Articles Posted in Primary Care

AR-15_Sporter_SP1_Carbine-300x120When partisans refuse to deal with deadly gun violence as a public health crisis and to support and fund rigorous research to guide  law-making, it’s unsurprising that extreme and outlandish notions rush to occupy a noxious space in public discussions — a condition one think tank has labeled “truth decay.”

Let’s not stoop, though, to useless bickering about our respective “thoughts” on guns, but rather stick to facts and credible evidence to figure how the nation can better prevent mass shootings.

Exhibit A:  A South Florida radiologist’s essay on the lethal results of wounds inflicted by high-powered battlefield weapons like the AR-15 used in the recent mass shooting at a Florida high school.

influenza-virus-fulltext-300x203As the flu epidemic rages across the country, it also may be testing the oft-tenuous public respect for preventive medicine, especially as patients get hit with surprise medical bills and experts struggle to explain the complexities and limits of protections afforded by vaccinations.

Are flu shots useful or not?, many Americans may be asking, as this season’s infections hit marks not seen for at least a decade. (Spoiler alert: Yes, get that shot!) Flu kills many more patients than many realize, and this year, the virus is on track to claim as many as 4,000 lives a week.

The toll among children has been scary, with the deaths of 84 youngsters blamed on flu. Three out of four of the youngsters who died from flu had not been immunized, officials say.

banyan-300x173Federal officials offer a glimmer of hope in caring for head injuries, especially the sharp, repeated, and often damaging blows that  afflict athletes and which millions worldwide are witnessing, yes, as part of the Winter Olympic Games.

The federal Food and Drug Administration has announced that it has approved a long-awaited blood test that can help doctors determine the severity of traumatic brain injuries. This test will provide a cheaper, easier, more convenient, and likely faster way to handle the rising health bane of concussions, rather than relying on computed tomography or CT scans using big machines and a form of X-rays.

As the New York Times reported:

fuelingepidemic-235x300A U.S. Senate Committee has ripped Big Pharma for making millions of dollars in pernicious payments to patient advocacy groups, so they could legitimize and assist in promoting powerful prescription painkillers, a practice that investigators say helped fuel the opioid drug abuse epidemic.

The committee report says:

Patient advocacy organizations and professional societies play a significant role in shaping health policy debates, setting national guidelines for patient treatment, raising disease awareness, and educating the public. Even small organizations— with ‘their large numbers and credibility with policy makers and the public’—have ‘extensive influence in specific disease areas.’ Larger organizations with extensive funding and outreach capabilities ‘likely have a substantial effect on policies relevant to their industry sponsors.’

With estimates that more than 150,000 of America’s young have been exposed to campus shootings since 1979, it seems curious, to be generous, for so many to just bend a knee and not see that the nation is in the grip of a public health crisis — a crisis that with clear thinking could be stopped.

If Americans of another age got “scared straight” about the dangers of intoxicated driving by seeing gruesome educational movies, well, then, it might be worth getting more people to read the post-mortem, detailing the human carnage caused just a few months ago by a psychotic’s firing from a hotel perch into a music festival crowd below in Las Vegas. See, for example, the video above showing the damage caused by assault-style weapons.

Even as the nation struggles with alcohol and drug abuse, it’s clear that more public health effort needs to be directed at helping expectant mothers understand how much substances they ingest can harm their kids.

The New York Times reported that a new study published in the JAMA medical journal has conservatively estimated that “fetal alcohol spectrum disorders affect 1.1 to 5 percent of children in the country, up to five times previous estimates.”

srabuse-300x150Imagine if Uncle Sam permitted everyone who lives in Newport News, Va., or maybe Fort Lauderdale, Fla., to be chemically restrained, drugged with powerful medications so they fell, day and night, into a speechless stupor. Now, further envision the furor if these 180,000 souls and their families each were forced to pay as much as $100,000 annually  to be reduced to a near vegetative state.

This real situation with over-medicated Americans, in this case seniors in nursing homes, is just one more cruelty happening against the aged. It’s also hard to see federal officials issuing faint praise on how regulations slowly — too painfully so — are reducing abuse of potent anti-psychotics in the nation’s care for the old, especially those with dementia.

The Centers for Medicare and Medicaid Services, aka CMS, has issued new data on its seven-year campaign to slash elder care facilities administering antipsychotics sold under brand names like Abilify, Risperdal, and Zyprexa. Questions also have been raised about a newer drug, the little red pill branded as Nudexta.

carwreck-300x225Although Congressional Republicans and the Trump Administration may not want to stop their relentless assault on the Affordable Care Act, aka Obamacare, there may be other reasons to persuade them to do so.

Researchers at the nonpartisan, not-for-profit RAND Corp., for example, have looked at existing studies and data and asked if the recent GOP move, in the huge tax cut bill, to halt the ACA’s health insurance mandate will have unintended consequences.

They say the repeal of the requirement that all Americans show they have health coverage when they pay their taxes may “ripple out” to other insurances they carry — meaning that tens of millions of motorists may pay more for auto insurance and businesses could see hikes in workmen’s compensation costs they already struggle to pay.

oxy-300x179Purdue Pharma, which built a multi-billion-dollar family empire, in part, by overcoming doctors’ resistance to prescribing powerful painkillers like its own powerhouse  OxyContin, has decided to curb its quarter-century of aggressive and controversial drug marketing — efforts that critics and lawsuits say helped fuel the nation’s opioid drug abuse epidemic.

The company has said that it will cut its sales staff by half and the 200 or so salespeople who stay no longer will haunt doctor’s offices to push OxyContin. Instead, the company said it will direct prescribers to materials on that drug, published by the Centers for Disease Control and Prevention and the office of the U.S. surgeon general.

“We have restructured and significantly reduced our commercial operation and will no longer be promoting opioids to prescribers,” the company, based in Stamford, Conn., said in a statement quoted by Reuters.

cdc-feb10-hospitalflu-300x186The Winter Olympic Games and the Super Bowl can offer fans not just exciting sports spectacles but also important health insights and information— everything from the risks of viruses and the value of hand washing to the dangers of head blows and why Americans may be slowly changing their minds about how they feel about violent recreations.

Let’s start with what can happen when you put more than 2,000 elite athletes from 92 nations in a village setting in Pyeongchang, South Korea. It’s no surprise that  contagious illnesses can break out, and in this case the noxious norovirus. More than 100 cases of the highly infectious viral illness at the Olympic site have been confirmed already, and 1,200 people — many of them security guards for the Games — have been quarantined with disease symptoms. (The South Korean military has sent in forces to assist with security, in place of the quarantined guards).

Norovirus, aka the winter vomiting disease, is a gastrointestinal bug with other symptoms including diarrhea, nausea, and stomach pain, according to the according to the CDC. Its symptoms typically start 12 to 48 hours after patients come in contact with the virus. Symptoms might also include headache and body aches. Fever is uncommon. The sickness is highly contagious, spreading when viral particles get aerosolized over large areas. Hygiene becomes key in outbreaks, as public health experts have emphasized and global cruise lines have discovered.

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