wheartatttack-238x300As cardiologists and oncologists swap cross-fire about the conditions they treat and how they do so, here’s hoping that, above all, their female patients end up helped and not harmed, getting vital information about risks and benefits of therapies for two of the leading killers of women: heart disease and breast cancer.

What’s behind the medical specialists’ cross currents? Cardiologists and the American Heart Association are pointing to a major therapeutic statement published in the medical journal Circulation.

On the one hand, it provides what many see as an important, needed call to doctors of all kinds to recognize that heart disease among women goes “dangerously under-diagnosed and under-treated,” due in no small part because practitioners still fail to see that women suffer heart attacks in different ways than do many men. They do not, for example, suffer stabbing chest pain, radiating into the arm. Instead, as they experience clogs in tiny veins and arteries, they may feel a constant exhaustion and a discomfort as if they were having their chest squeezed or crushed.

immodium-300x169The opioid epidemic has become so pernicious that it can be exhausting to even try to see its expansive harms. But it’s crucial to keep confronting the many ways this lethal scourge affects Americans and their lives, if only to hope that politicians, policy-makers, doctors, hospitals, and many others get off their duffs and do something about it.

This crisis — which includes more than 64,000 overdose deaths in 2017 alone — has reached in a surprising new way into many households’ medicine cabinets. It’s not due to potential abuses of potent pain-killers that many may have stashed there. Nope, now federal officials are fretting about the current dosages of the key ingredient in common, over-the-counter anti-diarrhea medications like Imodium.

It turns out that the substance known generically as loperamide, useful in stopping the runs, happens to be part of the opioid family, an addictive drug class that includes morphine and oxycodone. Drug users have turned now to abusing anti-diarrhea meds, which are sold in high-count packages and at dosages that authorities want reduced.

schuchat-201x300fitzgeraldBrenda Fitzgerald, a rich doctor who not only wouldn’t pull her hand out of her personal cookie jar of investments and instead plunged it even deeper during her conflicted time in public office, finally has quit the top job at the respected federal agency charged with protecting the nation’s health from disease and other dangers.

The appointed chief of the Centers for Disease Control and Prevention (shown at top, left)  was ethically impaired before and during her half-year term, arguably to the major detriment of her job and the public’s health.

She was forced to resign after media disclosures that not only had she slow-walked her divestment in a multi-million-dollar portfolio, owned with her husband, of Big Pharma and other health care enterprises, but, even after she joined the CDC, she was caught buying and selling Big Tobacco stocks.

Nassar-Mich-AG-and-AP
His basic credentials would come under fire, but they were sufficient for the “doctor” to insinuate himself into major institutions, and, worse, into the lives of hundreds of girls and young women on whom he inflicted a tragic toll. His combination of enthusiasm — he was a rah-rah kind of guy— extreme controlling conduct, and horrific “treatments” never seemed to set off the red flags they should have.

Instead, Larry Nassar — an osteopath who served as an athletics and team caregiver for USA Gymnastics and Michigan State University — got away for years with abusing adolescent females put under his  sway. He purportedly provided medical services to them, many in exclusive and demanding athletic camps where young participants were cut off from their friends, family, coaches, and personal physicians. He “treated” aspiring Olympians, at all hours of the night and day, alone and without any other adults around, in their bedrooms, on their beds — not in medical offices or athletic training facilities.

He enthusiastically told his patients, many of whom excelled at their sport because of their willingness to please adults and to be coached, that he could deal with their pains and injuries with what he termed pelvic manipulations in which he digitally penetrated them in their private parts. Without medical cause or justification, he conducted repeated and invasive “exams” of girls and young women’s genitals.

belts-300x163Preventive measures, even small ones, can be life changing and lifesaving. They can safeguard drivers and passengers in car wrecks, protect young folks during a bad flu season, and ensure that fewer Americans still take up one of the proven, major health harms — smoking.

Let’s start with a simple, often overlooked vehicular precaution: Buckle up that seat belt, please. As New York Times columnist David Leonhardt noted in a recent Opinion section roundup, the number of Americans killed on the roads who fail to wear vehicle restraints, notably seat belts, has hovered “between 48 percent and 51 percent in each of the past five years.”

