Primary Care

January 3, 2020

A patient’s painful and powerful reminder of harms inflicted by drug diversions

Hospitals, clinics, and other health care settings — and those who staff them — aren’t immune to the ravages of the opioid crisis and its related abuse of prescription and illicit drugs. For patients, their caregivers’ addictions can have serious consequences, including a less-discussed nightmare: diversions of their drugs.

Lauren Lollini, a psychotherapist and a patient-safety advocate, has penned a powerful and scary Op-Ed for Stat, a health and medical news site. She describes how, while undergoing a relatively routine kidney stone removal at a respected Denver hospital, she was infected with hepatitis C — a draining and chronic liver disease that is blood-borne and is often associated with drug abusers. Lollini, however, had been healthy and did not use drugs. So, how did she get so sick? As she explained:

“[An investigation by the] Centers for Disease Control and Prevention, showed that I and at least 18 others had been infected with hepatitis C by Kristen Parker, a technician at Rose Medical Center who had tested positive for the disease before she was hired. She stole patients’ fentanyl-filled syringes off medication trays, injected herself with the painkiller, then refilled the syringes with saline. In the summer of 2009 — about three months after I learned I had hepatitis C — Parker was arrested in one of the biggest hospital drug diversion incidents to date. In 2010, she was sentenced to 30 years in prison.”

January 2, 2020

Here’s something as frightful as the weather outside: winter weight gain

by Patrick A. Malone

Many of us may feel a little too hefty after weeks of seasonal feasting and merrymaking. But Old Man Winter also may share a slice of the blame for our weight gain at this time of year and beyond.

Packing on a pound or two, maybe even five, may be more common at this time of year than many realize, researchers say. Blame it not only on drinking and eating with friends for the holidays. It also may be due to our increased sedentary behaviors due to cold and stormy weather. As the Washington Post reported:

“On average, research shows that people gain one to two pounds over the winter months. For instance, a study of 195 people at the National Institutes of Health found weight gain of about one pound between late September and March. A study of 248 U.S. military personnel, who were enrolled in a weight-loss program, found that people added about two pounds from fall to winter. Here’s something else. There also is evidence that American adults gain one to two pounds each year, gradually accumulating weight over decades. Winter weight gain may be a major culprit, so perhaps we should view the season as a particularly risky time for adding excess padding. Indeed, 165 subjects in the NIH study returned for a September weigh-in and, on average, were 1.4 pounds heavier than the year before. A note: One to two pounds on average means that some people don’t gain any weight while others gain five pounds or more. And in a rude twist of fate, the people who gain the most are more likely to be already overweight or obese.”

December 30, 2019

Some Grinch-y news about a few popular holiday gifts

by Patrick A. Malone

Consumers may need to give a few seasonal gifts a second look about their safety and other health-related issues:

Powerful rare-earth magnets, used in many toys and especially in shape construction kits, pose big risks to kids when swallowed.
Widely used over-the-counter genetic testing kits may subject users to major privacy concerns they never contemplated. The risks have risen enough so the Pentagon has issued a warning to service personnel.

December 29, 2019

Big cash gives Big Pharma and device makers a dubious sway over doctors

by Patrick A. Malone

Although it’s always important to remember in research studies that associations don’t prove causation, findings from two separate works should raise serious concerns about doctors’ independence and judgment in prescribing drugs and reporting conflicts of interest about payments from makers of medical devices.

That’s because doctors who get money from drug makers in connection with a specific medication tend to prescribe that drug “more heavily” than colleagues who don’t get similar cash, ProPublica, a Pulitzer Prize-winning investigative site, has found.

And doctors who are among those receiving the highest compensation from surgical and medical device manufacturers show some of the biggest discrepancies between the sums they report for institutional conflicts of interest and what a federal database of payments shows, according to physician-researchers at the University of California, Irvine (UCI).

December 27, 2019

U.S. to require vapers and smokers to be at least age 21 to buy tobacco in any form

by Patrick A. Malone

Consumers soon may need to be 21 or older to buy burning tobacco cigarettes or e-cigarettes, the key component of the national health nightmare of “vaping.”

Both the House and Senate have passed the higher age requirement and President Trump is expected to sign it, joining hundreds of states (including Maryland, as illustration shows) and cities that have sought to make it tougher for Americans to damage their health with the popular products.

