braintraumaIt may sound macabre. But advocates say a critical step to address important gender disparities in the care and research on concussions’ harms may rest in convincing more women to donate their brains to science. This has already  helped to prove the debilitating and deadly effects of head trauma among men in pro sports.

In contrast to the many and growing number of male athletes (especially pro football players) and their families who have allowed post-mortem brain studies, far fewer elite female players have agreed to similar research. Stat, the online health information site, says soccer stars Brandi Chastain, Abby Wambach, and Megan Rapinoe are among the public few.

Autopsies are often the only way, for now, for experts to definitively diagnose debilitating conditions like chronic traumatic encephalopathy (CTE) that result from repeated head trauma (concussions).

IVThree Washington, D.C.-area teaching hospitals have ranked in the lowest-scoring group nationally on preventing infections when their patients are hooked up to central lines, intravenous tubes that supply fluids, medications, and nutrients to those in dire need. Two institutions in the region rated highly.

Consumer Reports deserves credit for its continuing reporting on hospital acquired infections (HAIs), a scourge that in 2011 afflicted 650,000 already ailing Americans and which contributed to 75,000 deaths. The advocacy group says 27,000 patients were felled with central line infections in 2015, with a quarter of these especially sick and frail individuals dying of them. Treating patients for central line infections cost on average $46,000—more than for any other HAI.

The area teaching hospitals that the magazine ranked poorly, based on an analysis of federal data from 2011 to 2015, were: George Washington University Hospital, Holy Cross Hospital in Silver Spring, and Howard University Hospital. The two high-ranking institutions were: MedStar Franklin Square Medical Center in Baltimore and Sentara Norfolk (Va.) General Hospital.

NL_DifferenceThere’s  more encouraging news about dementia rates, which a new study has found fell 24 percent between 2000 and 2012, decreasing among Americans 65 and older from 11.6 percent to 8.8 percent. The experts aren’t sure why the rates declined. But it means that 1.5 million or so seniors will be spared the severe cognitive declines that would have been expected from earlier rates of the tragic disease.

Researchers, who published their latest findings in the peer reviewed and respected Journal of the American Medical Association, said that greater educational attainment and improved heart health may have led to the decreases in the prevalence of the condition associated with loss of memory or other mental abilities so severe it interferes with daily life. Alzheimer’s disease is most commonly linked to dementia. Vascular dementia is the second most common type of dementia and occurs after a stroke.

The new study, funded by the National Institutes of Health and on Aging (NIH and NIA), produced continuing surprises as experts have projected an explosion in cases among Americans, who are increasingly gray, obese, and diabetic—factors that significantly increase dementia risks.

vox ocareAs speculation explodes about what the GOP and the president-elect will or won’t do with the Affordable Health Care Act (aka Obamacare), Medicare, and Medicaid, skeptical citizens would be well-served to learn as much as they can about critical policy concerns. Ask tough questions and be wary of counterfactual contentions. Here are a few prime subjects:

Debunking so-called ‘tort reform’

  • A tip of the hat to the Center for Justice and Democracy at New York University for providing research that debunks what may be a component of the multi-pronged attack on Obamacare: the falsehood that one way to contain rising medical costs is to enact so-called “tort reforms,” especially those that target medical malpractice lawsuits. I’ve written about this canard. These bad policy measures: strip patients of invaluable rights to sue; impose arbitrary, cruel, and unsupported caps on what they can recover from doctors and hospitals that harm them significantly; and fail to curb rising medical costs, no matter how partisans shill to sell them. The center’s new research points out that insurers play a huge role in creating malpractice liability crises. Although they blame malpractice lawsuits for driving up coverage costs and causing physicians to practice “defensive” over-testing and other negative medical practices, insurers, the center’s research shows, actually are at the root of many cost explosions due to their own avaricious practices. That’s because insurers rely on market investments to pump up their premium and capital reserve revenues. They have sent coverage costs skyrocketing in good times and bad to ensure they have money to invest and profit more with Wall Street, or to supplement their reserves when their stock losses mount. Meantime, medical malpractice claims and premiums are at historic lows—certainly nowhere near levels to justify hype about how the health care system would benefit from so-called tort reforms.

hep-c-imageAlthough the partisan wrangling over what’s next with American health care seems to ignore the maddening realities confronting patient-consumers,  a new look at the plight of poor Kentuckians provides a harsh look at the collision of many major health policy controversies including soaring drug prices, the Affordable Care Act, and the prescription drug abuse crisis.

Stat, the online health news site, deserves credit for the grim picture it painted of health care dysfunction in the nation’s heartland. Kentucky has been ravaged not only by opioid drug abuse, including record numbers of overdose deaths, it also is struggling with a stark, related rise in diseases.  In particular, cases of Hepatitis C have skyrocketed by 364 percent in Kentucky and surrounding states. Infections are growing most among young, rural whites, and to the growing concern of public health officials, Kentucky is recording increasing numbers of cases in which pregnant moms are infecting their babies.

Hepatitis C, a viral infection that damages the liver and is a factor in 19,000 Americans’ death annually, can lurk in the body for long periods before becoming deadly. As many as 4 million Americans may carry it and not know it until their liver damage becomes severe. The virus (depicted in the illustration above) spreads among addicts of pain-killing medications because they too often progress from prescription pill-popping to shooting up other increasingly powerful opioids like fentanyl and heroin.

emergency-services_overviewYour kid takes a tumble and breaks an arm at a sleep-over. Your spouse, on a business trip, suffers sudden chest pain and shortness of breath. You’re in beach slippers and step by accident on a shard of glass stuck in the sand. Now, you’ve got oodles of time to check your insurance policy to  find the nearest emergency room that’s covered by your insurer, right? And you’ll be asking every physician who treats you if they’re part of your network, right?  Well, no, nobody does that.

