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Stroke victims don't call 911, delay crucial treatment
In an ischemic stroke, a blockage in a blood vessel stops essential oxygen and nutrients from reaching the brain.
April 30th, 2013
01:12 PM ET

Stroke victims don't call 911, delay crucial treatment

Despite public outreach campaigns, a third of all stroke patients don’t call an ambulance to get them to the hospital, leaving them vulnerable to delayed treatment and worse outcomes, according to a new study published in the journal Circulation.

The authors analyzed data on more than 204,000 patients, seen at 1,563 U.S. hospitals between 2003 and 2010.  Patients who arrived by ambulance were about twice as likely to arrive at a hospital quickly, and were about 50% more likely to receive intravenous TPA – a clot-busting drug – within the recommended three-hour window, when it’s most effective.

“Time is the essence,” said Dr. O. James Ekundayo, the study’s lead author and an assistant professor at Meharry Medical College in Nashville. “The earlier to the hospital, the better – the earlier you’re evaluated and given treatment.” FULL POST


Medicaid: States turning down free money, group says
November 26th, 2012
02:37 PM ET

Medicaid: States turning down free money, group says

It’s flown under the radar, but perhaps the most dramatic element of Obamacare isn’t changes to Medicare, or the requirement for millions to purchase insurance –- it’s the planned expansion of Medicaid.

That expansion would cover an additional 21.3 million people within the next decade, reducing the number of uninsured nearly by half, according to a new report from the Kaiser Family Foundation, an organization specializing in health care policy.

While that sounds like good news, the sheer size of the expansion has many people worried about cost. Since the Supreme Court ruled that states cannot be forced to participate, eight states have said they won’t expand their current Medicaid programs, and several others say they may follow suit.  But the KFF report says those states may be making life unnecessarily hard for their poorest citizens. FULL POST


Stem cells vs. heart attacks
November 6th, 2012
01:47 PM ET

Stem cells vs. heart attacks

For years it was thought that most damage from a major heart attack was permanent:  Dead tissue turns to scar tissue, leading to the heart muscle’s gradual deterioration.

But now, there is growing optimism that stem cell therapy may help patients with damaged hearts return to a fully functional life, based on results from early studies.

Of course, larger studies have to confirm the results and the devil is in the details. Those details were on display in a series of five presentations Tuesday at the American Heart Association conference in Los Angeles.

Most promising was long-term data on 20 patients with severe, long-term heart failure stemming from past heart attacks.  These patients not only improved dramatically after receiving an infusion of their own heart stem cells, but continued to get better two full years after treatment.

“That’s from just one injection of these cells,” says Dr. Roberto Bolli, the lead researcher and chief of cardiology at the University of Louisville.  Such improvement is virtually unheard of, he explains.  With standard care, “we know that these patients don’t get better with time because once you have a scar, you have a scar.” FULL POST


Task Force: Tell young patients to stay out of sun
May 7th, 2012
05:01 PM ET

Task Force: Tell young patients to stay out of sun

The group that sparked an outcry of criticism with its advice on mammograms and prostate cancer screening, said Monday that doctors should counsel young people to avoid sun exposure, to reduce the risk of skin cancer.

The advice applies to fair-haired people between the ages of 10 and 24, according to guidelines released Monday by the U.S. Preventive Services Task Force.  For adults older than 24, there is not enough evidence to say whether counseling about sun exposure makes a difference, according to the Task Force. The guidelines are published in the Annals of Internal Medicine.

FULL POST


Health care costs to surpass total income?
March 14th, 2012
03:13 PM ET

Health care costs to surpass total income?

Take a close look at the chart up above. It’s taken from a new paper, in the Annals of Family Medicine. If you believe the doctors who put it together, it tells one of the scariest stories you’ll ever hear.

The gentle upward slope represents the median income for an American family, projected through 2035. The lighter colored curve is projected average spending on health care - insurance premiums, and out of pocket costs.

