A Weekly Compilation of Clinical Laboratory and Related Information
from The Division of Laboratory Science and Standards
January 17, 2013
View Previous Issues - Healthcare News Archive
New Standards of Practice Needed in Cancer Tissue Sampling
Genomics is poised to become a major force in cancer care, and therapy guided by genetics is being embraced within established strategies for the treatment of a number of malignancies.
However, in order for this field to expand, standards for acquiring appropriate tissue samples to conduct comprehensive genomic analyses also must evolve, say the authors of a new study. A number of challenges and issues need to be addressed in order to move both the pathology and oncology communities toward a new practice of incorporating larger tissue samples, write the authors of a Viewpoint published in the January 2 issue of Journal of the American Medical Association.
CDC: 11 Biolab Workers Infected From 2004-10
At least 11 workers at U.S. biological laboratories were infected with dangerous pathogens from 2004 to 2010, the federal Centers for Disease Control and Prevention said in a report on security measures stemming from the deadly 2001 anthrax attacks. None of the infected workers died. The Atlanta-based agency said the infection rate of 1.6 per 10,000 workers was far lower than the rate of general occupational illnesses in scientific research and development facilities.
“If you look at the report as a whole, it’s a success story,” said report co-author Robbin S. Weyant, who oversees CDC regulation of about 70 “select agents and toxins” deemed a severe threat to human, animal or plant health.
HHS Delays Enforcement of HIPAA Transaction Rules Until April
The Centers for Medicare & Medicaid Services' Office of E-Health Standards and Services has announced it will not enforce operating rules under HIPAA until April 2013.
Provisions in the Patient Protection and Affordable Care Act required HHS to adopt a single set of operating rules for each HIPAA transaction standard to improve its utility and reduce administrative costs. The operating rules — intended to make the application of the HIPAA standards more consistent and efficient — took effect Jan. 1 for HIPAA-covered entities.
Court Upholds Controversial Dialysis Law
A federal appeals court upheld the constitutionality of a heavily lobbied 2002 law that prevents Florida doctors from referring kidney-dialysis patients to labs in which the doctors have financial stakes. National dialysis-clinic companies Fresenius Medical Care Holdings, Inc., and Davita, Inc., along with a Davita subsidiary, challenged the restrictions, arguing that they conflicted with a federal law and were aimed politically at helping a Florida laboratory firm.
But the 11th U.S. Circuit Court of Appeals issued a 23-page ruling that upheld the law, which the state contends was designed to help hold down health-care costs and prevent over-utilization of services and conflicts of interest. The three-judge panel agreed with a lower court that, among other things, the law did not discriminate against Fresenius and Davita and didn't violate their constitutional rights. "Because it is reasonably conceivable that Florida ESRD (end-stage renal disease) patients would be better served if their physicians were prohibited from making self-referrals to associated laboratories, we conclude that the Florida act survives rational basis scrutiny and that the law does not deprive appellants (Fresenius and Davita) of their rights to substantive due process,'' part of the ruling said.
CMS Announces Over 100 New ACO Contracts
Medicare nearly doubled the size of one accountable care program as of Jan. 1 with 106 new ACO contracts that offer hospitals and doctors financial incentives to improve quality and slow health spending. The CMS announced its latest and largest round of accountable care organizations under the Medicare shared-savings program, which launched in April last year with 27 ACOs. Another 89 ACOs were named to the program last July. The Center for Medicare and Medicaid Innovation separately launched 32 Medicare ACOs known as Pioneers roughly one year ago. CMS said half of ACOs are physician-led and care for less than 10,000 Medicare enrollees.
NIH Wants Gene Function Studies to Support Undiagnosed Diseases Program
The US National Institutes of Health wants to provide further support for efforts to understand the function of genes that may be involved in certain diseases, particularly genes that have recently been identified through its Undiagnosed Diseases Program, the agency said this week. It plans to award up to $150,000 to supplement such efforts next year. Since it launched in 2008 with the mission of studying the "most puzzling medical cases" that are referred to the NIH Clinical Center, the UDP has received around 6,300 inquiries that have led to the evaluation of 450 patients and the diagnosis of around 100 patients.
