February 17th, 2011 by RyanDuBosar in Health Policy, Research
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Less than one in three primary care practices offer all 10 recommended adult vaccines, citing a variety of financial and logistical reasons.
Researchers sponsored by the Centers for Disease Control and Prevention sampled 993 family physicians and 997 general internists. Of the respondents, 27 percent (31 percent of family practitioners and 20 percent of internists) stocked all 10. Results appear in the Feb. 17 issue of the journal Vaccine.
The 10 vaccines were hepatitis A; hepatitis B; human papillomavirus vaccine (HPV); combined measles, mumps, and rubella (MMR); meningococcal conjugate vaccine (MCV4); pneumococcal polysaccharide (PPSV23); tetanus diphtheria (Td); combined tetanus, diphtheria, and pertussis (Tdap); varicella; and zoster.
Of the responding practices, two percent plan to stop vaccine purchases, 12 percent plan to increase them and the rest had no plans to change their vaccination stocking habits. But physicians who identified themselves as their respective practices’ decision makers for stocking vaccines were more likely to decrease the number of different vaccines stocked for adults (11 percent vs. three percent; P=.0001).
The National Vaccine Advisory Committee, a group that advises the various federal agencies involved in vaccines and immunizations, arrived at even bleaker figures in 2009, reported the April 2009 issue of ACP Internist. For example, 62 percent of decision makers in practices said they had delayed purchase of a vaccine at some time in the prior three years due to financial concerns. And in the prior year, 16 percent of practice decision makers had seriously considered stopping vaccinations for privately-insured patients due to the cost and reimbursement issues. Read more »
*This blog post was originally published at ACP Internist*
February 12th, 2011 by RyanDuBosar in News, Research
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Enriched chicken feed may have resulted in eggs having less cholesterol and more Vitamin D than previously measured, reports the U.S. Department of Agriculture (USDA).
A large egg today has about 185 milligrams of cholesterol, down 14 percent from 215 milligrams in 2002, according to new research from the USDA’s Agricultural Research Service, reports USA Today. Also, an egg today has 41 international units (IUs) of Vitamin D, up 64 percent from 25 IUs measured in 2002. (That’s still only about 7 percent of the 600 IUs recommended per day.)
The agency regularly does nutrient checks on popular foods, this time analyzing eggs taken from store shelves in 12 locations around the country. The American Egg Board said in a press release that hen feed is made up mostly of corn, soybean meal, vitamins and minerals. Nutrition researchers at Iowa State University are also looking into reasons why cholesterol in eggs is decreasing.
The government’s “Dietary Guidelines for Americans” recommend that most people eat less than 300 milligrams of total dietary cholesterol a day, and people at a high risk of cardiovascular disease should eat less than 200 milligrams a day. The average American man consumes about 337 milligrams of cholesterol a day and the average woman consumes 217 milligrams, reports the Los Angeles Times.
One egg a day fits within the average, healthy American’s diet, reports WebMD, citing research funded by the Centers for Disease Control and Prevention and by the American Egg Board — owners of the slogan “the incredible, edible egg.”
*This blog post was originally published at ACP Internist*
February 5th, 2011 by Felasfa Wodajo, M.D. in Opinion, Research
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The cost of managing chronic diseases is the largest portion of healthcare expenditures in developed countries. For example, the prevalence of adult acquired diabetes has been rising in the United States, in concert with increasing rates obesity. The CDC has termed it an “epidemic,” especially in light of the massive costs incurred by the healthcare system due to diabetes.
The deleterious health effects of many chronic conditions can be diminished by behavior modifications. While few would underestimate the difficulty of having patients lose weight or exercise more, good management of blood sugar in diabetes is both objectively measurable and strongly correlated with reduced end-organ damage.
This is among the reasons why Research2Guidance has recently nominated diabetes as the condition most likely to be most targeted by mobile medical software and devices (mHealth). This finding is part of their recently published Global Mobile Health Market Report 2010-2015. This is the same report that also predicted that, in the future, medical apps are likely to be distributed by physicians and healthcare institutions.
This time Research2Guidance is highlighting the portion of the survey where they looked into where mobile devices have the most potential to affect health outcomes. While other chronic conditions such as hypertension and obesity have larger populations, the market researchers felt diabetes had the largest market potential due to the huge cost saving potential, the demographic and geographic overlap between smartphone users and people with diabetes, and the real potential to improve blood sugar management using mobile devices. Read more »
*This blog post was originally published at iMedicalApps*
January 20th, 2011 by PJSkerrett in Better Health Network, Health Tips
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Good news for parents, teachers, pediatricians, and others engaged in the ongoing battle against lice: The Food and Drug Administration (FDA) just approved a new treatment for head lice in children age four and older. Called Natroba, it’s a liquid that is rubbed into the hair and allowed to sit for 10 minutes before being rinsed off. Natroba is a useful addition to the anti-lice arsenal, since some head lice have become resistant to permethrin and pyrethrins, the active ingredients in over-the-counter anti-lice products such as Nix and Rid.
Head lice are tiny insects that go by the big name Pediculus humanus capitis. They thrive in the warm tangle of human hair, feeding off blood in the scalp and breeding with abandon. A female lays eggs called nits that she attaches to strands of hair. Nits hatch after about eight days, become adults in another week or so, feed for awhile, then begin to make more lice.
CDC photo of the stages of the life of a head louse, with a penny for size comparison.
What To Do
First off, here’s what not to do: Don’t shave your or your child’s head, or coat it with petroleum jelly or mayonnaise or anything else designed to “suffocate” the parasite. You’ll probably end up with greasy, smelly, lice-infested hair.
Current guidelines from the American Academy of Pediatrics call for the use of an over-the-counter product containing permethrin or pyrethrins as a first salvo against head lice. Shampoos and rinses made with these substances are generally effective. Most treatments for head lice need to be used twice, seven to 10 days apart, along with combing wet hair with a fine-toothed nit comb. Some lice are resistant to pyrethrin and permethrin. Stronger prescription drugs, such as malathion and lindane, also work but aren’t as safe for humans. That’s where Natroba comes in. Read more »
*This blog post was originally published at Harvard Health Blog*
January 7th, 2011 by KevinMD in Better Health Network, Opinion
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Doctors today are wary about treating chronic pain. One of the main worries is precipitating fatal opioid overdoses. Indeed, according to the CDC, and reported by American Medical News, “fatal opioid overdoses tripled to nearly 14,000 from 1999 to 2006 … [and] emergency department visits involving opioids more than doubled to nearly 306,000 between 2004 and 2008.”
Requiring chronic pain patients to sign pain contracts is a way to mitigate this risk. But how does that affect the doctor-patient relationship?
Indeed, a contract is an adversarial tool. Essentially, it states that a patient must comply with a strict set of rules in order to receive medications, including where and how often they obtain controlled substances, and may involve random drug testing. Break the contract and the patient is often fired from the practice. Read more »
*This blog post was originally published at KevinMD.com*
