cig-300x225The nation’s long war on one of its leading preventable killers has taken a surprising tactical turn, as the head of the federal Food and Drug Administration has declared that tobacco companies will face new regulations aimed at slashing nicotine in cigarettes.

FDA Commissioner Scott Gottlieb argues that cutting the noxious and addictive nicotine will help Americans unhook themselves from tobacco use, prompting less cigarette smoking, and, potentially increasing the use of possibly less harmful health vices, like nonburning “e-cigarettes” for vaping.

Gottlieb, at the same time, put further off a planned FDA crackdown on e-cigarette makers, delaying for several years requirements that they disclose ingredients in their colorful, flavored vaping liquids and demonstrate that they and other e-cigarette products do not cause health harms.

obama-240x300As the late, sultry diva Peggy Lee used to croon: Is that all there is?

The Republicans in Washington, after seven years of trying and dozens of faux earlier votes, have failed to repeal and replace the Affordable Care Act. Obamacare, the signature legislation of the previous Democratic administration, persists as the law of the land.

Not hearing champagne corks flying after the end for now of the desperate legislative floundering of Republicans in the House, Senate, and White House?

spinning-300x200Although many sports enthusiasts relish the summer as a peak time to train hard to get especially fit, wise athletes for safety’s sake may wish to build their way up to exhausting workouts, and to ensure they’re staying hydrated in healthful ways, while also recognizing that endurance competitions may alter their bodies in ways that they should at least be aware of.

The New York Times has posted an eyebrow-raising story on the perils to hard-driving jocks, male and female, of “rhabdo,” aka rhabdomyolysis, a “rare but life-threatening condition often caused by extreme exercise. It occurs when overworked muscles begin to die and leak their contents into the bloodstream, straining the kidneys and causing severe pain.”

Two doctors say they treated three recent, severe rhabdo cases brought on when novices in not great shape leaped into intense spinning classes, demanding exercise regimens lasting around an hour and involving specialized stationery bicycles. They found in medical literature 46 other, documented rhabdo cases, with 42 tied to novices’ spinning.

ExpiredDrug-300x225Americans each year needlessly toss hundreds of millions of dollars in costly, valuable, and still potent drugs, a wasteful practice driven by a “myth,” the mistaken belief in and scrupulous adherence to already debunked product expiration dates.

Drug discards, including of medications that may be in short supply nationwide, occur all along the distribution chain, from corner druggists up to giant health system pharmacies.

The practice flies in the face of known evidence, much of it developed, verified, and shared by the same force that presses for expired meds to get tossed: Uncle Sam.

nucarmen-189x300Although smaller community hospitals may provide treatments that are as good and as safe, Americans flock to academic medical centers for specialized care and complex procedures. They’re lured to the big, pricey institutions by their stellar reputations, state-of-the-art facilities, and top-line specialists. These tall, shiny complexes, combining medical education, research and clinical care, also have deep roots in their communities and become political powerhouses in their own right.

Which is why many in the nation’s No. 2 city are abuzz over a Los Angeles Times investigation into the “secret life” of Carmen A. Puliafito, a Harvard-trained eye expert. Until 18 months ago, he had served for a decade as the $1 million-a-year dean of the University of Southern California’s Keck School of Medicine. As Keck’s top doc, the paper says, he “oversaw hundreds of medical students, thousands of professors and clinicians, and research grants totaling more than $200 million … [and] was a key fundraiser for USC, bringing in more than $1 billion in donations, by his estimation.”

The university—which is Los Angeles County’s largest employer, a haven for affluent offspring of West Coast elites, and long has craved global recognition—hired and backed Puliafito to boost the medical school’s  standing.  But during his tenure, the Los Angeles Times found, Puliafito also “kept company with a circle of criminals and drug users who said he used methamphetamine and other drugs with them.” As the paper describes it:

PE-Color-240x300The Republicans haven’t waved a white flag—yet. They may never formally surrender. But the GOP’s seven-year, take-no-prisoners campaign to repeal and replace the Affordable Care Act, aka Obamacare, has foundered. For good?