The damage caused by smoking have been well proven for decades now, with the American Cancer Society reporting the nasty habit’s persistent toll:

December 20, 2019

Intoxicated drivers keep killing too many. New, targeted tactics may be needed.

by Patrick A. Malone

Politicians and police may need to step up their crackdown on drug- and alcohol-impaired drivers, targeting repeat offenders with substance-abuse and mental health problems who also are “disproportionately responsible for fatalities,” a leading traffic safety group recommends.

As the Wall Street Journal reported of new work by the Governors Highway Safety Association and its consultant Pam Fischer:

“Nearly 30% of all vehicular-crash deaths in the U.S. last year were alcohol-related … Last year, 10,511 people died in crashes involving at least one driver with a blood-alcohol concentration of at least .08%, the legal cutoff in every state except Utah, federal figures show. While that represented a 3.6% drop from 2017, alcohol-related fatality levels have largely stagnated for the past decade. ‘What we’re failing to do is get to the root cause of why they’re doing this, what’s behind the behavior,’ [said Fischer].”

December 17, 2019

As Americans struggle with soaring medical costs, top health officials bicker over their expense reports

by Patrick A. Malone

Here’s a point to ponder: A quarter of Americans say they or someone they know has put off treatment for a serious medical condition due to cost. That’s the worst such response pollsters at Gallup have gotten on this matter in almost three decades.

Two people have a lot to say about Americans’ health care finances, including their insurance, drug prices, and protections if they are poor, old, young, or chronically ill, physically or mentally. But, gee, the duo of Alex and Seema just can’t get along. They’re not playing nice. It’s gotten so bad that their big bosses, Don and Mike, have called them both in for a tough chat about working together.

Now, if it were you and me, and the office politicking got so out of hand that it attracted enough national attention to potentially embarrass majordomos of the organization, wouldn’t there be a screen door banging with some suits also getting tossed to the curb?

December 15, 2019

Active duty military personnel near a small win on medical malpractice claims

by Patrick A. Malone

The U.S. government is on the brink of giving active duty military personnel half a legal loaf when it comes to a fundamental constitutional right — their chance to seek justice in the civil courts if they suffer harms while receiving medical services in noncombat situations.

If the U.S. Senate approves, as expected, a House-passed measure, and it is signed by the president, as he has said he will, active military members soon may be able to make medical malpractice claims, as they couldn’t before. But the disputes won’t be decided in the civil justice system. Instead, they will stay under military control.

That’s far less than ideal. To understand why, and how this compromise got struck, it’s necessary to dive a little into federal law.

December 13, 2019

How does science advance on brain injuries? One star’s grim diagnosis at a time.

by Patrick A. Malone

Clinicians drew in a postmortem conference a full portrait of patient K-0623, based on a detailed questionnaire and research they had conducted into his life. They learned all about the deceased’s happy childhood, his early high school graduation, and his athletic prowess, including his stardom in an elite collegiate football program.

The neurologists, neuropsychologists, and psychiatrists also learned that the subject, known to them for now only by a number, had taken painkillers at one point, so he could keep up an all-too-brief NFL career.

December 12, 2019

Top experts, by failing to disclose conflicts of interest, shortchange taxpayers

by Patrick A. Malone

Elite researchers — professors and staff with ties to 20 of the nation’s top universities and the respected National Institutes of Health — may be failing to be as candid as institutions and laws require about their potential professional conflicts of interest, notably the significant sums they get from Big Pharma and medical device makers.

ProPublica, the Pulitzer Prize-winning investigative organization, and the Los Angeles Times jointly scrutinized the experts’ required disclosures, finding they not only fall short. They may fail to give the public a fair view of the credibility of their findings. And, in California, they may be a unique rip-off of the state’s top university system. The “UCs” provide research faculty with costly facilities and other support, as well as sharing its global renown — in exchange for revenue the experts may earn outside the system.

In total, after examining records on tens of thousands of university scholars and NIH experts, ProPublica not only has made public its “Dollars for Profs” database, it also quotes federal watchdogs as estimating that with the NIH alone, conflicts of interest with agency grants amounts to $1 billion.