United States

23 million Americans failed to get recommended colorectal cancer screenings

About 23 million American adults have failed to receive the recommended screening for colorectal cancer (CRC), according to a report today from the Centers for Disease Control and Prevention (CDC). However, researchers say people are more likely to get the potentially lifesaving tests if they are offered a choice of methods.

The proportion of U.S. adults who are up to date with their recommended CRC screenings increased from 54 percent in 2002 to 65 percent in 2012, according to the report. Researchers attribute this to an increased use of colonoscopies, in which a physician uses a flexible, lighted tube to search the rectum and entire colon for polyps and cancers – many of which can be removed during the procedure.

But during the same 10-year time period, two other recommended tests declined in use: sigmoidoscopy and high-sensitivity fecal occult blood testing (FOBT). A sigmoidoscopy is similar to a colonoscopy, but the doctor performing it uses a shorter tube to examine the rectum and lower third of the colon. With FOBT, a patient collects a small stool sample at home and mails it to a laboratory to test for traces of blood.

Many doctors recommend colonoscopy to their patients because it provides the most complete view of the colon. But it’s also the most invasive of the recommended CRC tests and requires patients to undergo a strict diet the day before screening to help empty the colon.

Research suggests patients who choose FOBT are more likely to complete the test than those who choose colonoscopy. Therefore, federal health officials suggested that doctors offer all recommended CRC tests and identify a screening strategy that their patient is most likely to follow.

Rather than viewing colonoscopy as a rite of passage for everyone reaching their 50th birthday, researchers believe more adults will get screened for CRC if they’re encouraged to choose from a menu of strategies.

The U.S. Preventive Services Task Force recommends three screening options for adults in the 50 through 75 age bracket. The first option simply involves undergoing FOBT every year. The second option involves undergoing a colonoscopy every 10 years. The third option combines a sigmoidoscopy every five years with FOBT every three years.

Among adults who are up to date on their recommended CRC screening, 62 percent use colonoscopy, according to the CDC report. Just over 10 percent use FOBT, and less than 1 percent use a combination of sigmoidoscopy and FOBT.

“If someone has a strong family history of colon cancer or has polyps or a personal history of a disease such as inflammatory bowel disease, then colonoscopy is clearly preferred,” said Dr. Tom Frieden, director of the CDC. “However, for everyone else – and that’s the great majority of people – there is no proven benefit of one versus the other approach.”

Frieden added that the tests are not completely unrelated. For example, patients whose stool samples test positive for blood through FOBT are generally referred to undergo colonoscopies as a follow-up procedure.

Colorectal cancer claims approximately 50,000 lives in the United States each year and is the leading cause of cancer deaths among nonsmokers. However, public health officials say many of these lives could be saved through early detection if more people selected a screening plan and followed through with it.

“The best test is the test that gets done,” Frieden said.

Source: news.nom.co

“Fat letters” outrage some California parents

Some California parents are outraged because they say their children are being sent home with “fat letters,” or notes explaining that their children are considered obese.

California students are required by the California Department of Education to take a Physical Fitness Test that looks at six areas of fitness during grades five, seven and nine.

California happens to be one of 19 states that require schools to screen for obesity, and they do so through a body mass index test (BMI) reading, a height-to-weight ratio measurement that is used by doctors to designate if a person is underweight, normal weight, overweight or obese. This BMI screening is done at the same time as the Physical Fitness Test.

The department also requires that students are notified of their test results, normally via a letter, an information officer from the California Department of Education told CBSNews.com. However, individual local school districts can make the choice to let parents know the results as well. These letters include the BMI of each student.

The National Eating Disorders Association showed the Sacramento Bee one letter sent to a 12-year-old seventh grader. She was rated in the “Healthy Fitness Zone” in all categories except for aerobic (the ability to run one mile) and body mass index. The letter said she received a “needs improvement — health risk” grade in these two areas.

