Story By: by Judith Graham
Slowing the rising rates of obesity in this country by just 1 percent a year over the next two decades would slice the costs of health care by $85 billion.
Keep obesity rates where they are now â well below a 33 percent increase that’s been expected by some â and the savings would hit nearly $550 billion over the same 20 years.
Those are two attention-grabbing conclusions from an analysis released this morning at the Weight of the Nation conference in Washington, D.C., sponsored by the Centers for Disease Control and Prevention. Researchers from Duke University, RTI International and CDC prepared the analysis, published in the American Journal of Preventive Medicine.
It’s the latest work that shows the health care costs associated with obesity, and the stark financial consequence of the epidemic.
In the new study, researchers estimate that obesity will continue to rise and will affect 42 percent of adults by 2030. (Obesity represents a body mass index score, a ratio of weight to height, of 30 or higher. Separate estimates for children aren’t calculated.)
That projection reflects recent evidence that obesity has leveled off in some groups. So it’s lower than an earlier estimate that just over half of the nation’s adults would be obese by 2030. It also factors in conditions in the states that can affect the prevalence of obesity, such as unemployment, the availability of fast food, and price differences between healthful and less healthful food items.
While increases in obesity may have slowed some, the health trends still bode poorly â especially for people who are roughly 100 pounds overweight, with body mass index scores of 40 or higher.
That rapidly growing group of severely obese people, who have the most medical problems and incur the highest health care costs, will rise from about 5 percent of the population now to 11 percent by 2030, researchers suggest.
The findings are meant to be a call to action, as experts gathered at the CDC conference consider how best to to combat obesity, a public health problem that affects about 78 million adults and 12.5 million children and adolescents.
Proven interventions are now available. “We know more than ever about the most successful strategies that will help Americans live healthier, more active lives and reduce obesity rates and medical costs,” said Dr. William H. Dietz, director of the CDC’s division of nutrition, physical activity and obesity, in a prepared statement.
The fight won’t be cheap. Still, the new study from Duke, RTI and CDC researchers shows that even a small dent in obesity rates could pay off.
The Dinosaurs’ Nemeses: Giant, Jurassic Fleas
May 11, 2012
Story By: by Christopher Joyce
An illustration of the Chinese Jurassic “pseudo-flea,” which lived in the Middle Jurassic in northeastern China.
“Let’s face it,” he says, “they’re the only small creature that would attack a dinosaur. Anything else that was larger would definitely have been eliminated.”
It’s been a veritable flea circus lately in the fossil-hunting business. Just last month Chinese scientists announced the discovery of another set of flealike insects preserved in amber. They’re much like the new ones Poinar examined, which are described in the journal Current Biology. A team of scientists led by Tai-ping Gao at Capital Normal University in Beijing found them.
Poinar says the world about 150 million years ago apparently was getting increasingly buggy, and those insects were changing the dinosaurs’ world. They did that in at least two ways. Because they were pollinators, insects probably encouraged the evolution of flowering plants rather than fernlike plants. Plant-eating dinosaurs that couldn’t adapt to a new diet would’ve been in trouble.
And scientists who study dinosaur feces â yes, they do do that â say dinosaurs had diseases, parasites and worms. Poinar says they probably got some of them from insects like these pseudo-fleas. “To a lot of them, this was something brand new they hadn’t been exposed to before,” he says, “and it would have decimated the population. And it wasn’t just one disease but a combination of diseases.”
He says those diseases could have hastened the demise of dinosaurs.
Hi-tech car aid for older drivers
April 24, 2012
A team at Newcastle University is developing new technology aimed at helping older drivers stay on the road.
It also uses pictures of local landmarks, such as a post box or public house, as turning cues for when people are driving in unfamiliar places.
Phil Blythe, professor of intelligent transport systems at Newcastle University, said: "For many older people, particularly those living alone or in rural areas, driving is essential for maintaining their independence, giving them the freedom to get out and about without having to rely on others.
