Public Health
Lack of health insurance limits hepatitis C patients’ access to latest antiviral therapy
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New research has determined that patients in the U.S. with hepatitis C virus (HCV) are twice as likely to not have health insurance coverage compared with those without the disease. In fact researchers found only a third of HCV infected Americans have access to antiviral therapy; the remaining are either uninsured or not candidates for therapy due to treatment contraindications. Details of this study are published in the March issue of Hepatology, a peer-reviewed journal of the American Association for the Study of Liver Diseases (AASLD).
HCV is the most common cause of chronic liver disease, hepatocellular (liver) cancer, and liver transplantation in the U.S., with up to 85% of HCV-positive individuals (3.5 million) developing chronic HCV infection. Symptoms of chronic HCV are non-specific which can inhibit diagnosis and as many as 75% of patients are unaware of their HCV infection (Hagan et al., 2006). Furthermore, the Centers for Disease Control and Prevention (CDC) estimates that HCV causes 12,000 deaths in the U.S. each year.
“Successful treatment with antiviral therapy improves health-related quality of life in patients with HCV and could potentially reduce morbidity and mortality in patients,” said Zobair Younossi, MD, MPH, from the Center of Liver Diseases at Inova Fairfax Hospital in Virginia and lead author of the study. “A significant number of HCV patients, however, may not even have access to antiviral therapy due to lack of adequate health insurance coverage.” It is estimated to cost up to $48,000 per year for monitoring and treatment of HCV.
Paper Urges Physicians to Assess Practices for Care of LGBT Patients
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Noting that a patient’s level of comfort and trust significantly impacts the type of medical care provided and received, a newly published paper outlines ways that physicians can examine how their own beliefs and practice habits affect their ability to treat lesbian, gay, bisexual and transgender (LGBT) patients. The paper, which appears in the current issue of The Health Care Manager, outlines several minor but effective changes physicians can make to establish an office environment that is comfortable to all patients.
“LGBT patients can disproportionately experience social and behavioral risk factors that can affect health,” said lead author Dr. Joshua Coren, a family physician at the UMDNJ-School of Osteopathic Medicine. “When evaluating these risk factors, physicians need to ask questions nonjudgmentally to avoid causing their LGBT patients to feel scrutinized or even stigmatized.”
Among the authors’ recommendations are changing background information forms by expanding gender identification and relationship preference categories, noting that when only two options are available transgendered patients may struggle to identify their gender or bisexual patients may not be able to accurately describe their polyamorous relationship with men and women.
Fiber intake associated with reduced risk of death
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Dietary fiber may be associated with a reduced risk of death from cardiovascular, infectious and respiratory diseases, as well as a reduced risk of death from any cause over a nine-year period, according to a report posted online today that will be published in the June 14 print issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Fiber, the edible part of plants that resist digestion, has been hypothesized to lower risks of heart disease, some cancers, diabetes and obesity, according to background information in the article. It is known to assist with bowel movements, reduce blood cholesterol levels, improve blood glucose levels, lower blood pressure, promote weight loss and reduce inflammation and bind to potential cancer-causing agents to increase the likelihood they will be excreted by the body.
Yikyung Park, Sc.D., of the National Cancer Institute, Rockville, Md., and colleagues analyzed data from 219,123 men and 168,999 women in the National Institutes of Health-AARP Diet and Health Study. Participants completed a food frequency questionnaire at the beginning of the study in 1995 and 1996. Causes of death were determined by linking study records to national registries.
Grant targeting obesity awarded to HealthNet
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The New York State Department of Health awarded a five-year grant to Herkimer County HealthNet, Inc. to establish programs to prevent obesity, type 2 diabetes and other chronic diseases in Herkimer County.
The grant is for $87,500 for the first six months — October 2010-April 2011 — and $175,000 each year for the remaining period of the grant.
Obesity and diabetes are the two most critical public health threats to New Yorkers and Americans, reducing quality of life, likely shortening the life span, increasing health care costs and reducing productivity in the work place and at school.
Treating mild strokes with clot-busting drug could save $200 million annually, study shows
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Treating mild strokes with the clot-busting drug approved for severe stroke could reduce the number of patients left disabled and save $200 million a year in disability costs, according to new research from the University of Cincinnati (UC).