The Association told the Bee that it feared that students who read this letter may be influenced into developing eating disorder behaviors like skipping meals, vomiting or taking laxatives. The group previously found that 42 percent of first through third grade girls have said they want to be thinner, and 81 percent of 10-year-olds are afraid of being fat.

Some other California school districts, including those in the San Fernando Valley, go a little further and specifically send letters just addressing a child’s obesity issue to their parents — not just their test results.

“We let the parents know in a gentle fashion, but we also send out a ton of handouts to try to help that family,” Lauren Schmitt, a registered dietitian who works with preschoolers in the San Fernando Valley, told CBS Los Angeles.

Schmitt said that they use growth charts and percentiles to make their obesity judgments. If a child is in the 95th percentile for their age and weight or height and weight, they are considered to be obese. She said out of the 900 two to five-year-olds she works with, about 200 are obese.

“It shouldn’t be a stigma. It’s not a way to categorize someone. It’s just showing that this child has increased risk to be obese as an adult, which then could lead to quite a few chronic diseases,” said Schmitt.

Massachusetts was another state that mandated BMI screening for students and required parents to be notified if the child was overweight or obese. However, the state reversed its decision on the “fat letters” in October because of concerns over bullying and self esteem.

I think it just hits home, that it’s very common sense. Why are we doing this?,” Tracy Watson, whose son Cam was sent home with a letter than he was obese, told CBS Boston. “These letters were doing more harm than good to kids out there.”

However, Harold Cox, a member of the Massachusetts Public Health Council, voted that the letters are necessary because they teach parents about healthy lifestyles, diets and exercise.

Childhood obesity rates have more than doubled in children and tripled in adolescents over the last three decades, according to the Centers for Disease Control and Prevention. Now, more than one-third of children and adolescents were overweight and obese.

“Just because you don’t like the information that you’re getting doesn’t mean you shouldn’t get the information,” Cox said to CBS Boston. “Obesity is not going away. A third of our children in our state have some weight problem.”

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Painkiller Overdose Deaths Strike New York City’s Middle Class

Drug overdoses are usually thought to afflict mainly the poor and troubled. But it looks like OxyContin and other opioid painkillers are changing the picture.

People in stable, middle-class neighborhoods are also dying from opioid overdoses, a study in New York City finds.

Opioids have become among the most popular drugs of abuse in the past decade, with deaths from overdoses of oxycodone, hydrocodone and codeine eclipsing those from heroin and cocaine combined.

Fatal overdoses from prescription painkillers more than tripled from 1991 to 2007, according to the Centers for Disease Control and Prevention.

To find out what was happening in New York City, researchers at Columbia University’s Mailman School of Public Health mapped the 447 unintentional deaths from opioid painkiller overdoses in its five boroughs from 2000 to 2006. They then compared those deaths to heroin overdoses and accidental deaths from other causes, such as falls and drowning.

The heroin deaths were mostly in low-income neighborhoods where many people struggle with crime, fractured families and untreated mental health problems.

The prescription painkiller deaths were more common in areas where you don’t see much heroin — solid working-class neighborhoods in Staten Island and parts of the Bronx.

“We were very surprised to see these very different patterns for heroin and analgesic,” Magdalena Cerda, an Columbia epidemiologist and lead author of the study, tells Shots.

That may be because people in those neighborhoods are more likely to be prescribed painkillers, Cerda says. “There you see a higher percentage of policemen, firefighters, construction workers,” she says. “They may have a higher percentage of back pain as a result of work-related injuries.”

It’s also easier to get an OxyContin prescription filled at pharmacies or physicians in middle-class neighborhoods, she adds. That’s backed up by earlier studies that found that pharmacies in low-income, minority neighborhoods in the city don’t have enough prescription painkillers to meet legitimate demand.

The findings were published in the American Journal of Public Health.