"And people base their whole lives around driving a car, having mobility.
"But we all have to accept that as we get older our reactions slow down and this often results in people avoiding any potentially challenging driving conditions and losing confidence in their driving skills. The result is that people stop driving before they really need to.
"What we are doing is to look at ways of keeping people driving safely for longer, which in turn boosts independence and keeps us socially connected."
Dr Amy Guo, who is leading the older driver study, said it had produced some surprises.
"For example, most of us would expect older drivers always go slower than everyone else but surprisingly, we found that in 30mph zones they struggled to keep at a constant speed and so were more likely to break the speed limit and be at risk of getting fined.
"We're looking at the benefits of systems which control your speed as a way of preventing that."
The team is also looking at displaying information on the windscreen, rather than the dashboard – so drivers do not feel the need to look away from the road – and systems that can detect if the car has strayed out of its lane.
Car manufactures have expressed interest in the work, and Prof Blythe said some of the technologies could be seen "soon", with others within "five to 10 years".
Michelle Mitchell, charity director general of Age UK, said: "Ability, not age, should determine how safe someone is on the road – so any research should look at all drivers and what makes them safe or unsafe.
"When it comes to driving, everyone is responsible, at whatever age, for making sure they are safe on the road.
"The emphasis should be on supporting older people to continue driving safely so that older people retain their ability to get out and about."
© 2011 BBC News (www.bbc.co.uk)
Story By: by Rob Stein
This illustration shows a device made by MammoSite used to deliver targeted doses of radiation as part of brachytherapy.
When Lisa Galloway was trying to decide what kind of radiation treatment to undergo after surgery for early breast cancer, she jumped at the chance to get a newer, quicker approach.
Instead of dragging on for weeks, the newer form of radiation, called brachytherapy, only takes five days.
“Five days compared to 33 days, I was like, ‘Yay!’ ” says Galloway, 53, of Silver Spring, Md. “So I wanted it so badly. I got it â I got my wish.”
But there’s an intense debate under way about whether the approach is being used too widely before there’s clear evidence it’s as effective as the traditional approach.
“I see the rush to brachytherapy is somewhat inappropriate because it has not yet been proven in a randomized trial to be as effective as a standard treatment,” says Bhadrasain Vikram of the National Cancer Institute.
Traditional post-surgical treatment for early breast cancer often involves delivering radiation to the breast externally at relatively low doses over about six weeks. The new approach involves delivering higher doses in a more targeted way from inside the breast over a shorter period of time.
To get ready for brachytherapy, a surgeon temporarily implants a small device called a catheter in the spot where the tumor was removed. The device houses a bundle of tiny, flexible tubes that protrude from the side of the breast.
For each treatment, a technician connects each of the tubes from the implant to a radiation machine. That allows the doctor to deliver high doses of radiation to specific spots inside the breast.
The radiation comes from a tiny pellet that’s at the end of a very thin wire. One by one, the radiation-tipped wire snakes in and out of each tube in the implant. Patients get treated twice a day for 10 days. Each session takes a few minutes.
In recent years, the popularity of the therapy has soared, rising from less than 1 percent of patients in 2001 to 10 percent in 2006, Vikram says.
“It was a tenfold increase over a five-year period,” he says.
Vikram worries that there’s not enough proof yet that brachytherapy is as effective as what doctors have been using for years. And, he notes, there are some big concerns: “that the tumor will recur and women will need more mastectomies, and/or the tumor may spread to other parts of the body and kill the woman, or it may have more toxicity in the long term.”
Those fears spiked in December when Benjamin Smith of the M.D. Anderson Cancer Center in Texas unveiled the results of a big study at a scientific meeting in San Antonio.
“We found that the decision of whether or not a patient was treated with brachytherapy or whole breast irradiation was the single most important predictor of whether they had a mastectomy within five years of their cancer diagnosis,” Smith says.