Political prediction is a knucklehead’s sport. It’s never safe to predict what’s going to happen, especially when unpredictable tragedies rear up like  Sen. John McCain’s brain cancer diagnosis.

No matter. We now know painful truths about the politicians who have sway over our health care—and will continue to do so in vast ways, Trumpcare or no.

viagra-300x169This fall’s National Football League games will be markedly different in an unexpected way that also offers insight into the nation’s skyrocketing costs of medical care.

The makers of the erectile dysfunction drugs Viagra and Cialis are yanking $50 million in advertising from TV broadcasts of NFL games, their top contact point with male consumers.  Indeed,  the makers of both drugs are going dark with their costly ads across a variety of sports programs, including summer pro golf and tennis.

After billions of dollars in revenues reaped every year for their manufacturers, Viagra and Cialis both are Big Pharma hot shots no longer. They may have erased any remaining decorum on TV over the years with their advertising and marketing hype. But they cannot outrun a typical drug’s economic life cycle. Their patents are expiring, and their makers are trying to figure how best to exploit their profitable, branded drugs when generics—already regulator approved and ready to go—saturate markets and drive prices down, perhaps as early as next year.

fda-300x125Pro-business and anti-consumer  lawmakers in Congress are racing to slacken rules for medical device makers to report problems with their products. This move may imperil more patients, many of whom already have been harmed and some even killed already by defective and dangerous medical devices.

The dispute focuses on a provision to triple the time that companies would get to report product issues to the federal Food and Drug, giving medical device makers three months to do so, rather than 30 days as now required. They still must report to the agency immediately any incident in which a patient is harmed.

Although consumer safety advocates are decrying the oversight changes that GOP members of Congress are pressing, medical device makers are downplaying the regulatory shifts, saying they will eliminate needless bureaucracy. They say that if lawmakers don’t approve the rule changes it may sink the broader and crucial legislation they’re embedded in. The House has just approved and sent to the U.S. Senate the bigger FDA bill, which also provides 60 percent of the fee-based funds for agency drug and medical device reviews.

anesthesia-300x153Some of the very medical specialists who are supposed to put patients to sleep experience big problems themselves staying awake, with more than half of anesthetic trainees reporting in a new national survey in Britain that they had crashed their cars or nearly done so while headed home after long night shifts.

American doctors’ social media responses to this new research indicate that work weariness and drowsy driving are perils for practitioners on this side of the Atlantic, too.

The doctors’ complaints also underscores the irrationality of recent decisions by American medical educators to reinstate long shifts for interns and residents, trainees who play important—and sleep-deprived— front-line roles in providing medical services to too many patients in academic medical centers and hospitals nationwide.

Pinocchio_Smoking-300x169Tougher ratings for movies targeting teen-agers and higher cigarette taxes may be two good ways to crack down on Big Tobacco’s persistent and harmful peddling of its poisonous wares, health experts say, based on information flowing from the sprawling Golden State.

The federal Centers for Disease Control and Prevention has just assessed Hollywood’s progress in reducing depictions of tobacco in the movies, finding that, under pressure from anti-smoking campaigns,  Tinsel Town had slashed its showing of the use or implied use of cigarettes, cigars, pipes, hookah, smokeless tobacco products and electronic cigarettes from 2005 to 2010. But that progress has reversed since then, and now, based on top 10 grossing movies in any calendar week, cinematic depictions of tobacco use has soared by 80 percent.

Although pictures rated G or PG, those films most accessible to the broadest movie-going audiences, saw reductions in their showing of smoking and other tobacco use, depictions of these negative health practices rose sharply in movies aimed more at teenagers and older youths  in those works with ratings of PG-13 (by 43 percent) and R (by 90 percent).

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