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Cardiovascular Care: Costs Could Triple By 2030

Real total direct medical costs of cardiovascular disease (CVD) could triple, from $273 billion to $818 billion (in 2008 dollars) by 2030. Real indirect costs, such as lost productivity among the employed and unpaid household work, could increase 61 percent, from $172 billion in 2010 to $276 billion.

Results appeared in a policy statement of the American Heart Association.

CVD is the leading cause of mortality and accounts for 17 percent of national health expenditures, according to the statement. How much so? U.S. medical expenditures rose from 10 percent of the Gross Domestic Product in 1985 to 15 percent in 2008. In the past decade, the medical costs of CVD have grown at an average annual rate of 6 percent and have accounted for about 15 percent of the increase in medical spending.

The spending is associated with greater life expectancy, “suggesting that this spending was of value,” the authors wrote. But as the population ages, direct treatment costs are expected to increase substantially, even though lost productivity won’t, since seniors are employed at lower rates.

If current prevention and treatment rates remain steady, CVD prevalence will increase by about 10 percent over the next 20 years. The estimate reflects an aging population, and one that is increasingly Hispanic. To prepare for future cardiovascular care needs, the American Heart Association projected future costs. By 2030, 40.5 percent (116 million) of the population is projected to have some form of CVD. Read more »

*This blog post was originally published at ACP Internist*

Know Thy Calories: Nutrition Labeling Guidelines For Restaurants

As part of the new healthcare legislation (Affordable Care Act), the FDA has now published its guidelines for restaurants to inform consumers of the calorie counts of food. It establishes requirements for nutrition labeling of standard menu items for chain restaurants and chain vending machine operators.

This is important because Americans now consume an estimated one-third of their total calories from foods prepared outside the home. Consumers are generally unaware of the number of calories they consume from these foods, and being overweight or obese increases the risk of a number of diseases including heart disease, type 2 diabetes, stroke, and cancer.

Here’s what the guidelines say:

— Restaurants with 20 or more locations must disclose the number of calories in each standard menu item on menus and menu boards (have 19 chain locations? You get a pass. Daily specials also get a pass.)

— Additional written nutrition information must be available to consumers upon request (total fat, saturated fat, cholesterol, sodium sugars, carbs, fiber, protein, etc.)

— The menu must say that the additional nutritional information is available. Read more »

*This blog post was originally published at EverythingHealth*

Pregnancy After 45: A High-Risk Dilemma

As more older women attempt to beat the biological clock and conceive, they are at greater risk for developing birth-related complications. For women over 45, there is less than a 1 percent chance of getting pregnant using their own eggs. Successful pregnancy for women over 45 is nearly always the result of in-vitro fertilization (IVF) and the use of an egg donor.

Researchers at Tel Aviv University reviewed birth records from 2000 to 2008, specifically looking at the records of 177 women who gave birth at the age of 45 and beyond. The majority of the women had IVF and received donor eggs, and 80 percent of the babies were delivered via cesarean section (C-section).

Despite their celebrity, Kelly Presley (age 47), Celine Dion (age 42), and Mariah Carey (age 40), are older pregnant women who are at risk. The premature birth of Celine Dion’s twin sons did not surprise me at all. Women over 35, and especially those over 45 with underlying medical problems, should be treated prior to becoming pregnant. I cannot emphasize this enough. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Simple Blood Test To Detect Mild Brain Injury?

Via USAToday.com:

FREDERICK, Md. — The Army says it has discovered a simple blood test that can diagnose mild traumatic brain damage [TBI] or concussion, a hard-to-detect injury that can affect young athletes, infants with “shaken baby syndrome” and combat troops.

“This is huge,” said Gen. Peter Chiarelli, the Army vice chief of staff.

Yes, it is, if it pans out. There’s so little actual information in this that it’s hard to get excited about it, but let’s say they’ve isolated a “brain injury” protein.

First, it would have uses outside traumatic brain injury (TBI), though that in and of itself might be useful. I don’t want to poo-pooh this test for TBI, but there are already rules for returning to contact sports (and combat has to be the ultimate in contact activities), so what’s the purpose here? (I forsee more Purple Hearts, which is fine.)

Stroke? TIA? Seizure? Pseudotumor cerebri, as a strain indicator? What if this is the test that allows us to diagnose meningitis without doing lumbar punctures? I’m all in on that front. Let’s hope this pans out, for all our sakes.

*This blog post was originally published at GruntDoc*

Apple’s Steve Jobs On The iPad’s Use By Kids With Special Needs

In a Wall Street Journal profile on how iPad apps are being used by special needs children, such as those who have speech impediments and as a communication tool — Steve Jobs commented on how even he did not have the foresight to see that the iPad could be used in such a fashion.

“We take no credit for this, and that’s not our intention,” Mr. Jobs said, adding that the emails he gets from parents resonate with him. “Our intention is to say something is going on here,” and researchers should “take a look at this.”

Last year we reported on how how much cheaper Apple’s portabile devices were compared to the traditional speech software/hardware products, and how insurance companies were hesitant to reimburse for a significantly cheaper Apple products verse industry products. At the time of our report, insurance companies were willing to reimburse up to $8,000 for a product that could be replaced by an iPod Touch with speech therapy apps would cost approximately $600. Since our report on the topic last year, not much has changed. Read more »

*This blog post was originally published at iMedicalApps*

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Latest Book Reviews

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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