Mastectomies were rare no matter what kind of radiation women got. But they were about twice as common among the women who got brachytherapy, Smith and his colleagues found. That’s a red flag that brachytherapy might not be snuffing out the cancer as well, Smith says.
“The most plausible explanation for our data is that women treated with brachytherapy were at increased risk of having a recurrence of cancer in their breast,” he says.
Smith and his colleagues also found that women getting brachytherapy were more likely to experience minor complications, such as infections and bleeding.
“When you put together significantly increased risk of a lot of different complications and a treatment that’s slightly less effective potentially than whole breast irradiation, then you start to wonder, ‘What is the role of this treatment? And have we adopted it too quickly before we really understand how to use it correctly?’ ” Smith says.
He and Vikram say women should get brachytherapy for breast cancer only as part of carefully designed studies.
Other doctors disagree. For one thing, they say the data Smith used are old, coming from when doctors were just starting to learn how to do brachytherapy for breast cancer. In addition, they argue, other studies indicate brachytherapy is effective, at least for some patients: mostly older women with very small tumors that haven’t spread.
“We have data that shows that in appropriately selected patients that are treated with five-day treatment, the outcome is very good and the toxicity is very low,” says Douglas Arthur of the American Brachytherapy Society.
In addition to being more convenient, the more targeted approach avoids some complications.
“Less radiation means less side effects. They don’t get fatigue. They don’t get the darkening, reddening, tenderness of the skin related to external beam radiation,” says Martin Keisch of the University of Miami Hospital. “You don’t get that with the internal radiation you are receiving with brachytherapy.”
Galloway’s doctor, Sheela Modin of Holy Cross Hospital in Silver Spring, acknowledges that there are still questions about brachytherapy.
“At this point, we’re being very conservative, based on the data that’s available right now. And in select patients, and they tend to be older women, that this is a reasonable approach,” Modin says.
“I don’t do everybody. It would only be someone who has early stage breast cancer,” she says
For her part, Galloway wasn’t crazy about walking around with the brachytherapy implant. And she says it was kind of weird to feel little jolts of vibration during the treatment. But she was relieved to get her radiation treatment over quickly.
“I’m very happy, yeah, very happy,” says Galloway, who got the implant taken out after her final day of treatment.
A large federally funded study is trying to clarify the risks and benefits of brachytherapy for breast cancer. But the results won’t be out for years.
Story By: by Nancy Shute
Finding out that you have cancer greatly increases the risk of death by heart attack or suicide, according to a new study. That risk is especially big in the first week after getting the bad news.
The notion that stress can spark a heart attack has long been part of folklore. Only in the past decade have scientists connected emotional stress with physiological reactions that can bring on a heart attack. Heart attacks spike after the death of a loved one or a natural disaster, so it makes sense that could happen after a devastating medical diagnosis, too.
Researchers looked at the medical records of 6 million people in Sweden from 1991 to 2006. The country’s medical registry made it possible to match death records with cancer diagnoses. Suicide rates among people told they had cancer spiked in the first week after getting the news, with 2.50 suicides per 1,000 person-years of life, compared with 0.18 in people without cancer diagnoses.
The risk of suicide was greatest for people who were diagnosed with esophageal, liver or pancreatic cancer â some of the deadliest forms of cancer. For all patients, suicide risk declined over time. But in the first year after a diagnosis, people with cancer were about three times as likely to commit suicide. The results were published in the New England Journal of Medicine.
Deaths from heart attack also spiked in the first week, almost tripling compared to people without cancer. But the risk dropped more quickly than did suicide risk, and after a year it wasn’t significantly higher than for the population in general.
The fact that the risk of death increases immediately after diagnosis shows that it’s the diagnosis, not the stresses of cancer treatment, causing the deaths, according to Unnur Valdimarsdottir, head of the Centre of Public Health Sciences at the University of Iceland and a co-author of the study. She and her colleagues had earlier found a sharp increase in deaths after a prostate cancer diagnosis. This study looks at all major cancers, and it found that the risk rose along with the seriousness of the cancer.
