Articles Posted in Clinical guidelines

diabetesreuterrise-300x120More than 100,000 people in this country died last year due to diabetes. That’s 17% more than the year before. And in younger age groups, it’s even worse: deaths from diabetes climbed 29% last year  among those ages 25-44, federal data show.

The figures should raise huge alarms that diabetes, as exposed by the coronavirus pandemic, is “out of control,” reported Chad Terhune, Robin Respaut, and Deborah J. Nelson for Reuters news service.

Their investigation, including an analysis of federal data to draw a depressing depiction of diabetes’ significant damages to the health of millions of Americans, found that the pandemic only begins to show huge failures in the care of what should be a manageable illness:

bugatti-300x118If big hospitals really want to keep surgeons happy and provide them with greater comfort during procedures, why not build giant, sanitary glass garages next to operating rooms and let docs park their Bentleys, Lamborghinis, and Bugattis there for ogling and maybe even to take a break under the vehicles’ hoods?

Okay, maybe we’re being a bit too snarky.  Yet that hyperbolic scenario just might be cheaper and more medically justifiable than the sustained embrace by specialists and profit-seeking institutions of fancy robotic surgical devices costing more than $1 million annually — and for which patients, ultimately, pay. Here’s what the New York Times reported of yet another published meta-analysis of dozens of studies on the devices and their outcomes found:

“Surgical procedures performed with the aid of a robot is sometimes marketed as the ‘best’ form of surgery. But a recent review of 50 randomized controlled trials, testing robot-assisted surgeries against conventional methods for abdominal or pelvic procedures, suggests that while there may be some benefits to robotic surgery, any advantages over other approaches are modest … Some surgeons believe that these robots allow more precision during the operation, shorter recovery time, and generally better clinical outcomes for patients. But the review found that in many ways, compared outcomes from the robotic and conventional procedures showed little difference.

deltadixieft-300x187The coronavirus has killed almost 630,000 Americans, with the pandemic adding in its fourth surge now under way 1,000 deaths a day or 42 fatalities per hour.

The disease has infected almost 38 million of us, with more than 145,000 new cases occurring each day in recent weeks.

More than 90,000 coronavirus patients were in hospitals nationwide in the last week, more than in any previous surge except last winter’s, the New York Times reported.

cpaprecall-300x139Millions of patients with serious, diagnosed sleep disorders now are wrestling with a daytime nightmare: Medical devices designed to help them avoid damage from their conditions have been recalled for major and concerning defects.

But consumers complain that they’re getting poor and too little information about their health options until the device maker more fully addresses the products’ problems.

The manufacturer under regulatory and consumer fire is Royal Philips NV, which has recalled its “devices known as CPAP and BiPaP machines,” the Wall Street Journal reported, adding that the products “gently push air into the lungs and are primarily used to treat sleep apnea.”

medscrewsuw-171x300Patients, regulators, hospitals, and doctors themselves need to open their eyes and ask tougher questions about the eyebrow-raising trend occurring among a specialized set of “sawboneses” — orthopedists and neurosurgeons.

Hundreds of them are profiting handsomely, not on their  medical skills  but rather their investments in and relationships with surgical hardware. The specialists also are increasingly reliant, in dubious fashion, on medical device salespeople.

Fred Schulte, an investigative reporter with the independent, nonpartisan Kaiser Health News service, has written a pair of detailed news articles raising yet more questions about medical devices, specifically the $3 billion that floods a peculiar pipeline between those who operate on patients’ backs, knees, hips, and shoulders and the companies that provide the surgical hardware for the procedures.

aduhelm-150x150The nation’s largest integrated health system has declined to cover a drug approved by the federal Food and Drug Administration for treatment of early Alzheimer’s disease. The action is not only a rebuke by the Department of Veterans Affairs to the FDA, it also offers support of sorts to a plea by President Biden for a way that he says Congress could help slash at soaring prescription drug prices.

The drug that the VA says it will support only in highly select cases — due to safety and effectiveness concerns — for the 9 million patients in its system (military veterans and their loved ones) is made by Biogen and is called Aduhelm.

The FDA approved the prescription medication to the consternation of its own experts and leading specialists in dementia care based on multiple clinical trials which the company itself had deemed unsuccessful.

casey-150x150wyden-1-150x150Senate Democrats, including chairs of two powerful committees, have started to tackle the nightmarish problems that experts blame for allowing the coronavirus pandemic to take a terrible toll on vulnerable residents of nursing homes and other long-term care facilities.

Under a bill introduced by Ron Wyden, an Oregon senator and chair of the Senate Finance Committee (shown above, left), and Bob Casey Jr., a Pennsylvanian and chair of the Aging Committee (above, right), federal officials would both push and assist the facilities to improve health worker staffing, infection control, and regulatory oversight, notably through better inspections, the Associated Press and other news organizations reported.

The AP summarized the highlights of the Wyden-Casey measure, also supported by four other senators, thusly, noting it seeks to:

covidhotspotmap08142021nyt-300x180As the latest coronavirus surge worsens, public health efforts to quell the pandemic are targeting two groups that might be dubbed the can’t-s and won’t-s.

Federal regulators sought to assist the first group by approving coronavirus vaccination booster shots for a select group of patients — those whose compromised immune systems could not generate sufficient protection with standard shot regimens.

Experts say that individuals who have undergone organ transplants or who may be undergoing cancer treatments or otherwise have low immune systems may benefit from the booster shots.

fdahvad-230x300The federal Food and Drug Administration too often fails to protect patients from defective and dangerous medical devices because it lets manufacturers self-police themselves, cozies up to companies rather than trying to compel safety fixes, and inadequately informs the public and medical community about problem products.

If that sounds like too broad and harsh an indictment of poor performance by a purported watchdog agency, just read the deep dig by ProPublica, the Pulitzer Prize-winning investigative journalism site, into the FDA’s record with the HeartWare Ventricular Assist Device, or HVAD.

ProPublica details the unacceptable actions that put thousands of patients at risk with a heart pump that cost $80,000, required major surgery, and that the FDA knew had significant problems but still allowed highly vulnerable people to have implanted. As reporter Neil Bedi found:

From the It’s-about-time department: Nursing homes and long-term care facilities finally have started to require their health workers to get vaccinated against the coronavirus.

The federal Centers for Disease Control and Prevention has reported as of Aug. 6 that ~1.6 million long-term care residents and 1.3 million health workers in the care facilities were fully vaccinated.

But with coronavirus cases, hospitalizations, deaths, and community spread spiking this summer — especially due to the unvaccinated and the Delta variant — nursing homes have seen worrisome signs of their own of the pandemic’s resurgence. And they, along with other health care institutions, can no longer ignore the safety and effectiveness of the coronavirus vaccines, the New York Times and other media organizations have reported. As the newspaper noted:

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