The study led by Pooja Khatri, MD, an associate professor in the department of neurology, examined the public health impact of treating mild strokes with the clot-busting drug intravenous tissue plasminogen activator (tPA). It is being presented Wednesday, Feb. 9, in Los Angeles at International Stroke Conference 2011, the annual meeting of the American Stroke Association.
The research is part of the Greater Cincinnati/Northern Kentucky Stroke Study, begun in 1993 at the UC College of Medicine, which is funded by the National Institutes of Health (NIH) and identifies all hospitalized and autopsied cases of stroke and transient ischemic attack (TIA) in a five-county region. The NIH also funded the study led by Khatri.
Childhood Chronic Illness Affects Future Income, Education, Career
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Today, more children than ever survive serious chronic illness. Many thrive as young adults, but a large new study finds that for some, early illness can lead to fewer years of education, more joblessness and lower pay.
The good news is that when they grow up, these kids are just as likely to blossom socially, enjoy romantic relationships and get married as healthy kids, finds the study in the Journal of Adolescent Health online.
Researchers led by Gary Maslow, M.D., looked at two sets of interview data from the National Longitudinal Study of Adolescent Health. The more than 13,000 respondents were middle or high school students during the 1994-1995 school year.
Food industry partnerships may carry risks
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Health charities and health organizations must tread carefully when partnering with the food industry as it may risk compromise health promotion goals, states an editorial in CMAJ (Canadian Medical Association Journal) (pre-embargo link only).
Partnerships with major food companies are attractive for health charities and organizations because they bring additional funding and support. For the food industry, these relationships can help burnish their brands, support marketing efforts and help with lobbying but they may obscure the very messages that health organizations are promoting.
“Corporations are not the problem,” write Drs. Paul Hébert, Editor-in-Chief, CMAJ and Yoni Freedhoff, Medical Director, Bariatric Medical Institute, Ottawa. “By definition, corporate spending must serve to increase shareholder value - a transparent fiduciary requirement that should encompass philanthropic efforts. Health organizations, even when desperate for money or resources, should avoid co-branding with the food industry.”
Hepatic vein thrombosis following liver resection
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Patients undergoing liver surgery have long been considered to be at low risk of venous thromboembolism. However, pulmonary embolism has recently emerged as an increasingly frequent and potentially fatal complication following liver resections.
A research article published on January 21, 2011 in the World Journal of Gastroenterology addresses this question. The authors shed a new light on this discrepancy by reporting two patients who developed thrombi in their hepatic veins following hepatectomy.
The report indicated that thrombosis may occur in hepatic veins after liver resection as a result of intra- or postoperative local injury. This would explain why pulmonary emboli have been observed in the absence of peripheral deep vein thrombosis. This hazard should be taken into account when performing extensive coagulation of the raw surface of the liver when a major hepatic vein is exposed.
Fast growth, low defense—plants facing a dilemma
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Plants are attacked by a multitude of insects and mammals. As defense against these herbivores they developed complex defense mechanisms over the course of evolution: spines, thorns, leaf hairs and a number of toxic chemical substances. For decades it has been controversially discussed whether the production of defense traits incurs costs to the plants. Now, using a new method the ecologists and plant biologists of the University of Zürich together with their American colleagues demonstrate these costs accurately in a Proceedings of the Royal Society article.
For their study, the researchers planted different «knockout»-mutants of the same genotype of the model plant Arabidopsis thaliana. They then harvested a subset of these plants in evenly distributed intervals to measure the biomass growth over the whole plant life. «Mutants with suppressed defense mechanisms showed an increased growth rate» Tobias Züst explains the result of his study. But the faster growth comes at an added cost: aphids reproduce faster on these plants than on slow growing plants with intact defense mechanisms. This is a result of the fact that fast growing plants provide more resources to the herbivore than slow growing plants in the same amount of time.
The study shows that natural resistance is often not compatible with fast growth. This finding is of great importance for agricultural crops: These crops have been selected for high yield and as a consequence have very low natural resistance to herbivores, consequentially requiring high input of insecticides.
IU-led “Growing Our Own” report offers solutions to address decline in U.S. dental faculty
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A new report by an Indiana University School of Dentistry department chair with researchers from six other U.S. dental schools is calling for quick and creative solutions to address the growing scarcity of full-time faculty members within the nation’s dental school programs.
The report cites widening pay gaps between private practice dentists and clinical professors at dental schools as one factor in fewer dentists committing to careers in teaching. Clinical faculty also report being overwhelmed and burned out by the workload demands of teaching, clinical, research and administrative responsibilities. Published in the January edition of the Journal of Dental Education, the paper calls for the development of mandatory mentoring programs, among other recommendations, to help reverse the trend.
