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Study: 1/3 of knee replacements are questionable
June 30th, 2014
03:34 PM ET

Study: 1/3 of knee replacements are questionable

Whether to replace aging knees can be a tough decision. More than 650,000 Americans underwent total knee replacement surgery last year, but a new paper from researchers at Virginia Commonwealth University suggests that a third of those were not “appropriate,” based on standard medical criteria.

The study authors analyzed 175 cases, looking at imaging tests to find the degree of arthritis, as well as each patient’s age and reported pain level. Only 44% of the operations were rated “appropriate.” Thirty-four percent were “inappropriate,” while 22% were inconclusive.

But appropriateness is in the eye of the beholder, says Dr. Jeffery Katz, an orthopedic surgeon at Brigham and Women’s Hospital in Boston. When the current criteria were developed in the late 1990s, knee replacement “was considered a treatment of last resort,” Katz writes in an editorial published alongside the study in the Journal of Arthritis and Rheumatism. Today, many are being done in relatively healthy people in their 50s and 60s.
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Only 10% of alcoholics get meds to treat addiction
May 14th, 2014
09:39 AM ET

Only 10% of alcoholics get meds to treat addiction

Ask the average person how to treat alcoholism, and they’ll probably describe an AA meeting or maybe a 30-day stint in a fancy rehab center. What won’t leap to mind, even for most experts, is medication.

That’s a missed opportunity, according to an analysis of more than 120 research studies that found that prescription medication helps addicts reduce their drinking and the associated harms.

Taken together, the studies involved 22,803 patients who abused alcohol. The bulk of the papers looked at the medications naltrexone or acamprosate. Both made addicts less likely to drink again and reduced the number of “drinking days” when they did relapse.
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Schools picking up autism tab
February 11th, 2014
11:55 AM ET

Schools picking up autism tab

The surge in autism diagnoses since the year 2000 has come with a massive cost that’s shouldered largely by the public school system, say researchers at the Harvard School of Public Health.

In what’s billed as a conservative estimate, they say the “economic burden” of an autism diagnosis is more than $17,000 a year through age 17, with medical costs making up less than 20% of the total. The biggest chunk of the tab, $8,610, is picked up by schools, according to their paper, published Monday in the journal Pediatrics.

“The education system is already under a lot of financial strain,” says Tara LaVelle, the lead author, who is now an associate policy researcher at the RAND Corporation. “We need policies at the federal, state and local level to make sure funds are available to provide appropriate intervention.” FULL POST


New deadly flu launched by live bird markets
August 21st, 2013
05:01 PM ET

New deadly flu launched by live bird markets

The new strain of bird flu that killed at least 40 people in China this year likely evolved through close contact between ducks and chickens in markets selling live birds, according to a genetic analysis published in the journal Nature. At least 130 people became infected during the outbreak, which began in March.

“We clearly identified that the source of human infection came from the infected chickens, not any other types of birds,” said Yi Guan, a professor of virology at the University of Hong Kong and one of the study authors. The analysis also shows the virus was shed from the birds' oral or upper respiratory tract, not from fecal material. According to Yi, this suggests that H7N9 reasonably well adapted to infect humans, a finding that's supported by other research.

The research group also discovered a previously unrecognized variety of bird flu – an H7N7 strain, with a genetic makeup similar to the novel H7N9 strain. The H7N7 strain was also able to infect mammals in laboratory conditions.

Any variety of influenza is broadly characterized by two of its proteins: the type of hemaglutinin (“H”) and the type of neuraminidase (“N”).
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Your food, your vote
A new coalition rates Congress' votes on issues including farm subsidies, food safety and anti-hunger policies.
October 23rd, 2012
09:02 PM ET

Your food, your vote

Editors' note: Tom Colicchio talks about food and your vote on "Sanjay Gupta MD," Saturday at 4:30 p.m. ET and Sunday at 7:30 a.m. ET.

Jobs… Obamacare… Iran… and food?

Voters looking for a reason to support or oppose a candidate will find new ammunition in the first-ever “National Food Policy Scorecard,” created by a coalition of non-profits including environmental advocates, anti-hunger groups and activists including “Top Chef’s” lead judge and restauranteur Tom Colicchio.