New York City Ties Doctors’ Income to Quality of Care
In a bold experiment in performance pay, complaints from patients at New York City’s public hospitals and other measures of their care — like how long before they are discharged and how they fare afterward — will be reflected in doctors’ paychecks under a plan being negotiated by the physicians and their hospitals.
The proposal represents a broad national push away from the traditional model of rewarding doctors for the volume of services they order, a system that has been criticized for promoting unnecessary treatment. In the wake of changes laid out in the Affordable Care Act, public and private hospitals are already preparing to have their income tied partly to patient outcomes and cost containment, but the city’s plan extends that financial incentive to the front line, the doctors directly responsible for treatment. It also shows how the new law could change longstanding relationships, giving more power to some of the poorest and most vulnerable patients over doctors who run their care.
ASCP and the Association of Clinical Scientists Join Forces for Mutual Scientific Pursuits
ASCP and the Association of Clinical Scientists (ACS) signed a Memorandum of Understanding (MOU) effective Jan. 1 to collaborate on education, advocacy, and membership strategies to the mutual benefit of the pathologists and doctorate-level clinical scientists who belong to both medical organizations. This strategic alliance enables each organization to gain from one another’s areas of expertise.
“Through this alliance, ASCP recognizes the extraordinary contribution of doctorate-level clinical scientists to laboratory medicine,” says William G. Finn, MD, FASCP, ASCP Vice President. “I look forward to this collaboration because it is a win for all sides.
Source: http://www.ascp.org/. ASCP e-NewsBriefs
Natural Disasters Spur Innovation and Upgrades in the Lab
As the massive Hurricane Sandy bore down on the East Coast last October, water gushed through the entrances of New York University’s Langone Medical Center on New York City’s Upper East Side. As the water raced rapidly down the first floor corridors, hospital and laboratory staff began moving equipment into elevators to get to higher ground. The elevators shut down, and the entire hospital went dark.
“It was like being on the Titanic,” recalls Irina Lutinger, FACHE, MPH, MASCP, H (ASCP) DLM, Senior Administrative Director of Clinical Laboratories at the Medical Center, who was in her laboratory at the time. “It was very eerie.” A member of ASCP’s Board of Directors (BOD) and a longtime ASCP volunteer, Ms. Lutinger says that as devastating as natural disasters are, they offer hospitals and laboratories an opportunity to make significant upgrades in their aftermath and to learn invaluable lessons.
Working in the Medical Center’s favor was that it has a comprehensive emergency phone tree to contact employees in order of priority. The staff used cell phones and sent text messages to communicate because they couldn’t use emails with the network servers down. Additionally, all departments had emergency resources—flash lights, small lamps, extension cords, face shields, and gloves—stored in more than one location.
“A key lesson is: Where do you keep your data?” Ms. Lutinger says. “The information technology highway should be at the top of the list. The Medical Center makes network upgrades continuously. Yet the hospital facility was built a long time ago. A new hospital is being designed and will have fully upgraded infrastructure within a protected location.”
Health Centers Not Routinely Testing for HIV
Only one in five federally funded safety-net health centers reported testing all patients ages 13 to 64 for HIV, despite a 7-year-old CDC recommendation to do so, a government report found.
Another 55% reported targeting high-risk patients for testing, the Department of Health and Human Services Office of Inspector General (OIG) stated in a report. The high-risk testing is an approach aligning with recommendations from the U.S. Preventive Services Task Force.
Another 1% of sites reported testing all adults, but not teens. The remaining 24% of sites offered HIV tests only when patients requested it or had HIV symptoms, the report found.
Task Force Statement May Be Deterring Women From Mammography
In 2009, the US Preventive Services Task Force (USPSTF) recommended limiting the use of screening mammography. Researchers now report that the rate of screening has declined significantly in the Medicare population. The rate of screening mammography declined by 4.3% in 2010, a year after the USPSTF announced the new guidelines, according to David Levin, MD, professor and chair emeritus of radiology at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, and colleagues. The results of their study were presented at the Radiological Society of North America 98th Scientific Assembly and Annual Meeting.
