Category Archives: Health

High, Non-Transparent Prices And Aggressive Collection Tactics Erode Trust In Healthcare (JAMA)

From a JAMA Network online article (February 4, 2020):

Billing Quality is Medical Quality JAMA Network ViewpointHigh medical prices and billing practices may reduce public trust in the medical profession and can result in the avoidance of care. In a survey of 1000 patients, 64% reported that they delayed or neglected seeking medical care in the past year because of concern about high medical bills. The field of quality science in health care has developed measures of medical complications; however, there are no standardized metrics of billing quality.

JAMA NetworkA recent study found that only 53 of 101 hospitals were able to provide a price for standard coronary artery bypass graft surgery. Notably, among the hospitals that provided a price, the price ranged from approximately $44 000 and $448 000 and was not associated with quality of care as measured by risk-adjusted outcomes and the Society of Thoracic Surgeons composite quality score.

Possible metrics of assessing billing quality JAMA

In the same way that there is wide variation in pricing, aggressive collection tactics also can be highly variable by institution. In a recent analysis, 36% (48/135) of hospitals in Virginia garnished wages of patients with unpaid medical bills, and 5 hospitals accounted for 4690 garnishment cases in 2017, representing 51% of all cases.7 In total, 20 054 lawsuits were filed in Virginia against patients for unpaid debt. For many hospitals that sue patients, legal action follows multiple attempts to contact patients through letters and calls, and some hospitals may offer to set up payment plans or even negotiate charges.

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Sleep Studies: Even Low-Levels Of Light At Night Causes Diabetes In Elderly

From a Sleep Medicine online release (January 2020):

Sleep Medicine January 2020Our findings suggest that LAN (low-level light at night) exposure increases the incidence of diabetes in a general elderly population. Further research involving a large cohort with new-onset diabetes is warranted to elucidate these findings.

Highlights

  • Humans are commonly exposed to light at night.
  • Higher light exposure at night was significantly associated with higher incidence rate of diabetes.
  • The association was consistent in the analysis using the cut-off values of LAN as 3 and 5 lux.
  • Strengths include large samples adjusting a number of confounders.

The circadian timing system, located within the suprachiasmatic nucleus of the hypothalamus, controls fundamental energy homeostasis. Clock gene mutations induce obesity in mice, and the disruption of internal circadian rhythms decreases daily energy expenditures and leptin levels in humans. Light information received by the brain influences human circadian timing and metabolism; low-level light at night (LAN) significantly increased body mass and led to prediabetes in mice. In humans, bedroom LAN affected obesity parameters; however, the association between LAN and the incidence of diabetes in humans has not been studied.

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Health Infographics: The Most Common Types Of Cancer In U.S. By Gender

The Most Common Types of Cancer in the U.S. American Cancer Socieaty 2020

Cardiovascular disease remains the leading cause of death worldwide among middle-aged adults. However, deaths from cancer are catching up in high-income countries according to a study recently published in the medical journal The Lancet. Researchers calculated that cancer kills about twice as many people as cardiovascular disease in more developed countries. Globally, cancer could become the leading cause of death in just a few decades, the study said.

New Books On Ageing: “The Changing Mind” By Daniel Levitin (February 2020)

The Changing Mind A Neuroscientist's Guide To Ageing Well Daniel Levitin Feb 2020Challenging widely held assumptions about the diminishing abilities of an ageing brain, leading neuroscientist Daniel Levitin argues that we should view getting older as a beneficial experience rather than a form of cognitive entropy. Persuasively argued and consistently surprising, The Changing Mind will alter your perception of the relationship between age and intellect.

We have long been encouraged to think of old age as synonymous with deterioration. Yet, recent studies show that our decision-making skills improve as we age and our happiness levels peak in our eighties. What really happens to our brains as we get older?

More of us are living into our eighties than ever before. In The Changing Mind, neuroscientist, psychologist and internationally-bestselling author Daniel Levitin invites us to dramatically shift our understanding of growing older, demonstrating its many cognitive benefits. He draws on cutting-edge research to challenge common and flawed beliefs, including assumptions around memory loss and the focus on lifespan instead of ‘healthspan’.

Levitin reveals the evolving power of the human brain from infancy to late adulthood. Distilling the findings from over 4000 papers, he explains the importance of personality traits, lifestyle, memory and community on ageing, offering actionable tips that we can all start now, at any age.

Featuring compelling insights from individuals who have thrived far beyond the conventional age of retirement, this book offers realistic guidelines and practical cognition-enhancing tricks for everyone to follow during every decade of their life. This is a radical exploration of what we all can learn from those who age joyously.

