Category Archives: Health

Health: Asymptomatic Bacteriuria Diagnosis In Older Patients Should Not Require Antibiotics

From a New York Times online article:

Asymtomatic Bacteriuria DefinitionAt Dr. Soong’s hospital, withholding the results of urine cultures, unless doctors actually called the microbiology lab to request them, reduced prescriptions for asymptomatic bacteriuria to 12 percent from 48 percent of non-catheterized patients, with no loss of safety.

“The extra step of having the clinician call eliminated a lot of frivolous testing,” Dr. Soong said.

In patients who have none of the typical symptoms of a urinary tract infection — no painful or frequent urination, no blood in the urine, no fever or lower abdominal tenderness — lab results detecting bacteria in the urine don’t indicate infection and thus shouldn’t trigger treatment.

Older people, and nursing home residents in particular, often have urinary systems colonized by bacteria; they will have a positive urine test almost every time, but they’re not sick.

To read more: https://www.nytimes.com/2019/10/14/health/urine-tests-elderly.html

Health Care: Number Of Organ Transplant Physicians Shrinks As Demand Increases

From a StatNews.com online article:

Liver Transplants & DonorsMost Americans probably aren’t aware of the decline in the number of individuals training to become transplant physicians and how it will affect the future of medicine. Neither are the 2020 presidential hopefuls, all of whom have policies they believe best provide health care coverage for Americans without acknowledging or calling attention to the fact that soon there may not be enough doctors to do the work once more people are insured. We need a plan for that.

During the 25 years I’ve been a transplant doctor, I’ve cared for hundreds of patients who received lung transplants. I’m now worried about the growing number of people who will need this lifesaving procedure in the future but who won’t have enough transplant physicians to do it.

At any given time in the U.S., about 120,000 people are waiting for the call that they’ve been matched with a donor for a new lung, heart, liver, or kidney. That number will continue to rise, but the number of doctors to take the 2 a.m. call that a donor has been found for their patient and perform the transplant is dwindling.

To read more: https://www.statnews.com/2019/10/17/transplant-physicians-number-dwindling/?utm_source=STAT+Newsletters&utm_campaign=20aba6d000-First_Opinion&utm_medium=email&utm_term=0_8cab1d7961-20aba6d000-150443417

Medical Technology: 3D Deep-Learning Systems Show Promise For Automated Detection Of Glaucoma (Lancet Audio)

Lancet Digital HealthOur 3D deep-learning system performed well in both primary and external validations, suggesting that it could potentially be used for automated detection of glaucomatous optic neuropathy based on SDOCT volumes. Screening with the deep-learning system is much faster than conventional glaucoma screening methods (ie, by experienced specialists), can be done automatically, and does not require a large number of trained personnel on site. Further prospective studies are warranted to estimate the incremental cost-effectiveness of incorporating this artificial intelligence-based model for screening for glaucoma, both in the general population and among at-risk people.

To read more: https://www.thelancet.com/journals/landig/article/PIIS2589-7500(19)30085-8/fulltext

Health Care: Greater Use Of “Biosimilars” Could Save System $7 Billion

From a Health Care Finance News online article:

HealthCare Finance NewsBut greater use of biosimilars could create significantly more savings. If biosimilars obtained a 75 percent market share, less than the share of these medicines in many European Union nations, the resulting annual savings for the U.S. healthcare system could be nearly $7 billion, based on Winegarden’s analysis.

Not all drugs are created the same. Take generics and biologics: The former is a chemical-based medicine whose manufacture is easily replicated, while the latter is created using biological processes.

But there’s another key difference between those two classes of drugs, and it pertains to the financial state of the healthcare industry and to U.S. taxpayer dollars. Stated plainly, biosimilars have the opportunity to bring significant savings to state Medicaid programs and consumers with commercial insurance. That gives them a leg up over their chemical-based counterparts.

To read more: https://www.healthcarefinancenews.com/news/expanding-biosimilars-market-holds-potential-significant-savings-state-medicaid-programs?mkt_tok=eyJpIjoiTTJGbU1qTXpOVFpqTm1WbCIsInQiOiJrU3puNU4xNVB2eTBBVkpwQ3FGaWhYdDJwZEV0M1dlcFRBakNpOFZ5YVYyanpSSk9HeVZCQTBHbjY4ZktFXC82cm9JeWE3S2dUWm5HMXByYTVoOVB6SG9FaWRIWnRta2ZzZUNvN1g2WHVneVNtVEFpT1ZlZjEwWk1KbmFaXC9qN3N2In0%3D

Health Care: How “Non-Profit” Hospitals Are Driving Up Medical Costs

From an NPR online article:

Yale School of Public HealthThe irony is most hospitals are “nonprofit,” a status that makes them tax exempt. Many (but not all) do enough charity work to justify tax benefits, yet it’s clear nonprofit hospitals are very profitable. They funnel much of the profits into cushy salaries, shiny equipment, new buildings, and, of course, lobbying. In 2018, hospitals and nursing homes spent over $100 million on lobbying activities. And they spent about $30 million on campaign contributions. Health industries have also been funneling hefty sums into dark money groups. But their political power isn’t just the result of lobbying or electioneering. Hospitals are often the biggest employers in states and cities across America.

recent study by Yale School of Public Health economist Zack Cooper and colleagues takes a look at hospital politics and helps shed light on why American health care is so insanely expensive.