From 2005 to 2009, the rate had been increasing by just less than 1% each year, Dr. Levin reported. "There is no question that that drop was the result of this task force recommendation," Dr. Levin told Medscape Medical News. Stamatia Destounis, MD, from the Elizabeth Wende Breast Care Center and the University of Rochester School of Medicine and Dentistry in New York, told Medscape Medical News that the 2009 USPSTF recommendations "have caused confusion among patients and their referring doctors."
Study Shows ID Errors in Prostate Biopsies
As many as 3.5% of prostate biopsy specimens were contaminated or inadvertently switched with that of another patient, according to a review of 13,000 samples from 54 laboratories. The overall error rate was less than 1%, but rates among different types of labs ranged as high as 3.51%. No laboratory included in the study had an error-free performance record. Institutional approval for the study required investigators to remove all identifying information from the specimens. Consequently, the impact of the laboratory errors could not be assessed, as reported online in the American Journal of Clinical Pathology.
Unnecessary Pap Tests in Millions of US Women
In their report on cervical cancer screening released, the Centers for Disease Control and Prevention (CDC) startlingly estimated that 22 million women in the United States may have undergone such screening unnecessarily, because they had already had hysterectomies.
An expert approached by Medscape Medical News to comment on the issue cautioned that the data collected by the CDC were from women self-reporting and so may be subject to bias. She also suggested that some of the unnecessary testing, which is contrary to guidelines that have been in place for a decade, may be due to confusion stirred up by educational campaigns for the human papilloma virus vaccine Gardasil (Merck & Co).
The CDC analyzed data collected from 2000-2010 by the Behavioral Risk Factor Surveillance System on screening for cervical cancer using the Papanicolaou (Pap) test. In one of the articles published in Morbidity and Mortality Weekly Report, the CDC highlighted the fact that during the study period, screening in women after a hysterectomy had declined from 73.3% in 2000 to 58.7% in 2010. But this means that more than one half of the women were undergoing Pap tests unnecessarily, because hysterectomy involves removal of the cervix in the majority of cases (94% of cases, the CDC estimates).
Such women do not need cervical cancer screening — and it has been specifically discouraged in guidelines from all the major organizations since 2002-2003.
Source: Source: http://www.medscape.com/
Pap Test Could Help Find Cancers of Uterus and Ovaries
The Pap test, which has prevented countless deaths from cervical cancer, may eventually help to detect cancers of the uterus and ovaries as well, a new study suggests. For the first time, researchers have found genetic material from uterine or ovarian cancers in Pap smears, meaning that it may become possible to detect three diseases with just one routine test.
But the research is early, years away from being used in medical practice, and there are caveats. The women studied were already known to have cancer, and while the Pap test found 100 percent of the uterine cancers, it detected only 41 percent of the ovarian cancers. And the approach has not yet been tried in women who appear healthy, to determine whether it can find early signs of uterine or ovarian cancer. The team picked common mutations found in these cancers, and looked for them in tumor samples from 24 women with endometrial cancer and 22 with ovarian cancer. All the cancers had one or more of the common mutations.
False-Negative Results Found in HPV Testing
More than 12,000 women in the United States will be diagnosed with cervical cancer this year. Hundreds more may go undiagnosed because of the widespread use of a screening test that the Food and Drug Administration has not approved for detecting the human papillomavirus, or HPV, which causes nearly all cervical cancers.
Some of the largest national labs have for a decade routinely used test kits that contain a preservative, BD SurePath, that is approved for Pap tests but not HPV testing. The labs continue to use the tests despite a June 8 FDA warning that HPV tests using SurePath can produce false negatives and national guidelines that call for using only FDA-approved tests, an Arizona Republic investigation has found.
The result: Women may be told they are free of HPV when, in fact, they aren't. Such a misdiagnosis can allow the virus or cancer to become established and more difficult to treat.
PSA Screening Rate Drops After Major Trial Results Released
The number of men receiving prostate cancer screening has sharply declined since the publication of a major trial showing no improvement of mortality rates from screening with the prostate-specific antigen (PSA) test. The reasons for screening have also shifted, according to research presented at the American Public Health Association (APHA) 140th Annual Meeting. The percentage of men getting screenings due to a family history of prostate cancer, however, notably increased.