“We feel it is essential that mentoring programs be considered mandatory within dental schools if this trend toward a major crisis in dentistry is to be reversed as rapidly as possible,” said Dr. Vanchit John, chairman of the IU School of Dentistry’s Department of Periodontics and Allied Dental Programs and the lead author of the report. “Clinical faculty shortages could be characterized as the most critical challenge confronting dentistry.”
Americans oppose yanking healthcare law funds: poll
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Most Americans do not want Congress to block funding for various new healthcare measures even as the nation remains split on the sweeping overhaul passed last year, a poll published on Tuesday found.
More than half of those surveyed—62 percent—said they did not approve of lawmakers cutting off funds needed to implement changes, which range from new rules for health insurance companies to tax credits for small businesses and state grants.
The Republican-controlled House of Representatives this month passed legislation that would repeal the healthcare reform law signed by President Barack Obama last year, but the Senate is not expected to act on that bill. House Republicans say they now will try to disrupt the flow of money needed to implement the law.
Heart disease costs to triple in U.S. by 2030: report
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The costs of heart disease in the United States will triple between now and 2030, to more than $800 billion a year, a report commissioned by the American Heart Association predicted on Monday.
Treating high blood pressure will be the most expensive part of the cost, rising to $389 billion by 2030, the report projects, with overall heart disease rising by 10 percent by then.
The report is bad news for the United States, which already has the highest per capita healthcare costs in the developed world and is struggling to lower expenses. Last week the Republican-led House of Representatives voted to repeal President Barack Obama’s healthcare reform, in part, they said, because it did not cut costs.
Genetic sequencing alone doesn’t offer a true picture of human disease
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Despite what you might have heard, genetic sequencing alone is not enough to understand human disease. Researchers at Duke University Medical Center have shown that functional tests are absolutely necessary to understand the biological relevance of the results of sequencing studies as they relate to disease, using a suite of diseases known as the ciliopathies which can cause patients to have many different traits.
“Right now the paradigm is to sequence a number of patients and see what may be there in terms of variants,” said Nicholas Katsanis, Ph.D. “The key finding of this study says that this approach is important, but not sufficient. If you really want to be able to penetrate, you must have a robust way to test the functional relevance of mutations you find in patients. For a person at risk of type 2 diabetes, schizophrenia or atherosclerosis, getting their genome sequenced is not enough – you have to functionally interpret the data to get a sense of what might happen to the particular patient.”
“This is the message to people doing medical genomics,” said lead author Erica Davis, Ph.D., Assistant Professor in the Duke Department of Pediatrics, who works in the Duke Center for Human Disease Modeling. “We have to know the extent to which gene variants in question are detrimental – how do they affect individual cells or organs and what is the result on human development or disease? Every patient has his or her own set of genetic variants, and most of these will not be found at sufficient frequency in the general population so that anyone could make a clear medical statement about their case.”
Cell binding discovery brings hope to those with skin and heart problems
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A University of Manchester scientist has revealed the mechanism that binds skin cells tightly together, which he believes will lead to new treatments for painful and debilitating skin diseases and also lethal heart defects.
Professor David Garrod, in the Faculty of Life Sciences, has found that the glue molecules bind only to similar glue molecules on other cells, making a very tough, resilient structure. Further investigation on why the molecules bind so specifically could lead to the development of clinical applications.
Professor Garrod, whose Medical Research Council-funded work is paper of the week in the Journal of Biological Chemistry (JBC) tomorrow (Friday), said: “Our skin is made up of three different layers, the outermost of which is the epidermis. This layer is only about 1/10th of a millimetre thick yet it is tough enough to protect us from the outside environment and withstand the wear and tear of everyday life.
Thousands protest in Berlin over dioxin scandal
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Thousands of German protesters marched in Berlin on Saturday to demand a change in farming methods and vent their anger at a food scandal in which cancer-causing dioxin was found in some eggs, poultry and pork.
The scandal, caused by contaminated animal feed, has outraged consumers, triggered international health alerts and hit sales of German eggs and meat.
Organizers said 22,000 people took part in the demonstration, entitled “We are sick of it. No to genetic engineering, animal factories and dumping exports.” Onlookers put the turnout at close to 10,000.
