Category Archives: Health
In a WTOP-FM interview, Health Affairs Editor-In-Chief Alan Weil assesses how consumers may (or may not) benefit from two long-anticipated rules, recently unveiled by the Trump Administration, that increase price transparency for both hospitals and insurers.
Sleep Podcasts: Older Adults Are More Likely To Suffer From Chronic (Long-Term) Insomnia
Beyond the constant tossing and turning of a sleepless night, it might surprise you to know that insomnia is affecting a fair hunk of the Australian population. A recent study released by the Sleep Health Foundation found that 15 per cent of us suffer from chronic insomnia disorder, and very few people are choosing to access help.
Guests:
Professor Robert Adams, Professor in Respiratory and Sleep Medicine for Flinders University, and lead researcher for Chronic Insomnia Disorder in Australia study for Sleep Health Foundation
Dr Moira Junge, health psychologist specialising in treating sleep disorders, board member for Sleep Health Foundation
Studies: Oral Liquid Salt Choline & Geranate (CAGE) Blocks Fat Absorption W/ 12% Weight Loss (Harvard)
From a Harvard news release:
…a new study from the Harvard John A. Paulson School for Engineering and Applied Sciences (SEAS) and Harvard’s Wyss Institute for Biologically Inspired Engineering has found that an orally administered liquid salt called Choline and Geranate (CAGE) can physically reduce the absorption of fats from food with no discernible side effects in rats, and reduces total body weight by about 12 percent.
“A reduction in body weight of 12 percent is like getting a human from 200 pounds down to 176, which is a significant change,” said first author Md Nurunnabi, a former Postdoctoral Fellow at the Wyss Institute and SEAS who is now an Assistant Professor of Pharmaceutical Sciences at The University of Texas at El Paso. “Our goal is to translate this work into a product that can help people maintain a healthier weight, and this study marks the very beginning of that journey.”
CAGE, which is a salt in its liquid state, was created a few years ago by Samir Mitragotri, the Hiller Professor of Bioengineering and Hansjörg Wyss Professor of Biologically Inspired Engineering, as part of an effort to improve the body’s absorption of medicines.
To read more: https://www.seas.harvard.edu/news/2019/11/locking-fats-cages-treat-obesity
Emergency Medicine: When “Treating Everyone” Meets “Triage”, Patients And Healthcare Must Wait
From a STAT online article:
The specialty of emergency medicine is firmly grounded in social justice and providing access to expert care to everyone who comes in. That means treating anyone, with any condition, at any time. And yet, embedded into emergency department operations is a system that might be perceived as unjust: the concept of triage. The emergency queue isn’t “first come, first served.” It’s nonlinear by design, since triage prioritizes the severity of illness. The severely ill or injured receive immediate attention. Everyone else, to various degrees, must wait.
There are situations when waiting feels immoral to me, not merely inconvenient. Being an emergency doctor means shouldering burdens for perceived injustices that we have little, if any, control over. Most of the beds were locked up with patients boarding in the ED, which means they are waiting for an inpatient bed to become available in the hospital.
Hospitals have high expectations regarding how quickly patients are seen in the emergency department, and my colleagues and I share that goal. But there’s less urgency when it comes to discharging patients from the hospital, which would unclog the backup in the emergency department — and its waiting room.
Health Diagnosis Podcasts: Dysautonomia (Invisible Illness) Affects Up To 3 Million Americans
From a Milwaukee Journal Sentinel online article:
“Dysautonomia is probably significantly more common than we realize,” says Jeremy Cutsforth-Gregory, a neurologist at Mayo Clinic in Rochester, Minnesota. “I think it’s significantly underdiagnosed.” In about half of POTS cases, he adds, the patient’s disease grows out of the immune response to an infection.
Ryan Cooley, a doctor and co-director of the Dysautonomia Center at Aurora Medical Center in Grafton, says detecting the disorder is especially challenging because “typically there isn’t a dominant symptom or physical finding.”
Perhaps the most common clue to the disorder is that patients find that when they stand up from a chair their heart races and they feel light-headed.
To read more: https://www.jsonline.com/story/news/2019/11/14/invisible-illness-leaves-millions-undiagnosed-barely-functioning/2507547001/
Health Studies: Regular, Brisk Exercise Lowers Inflammatory Cells, Heart Disease Death Risks
From a Science Magazine online article:
They found that these physically active mice had fewer inflammatory cells (leukocytes) than sedentary mice, an effect they traced to diminished activity of hematopoietic stem and progenitor cells (HSPCs). The lower activity of HSPCs was due at least in part to exercise-induced reduction in the levels of leptin, a hormone produced by fat tissue that regulates cells within the hematopoietic bone marrow niche.