“We believe that the shock of the diagnosis and corresponding magnitude of stress is highest during the immediate time window following diagnosis,” Valdimarsdottir tells Shots by email. “Other studies on different kinds of stressors, e.g. loss of relative, also indicate a remarkably short induction time between stress onset and cardiovascular outcomes.”
Interestingly, people who were already getting psychiatric care or treatment for heart disease were less likely to die, perhaps because their stresses were already getting some attention.
This suggests more support delivered along with a cancer diagnosis could reduce the risk of death. “We do believe that we have identified a critical time window where the resources of health care providers of cancer patients needs to be directed,” Valdimarsdottir says. “The important thing is that health care professionals, cancer patients themselves and their significant others are aware of these risks, and remain observant of early signs and symptoms of such serious hazards.”
Storms Threaten Great Plains With Hail, Tornadoes
April 18, 2012
Story By: All Things Considered
Major storms have reached a swath of the Great Plains from Oklahoma City up through central Kansas and into Nebraska. Weekends on All Things Considered host Guy Raz speaks with Chance Hayes, the Warning Coordination Meteorologist at the National Weather Service office in Wichita, Kansas.
Mom’s caffeine not linked to infant sleep problems
April 15, 2012
NEW YORK |
NEW YORK (Reuters Health) – A baby’s sleep may not suffer just because her mom likes a daily cup of coffee, a new study suggests.
The findings, experts say, don’t give the OK to heavy caffeine intake during pregnancy or breastfeeding. But they are in line with research suggesting that moderate amounts of caffeine may not pose a danger.
Small studies over the years have come to mixed conclusions on whether caffeine during pregnancy was linked to increased risks of miscarriage or premature birth.
But more recently, larger studies have failed to show any heightened risk. And in 2010, the American College of Obstetricians and Gynecologists (ACOG) said that 200 milligrams of caffeine a day — about the amount in a 12-ounce cup of coffee — probably did not carry pregnancy risks.
But not much has been known about whether caffeine, during pregnancy or breastfeeding, might disturb new babies’ sleep.
For their study, Dr. Ina Santos and her colleagues at Federal University of Pelotas, in Brazil, interviewed 885 new moms. The women answered questions about their caffeine intake and their infants’ sleep habits at the age of three months.
All but one of the mothers said they drank caffeinated beverages during pregnancy. About 20 percent were considered heavy consumers during pregnancy — downing at least 300 mg per day. And just over 14 percent reported a heavy caffeine intake three months after giving birth.
Overall, the researchers found no clear link between moms’ caffeine intake and their likelihood of reporting infant sleep problems.
Almost 14 percent of mothers said their three-month-old woke up more than three times each night — which was considered “frequent.”
But the odds were not statistically greater for moms who were heavy caffeine consumers, versus lighter consumers, Santos’s team reports in the journal Pediatrics.
“I think this report adds to the growing body of literature suggesting that moderate caffeine consumption during pregnancy is generally safe,” said Dr. William H. Barth Jr., chief of maternal-fetal medicine at Massachusetts General Hospital in Boston.
Barth, who was not involved in the study, chaired the ACOG committee that wrote the 2010 report.
While heavy caffeine consumers in this study got 300 mg or more per day, “I don’t think this report is too different from ACOG’s recent committee opinion,” Barth told Reuters Health in an email.
He said the bottom line for women is that moderate caffeine intake — up to a cup or two of coffee per day — seems safe during pregnancy.
“However,” Barth said, “we do not know if there are adverse effects of higher levels of caffeine consumption.”
As for breastfeeding, it’s generally thought that 300 mg of caffeine or less each day is OK, according to Dr. Lauren Hanley, an obstetrician at Mass General who specializes in breastfeeding issues.