Cerda and her colleagues are trying to get funding to look more closely at Staten Island and figure out what’s going on there. Are people first prescribed these drugs, and then start using them recreationally? Or do they become addicted while using them as prescribed? “Overdose fatalities are just the tip of the iceberg,” she says.

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One-Third of U.S. Adults Are Obese, CDC Says

The adult obesity rate in the United States remains as high as ever, with one in three Americans carrying unhealthy amounts of weight, according to a new federal report.

The obesity rate has remained essentially unchanged for a decade, despite the large amount of attention focused on its threat to public health, the U.S. Centers for Disease Control and Prevention found.

“It’s kind of a confirmation of what we saw last time, that the prevalence of obesity in adults may be leveling off,” said co-author Cynthia Ogden, a senior epidemiologist with the CDC’s National Center for Health Statistics. “From 2003-04 through 2011-12, there have been no statistical changes in obesity in adults.”

This persistent rate has proved frustrating to public-health experts, given that obesity is a leading risk factor for chronic illnesses such as diabetes, heart disease and arthritis.

“The goal of the human species since we evolved has been to have enough to eat, and we’ve gotten there. Unfortunately, it’s so plentiful we can take in more than [we] need,” said Matt Petersen, managing director of medical information and professional engagement for the American Diabetes Association. “The human body and brain is wired to take in more than a sufficient number of calories, and that’s a hard thing to change. We’re talking about really powerful aspects of our metabolism.”

The obesity epidemic continues to gnaw away at America’s economic potential. The U.S. economy loses an estimated $270 billion a year due to health care costs and loss of productivity associated with obesity and overweight, according to a 2011 report produced by the Society of Actuaries.

The CDC report found that nearly 35 percent of American adults are obese, with a body-mass index — a measurement of body fat based on height and weight — greater than 30. That equates to a person 5 feet 4 inches tall who weighs 175 pounds or more, or a person 5 feet 9 inches tall who weights 203 pounds or more.

The last estimate produced for 2009-10 found that 35.7 percent of adults were obese, Ogden said.

  • The report also included the following U.S. figures:
  • The prevalence of obesity is higher among middle-aged adults (39.5 percent) than among younger (30.3 percent) or older (35.4 percent) adults.
  • Overall, men and women have similar rates of obesity. However, 56.6 percent of black women were obese compared with 37.1 percent of black men.
  • Blacks have the highest obesity rate (47.8 percent), followed by Hispanics (42.5 percent) and whites (32.6 percent). Asians have the lowest obesity rate (10.8 percent).

“It just shows that we still have a lot of work to do,” said Rachel Johnson, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association. “We’re making a little bit of progress in childhood obesity — some very small declines, but it at least feels like we’re making some headway there. There are some small pockets in a few cities or states where we’ve seen a modest decline in childhood obesity, due to very aggressive interventions.”

The current means for battling obesity — dieting, bariatric (weight-loss) surgery, exercise — have so far proven unable to overcome the widespread availability of low-cost, high-calorie food, said Petersen at the American Diabetic Association.

The association has come up with a program for healthy eating and moderate exercise that is proving effective. “If we can successfully implement those programs at the community level nationwide, we are hopeful we will see a reduction in diabetes due to factors that should also address obesity,” he said.

But effectively tackling the adult obesity epidemic likely will involve structural changes in American society, Johnson said.

“My view is that we have to start making some pretty major environmental changes so we make the healthy choice the easy choice,” she said. “We’ve got to move beyond the idea that it’s all about personal choice and education, and we need to start making these environmental changes.”

She tossed out a few ideas — taxes to increase the price of unhealthy food, new ways to make healthy food cheaper and major employers offering healthy food in the workplace.

“The beginning of this century has got to be about behavior change,” Johnson said. “How do we help people make healthy choices, and how do we create an environment that’s conducive to good health?”

Read More : http://www.newsday.com/

U.S. approves first artificial pancreas system for diabetics

U.S. approves first artificial pancreas system for diabetics

The U.S. Food and Drug Administration has approved the first artificial pancreas system for diabetics that reads blood sugar levels and automatically shuts off the flow of insulin.