So brace yourself: a new study says that 1 in 5 Americans gets whacked after their ER visit with added charges not covered by insurers for out-of-network care. The surprise medical bills averaged $900 but ran as much as $19,000.

“To put it in very, very blunt terms: This is the health equivalent of a carjacking,” Zack Cooper, an assistant professor of health policy and economics at Yale University, commented to the New York Times. He is a co-author of the paper on surprise medical bills, published in the peer-reviewed New England Journal of Medicine.

1024px-Heart_anterior_exterior_viewHeart health news grabbed a lot of headlines in recent days, especially as experts gathered for a major national conference in New Orleans. But skeptical readers would do well to scrutinize the reports on topics like: who should take statins, what’s the role of lifestyle and genetics in heart disease, and how heart-safe is a well-known pain and inflammation medication?

U.S. task force issues new statin guidelines

Let’s start with the new recommendations on statins from the well-respected U.S. Preventive Services Task Force. The independent, influential advisory group—which sorts through research and seeks to offer authoritative, unbiased guidance about medical services and practices—said Americans 40 to 75 with no history of cardiovascular disease but certain risk factors might consider taking statins. The risk factors include whether they have high cholesterol, high blood pressure, diabetes or smoking. The panel said that puts them at a 10 percent or greater risk of having a heart attack or stroke in the next 10 years.

Thanksgiving-turkey-shared-via-creative-commons-by-Betty-Crocker-RecipesAs tens of millions of us set out to feast and give thanks, some thoughts about making the holiday safe and healthy:

Turn off the e-devices when driving

When driving to see friends and family, shut off the electronic devices, please, and forgo the apps on them, as long as you’re the one behind the wheel. The National Highway Traffic Administration says that, after a half century of declines, traffic fatalities in 2015 recorded their largest percentage leap in a half century—and in the first half of 2016, the figures are up 10.4 percent more over last year (17,775 road deaths). Officials say distracted driving is reaching deadly levels, especially as motorists tap devices and apps to send meaningless texts or take selfies. This already has proved fatal to innocent others, including  multiple-vehicle wrecks.  I deal in my practice with the tragic aftermath of the carnage that vehicles and negligent drivers can inflict. When you’re behind the wheel, you’re responsible for what can become a multi-ton missile. Be safe. If you’re under the influence—due to alcohol, marijuana, or prescription drugs— rely on a sober, designated driver.  Or take a taxi or tap Uber or Lyft. Or sleep on the couch or floor. We’ll be thankful you did.

INGLEWOOD, CA - 1988: Kareem Abdul Jabbar #33 of the Los Angeles Lakers holds his goggles during an NBA game at the Forum in 1988 in Inglewood, California. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and/or using this Photograph, user is consenting to the terms and conditions of the Getty Images License Agreement. Mandatory Copyright Notice: Copyright 1988 NBAE (Photo by Andrew D. Bernstein/NBAE via Getty Images)

INGLEWOOD, CA – 1988: Kareem Abdul Jabbar #33 of the Los Angeles Lakers holds his goggles during an NBA game at the Forum in 1988 in Inglewood, California. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and/or using this Photograph, user is consenting to the terms and conditions of the Getty Images License Agreement. Mandatory Copyright Notice: Copyright 1988 NBAE (Photo by Andrew D. Bernstein/NBAE via Getty Images)

Basketball legends Kareem Abdul-Jabbar and James Worthy donned them, as did pro football superstar Eric Dickerson, and onetime Reds third-baseman Chris Sabo. Goggles may make athletes look goofy, but new research suggests that young players and their parents and coaches might want to give these and other protective eye-wear a second look.

That’s because caregivers in emergency rooms across the country treat 30,000 sports-related eye injuries annually, a large majority of them in patients younger than 18 and a few younger than 10.

seqcore_slider_img_resizedAlthough doctors and hospitals report potentially sunnier news by the day about novel cancer treatments, it’s also worth keeping in mind that difficult obstacles like data misinterpretation still must be worked out to avoid endangering patients. The therapies themselves as well as cancer care overall can be crushing in their costs. And some experts also are raising questions about Big Pharma and the independence of advocacy groups that patients and families often turn to when diagnosed with different cancers.

Let’s start with the ray of optimism that the Washington Post reported for patients with advanced lung cancer. It kills more than 160,000 Americans annually, and isn’t diagnosed often until it reaches late stages. Lung cancer, the Post says, retains its stigma because of its proven link to smoking. Both smokers—and nonsmokers who also may develop the disease for many other complex reasons—are blamed for causing their own illness.

Oncologists have begun to look at this cancer not as one but many different disease, and the paper says immunotherapy may improve outcomes for a slice of late-stage patients, halting the disease’s spread and without the significant side-effects of current chemo or radiation treatments. In immunotherapy, patients’ cancers are tested to determine which drugs may best target and destroy tumors by unleashing the bodies’ own disease-fighting (immunity) systems.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
Washingtonian Top Lawyer 2011
Avvo Rating 10.0 Superb Top Attorney Best Lawyers Firm
Contact Information