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Medical Lectures: “Living Donor Liver Transplants” (UCSF Medical School)

Nationally, there are approximately 18,000 patients on the liver transplant list. Annually, about 6,000 patients receive a liver transplant. Because of the organ shortage, many patients waiting for liver transplants die on the list or become too sick to undergo transplant. Dr. John Roberts offers these solutions: expanded criteria donors, split livers and living donors. Recorded on 10/30/2019. 

More from: Organ Failure and Replacement: Why Organs Fail and What Therapies are Available for Organ Replacement (https://www.uctv.tv/organ-failure-rep…)

Studies: Steep Increase In “Early-Onset Colorectal Cancer”; First Screening At Age 45 Suggested (JAMA)

From a JAMA Network Open online release (Jan 31, 2020):

JAMA Network OPEN LogoSteep incidence increases between 49 and 50 years of age are consistent with previously undetected colorectal cancers diagnosed via screening uptake at 50 years. These cancers are not reflected in observed rates of colorectal cancer in the SEER registries among individuals younger than 50 years. Hence, using observed incidence rates from 45 to 49 years of age alone to assess potential outcomes of earlier screening may underestimate cancer prevention benefits.

Colorectal Cancer Incidence Rates per 100000 30 - 60 Years of age 2000-2016 JAMA

Early-onset colorectal cancer (EOCRC) incidence rates are increasing, and controversy exists regarding whether average-risk screening should begin at 45 or 50 years of age.1 In 2018, the American Cancer Society recommended that average-risk screening start at 45 years of age.2 Others recommend screening at 50 years of age, although the US Multi-Society Task Force on Colorectal Cancer recommends screening African American individuals at age 45 years of age owing to higher incidence, mortality, and earlier-onset disease.36 The American Cancer Society decision incorporated modeling studies that used updated incidence and mortality data encompassing time periods of increasing EOCRC incidence rates; modeling compared life-years gained by initiating screening at 45 vs 50 years.

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Dementia: Antioxidant “Flavonols” From Fruits & Vegetables Lower Alzheimer’s Risk By 48%

From a Rush University Medical Center online article:

The study found that participants in the group with the highest flavonol consumption were 48% less likely to develop Alzheimer’s dementia later on in life than participants with the lowest level. Of the 186 people in the highest group, 28 people, or 15%, developed Alzheimer’s dementia, compared to 54 people, or 30%, of the 182 people in the lowest group.

flavonols infographic Neurology Journal January 29 2020

People who eat or drink more foods with flavonol, which is found in nearly all fruits and vegetables, plus tea and wine, may be less likely to develop Alzheimer’s dementia, according to the Rush researchers. They published the results of their study in the Jan. 29 online issue of Neurology.

Flavonols are a type of flavonoid, a group of phytochemicals found in plant pigments. They are known for their beneficial effects on health due to their antioxidant and anti-inflammatory properties.

A total of 921 people with an average age of 81 participated in the Neurology study. These participants did not have Alzheimer’s dementia when starting the study.

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Health: “What Are Hernias & How Are They Repaired?”

Think of a hernia like a bulge in a damaged tire. The inner tube or soft tissue is normally contained by the abdominal wall, and if there is a leak or weak spot the soft tissue like fat or intestines can protrude through. Having a hernia will eventually require surgery to repair, and there are several different ways surgeons go about it.

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Studies: Irregular Sleep Disrupts Pancreatic “Circadian Rhythms”, Leading To Type 2 Diabetes

From a Technology Networks online article:

Technology NetworksBy comparing the pancreatic cells of type 2 diabetic human donors with those of healthy people, researchers at the University of Geneva (UNIGE) and at the University Hospitals of Geneva (HUG), Switzerland, were able to demonstrate, for the first time, that the pancreatic islet cells derived from the Type 2 Diabetic human donors bear compromised circadian oscillators.

The disruption of the circadian clocks was concomitant with the perturbation of hormone secretion. Moreover, using clock modulator molecule dubbed Nobiletin, extracted from lemon peel, the researchers succeeded in “repairing” the disrupted cellular clocks and in partial restoring of the islet cell function. These results, published in the Proceedings of the National Academy of Sciences of the United States, provide a first insight into innovative approach for diabetes care.

PNAS Pancreatic Islets from type 2 diabetes

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The circadian clock system (from Latin “circa diem”, about a day) allows the organisms to anticipate periodical changes of geophysical time, and to adjust to these changes. Nearly all the cells in our body comprise molecular clocks that regulate and synchronize metabolic functions to a 24-hour cycle of day-night changes.

Today, increasing evidence show that disturbances in our internal clocks stemming from frequent time zone changes, irregular working schedules or ageing, have a significant impact on the development of metabolic diseases in human beings, including type-2 diabetes. Such disturbances seem to prevent the proper functioning of the cells in the pancreatic islet that secrete insulin and glucagon, the hormones that regulate blood sugar levels.

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