The device, made by Medtronic Inc, could help the 3 million Americans living with type 1 diabetes better manage their disease, which causes the immune system to destroy cells in the pancreas that make insulin.

Patients suffering from type 1 diabetes, the inherited version of the disease, have to regularly monitor their blood sugar levels and take insulin several times a day.

Too little or too much of insulin can lead to several health problems, ranging from kidney failure and heart disease to brain damage.

The device includes an insulin pump and a glucose sensor that stops insulin delivery when blood glucose reaches a preset level.

The system has been approved for use by diabetics aged 16 years and older. Medtronic said it would conduct a post-approval study that would include children aged 2 years and older.

The Minneapolis, Minnesota-based company said it would begin ramping up production immediately to prepare for a launch in the next few weeks.

The company will also directly follow up with patients and make certain manufacturing changes according to the requirements of the approval and an accompanying warning letter it was issued on Sept. 19.

Medtronic said it has already addressed many of the observations in the warning letter and was committed to resolving the remaining issues as quickly as possible.

Source: Reuters.com

NY 5 year old girl, saves mom’s life

A 5-year-old Long Island girl is credited with saving her mother’s life.

Authority’s say Jillian Given was “calm and collected” when she dialed 911 and told a dispatcher her mother was diabetic and had passed out.

Jillian told the dispatcher she was 5 years old and had tried to call her father but didn’t get him.

The incident occurred on Sept. 16.

She said her mother, Elisabeth Given, was breathing but not awake.

Nesconset fire department assistant chief John Martins tells Newsday he’s never seen a 5 year old “as well-versed and as calm as she was.”

Given is a registered nurse and diabetes educator. She says she had coached Jillian on emergencies.

The family on Wednesday thanked officials who responded to Jillian’s call.

Source: http://poststar.com/news/state-and-regional/ny-girl-credited-with-saving-mom-s-life/article_3b983003-4cd5-5643-aef3-24a9db67ec6b.html

How Many Die From Medical Mistakes In U.S. Hospitals?

It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient’s death, the numbers come out worse.

In 1999, the Institute of Medicine published the famous “To Err Is Human” report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials — and quoted ubiquitously in the media.

In 2010, the Office of Inspector General for the Department of Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.

Now comes a of the Journal of Patient Safety that says the numbers may be much higher — between each year who go to the hospital for care suffer some type of preventable harm that contributes to their death.

That would make medical errors the, behind heart disease, which is the first, and cancer, which is second.

The new estimates were developed by John T. James, a ‘s space center in Houston who runs an advocacy organization called . James has also about the death of his 19-year-old son after what James maintains was negligent hospital care.

Asked about the higher estimates, a spokesman for the American Hospital Association said the group has more confidence in the IOM’s estimate of 98,000 deaths. ProPublica asked three prominent patient safety researchers to review James’ study, however, and all said his methods and findings were credible.

What’s the right number? Nobody knows for sure. There’s never been an actual count of how many patients experience preventable harm. So we’re left with approximations, which are imperfect in part because of inaccuracies in medical records and the reluctance of some providers to report mistakes.

Patient safety experts say measuring the problem is nonetheless important because estimates bring awareness and research dollars to a major public health problem that persists despite decades of improvement efforts.

“We need to get a sense of the magnitude of this,” James said in an interview.

James based his estimates on the findings of four recent studies that identified preventable harm suffered by patients — known as “adverse events” in the medical vernacular — using use a screening method called the , which guides reviewers through medical records, searching for signs of infection, injury or error. Medical records flagged during the initial screening are reviewed by a doctor, who determines the extent of the harm.

In the four studies, which examined records of more than 4,200 patients hospitalized between 2002 and 2008, researchers found serious adverse events in as many as 21 percent of cases reviewed and rates of lethal adverse events as high as 1.4 percent of cases.

