loyola is about $42,000, before the negotiated insurance rates. The most expensive items on a typical hip replacement bill include about $11,000 for the hip implant, said Richard Kudia, Loyola's vice president of patient financial services
Kudia said some patients do ask in advance about costs of surgery and other medical procedures, and those questions require "a little bit of research" to come up with an average estimate. Costs vary from center to center because "there is no standard pricing among hospitals across the country. Each hospital develops its own pricing depending on its market," he said.
An editorial accompanying the hip replacement study said "there is no justification" for the huge cost variation the researchers found.
A few online sites provide price comparisons for common medical procedures, but the editorial said that kind of information "is of almost no value" without information on hospital quality.
A proposed federal measure that would have required states to force hospitals to make their charges public failed to advance in Congress last year but could be revived this year, the editorial says.
"It is time we stopped forcing people to buy health care services blindfolded," the editorial said.
11 February 2013
Watson Supercomputer Now Available to Doctors for Advice
Story first appeared on USA Today -
The Watson supercomputer is graduating from its medical residency and is being offered commercially to doctors and health insurance companies, IBM said Friday.
IBM, the health insurer WellPoint and Memorial Sloan-Kettering Cancer Center announced two Watson-based applications — one to help diagnose and treat lung cancer and one to help manage health insurance decisions and claims.
Both applications take advantage of the speed, huge database and language skill the computer demonstrated in defeating the best human "Jeopardy!" players on television two years ago.
Armonk-based IBM said Watson has improved its performance by 240 percent since the "Jeopardy!" win.
In both applications, doctors or insurance company workers will access Watson through a tablet or computer. Watson will quickly compare a patient's medical records to what it has learned and make several recommendations in decreasing order of confidence.
In the cancer program, the computer will be considering what treatment is most likely to succeed. In the insurance program, it will consider what treatment should be authorized for payment.
Watson (actually named for IBM founder and not the Sherlock Holmes' friend, Dr. Watson) has been trained in medicine through pilot programs at Indianapolis-based WellPoint and at Sloan-Kettering in New York.
Manoj Saxena, an IBM general manager, said the supercomputer has ingested 1,500 lung cancer cases from Sloan-Kettering records, plus 2 million pages of text from journals, textbooks and treatment guidelines.
It also learned "like a medical student," by being corrected when it was questioned by doctors and came up with wrong answers, Saxena said in an interview.
"Watson is not making the decisions" on treatment or authorization, Saxena said. "It is essentially reducing the effort for doctors and nurses by going through thousands of pages of information for each case."
The lung cancer program is being adopted by two medical groups, the Maine Center for Cancer Medicine and WestMed in New York's Westchester County. Saxena said it should be running at both groups by next month.
WellPoint itself is already using the insurance application in Indiana, Kentucky, Ohio and Wisconsin. It will be selling both applications — at prices still to be negotiated — and will compensate IBM under a contract between the two companies, an IBM spokeswoman said.
WellPoint said using Watson should not increase insurance premiums because of savings from waste and errors.
The Watson supercomputer is graduating from its medical residency and is being offered commercially to doctors and health insurance companies, IBM said Friday.
IBM, the health insurer WellPoint and Memorial Sloan-Kettering Cancer Center announced two Watson-based applications — one to help diagnose and treat lung cancer and one to help manage health insurance decisions and claims.
Both applications take advantage of the speed, huge database and language skill the computer demonstrated in defeating the best human "Jeopardy!" players on television two years ago.
Armonk-based IBM said Watson has improved its performance by 240 percent since the "Jeopardy!" win.
In both applications, doctors or insurance company workers will access Watson through a tablet or computer. Watson will quickly compare a patient's medical records to what it has learned and make several recommendations in decreasing order of confidence.
In the cancer program, the computer will be considering what treatment is most likely to succeed. In the insurance program, it will consider what treatment should be authorized for payment.
