Articles Posted in Research Studies

cdcwalensky-150x150The federal Centers for Disease Control and Prevention, one of the world’s premier public health agencies, will try to revamp itself after taking months of a political, scientific, and reputational battering for too often performing in shambolic fashion in response to the coronavirus pandemic.

Rochelle Walensky (shown, right) appointed the agency’s chief in December 2020, announced in April of this year that she had asked outside experts to conduct a top-to-bottom review of the CDC and to recommend reforms.

She now has told her 11,000 agency colleagues that the much-needed scrutiny showed that the CDC, with its $12 billion budget, had become too ponderous, bureaucratic, and academic in its work, communicating too slowly, badly, and in confusing ways with its most important constituents: the American people. As the New York Times reported of Walensky’s blunt assessment of the suboptimal response to the pandemic that has killed more than 1 million and infected 93 million-plus of us:

debtnprkhnnursinghomesuits-247x300When seniors need full-time institutional care, or when the injured or debilitated require similar 24/7 attention, loved ones — and even friends — must take care to read and re-read any documents that nursing homes and other long-term care facilities shove before them to sign during the stressful admissions process.

That’s because the owners and operators of the facilities soon may create a financial nightmare for the unwitting document signers, fueling what is the huge shame of the U.S. health care system: medical debt.

Most regular folks might think that the financial obligations incurred in long-term care facilities rightly belong to the adult residents. They’re 21 and older, and unlike minor kids carted into urgent, or emergency rooms for treatment, the residents typically have, until their situations suddenly shift, been responsible, including legally, for their lives and personal business.

charity2-150x150Play this one out in your mind: a guy you know at church — he’ll be the first to let you know he makes $200,000 a year — tells you about how he gave to charity a junker car worth not more than $4,600 (2% of his income). Now what’s your reaction if you learn this guy got thousands of dollars in tax breaks for that giving?

Is this savvy business conduct? Or does it make you sputter even while sitting in the pews on Sunday?

Now multiply the sums involved, exponentially, and it should be cause for questions anew about the nation’s hospitals and their charitable care. As the Wall Street Journal reported of its dive into the institutions’ required federal disclosures:

cdcoverdosedeaths-300x175The opioid drug abuse and overdose crisis is not only smashing fatality records, it also is slamming poorer people and communities of color and taking a savage toll on younger black Americans.

The federal Centers for Disease Control and Prevention has analyzed data from Washington, D.C., and 25 states, finding in its study published online, as the New York Times reported:

“Overall, overdose deaths jumped 30% from 2019 to 2020 … Deaths among black people rose 44%, about twice the increase in deaths among white people (22%) or Hispanic people (21%). Deaths among American Indians and Alaska Natives increased 39%. Measured as a portion of the population, in 2020, deaths among black people were higher than in any other racial or ethnic group — 39 per 100,000, compared with 31 for white people, 36 for American Indian and Alaska Native people and 21 for Hispanic people. ‘The disproportionate increase in overdose death rates among blacks and American Indian and Alaska Native people may partly be due to health inequities, like unequal access to substance use treatment and treatment biases,’ said Dr. Debra Houry, acting principal deputy director of the CDC.”

ahaessential8-300x267 Get some sleep!

That’s not just a late-night nudge for the kids from their parents.  It is strong new advice patients will hear from their cardiologists and other doctors, as the American Heart Association has added sleep to its list of important ways for folks to avoid cardiovascular conditions, stay healthier, and live longer, the Washington Post reported.

The association has focused on behavioral and other factors for a time now to battle the leading cause of death in this country: heart disease. The federal Centers for Disease Control and Prevention has reported that almost 700,000 Americans died of heart disease in 2020. The ailment costs the country $230 billion annually. The heart association experts added sleep to the “Life’s Essential 8” list of safeguards, reporting this in an article published in a medical journal:

candidanew-300x150With the coronavirus pandemic surging anew due to the highly infectious Omicron BA.5 variant, federal authorities reported recent data that should give Americans plenty of reason to heed public health warnings and avoid hospitalization if they possibly can.