By combining the findings and extrapolating across 34 million hospitalizations in 2007, James concluded that preventable errors contribute to the hospital patients annually.

That is the baseline. The actual number more than doubles, James reasoned, because the trigger tool doesn’t catch errors in which treatment should have been provided but wasn’t, because it’s known that medical records are missing some evidence of harm, and because diagnostic errors aren’t captured.

An estimate of 440,000 deaths from care in hospitals “is roughly one-sixth of all deaths that occur in the United States each year,” James wrote in his study. He also cited other research that’s shown hospital reporting systems and peer-review capture only a fraction of patient harm or negligent care.

“Perhaps it is time for a national patient bill of rights for hospitalized patients,” James wrote. “All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes.”

Dr. Lucian Leape, a Harvard pediatrician who is referred to the was on the committee that wrote the “To Err Is Human” report. He told ProPublica that he has confidence in the four studies and the estimate by James.

Members of the Institute of Medicine committee knew at the time that their estimate of medical errors was low, he said. “It was based on a rather crude method compared to what we do now,” Leape said. Plus, medicine has become much more complex in recent decades, which leads to more mistakes, he said.

Dr. David Classen, one of of the Global Trigger Tool, said the James study is a sound use of the tool and a “great contribution.” He said it’s important to update the numbers from the “To Err Is Human” report because in addition to the obvious suffering, preventable harm leads to enormous financial costs.

Dr. Marty Makary, a surgeon at Johns Hopkins Hospital whose book Unaccountable calls for greater transparency in health care, said the James estimate shows that eliminating medical errors must become a national priority. He said it’s also important to increase the awareness of the potential of unintended consequences when doctors perform procedure and tests. The risk of harm needs to be factored into conversations with patients, he said.

Leape, Classen and Makary all said it’s time to stop citing the 98,000 number.

Still, hospital association spokesman Akin Demehin said the group is sticking with the Institute of Medicine’s estimate. Demehin said the IOM figure is based on a larger sampling of medical charts and that there’s no consensus the Global Trigger Tool can be used to make a nationwide estimate. He said the tool is better suited for use in individual hospitals.

The AHA is not attempting to come up with its own estimate, Demehin said.

Dr. David Mayer, vice president of quality and safety at Maryland-based , said people can make arguments about how many patient deaths are hastened by poor hospital care, but that’s not really the point. All the estimates, even on the low end, expose a crisis, he said.

“Way too many people are being harmed by unintentional medical error,” Mayer said, “and it needs to be corrected.”

Source: http://www.npr.org/blogs/health/2013/09/20/224507654/how-many-die-from-medical-mistakes-in-u-s-hospitals

What does California’s new toxic substances law mean?

What does California’s new toxic substances law mean?

A short while ago, the point out of California one particular-upped these producers by approving the landmark Safer Buyer Products and solutions polices, which choose effect October one, 2013 and will need companies to look for safer options to the harmful chemical ingredients at this time located in usually applied goods.

As the California Department of Toxic Substances Management (DTSC) observed in a press release, this is a single of the initially programs of its form in the planet. The laws lay out an considerable, time-consuming critique procedure that commences with the condition establishing a list of “Candidate Substances.”

Suppliers can then figure out if any of their “Priority Products” consist of a person of these substances perform an “Alternatives Analysis” as to what safer ingredients might be substituted and then wait around for “Regulatory Responses” to be issued.

All this may possibly audio easy ample, but could just take years to generate true outcomes in the marketplace. The eventual implications, nonetheless, are exceptionally extensive-achieving: If manufacturers have to reformulate their goods for sale in California – by considerably the most populous state in the country – they’ll probably do so throughout the board for merchandise sold in all states, in any nation.

