Articles Posted in Clinical guidelines

babewithbottle-300x293Americans keep suffering the dire consequences of corporations’ relentless pursuit of profits, their stifling of beneficial competition, and their failure to secure the production of their products. These now include desperately needed, specialized baby formula and contrast dyes used in diagnostic imaging studies for seriously ill and injured patients.

A special place in perdition needs to be reserved for those who have put infants at risk of hunger and illness by allowing the feeding crisis to explode and for boobs who are rushing in with finger-snapping, fact-light, and unworkable actions for parents to respond.

Let’s be clear that the formula mess, bad for all families across the country, hits hardest at the working poor and the poor. As the New York Times reported:

coronapreventablenpr-300x226President Biden has ordered flags in public buildings across the country to be flown at half staff as the nation officially mourns 1 million American deaths due to the coronavirus pandemic. As he noted in a statement:

“One million empty chairs around the dinner table. Each an irreplaceable loss. Each leaving behind a family, a community, and a nation forever changed because of this pandemic. Jill and I pray for each of them. To those who are grieving and asking yourself how will you go on without him or what will you do without her, I understand. I know the pain of that black hole in your heart. It is unrelenting. But I also know the ones you love are never truly gone. They will always be with you. As a nation, we must not grow numb to such sorrow. To heal, we must remember. We must remain vigilant against this pandemic and do everything we can to save as many lives as possible, as we have with more testing, vaccines, and treatments than ever before …”

The milestone that the country likely hit a while ago, a toll that many experts hoped would never be reached has proved hard to grasp for too many people in this country. The coronavirus deaths are the equivalent or exceed the populations of cities like San Jose, Calif., Austin, Tex., or Jacksonville, Fla. The comparisons are inexact and not easy, but with Memorial Day approaching, is it appropriate to note that the U.S. pandemic deaths now roughly equal the nation’s fatalities in the Civil War, World War I and World War II combined?

family-300x241While the nation’s pediatricians have announced an important, high-minded goal of eliminating racial bias in the medical treatment of children, working parents and other full-time caregivers for kids need a different kind of help, too, for a growing, serious problem — burnout.

These seemingly different issues share a common discovery point, rooted in challenges made large by the coronavirus pandemic and the recent unrest over social injustices experienced by communities of color, news media reports say.

Medical practitioners of various kinds, including kids’ specialists, have been forced to reexamine their consciences and beliefs even before but especially after the 2020 death in police custody of George Floyd, the AP reported. For pediatricians and their important practice group, this led to a medical reckoning, valuable to all patients but especially those of color:

cabinetdrugcomputertech-300x178Big Pharma has made the nation so pill-obsessed that prescription drugs pose big risks to the safety of the seriously sick and injured and the finances of retirees.

Recent news stories have warned, for example, that:

aspirinme-225x300Aspirin has gotten its crown knocked askew as a cheap, effective low-dose heart problem preventer for older Americans.

That’s because the U.S. Preventive Services Task Force has weighed the evidence, heard the comments, and recommended against patients 60 and older taking the common drug to avert cardiovascular diseases. The experts gave this purportedly protective step a “D” grade.

The USPSTF is an elite, independent, and influential group of experts who advise the federal government, insurers, and clinicians about the safety and effectiveness of medical tests and procedures based on rigorous consideration of their merits.

changingcovidtollap2022wp-300x216The coronavirus pandemic has become such a central part of so many people’s lives that the temptation is great to ignore its persistent, calamitous effect — and how some of the worst of these can be dealt with more than ever in relatively easy, safe, convenient ways.

Looking recent data about the disease, it is possible to start to downplay the virus, suggesting it could be reaching the endemic stage in which it still poses high perils but is not a crisis condition, as it has been for months now. Consider, for example, how widespread coronavirus infections have become, especially due to the recent surge involving the highly contagious Omicron variant. As the New York Times reported:

“Sixty percent of Americans, including 75% of children, had been infected with the coronavirus by February, federal health officials reported … — another remarkable milestone in a pandemic that continues to confound expectations. The highly contagious Omicron variant was responsible for much of the toll. In December 2021, as the variant began spreading, only half as many people had antibodies indicating prior infection, according to new research from the Centers for Disease Control and Prevention. While the numbers came as a shock to many Americans, some scientists said they had expected the figures to be even higher, given the contagious variants that have marched through the nation over the past two years.”

chromosomes-harvardExpectant parents, doctors, and regulators need to reconsider the rising use of gee-whiz genetic testing as  doubts emerge about popular blood screenings to detect rare prenatal disorders and a costly test relied on by couples undergoing in-vitro fertilization (IVF) treatment.

