The New York Times (4/26, Bakalar) in its “Well” blog reports that treating expectant mothers “for depression may benefit not just themselves but their babies as well,” the findings of a 7,267-patient study published in the May issue of Obstetrics & Gynecology suggest. After controlling for confounding factors, investigators “found that depressive symptoms were associated with a 27 percent increased relative risk of preterm birth (less than 37 weeks of gestation), an 82 percent increased risk of very preterm birth (less than 32 weeks of gestation), and a 28 percent increased risk of having a baby small for gestational age.”
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NBC News (4/26, Fox) reports that research suggests “night shifts can cause heart disease, and this raised risk appears to be independent of obvious causes such as an unhealthy diet and lack of exercise.”
CBS News (4/26, Welch) reports that investigators “analyzed 24 years worth of data on about 189,000 women who participated in the Nurses’ Health Study I and II.” The research indicated “that women who reported working more than 10 years of rotating night shifts had a 15 to 18 percent increased risk of developing coronary heart disease than those who did not.” The findings were published in the Journal of the American Medical Association. HealthDay (4/26, Reinberg) reports, however, that “the more time that elapsed after quitting such night shift work, the lower the risk for heart disease...said” lead researcher Celine Vetter. The New York Times (4/26, A15, Saint Louis, Subscription Publication) reports that yesterday, the Food and Drug Administration recommended that physicians “should exercise caution in prescribing to pregnant women an oral drug for yeast infections because of new evidence suggesting a possible link to miscarriage.” Previously, the agency “had previously warned that chronic high doses of the drug, fluconazole (brand name Diflucan), might be linked to ‘a rare and distinct set of birth defects’ in infants whose mothers took it in the first trimester” in doses ranging from “400 to 800 milligrams a day.”
The NBC News (4/26, Fox) website reports that in a safety alert issued April 26, “the Food and Drug Administration announced...it’s checking into a report that suggests a commonly used yeast infection pill may raise the risk of miscarriages and birth defects” at one or two doses of just 150 milligrams each. MedPage Today (4/26, Walker) reports that FDA labeling currently “does not address extended use, only indicating that a single dose of 150 mg taken during pregnancy to treat a vaginal yeast infection does not increase risk of birth abnormalities or other problems during pregnancy.” In the New York Times (4/27) “Well” blog, Tim Lahey, MD, MMSc, writes, “Ten thousand people ages 13 to 24 are given H.I.V. diagnoses every year in the United States, and epidemiologists estimate fully half of young people with H.I.V.” are unaware they have it. Contributing to the problem “is the low rate of H.I.V. testing in young people, despite the recommendation by the Centers for Disease Control and Prevention that every sexually active person over the age of 13 get tested.” A few months ago, “C.D.C. researchers reported in [pdf] Pediatrics that pediatricians and parents are testing five times fewer young people for H.I.V. than recommended by national guidelines.”
In “To Your Health,” the Washington Post (4/27, Cha) reports that in a study published online April 27 in JAMA Surgery, researchers who analyzed “421,476 patient records from a national database of hospital inpatients...discovered that a mere seven procedures accounted for approximately 80 percent of all admissions, deaths, complications and inpatient costs related to emergency surgeries.” Those surgeries include “removing part of the colon, small-bowel resection, removing the gallbladder, operations related to peptic ulcer disease, removing abdominal adhesions, appendectomy and other operations to open the abdomen.” HealthDay (4/27, Thompson) points out that researchers focused on “procedures that meet the definition of emergency general surgery as created by the American Association of Surgery for Trauma,” including “operations to deal with gastrointestinal problems, soft tissue infections and hernias.” In particular, investigators honed in on “emergency general surgery performed within two days of hospital admission due to a serious medical condition,” but excluded “heart-related procedures and surgery prompted by traumatic events. Report finds substantial variations in prices of common medical procedures across state lines4/29/2016 According to USA Today (4/27, O'Donnell) a new report from the Health Care Cost Institute (HCCI) finds that “huge variations exist in the prices of some of the most common medical procedures across state lines.” However, “some experts say the data is of little use to consumers who rarely know what they owe until the bills arrive.” The report was published in Health Affairs.