Salivary Gland Biopsy May Diagnose Parkinson's Disease
Salivary gland biopsy appears to be a diagnostic test for Parkinson's disease, a new study suggests. A biopsy of the submandibular gland that shows the presence of the abnormal protein alpha-synuclein is highly indicative of Parkinson's, as distinct from other neurodegenerative disorders that can mimic the disease, said lead study author, Charles Adler, MD, PhD, from the Mayo Clinic Arizona, Scottsdale, Arizona.
"There is currently no diagnostic test for Parkinson's disease in living patients. The only way to make the diagnosis is at autopsy, when you can see an abnormal protein, alpha-synuclein, in certain brain regions," Dr. Adler, a fellow of the American Academy of Neurology, told Medscape Medical News.
Precise Troponin Test Could Cut SPECT Use in ED
A high-sensitivity troponin T (hsTnT) test correlated well with abnormal cardiac SPECT scans, potentially allowing for less use of the costly imaging modality for emergency chest pain patients, researchers suggested.
The median hsTnT levels in patients with abnormal SPECT myocardial perfusion imaging (MPI) was more than twice those in patients with normal imaging results: 9.41 versus 4.89 pg/mL (P=0.001), according to a study released this week in the Journal of the American College of Cardiology: Cardiovascular Imaging.
Technique IDs Deadliest Whooping Cough Cases
Taking early and repeated white blood cell counts is vital in diagnosing whooping cough (pertussis) in infants and identifying which of them have the highest risk of dying from the respiratory infection, according to a new study. Researchers examined the medical records of 31 infants admitted to five pediatric intensive-care units in California between September 2009 and June 2011. In 2010, California had its highest pertussis rate in 60 years.
Hospitals Speed up Flu Testing for Hectic Season
Laboratory testing for the flu has traditionally taken so long to yield results that most people recovered before finding out if they actually had the virus. But about half a dozen Chicago-area hospitals can now diagnose influenza in just more than an hour through a federally approved machine that has been working overtime during what is shaping up as a horrendous season for the flu.
"If you don't have this test, then you're just guessing what the best thing to do could be," said Paul Schreckenberger, Loyola University Health System's authority on the FilmArray Respiratory Panel. A faster and more accurate diagnosis can lead to more effective treatment. "It is important for the physician to know what they're dealing with," Schreckenberger said. "They can't just look at the patient or read their symptoms."
The screening device — the second of its type to be approved by the U.S. Food and Drug Administration — tests a nasal sample for 17 types of viruses and three kinds of bacteria.
Morehouse Seeks Patent on Malaria Diagnosis Kit
Morehouse School of Medicine is seeking to patent a new way to diagnose and manage malaria. According to a patent application made public, the technology detects biomarkers -- a small molecule, protein or nucleic acid -- that can be detected and measured in body fluids to predict the severity and mortality of malaria.
Researchers at Stanford University and Intel Develop Silicon Microarray Chip Capable of Producing Clinical Pathology Laboratory Test Results in Minutes
At the heart of a new point-of-care technology is a prototype silicon chip that contains up to 9,000 peptides and allows real-time analysis in just minutes. Researchers say this technology can significantly reduce the time-to-answer when compared to existing clinical laboratory testing technologies. This new prototype silicon chip is an on silico peptide microarray. It could help researchers better understand how proteins interact in the body. In turn, that will lead to improved diagnoses of numerous diseases.
Baylor, Berry Genomics Team on Non-invasive Prenatal Dx
Baylor College of Medicine said that it will partner with the Chinese prenatal testing company Berry Genomics to combine their capabilities to improve prenatal genetic testing methods. The partners plan to harness BCM's gene-chip microarray technologies that assess chromosome structure and Berry Genomics' technologies, which are used to evaluate fetal DNA in maternal plasma.