Regular physical activity is associated with a lower rate of death from heart disease, but the underlying mechanisms are not fully understood. Frodermann et al. examined the effect of exercise on cardiovascular inflammation, a known risk factor for atherosclerosis, by studying mice that voluntarily ran for long distances on exercise wheels.
To read more: https://science.sciencemag.org/content/366/6469/1091.2
Medical Perspectives: “Stroke – The Doctor As Patient” (The Lancet)
From a The Lancet online article:
As a consultant, I had profoundly failed to appreciate the experience of fatigue and apathy among patients. More than excessive tiredness, the fatigue was overwhelming, turning simple activities into insurmountable, exhausting challenges. It was frustrating and I fell into the trap of overexertion when I did have energy, thus exhausting myself and sabotaging the day’s recovery plan. Had staff not been so adept at encouraging me when I lacked energy and holding me back when I tried to overdo things, I would have squandered much valuable rehabilitation time.
I was a consultant in neurological rehabilitation for acquired brain injury when, at the age of 62 years, I had a stroke. Running for a train, I experienced pain in the right side of my head and mild weakness and sensory loss in my left limbs. I thought I’d had a stroke, but I was remarkably calm. It was late and my instinct was to get home, where I went to the study. In the morning, I found myself on the floor, half-blind, half-paralysed, and terrified.
.
Scans showed a large intracerebral haemorrhage in the area of the right basal ganglia. My symptoms could be explained by the damage to my brain—my medical world was in order, something to hold on to. I discussed my diagnosis and treatment with my colleagues during brief waking periods, grateful that they still saw the person I was before my stroke. Meanwhile, my wife was in the good hands of staff who treated her with sensitivity, giving her plain facts and support.
Technology Podcasts: “The Digitisation Of Healthcare” (Economist)
There can be few applications of digital technology more worthwhile than saving lives, but integrating digital technology into healthcare systems is uniquely complex. This episode provides an introduction to some of the challenges that healthcare providers face in their pursuit of digital innovation, and explores some of the paths forward.
Host Pete Swabey is joined by Professor Ann Blandford, deputy director for digital health at the UCL Institute of Healthcare Engineering; by Jackie Hunter, chief executive, clinical programmes & strategic relationships at AI-powered drug development firm Benevolent.AI; and by Elizabeth Sukkar, managing editor and global editorial lead for healthcare at The EIU. Sponsored by DXC Technology.
Health Studies: Eating After Exercise Found To Burn “Twice The Fat”
From a New York Times online article:
The riders who had pedaled on an empty stomach, however, had incinerated about twice as much fat during each ride as the men who consumed the shake first. The riders all had burned about the same number of calories while pedaling, but more of those calories came from fat when the men did not eat first.
Those riders also showed greater improvements in insulin sensitivity at the end of the study and had developed higher levels of certain proteins in their muscles that influence how well muscle cells respond to insulin and use blood sugar.
Working out on an empty stomach could amplify the health benefits of the activity, according to a well-timed new study of the interplay of meal timing, metabolic health and moving. The study, which involved sedentary men and moderate cycling, suggests that whether and when we eat may affect how exercise affects us.
To read more: https://www.nytimes.com/2019/11/27/well/move/eating-food-exercise-fasting-insulin-weight-loss-fat.html
Health Podcasts: Which Drug Prices Should Medicare Negotiate? (NE Journal Of Medicine)
From a New England Journal of Medicine article:
Medicare negotiation of prescription-drug prices would bring U.S. government policies in line with those of other high-income countries, and the idea is popular with both the public and policy analysts. But it would represent a sea change for pharmaceutical firms, which will maintain that any threat to their pricing power will slow innovation.
Negotiating prices of 10 too-little drugs and 10 too-late drugs to levels currently paid in the United Kingdom would produce about $26.8 billion in savings in 2019 alone, most of which ($25.9 billion) would come from savings on drugs in the latter category. Over time, the drugs included could change. For instance, in 2020 this category might include Revlimid (lenalidomide), which generated $6.5 billion in 2018 U.S. sales; its price in the United Kingdom is 32% of that in the United States.
Americans all along the political spectrum favor allowing Medicare to negotiate the prices it pays for prescription drugs.1 In September, House Speaker Nancy Pelosi (D-CA) introduced what is now called the Elijah E. Cummings Lower Drug Costs Now Act of 2019 (H.R. 3), and the bill would have Medicare do just that.
Although there are draft pieces of legislation and regulation that take aim at the rising cost of drugs, H.R. 3 is the legislative tip of the spear for price negotiation. If it became law, Medicare would target drugs that claim the largest share of the health care budget and that face limited competition from generics or biosimilars. I propose an alternative set of drugs for price negotiation: those that have too little evidence to support full approval or are too late in their life cycle to justify continued high prices.
To read more: https://www.nejm.org/doi/full/10.1056/NEJMp1912736?query=recirc_inIssue_bottom_article
Boomers Daily 