Cooper and his colleagues have spent years investigating whether this was true, filing Freedom of Information Act requests and crunching data. They’ve uncovered evidence that suggests it was true. They find that legislators who were on the fence and voted “yea” for the legislation were 700% more likely to see a large bump in Medicare payment rates to hospitals in their district. Between 2005 and 2010, Congress shelled out over $2 billion to 88 hospitals through the horse-trading Section 508 provision. It was a clear win for these hospitals, which spent the money on more equipment, buildings, services, and staff.

To read more: https://www.npr.org/sections/money/2019/10/15/769792903/how-non-profit-hospitals-are-driving-up-the-cost-of-health-care

Studies: Antibiotics Impair Microbiome Composition, Reducing Flu Immunity

From a Science Magazine online article:

Antibiotic use diminished the gut microbiome composition and impaired the ability of the immune system to generate antibodies. Treatment with antibiotics also disturbed bile acid metabolism and caused inflammatory responses.

From the original findings the Journal “Cell.com”:

Emerging evidence indicates a central role for the microbiome in immunity. However, causal evidence in humans is sparse. Here, we administered broad-spectrum antibiotics to healthy adults prior and subsequent to seasonal influenza vaccination. Despite a 10,000-fold reduction in gut bacterial load and long-lasting diminution in bacterial diversity, antibody responses were not significantly affected. However, in a second trial of subjects with low pre-existing antibody titers, there was significant impairment in H1N1-specific neutralization and binding IgG1 and IgA responses.

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In addition, in both studies antibiotics treatment resulted in (1) enhanced inflammatory signatures (including AP-1/NR4A expression), observed previously in the elderly, and increased dendritic cell activation; (2) divergent metabolic trajectories, with a 1,000-fold reduction in serum secondary bile acids, which was highly correlated with AP-1/NR4A signaling and inflammasome activation. Multi-omics integration revealed significant associations between bacterial species and metabolic phenotypes, highlighting a key role for the microbiome in modulating human immunity.

Diet Studies: “Dietary Fructose” In Soft Drinks, Foods Impairs The Body’s Ability To Burn Fat

From a Cell Metabolism online release:

Cell Metabolism Journal CoverIn summary, dietary fructose, but not glucose, supplementation of HFD impairs mitochondrial size, function, and protein acetylation, resulting in decreased fatty acid oxidation and development of metabolic dysregulation.

Dietary sugars, fructose and glucose, promote hepatic de novo lipogenesis and modify the effects of a high-fat diet (HFD) on the development of insulin resistance. Here, we show that fructose and glucose supplementation of an HFD exert divergent effects on hepatic mitochondrial function and fatty acid oxidation. This is mediated via three different nodes of regulation, including differential effects on malonyl-CoA levels, effects on mitochondrial size/protein abundance, and acetylation of mitochondrial proteins. HFD- and HFD plus fructose-fed mice have decreased CTP1a activity, the rate-limiting enzyme of fatty acid oxidation, whereas knockdown of fructose metabolism increases CPT1a and its acylcarnitine products. Furthermore, fructose-supplemented HFD leads to increased acetylation of ACADL and CPT1a, which is associated with decreased fat metabolism.

To read more: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(19)30504-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1550413119305042%3Fshowall%3Dtrue

Future Of Hospital Design: EIR Healthcare’s Prefab “MedModular” Hospital Rooms Are Customizable

From the EIRHealthcare.com website:

home_fullyEIR Healthcare collaborates with each hospital to customize the optimal space. Through our technology and design, doctors, nurses and any healthcare professional interacting with patients in a MedModular room are equipped to provide nothing short of excellence within every interaction. EIR Healthcare was presented with a 2018 iF Design Award for our “Hospital of the Future” professional concept.

When a MedModular room is delivered, it is done so with every detail already executed from both technology and space design standpoints, which results in optimizing the efficiency in which hospitals and other healthcare environments are constructed – and completed.

Website: https://eirhealthcare.com/EIR

Health Technology: Digital Therapeutics Startup “Kaia” Targets Chronic Pain With AI-Guided Exercise

From a VentureBeat.com online review:

Kaia Digital ExerciseKaia’s iOS and Android apps were developed with the help of physiotherapists, pain management physicians, orthopedic surgeons, and clinical psychologists, the company claims, and are registered as Class 1 medical devices with the Food and Drug Administration. They serve up video clips covering basic back and COPD pain information and step-by-step physiotherapy exercises, in addition to psychological strategies, such as mindfulness and muscle relaxation.

During each of the over 120 15-minute exercises, in-app computer vision models track connective points on the body through a device’s front-facing camera while an on-screen wireframe model illustrates the steps. Audio feedback informs users whether they’re performing exercises correctly and how they might improve, and a built-in chat tool allows them to consult with a physiotherapist or sports scientist on questions related to specific moves.

To read more: https://venturebeat.com/2019/09/17/kaia-raises-8-million-to-treat-chronic-pain-with-ai-guided-exercise/