Mayo Clinic Teams With Optum Unit of UnitedHealth
The Mayo Clinic and the Optum unit of UnitedHealth Group Inc. are teaming up on a research and innovation facility aimed at improving patient care. Optum Labs will be based in Cambridge, Mass. Mayo and Optum said in a joint statement they'll combine their extensive clinical and claims data to help health care providers create the most efficient approaches to care.
Bioengineer Developing Needle-Free 'Nanopatch' Vaccines
A fingertip-sized "nanopatch" covered in thousands of vaccine-coated microscopic spikes may someday transform delivery of life-saving vaccines against potentially fatal diseases. Mark Kendall, a biomedical engineer with a fascination for problem solving, has developed the device. After 160 years of using needles and syringes for immunization, he says, at-risk people - especially those in poorer, tropical, remote countries - need something simpler, stabler and easier to use. And he thinks he has the answer.
"Most current vaccines are delivered via the needle and syringe system that was developed in 1853," Dr. Kendall said in an interview from his laboratory in Australia. "It's effective on many levels but it also has many downsides." His nanopatch has yet to prove itself in human clinical trials, but has had impressive results in animal tests.
Leishmaniasis: A Genetic Link Found in Far-Flung Victims of a Lethal Form of a Parasitic Disease
Whether someone bitten by a sandfly goes on to develop the most lethal form of leishmaniasis is determined partly by the victim’s own genes, a new study suggests. Researchers are not sure what those mutations do, but the nearest stretch of DNA determines how white blood cells “grab” invaders to trigger immune responses, said Peter J. Donnelly, an Oxford statistics professor who also heads the Wellcome Trust Center for Human Genetics and was one of the paper’s authors. While it is widely known that immune-system genes influence susceptibility to cancer, learning that they may also control susceptibility to a parasitic disease was “quite interesting,” Dr. Donnelly said.
Synthetic Stool Stymies Stubborn C. Difficile
In a small proof-of-concept trial, two patients with refractory C. difficile infection got back to regular bowel movements within 2 or 3 days of receiving a substitute stool mixture, and remained symptom-free at 6 months, Elaine Petrof, MD, of Kingston General Hospital in Ontario, and colleagues reported online in Microbiome. The synthetic stool was comprised of 33 bacterial strains cultured from the feces of a healthy donor. Compared with a standard fecal transplant, having a cleaner culture can eliminate viruses and pathogens and lets the clinician control the type of bacteria given, Petrof and colleagues wrote.
More centers have become comfortable with transplanting feces from a healthy donor in order to treat C. difficile infection, as evidence mounts that it offers a quick cure. But it's often stymied by concerns about infection or apprehensive patients, the researchers said. So they [The researchers] developed synthetic stool, dubbed "RePOOPulate," by taking feces from a healthy 41-year-old female donor and culturing out various bacterial strains. They initially came up with 62 isolates and pared that figure down to 33 after using 16S ribosomal RNA gene sequencing to determine antibiotic susceptibility. They also looked at stool datasets from healthy donors to determine the appropriate proportions of bacteria they should include in their formulation.
Heart Muscle Cells Regenerate in Kids, Research Shows
Human hearts continue to generate new cells after birth, a finding that could lead to new ways to treat heart problems, researchers say. The team, from Boston Children's Hospital, analyzed specimens from the hearts of healthy people, up to age 59. They found that heart muscle cells in infants, children and teens continue to divide and increase in number. This regeneration peaks during infancy and then declines. It then increases during the adolescent growth spurt and continues until about age 20, according to the study, which was published in the Jan. 7-11 online issue of the journal Proceedings of the National Academy of Sciences. The findings overturn the long-held belief that growth in the human heart after birth occurs only by enlargement of existing cells, and raise the prospect that it may be possible to stimulate the production of new cells in order to repair damaged hearts.
Study Questions Notion That Bodies That Are Pear-Shaped Are Healthier Than Apple-Shaped
People who are "apple-shaped" - with fat more concentrated around the abdomen - have long been considered more at risk for conditions such as heart disease and diabetes than those who are "pear-shaped" and carry weight more in the buttocks, hips and thighs.
But new research conducted at UC Davis Health System published in The Journal of Clinical Endocrinology and Metabolism provides further evidence that the protective benefits of having a pear-body shape may be more myth than reality. The journal article is posted online and will appear in the March 2013 print edition.