That’s the case for healthy, full-term babies at least, Hanley told Reuters Health in an email.
But preterm infants and newborns metabolize caffeine more slowly, and may be more sensitive to the small amount of caffeine that passes into breast milk.
And studies suggest that high amounts of caffeine during breastfeeding — “much higher” than 300 mg per day, Hanley said — are related to “jitteriness,” fussiness and poor sleep in babies.
Coffee is, of course, not the only source of caffeine. The 200- to 300-mg limit suggested for pregnant or breastfeeding moms would also translate to about four 8-ounce cups of tea or five 12-ounce cans of soda a day.
SOURCE: bit.ly/Hf4y9Y Pediatrics, online April 2, 2012.
© 2011 REUTERS (www.reuters.com)
White-Nose Syndrome: A Scourge In The Bat Caves
April 12, 2012
Story By: by Veronique LaCapra
This map shows the prevalence and spread of white-nose syndrome among bats in the eastern U.S. since 2007. Incidences of white-nose syndrome have been spreading west and south.
But, Elliott says, there’s still a lot we don’t know about the disease.
“It is still a bit of a mystery exactly what the ultimate cause of death is,” he says. But what is clear, Elliott says, is that the fungus is changing the bats’ behavior.
“In heavily infected sites, the bats roost in odd locations, often near the entrance of the site, and will be seen flying out of the site in the middle of the day, in the middle of the winter sometimes, when there’s no obvious good reason for them to be flying out and around,” he says.
Scientists have a number of theories about why the bats are dying. They may be using up their winter fat reserves too soon and starving to death; bats that go out in the daytime make easy pickings for predators; they might be dying from the cold. And since bats regulate water loss through their wings, the flesh-eating fungus could cause deadly dehydration.
Some species have been hit harder than others. The once common little brown bat has seen its northeastern populations plummet, and five other species have also been affected.
“We are basically monitoring and watching one of the greatest population declines through disease that’s ever been recorded for a mammal species, and that is certainly of concern, to put it mildly,” says Jeremy Coleman, the national white-nose syndrome coordinator for the U.S. Fish and Wildlife Service. He says now that white nose has crossed the Mississippi, it will likely spread throughout the Midwest. And it’s not just moving westward.
Where there’s heat, there’s blood, and scientists now know how vampire bats detect it.
“This past winter we did see white nose confirmed in northeastern Alabama, which is also disconcerting, especially given the fact that this winter was very warm, uncharacteristically so,” he says. Coleman says some scientists had hoped the cold-loving fungus that causes white-nose syndrome might not be able to survive so far south.
It’s unclear what the loss of so many bats will mean for the environment. Elliot, with the Missouri Department of Conservation, says bat guano provides nutrients to cave ecosystems. And bats eat a lot of insects, many of them pests on forests and crops.
“We estimate that there may be 800,000 to a million gray bats living in Missouri,” Elliot says. “And doing the math out, that could lead to over 540 tons of insects eaten per year by just that one species in Missouri.”
Without bats, Elliott says, those insects could become a costly headache for farmers.
So far there’s no way to treat white-nose syndrome or stop it from spreading from bat to bat. Elliott says the only thing we can do is limit access to public caves, and have people who do go caving disinfect their clothes and gear.
White-nose syndrome has already reached 19 states, and scientists expect it to keep going.
No access to prostate cancer drug
March 14, 2012
Patients with advanced prostate cancer in Scotland will not get access to a new drug which can extend their lives by more than three months.
Abiraterone, which costs £3,000 a month, had already been provisionally rejected for use in England and Wales.
The Scottish Medicines Consortium said the cost of the drug did not justify the health benefits.
Abiraterone is not a cure for prostate cancer, but it can give some men extra time with their families.
Prostate cancer is the most common cancer to affect men and the second most common cause of death.
The new drug is one of a handful of new treatments rumoured to have been used to prolong the life of the Lockerbie bomber Abdelbaset al-Megrahi, although none of these rumours have ever been confirmed.