With current trends, the authors say, in less than 20 years the average family will face medical costs that are higher than their total income. All of it.
FULL POST


On the trail of drug-resistant salmonella
August 5th, 2011
11:13 AM ET

On the trail of drug-resistant salmonella

Newer technologies offer a tremendous opportunity to track the development of highly dangerous bacteria, but tough economies and budget cuts threaten to choke off that promise, according to a pair of articles in the "Journal of Infectious Disease."

One paper by researchers from several European countries traced the gradual spread of a drug-resistant version of a salmonella strain known as S. enterica serotype Kentucky. According to Craig Hedberg, an environmental health scientist with the University of Minnesota School of Public Health, says the normal Kentucky strain does not often cause human illness. It mostly circulates, uneventfully, in poultry, without harming the birds.

About a decade ago, genetic analysis of samples from France, England and Wales, Denmark and the United States began to pick up a variant that’s resistant to powerful antibiotics, including ciproflaxin, or Cipro. Many of the samples came from human patients, who became seriously ill from the new strain. In 2002, it was rare, with just three human cases. By 2008, there were 489 confirmed human cases.

As Hedberg wrote in an editorial that accompanied the article, “the multi-drug resistant clone of S. Kentucky could be a major public health threat.”

This version of S. Kentucky is not the only strain of antibiotic-resistant salmonella. One well-known version is known as Salmonella Typhimurium DT104. Meanwhile, the salmonella that has sickened at least 78 people and led to a nationwide recall of ground turkey, can be treated with Cipro but is resistant to several other common antibiotics, according to the Centers for Disease Control and Prevention.

Chickens and turkeys have adapted to live with salmonella, which rarely makes the birds sick. Based on testing at U.S. poultry facilities, about 10 percent of the birds carry salmonella bacteria. Phyllis Entis, a microbiologist who spent seven years working on food safety for Canada’s federal government, and who now writes a blog on food safety issues, says the U.S. lags far behind Scandinavian countries in controlling salmonella in the food supply. Entis says that Denmark, whose data were featured in the S. Kentucky paper, does frequent tests for salmonella and does not allow infected poultry to enter the food system, even if it’s not associated with an outbreak.

“It is possible to do, and it can be done, with proper culling of infected flocks,” she said.

Al Yancy, Vice-President of Food Safety and Poultry Production programs for the U.S. Poultry and Egg Association, says such caution is unnecessary. “To condemn raw poultry simply because it tested positive for a ubiquitous organism, you might even say is morally and ethically untenable,” Yancy told CNN. “With raw chicken [or turkey], the aim is to be as safe as possible, but safe shouldn’t be defined as ‘no salmonella.’ This meat can be rendered safe by cooking and proper handling.”

According to Entis, the biggest factor in producing resistant bacteria is the use of antibiotics in poultry feed. That view was echoed in congressional testimony in 2009 by Joshua Sharfstein, deputy commissioner of the  Food and Drug Administration. At the time, Sharfstein said there is “clear evidence” that the use of antibiotics to promote growth in animals, encourages drug resistance. “Purposes other than for the advancement of animal or human health should not be considered judicious use.”

Yancy acknowledges widespread use of antibiotics by poultry producers, but says members of his organization – “the world’s largest trade association representing feathered species” – follow guidelines set by the American Veterinary Medicine Association, which call for antibiotic use to be limited where possible.

The article in the Journal of Infectious Disease says it appears the spread of drug-resistant S. Kentucky is associated with poultry, but says that can’t be confirmed without better surveillance data from poultry operations. He authors say it’s possible the strain was also spread through aquaculture – fish farming – especially on farms where poultry products were used to fertilize ponds, or where waste from the fish farms was used as a supplement in feed for the birds.

“This paper demonstrates both the opportunities and the challenges of doing this kind of surveillance,” Hedberg told CNN. “We need to take maximum advantage of surveillance systems, to get an early indicator of where problems are developing."