Yes, that’s a correct figure: Roughly half of those killed didn’t use one of the most publicized, almost reflexive safety steps around.

stroke2-300x169Although medicine has made advances in treating strokes, more than 795,000 Americans suffer them annually, they kill 140,000 of us each year, and they’re a leading cause of disability. But medical experts, revising their care guidelines, say that patients with the most common kind of stroke —  a clot blocking blood flow to the brain — may be better treated in an expanded window of still urgent time.

This higher but still guarded optimism does not apply to all stroke cases and not to all ischemic strokes (the kind that come from blood vessel blockages). Doctors have known for awhile now that it is vital to bust the damaging clot — and they had thought their time to do so with drugs like tPA and surgeries was constrained to six or so hours. This led specialists to their axiom, “Time is brain,” and to crash responses.

But for many patients, the tight treatment time frame was unhelpful. They might not be discovered quickly after suffering a stroke and being incapacitated. They might have had their stroke while sleeping, and doctors had decided the timing of their care based on when they could last recall being well — often putting them outside the six-hour limit. Some patients also live far from hospitals that could provide clot-busting drugs, or, even more key, surgeries to implant stents or a thrombectomy, a procedure in which doctors use a small tool to grab the clot and remove it.

chips-300x192Let’s give the faintest cheer — maybe of the Bronx variety — to the Republican-controlled Congress for, finally, reauthorizing the Children’s Health Insurance Program, aka CHIP.

This means that months of high and needless anxiety will end for nine million or so youngsters who will get health insurance, coverage that their poor or working poor families otherwise could not afford, even under the Medicaid program that serves the underprivileged. The six-year cost to Uncle Sam will be relatively small — $124 billion, and 375,000 poor and expectant moms also will benefit from CHIP, which has halved the uninsured rate among kids in the last decade.

The much-liked program got caught in a bitter partisan cross-fire, becoming a last-minute bargaining chip by congressional Republicans in the battle over the short-lived  shut-down of the federal government. (Which, incidentally, ended up as a boondoggle that enriched health care industry players — who didn’t need the boost — by more than $31 billion.) GOP lawmakers, who in 2017 passed a $1.5 trillion tax cut package that chiefly will benefit corporations and the richest Americans, spent weeks, claiming the country could not afford CHIP.

As the science keeps getting deeper, the news keeps getting worse about the harms that can be inflicted by repeated blows to the head in sports — and in life.

The path-breaking medical scientists at Boston University and elsewhere, who have helped to establish how concussions, notably in football, may lead to the onset of the neurodegenerative disease chronic traumatic encephalopathy or CTE, have told the Washington Post that their latest study may show that, “It’s really the hit that counts.”

dui-300x150Politicians and policy-makers can’t ignore the rising number of vehicular deaths, and they must crack down fast and hard on the increasing road toll associated with alcohol abuse.

At the request of the National Highway Traffic Safety Administration, a blue-ribbon expert group has examined not only the overall increase in road deaths — to 37,461 in 2016, a 5.6 percent rise over the year previous. The panel from the National Academies of Sciences, Engineering, and Medicine also focused on the 10,000 deaths per year attributed to alcohol impairment. The experts called these road fatalities, which are increasing in number, “entirely preventable,” and recommended tough ways to reduce booze-related deaths.

They have recommended that a new national sobriety standard should be put in place, the Associated Press reported, reducing motorists’ allowable blood-alcohol concentration “from 0.08 to 0.05. All states have 0.08 thresholds. A Utah law passed last year that lowers the state’s threshold to 0.05 doesn’t go into effect until Dec. 30.”

danger-194x300jeanne_lenzerJeanne Lenzer, a seasoned medical investigative reporter, points out that 32 million Americans — about one in 10 of us — have at least one medical device implanted in our bodies. These include artificial joints, cardiac stents, surgical mesh, pacemakers, defibrillators, nerve stimulators, replacement lenses in eyes, heart valves and birth control devices.

Most patients — indeed most of the public — may think federal regulators subject all this hardware to rigorous quality and safety testing.

That’s a wrong assumption. And though medical devices may be helping change and save many lives, Lenzer also warns they are harming and even killing too many patients. In a new book (The Danger Within Us), interviews, and in a recent Op-Ed in the New York Times (“Can Your Hip Replacement Kill You?”), she has argued that:

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