That’s in part because institutions, overwhelmed by the pandemic, have taken giant steps backward in preventing patients in their care from acquiring nasty bacterial and fungal infections in addition to the coronavirus, and from overusing and misusing lifesaving antibiotics, further fueling the rise of virulent super bugs, the federal Centers for Disease Control and Prevention says. As the New York Times reported:

“The spread of drug-resistant infections surged during the coronavirus pandemic, killing nearly 30,000 people in 2020 and upending much of the recent progress made in containing the spread of so-called superbugs, according to an analysis by the Centers for Disease Control and Prevention. Deaths caused by infections impervious to antibiotics and antifungal medications rose 15% during the first year of the pandemic compared to 2019, federal health officials found. Much of the increase was tied to the chaos wrought by the coronavirus as doctors and nurses struggled to treat waves of grievously sick patients whose illness they did not fully understand before vaccines and treatments were widely available. About 40% of the deaths were among hospitalized patients, with the remainder occurring in nursing homes and other health care settings, the CDC report found. Early on, many frontline hospital workers mistakenly administered antibiotics for viral lung infections that did not respond to such drugs, according to the study. Many of the sickest patients spent weeks or months in intensive care units, increasing the chances for drug-resistant bugs to enter their bodies through intravenous lines, catheters, and ventilator tubes.”

billpaying-150x150While Congress seems paralyzed or, at best, willing to shrink significantly its efforts to help Americans deal with the punishing costs of care in the U.S. medical system, could federal lawmakers be confronted at the same time with more compelling evidence about the need for aggressive, not timid, action?

Do beleaguered constituents need to barrage members of the House and Senate with copies of an excellent, painful series from NPR and the nonpartisan Kaiser Health News service on the crushing effects of medical debt on regular folks, especially cancer patients? Must voters write, call, and email  representatives to ensure they see the research findings of the Kaiser Family Foundation or the Commonwealth Fund about how nightmarish the U.S. medical system has become?

In detailing the “financial toxicity” that cancer patients experience with bankrupting treatment, KHN reporter Noam Levey mixes poignant human stories with scary economic data to detail how care for a leading killer of Americans may have improved medically but has become a calamity of a different sort. He makes these points among others (quoted liberally but without their sourcing, not fully included in these bullets for brevity’s sake):

agingwell-150x150Although Americans dread the possibility of experiencing dementia and other debilitating cognitive decline as they age, they can do more than let fear rule their lives — or twiddle their thumbs waiting for Big Pharma to drop billions of dollars more to develop magical and, so far, unworkable pills.

Instead, doctors, epidemiologists, and public health officials argue that non-pharmaceutical approaches can be beneficial to patients’ overall health and play a significant role in decreasing the likelihood of individuals suffering severe memory loss and more crucially dementia, notably in its most common condition Alzheimer’s, the New York Times reported.

Dr. Gill Livingston, a psychiatrist at University College London and chair of the Lancet Commission on Dementia Prevention, Intervention and Care, told New York Times columnist Paula Span this:

apachedash-300x177Anyone who has so much as contemplated buying a vehicle in recent times will quickly catch on to what experts fear may be a root cause of the nation’s spiking road toll: Step back and consider just how much importance manufacturers — and consumers — pay to those rolling infotainment systems.

Their screens have grown and dominate the dash. They no longer just control a tinny AM radio. They’re the gateway to powerful and all-encompassing entertainment systems. These can deliver high-fidelity music of all varieties, sports contests, news, and political commentary, as well as digital visual content viewable by passengers. The touchpad systems regulate the heat, air conditioning, and interior lighting. They also display ever-more sophisticated navigation, with dizzying maps, road and traffic conditions and warnings, as well as audio narratives of directions and even route highlights.

And what motorist now doesn’t have her cellphone linked into the “smart” vehicle system. This means dozens of contacts can be reached via conversation with a digital assistant, who then can hook a motorist up with the office, boss, spouse or partner, kids — and who knows who else? Combine this all, of course, with other driver displays — including speed, RPM, fuel consumption and conservation, engine temperature, and more.

kneeinjectionSince the 1970s, some doctors have treated arthritic knees by injecting them with hyaluronic acid, a substance originally derived from the combs of roosters. Specialists have zealously promoted this therapy, costing patients a few hundred dollars a pop and repeated so widely that Medicare alone pays $300 million annually for it. Doctors argue it reduces pain and increases joint mobility.

It hardly lives up to this billing, though, offering patients scant more relief than a placebo (saline, or salt water), researchers found after scrutinizing a half century’s worth of data from 169 clinical trials involving more than 20,000 patients.

The highly popular viscosupplementation procedure, as reported by Stat, a medical and scientific news site, showed an average effect “about 2 points beyond placebo effect on a pain scale that runs from 1 to 100.” The researchers from Canada, Britain, and China concluded this from their study, as published in BMJ, a respected medical journal of the British Medical Association:

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