Watson (actually named for IBM founder and not the Sherlock Holmes' friend, Dr. Watson) has been trained in medicine through pilot programs at Indianapolis-based WellPoint and at Sloan-Kettering in New York.
Manoj Saxena, an IBM general manager, said the supercomputer has ingested 1,500 lung cancer cases from Sloan-Kettering records, plus 2 million pages of text from journals, textbooks and treatment guidelines.
It also learned "like a medical student," by being corrected when it was questioned by doctors and came up with wrong answers, Saxena said in an interview.
"Watson is not making the decisions" on treatment or authorization, Saxena said. "It is essentially reducing the effort for doctors and nurses by going through thousands of pages of information for each case."
The lung cancer program is being adopted by two medical groups, the Maine Center for Cancer Medicine and WestMed in New York's Westchester County. Saxena said it should be running at both groups by next month.
WellPoint itself is already using the insurance application in Indiana, Kentucky, Ohio and Wisconsin. It will be selling both applications — at prices still to be negotiated — and will compensate IBM under a contract between the two companies, an IBM spokeswoman said.
WellPoint said using Watson should not increase insurance premiums because of savings from waste and errors.
07 February 2013
Daily Antiseptic Baths In Hospitals Reduce Infections
Story first appeared on US News -
Simple swab-based cleansing cut rates of some drug-resistant bacteria by 23 percent, study found
A daily swabbing with a simple antiseptic greatly decreases the number of life-threatening bloodstream infections and drug-resistant bacteria lurking among patients in acute-care hospital units, a new study suggests.
Researchers found that bathing patients with washcloths soaked with chlorhexidine -- a cheap, broad-spectrum antiseptic -- lowered the rate of hospital-acquired bloodstream infections by 28 percent.
Highly feared multidrug-resistant organisms such as MRSA (methicillin-resistant staphylococcus aureus) and VRE (vancomycin-resistant enterococcus) were reduced by 23 percent.
"We're talking about an intervention that's very simple to implement and minimal in cost," said study author Dr. Edward Wong, chief of infectious disease at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Va. "This can be laid on top of all the other things [experts recommend] to decrease the spread of these organisms."
The study is published in the Feb. 7 issue of the New England Journal of Medicine.
About 5 percent of hospitalized patients acquire healthcare-associated infections, often from bacteria entering the bloodstream through surgical incisions or catheters, according to the U.S. Centers for Disease Control and Prevention (CDC). The per-patient cost of treating such infections is enormous -- approximately $40,000, Wong said.
Wong and his colleagues analyzed more than 7,700 patients in nine intensive-care and bone-marrow-transplantation units in six hospitals. Health providers were randomly assigned to bathe patients with either no-rinse chlorhexidine-soaked washcloths or non-antimicrobial washcloths for six months, then alternate with the other product for an additional six months. Chlorhexidine wipes, when sold in bulk, cost less than 20 cents apiece on Internet sites.
The dramatically lowered rates of bloodstream infections and MRSA and VRE acquisition -- which can mean a patient is either a carrier or infected with the bacteria -- didn't surprise Wong, whose previous research yielded similar results.
"At least based on preliminary studies we've done, we knew we'd have some benefit but we wanted to make sure we could generalize," he said. Chlorhexidine wipes "are clearly going to cost much less than the cost of antibiotics or the cost of health care."
Dr. Philip Tierno, director of clinical microbiology and immunology at NYU Langone Medical Center in New York City, said his institution has been using chlorhexidine for years on patients about to have surgery.
"It's very good because it has residual effectiveness on the skin for a day or two," he said. "So when the surgeon cuts through flesh, it's less likely to impregnate the skin with organisms."
"If you get a very serious infection ... it may lead to significant problems," Tierno added. "This has a very good benefit and it's worthwhile to pursue."
Simple swab-based cleansing cut rates of some drug-resistant bacteria by 23 percent, study found
A daily swabbing with a simple antiseptic greatly decreases the number of life-threatening bloodstream infections and drug-resistant bacteria lurking among patients in acute-care hospital units, a new study suggests.
