Articles Posted in Clinical guidelines

drugbottles-300x200Tens of billions of dollars. Those sound like hefty sums. But will it ever be enough? Will, say, $50 billion offer justice and appropriate recompense to a nation wracked by an opioid and overdose crisis?

These figures aren’t pulled from thin air. They’re part of the reported settlement under negotiations to resolve more than 2,300 lawsuits, all bundled up now and under the sway of a federal judge in Ohio. He will launch a landmark opioids’ trial this week, starting with claims by two Ohio counties, unless Big Pharma firms remaining as defendants and the plaintiffs — including states, counties, cities, and Indian tribes — can strike a deal and settle.

The claimants, of course, themselves represent huge and diverse interests: their millions of individual constituents. And they disagree on how much money is fair, how it should be divided, and more. The drug makers and distributors, having seen some of their peers bail already for significant sums, assert they have reached their negotiating ceiling, somewhere around that magic $50 billion.

Risperdal-300x150When regular citizens get together in the civil justice system to deliberate difficult claims about complex matters, they may not get everything just right to the satisfaction of the disputing parties. But jurors’ wisdom and findings should not be taken lightly, especially by Big Pharma.

That’s why Johnson & Johnson — and other drug makers — may want to heed the message in a just-announced $8-billion verdict in a Philadelphia courtroom in a case involving a young Baltimore patient and Risperdal, a prescription antipsychotic medication.

It’s true that the whopping award to Nicholas Murray, now 26, likely will be reduced, probably substantially for J&J, a company that has built its brand on being “family friendly.”

bestdrink-300x150Milk and water — it’s that simple. That’s the latest and official recommendation for what children 5 and younger mostly should drink.

For parents, if any doubt persists, that advice comes from leading health authorities, including Healthy Eating Research, a nutrition advocacy group funded by the Robert Wood Johnson Foundation. The group developed the kids’ drink guidelines with the backing of the American Academy of Pediatrics, the Academy of Nutrition and Dietetics, the American Heart Association, and the American Academy of Pediatric Dentistry.

The experts cautioned grown-ups about giving children sugary drinks, including, in a sure-to-be-contested suggestion, recommending a hard cap on fruit juices: for 100% juice, less than a cup a day.

totshot-300x200The weather may be sunny and temperate, the seasonal foliage a slowly changing delight to behold. But the savvy are prepping for sterner days ahead. It’s that time of year when doctors and public health officials urge us all to get that annual flu shot.

It’s never easy to forecast the severity with which influenza will sweep the country. But early indications — including a child’s death already attributed to the illness — suggest this may be a bad year for the bug.

Don’t downplay the harms of this all-too-common sickness: The federal Centers for Disease Control and Prevention estimates that there were as many as 43 million flu illnesses in this nation in the 2018-19 season, with more than 20 million cases serious enough to cause patients to seek medical care. The CDC says there were as many as 647,000 hospitalizations and up to 61,200 flu-related deaths. That toll included more than 100 children killed by flu.

candidaauris-300x224The battle to reduce the sky-high cost of hospital care may have created its own unforeseen and harmful consequence: By hastening to get patients out of traditional hospitals and into skilled nursing facilities and long-term care centers, doctors and policy-makers may be contributing to a medical nightmare — serious infections acquired in health care institutions.

The New York Times reported that “public health experts say that nursing facilities, and long-term hospitals, are a dangerously weak link in the health care system, often understaffed and ill-equipped to enforce rigorous infection control, yet continuously cycling infected patients, or those who carry the germ, into hospitals and back again.”

Hospital-acquired infections (HAIs) pose significant risks to already ill and injured patients, as well as adding to the fearsome costs of institutional care, the Leapfrog Group, an independent patient safety and advocacy group has found. As Leapfrog has reported:

cloudvape-300x222How well does Scott Gottlieb, the former federal Food and Drug Commissioner, sleep at night? Or does he even pause to think much about his role in opening the door to what has become a widening and lethal health menace: vaping and e-cigarettes?

The federal Centers for Disease Control and Prevention has joined with respected specialists in public health and lung disorders to urge the public, most especially young Americans, to stop vaping and using e-cigarettes at least until authorities can sort out an outbreak of serious problems connected with the trendy practices involving inhaling of substances catalyzed by electric devices.

Vaping suddenly has been implicated in 450 cases in 33 states and it has been tied to at least five deaths. Dozens of young people have been hospitalized, some with significant and sustained lung damage requiring extensive medical treatment.

A key feature of great civilizations is that they strive to prevent outbreaks of deadly contagious diseases. So it’s more than worrisome that measles is making what the World Health Organization calls a “dramatic resurgence” in Europe.

Measles, an entirely preventable disease, has in a single year doubled the number of its cases in four European nations, including Great Britain, in the first half of 2019: 90,000 cases versus 44,000 in 2018. Measles has come back with such force that the countries no longer may be considered as having eliminated the infection.

This is a continental meance, too, as the New York Times reported:

brca-cancer-risk-261x300Many more women would benefit if their doctors took time to put them through a relatively easy screening using readily available questionnaires to determine if they might need further specialist assessment and a medical test for a genetic mutation linked to breast and other forms of cancer.

Women, however, should not routinely be subjected to the assessment, counseling, and testing for the BRCA 1 and BRCA 2 mutation, the influential U.S. Preventive Services Task Force has recommended, based on its blue-chip review of medical evidence. The task force gave the broad, routine approach its D grade, as in it should not be done.

The panel gave the careful and appropriate BRCA screenings its “B” grade, meaning they have moderate to significant benefits. The screening by primary care doctors is best suited for women with “a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations.”

Doctors and medical scientists have their hands more than full these days, struggling to get out vital, evidence-based information to benefit the public’s health. They must cope with challenges ranging from  battles with the growing problems of infections and vaccine “hesitance” to how to debunk celebrity humbug on diet and well-being.

The medical establishment’s communication nightmares, though, may be especially bad with women — a group that makes up half the population and plays a huge role in most households with medical decision making. Just consider two recent news reports, including on:

fda3smokewarns-300x166The U.S. government will try to tackle two of the toughest health care challenges around with new pushes involving graphic imagery and smoking prevention and the encouragement for doctors to screen their adult patients to better detect, avert, and treat drug abuse.

Both initiatives have their soft spots.

But officials say they must act in as many ways as they can. That’s because 480,000 people in the United States die each year from illnesses related to tobacco use, the American Cancer Society reports, adding, “This means each year smoking causes about 1 out of 5 deaths in the US.” Drug abuse and overdoses, meantime, killed more than 68,000 Americans in 2018 alone, exceeding the nation’s peak annual deaths from car crashes, AIDS or guns, the New York Times reported, based on data from the federal Centers for Disease Control and Prevention (CDC).

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