Optimism Linked to Higher Antioxidant Levels
Middle-aged adults who are more optimistic about their future tend to have higher serum antioxidant levels than their less optimistic peers, new research suggests. Investigators at Harvard University in Boston, Massachusetts, found that for every standard deviation increase in optimism, there was an increase in carotenoid concentrations of 3% to 13% in age-adjusted models.
"In other words, individuals with greater optimism tended to have greater levels of carotenoids such as beta-carotene," study investigator Julia K. Boehm, PhD, research fellow, Department of Society, Human Development, and Health, Harvard School of Public Health, told Medscape Medical News. "This is the first study of its kind to report a relationship between optimism and healthier levels of carotenoid concentrations," she added. The study is published in the January issue of Psychosomatic Medicine.
Australian Scientist Claims Major Breakthrough in AIDS Cure
An Australian scientist said he had discovered how to turn the HIV virus against itself to stop it progressing to AIDS, describing it as a major breakthrough in finding a cure for the disease.
David Harrich, from the Queensland Institute of Medical Research, said he had successfully modified a protein in HIV that the virus needed to replicate and instead made it inhibit virus growth. "I have never seen anything like it. The modified protein works every time," said Harrich. "If this research continues down its strong path, and bear in mind there are many hurdles to clear, we're looking at a cure for AIDS."
Harrich said the modified protein, which he had named Nullbasic, had shown a "remarkable" ability to arrest HIV growth in a lab environment and could have exciting implications both in curbing AIDS and treating existing HIV sufferers. He described it as "fighting fire with fire".
Cancer Falls Overall in US, but HPV Cancers Increase
Overall cancer death rates continue to fall in the United States, according to the Annual Report to the Nation on the Status of Cancer, which was published online January 7 in the Journal of the National Cancer Institute. Incidence rates for many different cancer types are also falling.
The report highlights cancers associated with human papillomavirus (HPV), and the potential for prevention by HPV vaccination. It was coauthored by researchers from the American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute, and the North American Association of Central Cancer Registries.
New Strain of Norovirus Spreads Around the World
A new strain of the winter vomiting disease norovirus has spread to France, New Zealand and Japan from Australia and is overtaking all others to become the dominant strain in Britain, health officials said. The norovirus variant, known as Sydney 2012, was identified in a scientific paper last week and Britain's Health Protection Agency (HPA) said genetic testing showed it was now causing more cases in England and Wales than other strains. Sydney 2012 does not carry worse symptoms than others but, like other norovirus strains, it can cause violent and projectile vomiting, diarrhea and sometimes fevers, headaches and stomach cramps. Norovirus cases have risen earlier than expected this winter in Britain, across Europe, Japan and other parts of the world.
3 Steps to Improving Medical Data Error Reporting
As is often the case in life, we hope to learn from our mistakes, and not repeat them. The same could be said for our healthcare system. To get there, we'll need a coordinated, holistic strategy to report and capture medical data. Here are three actions to consider.
- Electronic health record (EHR) systems must evolve. Currently, medical error data reporting is not built-in to EHR systems. Rather, it requires additional, often paper-based, steps that only add to the burden facing health professional’s each day.
- The healthcare system must aggressively embrace mobile technologies and the potential these new platforms afford to capture and report data. According to a recent Cisco report, there will be 10 billion mobile devices in use around the world by 2016. As mobile health expands, we should build secure applications to accelerate error reporting, ensuring that we capture new sources of data and help inform healthcare professionals to make better decisions for patients.
- We must combine a better reporting infrastructure and process with better analysis and insights. Improving reporting is just the first step; we must not let these new sources of data lie useless, compounding our existing "Big Data" problem in healthcare.
There is no way around it: Improving the quality and safety of the healthcare system will require transparent, consistent, and timely sharing of healthcare data for learning, analysis, and understanding. Improved medical error data reporting, enabled by health IT, moves us closer to this important goal.