Researchers found that bathing patients with washcloths soaked with chlorhexidine -- a cheap, broad-spectrum antiseptic -- lowered the rate of hospital-acquired bloodstream infections by 28 percent.
Highly feared multidrug-resistant organisms such as MRSA (methicillin-resistant staphylococcus aureus) and VRE (vancomycin-resistant enterococcus) were reduced by 23 percent.
"We're talking about an intervention that's very simple to implement and minimal in cost," said study author Dr. Edward Wong, chief of infectious disease at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Va. "This can be laid on top of all the other things [experts recommend] to decrease the spread of these organisms."
The study is published in the Feb. 7 issue of the New England Journal of Medicine.
About 5 percent of hospitalized patients acquire healthcare-associated infections, often from bacteria entering the bloodstream through surgical incisions or catheters, according to the U.S. Centers for Disease Control and Prevention (CDC). The per-patient cost of treating such infections is enormous -- approximately $40,000, Wong said.
Wong and his colleagues analyzed more than 7,700 patients in nine intensive-care and bone-marrow-transplantation units in six hospitals. Health providers were randomly assigned to bathe patients with either no-rinse chlorhexidine-soaked washcloths or non-antimicrobial washcloths for six months, then alternate with the other product for an additional six months. Chlorhexidine wipes, when sold in bulk, cost less than 20 cents apiece on Internet sites.
The dramatically lowered rates of bloodstream infections and MRSA and VRE acquisition -- which can mean a patient is either a carrier or infected with the bacteria -- didn't surprise Wong, whose previous research yielded similar results.
"At least based on preliminary studies we've done, we knew we'd have some benefit but we wanted to make sure we could generalize," he said. Chlorhexidine wipes "are clearly going to cost much less than the cost of antibiotics or the cost of health care."
Dr. Philip Tierno, director of clinical microbiology and immunology at NYU Langone Medical Center in New York City, said his institution has been using chlorhexidine for years on patients about to have surgery.
"It's very good because it has residual effectiveness on the skin for a day or two," he said. "So when the surgeon cuts through flesh, it's less likely to impregnate the skin with organisms."
"If you get a very serious infection ... it may lead to significant problems," Tierno added. "This has a very good benefit and it's worthwhile to pursue."
04 February 2013
Heart Health ABC's
Story first appeared on ABC News -
With more than 2 million heart attacks and strokes each year, and 800,000 deaths, according to the Centers for Disease Control and Prevention, cardiovascular disease is the leading cause of death for both men and women in the United States. One out of every three deaths is from heart disease and stroke.
These conditions are also the leading causes of disability, and they're costing this country a fortune -- together, heart disease and stroke hospitalizations in 2010 rang up $444 billion in health care expenses and lost productivity, according to the CDC.
It's the rare American who hasn't been touched by heart disease in some way. Just about all of us have known someone who has had cardiovascular illness, a heart attack or stroke. Heart problems can strike older folks, middle-agers, high schoolers, children -- even babies. No ethnicity is immune. And heart disease strikes people from all walks of life, famous or not.
But we can fight back against this scourge. Awareness is key.
With more than 2 million heart attacks and strokes each year, and 800,000 deaths, according to the Centers for Disease Control and Prevention, cardiovascular disease is the leading cause of death for both men and women in the United States. One out of every three deaths is from heart disease and stroke.
These conditions are also the leading causes of disability, and they're costing this country a fortune -- together, heart disease and stroke hospitalizations in 2010 rang up $444 billion in health care expenses and lost productivity, according to the CDC.
It's the rare American who hasn't been touched by heart disease in some way. Just about all of us have known someone who has had cardiovascular illness, a heart attack or stroke. Heart problems can strike older folks, middle-agers, high schoolers, children -- even babies. No ethnicity is immune. And heart disease strikes people from all walks of life, famous or not.
But we can fight back against this scourge. Awareness is key.