This is what the New York Times reported about what researchers have found about preimplantation genetic testing for aneuploidy, or PGT-A. It is an increasingly common screening in IVF and has led potential parents to discard embryos as unfeasible or unacceptable due to abnormalities to carry to term:

“PGT-A … has, over the last two decades, become a standard add-on to already pricey IVF procedures. But the test, which can cost anywhere from $4,000 to $10,000, has become controversial over the years as studies have cast doubt on whether it increases birthrates from IVF at all. A growing number of scientists have questioned the widespread use of the test, which leads to tens of thousands of discarded embryos per year and causes many women to believe they may not be able to carry biological children. A new study published last week details 50 patients who underwent transfers of abnormal embryos at the Center for Human Reproduction in New York City … The study reported eight births after 57 transfer cycles of embryos with abnormal genetic testing results since 2015. Seven of the babies were born healthy. The average age of the women in the study was 41 years old.

airlinemasking-205x300Hundreds of Americans keep dying each day due to the coronavirus. Tens of thousands of people across the country are reporting they are newly infected with the disease, even as at-home testing lowers this count. Thousands of patients still are hospitalized due to the virus that has killed at least 1 million in this country. But even as worrisome measures of the pandemic rise anew, important ways to battle the deadliest infectious disease outbreak in a century are dwindling.

Health officials are grappling with a federal judge’s ruling, upending nationwide what has been a minimally inconvenient step to quell the pandemic — a requirement for passengers to cover their faces while traveling on public transportation.

The judge — yes, an appointee from the last administration who was deemed by the Bar to be not qualified for her lifetime post — staked out a dubious legal view that federal officials overstepped their authority with the mask order.  U.S. District Judge Kathryn Kimball Mizelle, sitting in Tampa, Fla., asserted among other things in her ruling that she thinks Congress limited the Centers for Disease Control and Prevention to be involved only in “inspection, fumigation, disinfection, sanitation, destruction, or pest extermination.”

academies-300x90The nation’s nursing homes and other long-term care facilities are in dire need of drastic overhaul to dramatically improve the quality and safety of their treatment of the aged, sick, and disabled. They too often now get what one expert has described as “ineffective, inefficient, inequitable, fragmented, and unsustainable” care.

To repair the glaring, longstanding wrongs in these facilities — problems that critics say contributed to 150,000 resident deaths during the coronavirus pandemic — requires sweeping practical, regulatory, and financial changes in an industry focused on profits and resistant to change, according to newly published expert research report by the National Academies of Sciences, Engineering, and Medicine.

The academies, with members who are leaders in their fields, are private, nonprofit institutions that work outside of government to provide objective advice on matters of science, technology, and health.

cdchq-300x180A public health agency once held up as the world’s gold standard will put itself under the microscope and try to diagnose swift, appropriate remedies for the relentless criticism it has received for months of faulty performance in dealing with one of the most lethal infectious disease outbreaks in a century.

The federal Centers for Disease Control and Prevention (CDC) must improve its work in its core functions, including “beefing up the nation’s public health workforce, data modernization, laboratory capacity, health equity, rapid response to disease outbreaks, and preparedness within the United States and around the world,” the agency’s chief, Dr. Rochelle Walensky, has written to her 13,000 expert colleagues. She is insisting, no matter the political risks and practical difficulties, that significant changes must occur, the Washington Post reported, noting of the agency’s much-derided work on the coronavirus pandemic:

“Since the pandemic began more than two years ago, the once-storied agency has been under fire for its pandemic response, from initial delays developing a coronavirus test, to the severe eligibility limits to get the test, to missteps often attributed to Trump Administration meddling. But even under the Biden Administration, the agency’s guidance on masking, isolation and quarantine, and booster doses has been repeatedly faulted for being confusing. A consistent criticism has been the agency’s failure to be agile, especially with analysis and release of real-time data.

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