Your Medical Data in the Cloud? Not So Fast, Says HHS Privacy Official
When it comes to electronic health records, “the switch to cloud is inevitable.” That’s according to Joy Pritts, chief privacy officer at the Office of the National Coordinator for Health IT in the Obama administration, who spoke at a “Health Care, the Cloud, and Privacy” panel hosted by the Washington, D.C.-based advocacy group, Patient Privacy Rights.
Whether in paper or in digital format, the privacy of health information is protected by the Health Insurance Portability and Accountability Act, or HIPAA. But the move to electronic health records and cloud storage present new security challenges some in the health care industry do not appear ready to face. The headline for a year-long Washington Post examination released in December 2012 called the sector “vulnerable to hackers” and quoted computer scientist and technical director of the Information Security Institute at Johns Hopkins University, Avi Rubin as saying, “I have never seen an industry with more gaping security holes… If our financial industry regarded security the way the health-care sector does, I would stuff my cash in a mattress under my bed.”
UnitedHealth Exec Says Healthcare is a Fight for the Future of our Nation
UnitedHealth Group is pushing a theme of behavior change and incentives to improve America's troubled healthcare system – and, more importantly, the American patient. It's a battle that Reed Tuckson, MD, UnitedHealth's executive vice president and chief of medical affairs, says won't be easy. Tuckson's message is, in his words, dire. The American healthcare system is facing "a huge problem of a runaway freight train of costs," with no means of funding the increase in Medicare, Medicaid and Social Security budgets to cover the nation's increase in chronic diseases and aging-in-place residents and a projected decrease in healthcare providers.
Added to that, he said, are these statistics: 21 percent of Americans still smoke, with 1,000 kids a day becoming addicted to tobacco; and 26 percent of Americans say they get no exercise whatsoever.
DNA Pioneer James Watson Takes aim at 'Cancer Establishments'
A day after an exhaustive national report on cancer found the United States is making only slow progress against the disease, one of the country's most iconic - and iconoclastic - scientists weighed in on "the war against cancer." And he does not like what he sees.
James Watson, co-discoverer of the double helix structure of DNA, lit into targets large and small. On government officials who oversee cancer research, he wrote in a paper published on in the journal Open Biology, "We now have no general of influence, much less power ... leading our country's War on Cancer."
Doc Shortage May Be Smaller Than Projected
The projected shortage in the nation's primary care physician work force may be overstated, and any that does develop can be eliminated with wider adoption of EHRs and practice restructuring, a study suggests.
By working in practices of two or three doctors while shifting as little as 20% of patients to a nonphysician provider and using an EHR, "most if not all of the projected primary care physician shortage could be eliminated," according to an analysis of several scenarios published in the January issue of Health Affairs.
In Canada, Gonorrhea Defeats Another Antibiotic
Canadian doctors have documented the first failure in North America of cefixime, the front-line antibiotic for gonorrhea. Although the study was small – the doctors looked at only 133 cases total — nearly 7 percent of patients failed to be cured by the standard dose of cefixime, sold under the brand-name Suprax. The findings are published in the current issue of JAMA, the Journal of the American Medical Association. "We've heard of such cases in Asia and Europe. Now it's happening in North America," Dr. Robert Kirkcaldy of the U.S. Centers for Disease Control and Prevention tells Shots. "It's very concerning."
So far, there have been no treatment failures in the U.S., Kirkcaldy says. "Our treatment option in the U.S. is still highly effective." The effective dose of cefixime has crept up slowly over the past ten years. The CDC got concerned enough about the trend in August that officials told doctors to stop using cefixime altogether and switch to a related drug called ceftriaxone, or Rochephin. The CDC is looking to preserve cefixime's effectiveness.
New Medical Device Regulations Implemented in Russia
Russian regulators have reportedly published long-awaited changes to the country's regulatory process for medical devices. The revised regulations took effect January 1, 2013, according to Russian medical device regulator Rozsdravnadzor (in Russian only). Among possible changes to Russian medical device regulations previously reported by Emergo Group are new testing sample import permit, expert device review and clinical testing requirements.
Disclaimer- The information provided in this news digest is intended only to be general summary information. It does not represent the official position of the Centers for Disease Control and Prevention and is not intended to take the place of applicable laws or regulations.
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