Colon Cancer PostOp Chemo Underused

More than a decade after new treatment guidelines for the disease were issued, many patients with advanced colon cancer are not getting chemotherapy after surgery, despite clear-cut evidence it boosts survival, a study found.

Blacks, women and elderly patients were found to be less likely to get chemo, even though such treatment was shown to improve survival in all groups.

About two-thirds of the patients who received chemotherapy in addition to surgery were alive after five years, compared with about half of those who had surgery alone, according to the study in Wednesday’s Journal of the American Medical Association. On average, chemotherapy improved the five-year survival rate by about 16 percent.

From MSNBC.

We're unprepared...

Federal health officials have made little if any progress in disaster preparedness since 9/11 and state health departments are not faring much better, says a watchdog group that has given mostly low grades to public health agencies nationwide.

Pandemic flu, a natural disaster or an act of bioterrorism would strain health agencies' capacity to respond, and thus amplify the effects of a mass emergency, especially if one were to strike now, said experts from Trust for America's Health, a nonprofit and nonpartisan organization in Washington.

The group produced an unflattering critique of the nation's disaster readiness and a long list of low grades in its report: "Ready or Not? Protecting the Public's Health from Disease, Disasters and Bioterrorism." The report serves as a wake-up call to the Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services, and state health departments. It is the group's third such report.

"I think the report is even more critical this year in the wake of Hurricane Katrina," said former three-time U.S. Sen. Lowell Weicker, who is president of Trust for America's board. "The response to the hurricane was a sharp indictment of the nation's emergency response capabilities. "Overall, the federal government received a D+ grade," for all post-9/11 disaster preparedness, Weicker said.

Let's not get caught with our pants down...again.

From Newsday.

For a stress free recovery...

Even if spouses usually get along well, the stress caused by a half-hour argument can slow healing of a surgical wound by as much as a day, researchers here reported.


If they are generally hostile, the delay in wound healing can be doubled, according to Ronald Glaser, Ph.D., and Janice Kiecolt-Glaser, Ph.D., both of Ohio State here.


One implication of the finding, reported in the December issue of the Archives of General Psychiatry, is that marital stress plays an important role in recovery from surgery, Dr. Kiecolt-Glaser said.


"This shows why it is so important that people be psychologically prepared for their surgeries," she added.


Dr. Kiecolt-Glaser said the study, combined with previous work, suggests that "hospitals need to modify existing practices in ways that will reduce stress prior to surgery."


Reducing pre-surgical stress, both researchers said, would lead to shorter hospital stays, lower medical bills, and a reduced risk of nosocomial infection.

Well, this may be a good reason for the family to not visit a postop patient!

From Med Page Today.

Could they make this more confusing?

The good news for California's 4.3 million Medicare beneficiaries is that there are more than 60 prescription drug plans to choose from.

The bad news? There are more than 60 plans to choose from.

Additional bad news: Making the choice is time-consuming, confusing and often stressful.

"We've been inundated with calls. Our lines are jammed. We're seeing a lot of people with a lot of questions, and it can be very frustrating for them," says Deanne Beebe of the Medicare Rights Center, an independent nonprofit organization that helps educate seniors about Medicare.

Enrollment began Nov. 15 for Medicare's new prescription drug plan, also known as Medicare Part D. It will allow elderly and disabled Americans who are covered by the Medicare program to get subsidized drug coverage through private-insurance companies. Each region has its own set of drug plans, each with different benefits, costs and stipulations.

So let me get this straight. In typical government bureacracy, we've decided to confuse the elderly with so many choices that they don't ever get the drugs.

From Sign On San Diego.

Robo-Patients Allow Students To Practice In Canada

A simulator lab training centre set up by the anesthesia department allows students to experience the challenges of working in a hospital operating room in a setting that looks and functions as close as possible to the real thing. An official opening of the lab was held on Wednesday.

In a room on the first floor of the McMaster University Health Sciences Centre, the new training lab features computer-operated medical equipment hooked up to what appears to be a real patient on an operating room table. In fact, the patient is a $100,000 computerized, human-like robot that mimics bodily functions such as breathing, heartbeat, swelling and other changes in human conditions that might be experienced by an actual patient.

Medical students learn how to properly administer anesthesia and monitor the patient and medical equipment. A control room in the lab allows the instructor to watch the students and manipulate the mannequin's responses to mimic what might occur in a real-life situation. The patient's heart rate or breathing can change, and the throat or tongue can swell, requiring the students to think on their feet and make the necessary adjustments.

The use of simulation technology at McMaster will expand significantly in coming months, as the School of Nursing uses government funding to establish another simulation lab, complete with a family of robo-patients. The lab will provide a virtual hospital experience in which nursing students can practise assessment and treatment, and apply their critical, problem-solving skills using anatomically-correct, computerized mannequins that can speak and simulate different medical conditions. It will be utilized by students of the joint McMaster-Mohawk-Conestoga nursing program, and eventually expand to offer interprofessional training for students in a variety of health care training programs.