However, he said the strategies of regular surveillance and testing are threatened by budget cuts in Europe and the United States.  “Support for many public health activities, including primary and secondary prevention measures, such as public health surveillance, is considered discretionary,” he wrote in his editorial. “Therefore, cutting these funds does not appear to result in a direct and measurable harm.”

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July 25th, 2011
03:25 PM ET

High-profile longevity study retracted

It sounded like a breakthrough when researchers from Boston University reported that they had identified genes associated with living to 100 or even longer.  The findings, reported in the well-respected journal Science in July 2010, received a great deal of publicity.

But now, after coming under intense criticism, the study authors have retracted their findings because their  results aren't as dramatic as initially thought.

FULL POST


July 14th, 2011
05:44 PM ET

U.S.: Catching bin Laden justifies CIA vaccination ruse

A senior U.S. official on Thursday acknowledged CIA involvement in a vaccination campaign in Pakistan, but said it was a legitimate piece of the strategy for catching Osama bin Laden, who was killed by a U.S. raid on his hideout in Abbottabad in May.

"This was one small piece of a very large intelligence effort to determine that bin Laden was located at the compound, and it was conducted shortly before the May 1 raid. People need to put this into some perspective,” the official said, speaking on condition of anonymity. "The vaccination campaign was part of the hunt for the world’s top terrorist, and nothing else. If the United States hadn’t shown this kind of creativity, people would be scratching their heads asking why it hadn’t used all tools at its disposal to find bin Laden."

The comments are a response to criticism of the CIA role, which involved health workers going door to door in the neighborhood near bin Laden’s compound, offering vaccinations against Hepatitis B. According to reports in the Guardian and the New York Times, the goal was to collect DNA to aid in the eventual identification of bin Laden. It’s not clear if the mission was successful.

FULL POST


Could bin Laden hunt lead to more polio?
July 13th, 2011
01:55 PM ET

Could bin Laden hunt lead to more polio?

Leaders of the Global Campaign to Eradicate Polio are concerned that a reported CIA-led ruse could slow down an ambitious anti-polio push in Pakistan. The World Health Organization and Pakistan’s government renewed a massive vaccination effort in January, in part with a new $50 million pledge from the Bill and Melinda Gates Foundation.

This week, The Guardian and the New York Times reported that health workers went door-to-door in the town where Osama bin Laden was holed up, offering vaccinations against Hepatitis B.

Reportedly, the visits were part of a coordinated effort with the CIA, to try to collect DNA from bin Laden relatives to aid in his eventual identification. CIA officials would not comment, but residents of the Abbottabad neighborhood where bin Laden was found told CNN that two women did visit homes, offering free vaccinations. Christy Feig, a spokeswoman for the World Health Organization, said it was not part of a WHO campaign.  Michal Fishman, a spokeswoman for the Gates Foundation,  tells CNN that injectable hepatitis vaccinations would never be given door-to-door, unlike oral polio drops.

FULL POST


Angioplasty unnecessary in some cases, study finds
July 5th, 2011
06:14 PM ET

Angioplasty unnecessary in some cases, study finds

Half of all procedures done to widen arteries in non-emergency situations may be unnecessary, according to a study published in the Journal of the American Medical Association on Tuesday.

A percutaneous coronary intervention, also called PCI or angioplasty, is a procedure to widen a blocked or partially blocked artery. It’s often performed on patients suffering a heart attack, or an acute attack of angina. It’s also done on some patients with non-acute heart disease – partial blockages of one or more coronary arteries.

Researchers from several major heart centers analyzed more than half a million PCIs performed in the years 2009 and 2010, at more than a thousand hospitals. Of those done in acute situations, nearly all – more than 98% – were deemed “appropriate,” according to the study.  However, many PCIs in non-emergency situations were not recommended under guidelines developed by a leading group of heart experts.  Among non-acute cases, 50% were deemed “appropriate,” 38% “uncertain” and 12% “inappropriate,” according to the study.  Most of the inappropriate procedures were done on patients with low-risk heart conditions.

FULL POST


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About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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