The term “consumer products” is vague, making it challenging for businesses to exempt their goods from subsequent the laws. Luckily, California’s DTSC will prioritize a product for evaluation centered on the “Applicant Chemicals” it includes (if any), and just how dangerous these chemical compounds can be more than the everyday living cycle of the item – this means not just when it is made use of by the client, but also how poisonous its manufacturing method is on the atmosphere, among the other factors.

I admire California lawmakers for having this essential move in the name of public wellness, and I persuade shoppers to follow this story as it develops. Although it might take yrs for adjustments to be compelled on makers, all those with any amount of money of foresight will strike preemptively, and take away unsafe components ahead of currently being pressured to do so by regulation.

In the meantime, glance out for California’s list of “Prospect Chemicals,” to be unveiled at the conclude of October, and do some regulating of your have! Scour the cupboards and closets of your property and look at the chemicals on the list to individuals detailed as components on your favorite goods.

It is good that California desires to support safeguard its citizens, and by extension the relaxation of the region, from harmful substances, but only you can management which merchandise enter your dwelling and have an effect on the wellness of everybody inside.

Source: dailynewsen.com

US firm brings next generation pacemaker in India

St Jude Medical Inc, a global medical device company, today announced the launch of next generation pacemaker in India.

The NYSE-listed firm announced the first commercial implant of `Allure Quadra’, a cardiac resynchronisation therapy pacemaker (CRT-P), in the country.

The first-to-market quadripolar pacemaker system offers more pacing options for patients with heart failure (HF), a company release said here.

Quadripolar leads allow for increased implant efficiencies, which clinical data indicates can result in fewer surgical revisions. Broad clinical evidence on the advantages of the quadripolar technology has been documented in more than 100 publications worldwide, it said.

Explaining how this new technology works, Anil Saxena of Fortis Escorts Hospital, said: “Historically, pacing systems that treat heart failure included a lead with only one electrode in the heart. Later, these were replaced by leads with two electrodes.

“Nearly 40 per cent of patients do not effectively benefit from traditional pacing due to potential complications all of which require repeat surgeries.”

The new technology has four electrodes and 10 programmable pacing configurations, allowing electro-physiologists to manage their patients with greater flexibility and improved patient outcomes, Saxena said.

The worldwide prevalence of heart failure has been rising over the last few decades. More than 26 million people globally suffer from HF, with a prevalence rate in India estimated to range from 1.3 to 4.6 million people.

Severe obesity’ rising in US youth

About 5 percent of U.S. children and teens are “severely obese,” and the numbers are rising, according to a new statement from the American Heart Association.

Recent data suggesting that the rate of childhood obesity has started to level off, “a worrisome trend has emerged in the form of severe pediatric obesity,” the researchers wrote in their study published today in the journal Circulation.

“Severe obesity in young people has grave health consequences,” said study author Aaron Kelly, a researcher at the University of Minnesota Medical School in Minneapolis. “It’s a much more serious childhood disease than obesity.”

Severely obese children have higher rates of Type 2 diabetes and cardiovascular issues at younger ages, including high blood pressure, high cholesterol and early signs of atherosclerosis – a disease that clogs the arteries

Treating children and teens with of severe obesity is challenging, the researchers said. Many treatments that are commonly used with some success in overweight and obese children, such as lifestyle changes, are less effective in those with severe obesity.

The researchers recommended using a standard definition for severe obesity in youth; they define children over age 2 as severely obese if they have a body mass index (BMI) at least 20 percent higher than 95 percent of other children of the same age and gender. The researchers also said any child with a BMI of 35 or higher should be considered severely obese.

Based on this definition, a 7-year-old girl of average height weighing 75 pounds, or a 13-year-old boy of average height weighing 160 pounds, would be defined as severely obese.

Most experts recommend treating severely obese children first with the least intensive treatment options such as lifestyle changes, the researchers said. More intensive treatments such as medication and potentially surgery should be considered after other treatments have failed.

Increased funding will be needed for research into whether new medications and other treatments, including surgery, are safe and effective in treating children with severe obesity, the researchers said.