“I don’t think the average person thinks this stuff through,” says Colicchio, who sees a link between government policy and what families put on the table.  “When you see people who are struggling, and buying fast food for kids, it’s not because they think it’s great for you.  It’s because it’s cheap.  And it’s cheap because the government subsidizes corn, wheat and soy.  That’s what we’re supporting with our tax dollars.  What if we took that money and put it towards farmers growing fresh, organic vegetables?”
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The road to a more dangerous malaria?
A new study warns a malaria vaccine could lead to a more dangerous parasite.
August 1st, 2012
09:57 AM ET

The road to a more dangerous malaria?

Doctors have dreamed for decades of a vaccine against malaria, which sickens more than 200 million people every year. But a new study warns of a potential pitfall: a malaria vaccine could lead to an even more dangerous parasite.

The paper was published this week in the journal PLOS.  Researchers working with the leading candidate vaccine immediately questioned it, saying they’ve seen no sign of dangerous changes as a result of their work.

The study was performed on mice. Researchers monitored the malaria parasite through several generations, comparing parasites in mice who had been inoculated against malaria with mice those who did not receive vaccinations. In the former group, new malaria infections caused more severe illness, as measured by red blood cell count.

Vicki Barclay, the study’s lead author, said it shows a need to track the long-term impact of any malaria vaccine, especially since any such vaccine is expected to be “leaky” - meaning it won’t offer complete protection, and the disease will continue to spread, albeit at a slower rate. The fear is that malaria could become more deadly, even as it continues to infect people. FULL POST


A warning against genetic testing
April 2nd, 2012
03:54 PM ET

A warning against genetic testing

If you follow health news, you’ve heard talk about a person's “genetic risk" of disease. With companies offering personalized genetic tests for as little as $200, it’s tempting to think that a world of knowledge is at our fingertips.

But a new paper from some of the leading names in science throws a bit of cold water on the promise.

According to a group from Johns Hopkins University, led by two scientists known for breakthrough discoveries on the genetics of cancer, genomic sequencing “fails to provide informative guidance to most people about their risk for most common diseases.”
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Closing schools could stop the flu
February 8th, 2012
10:37 AM ET

Closing schools could stop the flu

In June 2009, the new H1N1 flu strain was spreading like wildfire in western Canada, just as it was in dozens of countries around the world. But within a few weeks, the flames were nearly out, and a new study pinpoints a possible reason: summer vacation.

On June 12, high schools in the province of Alberta let out for the summer. On June 19, the middle schools finished, followed by the elementary schools on June 26. Researchers from McMaster University compared those dates to the incidence of new H1N1 cases in Alberta, and using a complex statistical analysis, estimated that closing schools reduced flu transmission among school children by more than 50%.

That, in turn, reduced transmission in the population at large. The findings, published in the Annals of Internal Medicine, support the idea that closing schools could reduce or slow down a dangerous outbreak of influenza.
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Obama administration extends one deadline on birth control coverage
January 20th, 2012
05:19 PM ET

Obama administration extends one deadline on birth control coverage

The Obama Administration is standing by a decision to require all insurance plans to cover the use of contraceptives, but said Friday it would give some employers an additional year to comply.

The rule, which goes into effect August 1, 2012, requires all insurance plans to cover the cost of birth control. Many non-profits with religious affiliations, such as Catholic universities and hospitals, say that will force them to violate their basic tenets.

The Department of Health and Services announced Friday those employers would have until August 1, 2013, to meet the new requirement.
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Protect yourself against health insurance reversal
Joan Gagliardi was liable for $1.2 million when her insurance comany reversed its approval for her treatment.
December 9th, 2011
02:03 PM ET

Protect yourself against health insurance reversal

In 2008, Joan Gagliardi was diagnosed with a rare autoimmune disease that caused scarring on internal organs, including her windpipe. It began to choke off her ability to breathe, but doctors at the University of Miami Hospital kept the damage in check with a treatment known as IVIG: Infusions of immunoglobulin.

The bad news came in 2010, when Gagliardi learned that her insurance company, Highmark Blue Shield of Pennsylvania, which had previously approved the expensive treatments, had reversed itself. The denial was retroactive, leaving Gagliardi liable for $1.2 million or approximately $50,000 for each infusion.

Fortunately for Gagliardi, the hospital didn’t press its claim, choosing instead to negotiate with Highmark. This year they settled up, with Highmark agreeing to pay $382,229. Gagliardi was off the hook.

Surprisingly, it’s not uncommon for an insurer to reverse itself, even after a claim is paid. State laws vary, but companies often take up to a year to perform “utilization reviews,” in which they re-examine claims that they’ve already processed.
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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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