Doctor Perks from Pharmaceutical Companies
Story first appeared on the Los Angeles Times -
Though few patients realize it, many doctors receive thousands of dollars from pharmaceutical companies for each patient enrolled in an experimental drug trial. The medication might be the best thing for the patient's condition. The doctor's motives might be pure. But patients should be able to find out about such payments so they can discuss them with their doctors and decide for themselves whether the doctor's participation in an experiment might compromise his medical advice.
A provision of the 2010 healthcare reform law should bring new transparency about these and other corporate payments to physicians — including lavish dinners, gifts and industry-sponsored conventions that are more luxury vacations than medical conferences — by publishing the information in an online database. But the final regulations to implement the Physician Payment Sunshine Act were supposed to be published in October 2011; the database was supposed to go live later this year. Instead, the regulations are 15 months overdue.
As with the new food-safety act regulations — most of which were finally released in January, a full year past deadline — the sunshine rules have been drawn up by the appropriate agency but have been held up by the Office of Management and Budget. One theory for the delay, advanced by critics of the administration, is that President Obama wanted to avoid issuing regulations during election season, when the extent of government's reach was a contentious issue. That would be a poor excuse, if true. In any case, the election is over; at this point the delay smacks more of bureaucratic inefficiency than political expediency.
Most physicians put their patients' well-being first, but a study showed that doctors who receive food from a company are more likely to prescribe that company's products, even though they might not be doing it consciously.
The sunshine act isn't as strong as it should have been. Ideally, doctors would be the ones doing the divulging, making information about payments and gifts they have received readily available in their examining rooms. Not all patients will know about the online database or possess the savvy to use it. But the rules nonetheless are expected to influence behavior; public disclosure will make both physicians and drug companies more circumspect.
One question in the minds of consumer advocates is how much disclosure will reveal. For instance, if a company gives a doctor a large sum to lead a drug trial and that doctor spreads the money among other physicians who enroll patients, it's unclear whether those payments would be reported as coming from the drug company. The administration should release rules that fully reflect the spirit of the law, and it should do so soon.
Though few patients realize it, many doctors receive thousands of dollars from pharmaceutical companies for each patient enrolled in an experimental drug trial. The medication might be the best thing for the patient's condition. The doctor's motives might be pure. But patients should be able to find out about such payments so they can discuss them with their doctors and decide for themselves whether the doctor's participation in an experiment might compromise his medical advice.
A provision of the 2010 healthcare reform law should bring new transparency about these and other corporate payments to physicians — including lavish dinners, gifts and industry-sponsored conventions that are more luxury vacations than medical conferences — by publishing the information in an online database. But the final regulations to implement the Physician Payment Sunshine Act were supposed to be published in October 2011; the database was supposed to go live later this year. Instead, the regulations are 15 months overdue.
As with the new food-safety act regulations — most of which were finally released in January, a full year past deadline — the sunshine rules have been drawn up by the appropriate agency but have been held up by the Office of Management and Budget. One theory for the delay, advanced by critics of the administration, is that President Obama wanted to avoid issuing regulations during election season, when the extent of government's reach was a contentious issue. That would be a poor excuse, if true. In any case, the election is over; at this point the delay smacks more of bureaucratic inefficiency than political expediency.
Most physicians put their patients' well-being first, but a study showed that doctors who receive food from a company are more likely to prescribe that company's products, even though they might not be doing it consciously.
The sunshine act isn't as strong as it should have been. Ideally, doctors would be the ones doing the divulging, making information about payments and gifts they have received readily available in their examining rooms. Not all patients will know about the online database or possess the savvy to use it. But the rules nonetheless are expected to influence behavior; public disclosure will make both physicians and drug companies more circumspect.
One question in the minds of consumer advocates is how much disclosure will reveal. For instance, if a company gives a doctor a large sum to lead a drug trial and that doctor spreads the money among other physicians who enroll patients, it's unclear whether those payments would be reported as coming from the drug company. The administration should release rules that fully reflect the spirit of the law, and it should do so soon.
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