NBC News (4/27, Fox) reports on its website that “unlike other reports, this one looks at prices paid by people with private health insurance.” Congressional Quarterly (4/27, Evans, Subscription Publication) reports the researchers “used data from the Health Care Cost Institute to assess national commercial claims and compare 242 medical services prices across 41 states and the District of Columbia between Jan. 1, 2012, and Dec. 31, 2013.” Just “15 states had health care costs below the national average. Florida, Arizona, Tennessee, Maryland and Nevada had the lowest.” The report indicated that “Alaska had the highest average health care prices,” while “Wisconsin, North Dakota, New Hampshire and Minnesota made up the rest of the top five states with the highest health care costs.” Healthcare Finance News (4/27, Lagasse) reports, “Prices for services...varied significantly between cities within the same state.” The report also “found that prices varied more for certain services than for others.” USA Today (4/27, O'Donnell) reports that on Wednesday, CMS proposed a rule which “will adjust hundreds of thousands of physicians’ Medicare payments to reward or penalize them based on how healthy they keep their patients.” The rule will encourage physicians “to try new ways to keep people healthier, such as with home visits or help with housing – things that fall outside of traditional forms of reimbursable medicine.” Steven J. Stack, MD, president of the American Medical Association, lauded the proposal, saying, “It is hard to overstate the significance of these proposed regulations for patients and physicians.” Dr. Stack added that when Congress approved the doc fix in 2015, “lawmakers signaled that they wanted to transform Medicare by promoting flexibility and innovation in the delivery of care, changes that could lead to improved quality and better outcomes for patients.”
Congressional Quarterly (4/27, Young, Subscription Publication) reports that under the proposal, physicians “face a choice of moving into alternative payment models in which they face greater financial risks or rewards based on how Medicare judges their performance, or adapting to the new merit-based incentive payment system.” The article quotes Dr. Stack as saying, “‘While we have not yet digested the entire 962-page regulation, it appears on our initial review that CMS Acting Administrator Andy Slavitt and his senior management team have listened’ to doctors’ requests for less burdensome electronic reporting.” MedPage Today (4/27, Frieden) reports that Dr. Stack announced the AMA is releasing “new online information and resources to help physicians navigate the changing landscape.” Medscape (4/27, Terry) reports Dr. Stack pointed out that the “draft rules are only a first step in the rulemaking process.” He encouraged “physicians to offer comments on the rule during the upcoming 60-day comment period.” Bloomberg News (4/11, Tozzi) reports that researchpublished in the Journal of the American Medical Association indicates that “the wealthiest Americans can expect to live at least a decade longer than the poorest – and that gap, as with income inequality, is growing ever wider.” The study found that “top earning Americans gained 2 to 3 years of life expectancy between 2001 and 2014, while those at the bottom gained little or nothing.”
The NPR (4/11, Zarroli) “The Two-Way” blog reports the research also indicated that “poor people who reside in expensive, well-educated cities such as San Francisco tend to live longer than low-income people in less affluent places.” White women dying prematurely at higher rates since the turn of the century, analysis indicates In a 3,400-word article on its front page, the Washington Post (4/10, A1, Achenbach, Keating) reports, “White women have been dying prematurely at higher rates since the turn of this century, passing away in their 30s, 40s and 50s in a slow-motion crisis driven by decaying health in small-town America, according to an analysis...by The Washington Post.” This analysis, which uses CDC data, and “builds on academic research published last year, shows a clear divide in the health of urban and rural Americans, with the gap widening most dramatically among whites.” http://www.wsj.com/articles/when-patients-drive-their-doctors-crazy-1459793860
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