Cancer Research UK has criticised the decision.
Its chief executive, Dr Harpal Kumar, said: "Abiraterone is an important treatment because patients and doctors value the extra months of life it can give if prostate cancer has come back after chemotherapy.
"We need to find a way for it to be routinely available through the NHS. At the moment it is too expensive and the SMC must find a better way to ensure drugs that are proven to be effective for patients get approved."
Abiraterone will now only be available in Scotland through Individual Patient Treatment Requests or as part of a clinical trial.
The medicines watchdog for England and Wales, NICE, decided the drug did not justify the price tag in its provisional judgement.
However, advisers in Wales have approved its use on an interim basis until NICE makes its final decision.
Individual applications to be prescribed Abiraterone can be made.
The Scottish government said NHS boards have arrangements at local level for consideration of SMC "not recommended" medicines for individual patients in certain circumstances.
Some have said the NHS should provide the best treatments and catch up with survival rates in other countries.
However, others believe that pharmaceutical firms are over-charging and they should reduce their prices.
© 2011 BBC News (www.bbc.co.uk)
How Birth Control Saves Taxpayers Money
March 13, 2012
Story By: by Julie Rovner
While the controversy continues to swirl around radio talkmeister Rush Limbaugh and his admittedly inappropriate comments about Georgetown Law Student Sandra Fluke, an analysis from the left-leaning Brookings Institution adds an economic twist to the debate over coverage of contraception.
Love them or hate them, contraceptives do save taxpayers money, Brookings concludes.
The study, from the Brookings Center on Children and Families, looked at three different ways to prevent unintended pregnancies, which account for about half of all pregnancies in the U.S.
All three approaches more than pay for themselves. But one -â increasing funding for family planning services through the Medicaid program -â clearly outshines the other two in terms of cost-effectiveness.
Yes, you may have heard there are lots of ways to lower the rate of unintended pregnancy. There are mass media campaigns to urge young people to avoid unprotected sex. Other programs urge teens to delay having sex, or, as a fallback, teach them how to use contraception effectively. And then there’s Medicaid’s help low-income women afford the most effective contraceptive methods.
But this study, using a simulation model devised by Brookings, is the first to estimate exactly how much could be saved using each method.
It found that a national mass media campaign that would cost $100 million would result in about $431 million in savings to taxpayers, largely by reducing unintended pregnancy, particularly among people who don’t make much money.
Programs the Brookings researchers called “evidence-based teen pregnancy prevention,” which combine an emphasis on abstinence “while also educating participants about how to use various methods of contraception” have both reduced the rate of sexual activity and increased the use of contraception.
Spending $145 million on such programs would return $356 million to taxpayers, according to the model.
But by far the biggest return on investment would come from expanding access to family planning through Medicaid, something made possibly through the 2010 Affordable Care Act. A $235 million investment there would lower taxpayer costs of $1.32 billion by preventing unintended pregnancies.
“Evidence-based pregnancy prevention interventions are public policy trifectas: They generate taxpayer savings, they improve the lives of children and families, and they reduce the incidence of abortion,” writes Adam Thomas, the study’s author.
Big deal, say some people, unimpressed with the idea of birth control as a money saver.
“So you’re saying by not having babies born, we’re going to save money in healthcare?” asked an incredulous Rep. Tim Murphy (R-Pa.), of Health and Human Services Secretary Kathleen Sebelius at a House Energy and Commerce Health Subcommittee hearing last week.
Exactly, Sebelius replied, explaining what studies like the one from Brookings have shown for years. “Providing contraception as a critical preventive health benefit for women and for their children reduces health care funds,” she said.
“Not having babies born is a critical benefit. This is absolutely amazing to me. I yield back,” said Murphy.
In Limbaugh’s apology to Fluke, there’s no suggestion that he had changed his mind about who should pay for contraception: Women, not the government, should pick up the tab.