I remember when practicing on the patients was "on the job training;" ah, the good 'ol days. I think we're going to see a lot more simulators to learn procedures in the years ahead. If we can teach a pilot to land a jet on an aircraft carrier in a simulator, I'm sure we can figure out how to teach a doctor to remove a gallbladder.

From TechNudge.

Up your nose...

A new nasal vaccine against influenza, which helps patients avoid the needle, has caused no unexpected side-effects, U.S. government researchers reported Tuesday.

A study of the 2.5 million people who got the vaccine over the past two flu seasons showed no unexpected serious risks, according to the report in the Journal of the American Medical Association.

FluMist has been approved since 2003 for use against the seasonal flu, which kills 36,000 Americans every year and as many as 500,000 globally in an average flu season. But people have been slow to use it, despite efforts by U.S. health officials to promote its use

This is a great alternative for healthy, younger patients, especially those that are adverse to needles, such as children over 8 years old. It can set off asthmatic episodes in the series in a small percentage of patients with known asthma.

Anti-Perspirants & Breast Cancer

If you've checked out the back of your antiperspirant lately, you might have noticed something different: new labels required by the Food and Drug Administration. They point out that antiperspirants are "drugs" containing "aluminum" ingredients — that's what stops the sweat.

The aluminum is also what concerns some people, including Dr. Kris McGrath.

"I personally feel there is a very strong correlation between the underarm hygiene habits and breast cancer," McGrath tells CBS News correspondent Sharyl Attkisson.

McGrath, an immunologist and instructor at Northwestern University, has been intrigued by a potential breast cancer link since medical school.

It got personal when his wife — a frequent shaver and antiperspirant user — got breast cancer.

I thought this was some bit of urban legend, but apparently some are loking into a possible connection.

"Breast cancer has existed since Hippocrates. But when you plot the sales of antiperspirant deodorants with the incidence of breast cancer in the United States, they both have grown in almost a parallel fashion."

From CBS.

Virtual Medicine May Lead To Real Lawsuits

Peter Beasley is a busy man who currently has no health insurance. He's also a customer of TelaDoc Medical Services, a setup that allows him to call an unknown doctor and get medicine prescribed sight unseen.

Within an hour or so of his call to an 800 number, he gets a call from a doctor who discusses his symptoms and will often write a prescription.

TelaDoc provides its members -- which the company estimates at 30,000 -- with access to a doctor 24 hours a day, seven days a week.

While members like Beasley praise the service as a convenient way to address nagging medical needs at odd hours, others in the health care industry say treating patients without seeing them in person is worrisome, perhaps dangerous. California's medical board is investigating TelaDoc's activities in that state.

TelaDoc chief executive Michael Gorton said the Dallas-based company is merely providing a needed service and is not meant to replace the family physician. The company began offering its services nationwide this year after an earlier test run.

However, all is not ideal. Several physician groups, as well as state medical boards are looking into this brave new frontier of medicine. In their view, this is stretching the doctor patient relationship to a very thin limit- too thin for some.

But doctors' groups and medical ethics experts question the notion of putting convenience first.

"Practicing medicine without seeing the patient is still a dangerous thing," said Arthur Caplan, chairman of the department of medical ethics at the University of Pennsylvania. "From the doctor's point of view, it's not standard of care."

Dr. Larry S. Fields, president of the American Academy of Family Physicians, said he doesn't see the benefit of TelaDoc.

"As much as I'd like to put a positive spin on it, most patients can get to their family physicians just as quick by telephone," he said. Establishing a doctor-patient relationship should involve an office visit with a general exam and an ongoing plan for the patient's long-term health, Fields said.

While the American Medical Association doesn't have a specific policy on such services, there are some concerns for the patient, said AMA president Dr. Edward Hill. "Nothing we think can replace the face-to-face with a doctor."

From TechNudge.

Robo Suit

We developed the exo-skeleton type power assist system to realize the walking aid for the gait disorder person.
At the present time, HAL-3 is state of the art power assist system in the world.
Some sensors such as angle sensors, myoelectrical sensors, floor sensors etc. are adopted in order to obtain the condition of the HAL and the operator.
All of the motordrivers, measurement system, computer, wireless LAN, and power supply are built in the backpack.
Using the battery attached on the waist, HAL works as the complete wearable system.

Yes, this guy is serious. There is a lot of potential here, even though he looks like something out of a comic book.

Some more here, including the price tag. I'm not sure insurance will reimbuse for this; they'll claim it's experimental.

Tylenol...The Drug That Hospitals Trust Most

SEATTLE, Nov. 30 - Liver toxicity from acetaminophen poisoning is by far the most common cause of acute liver failure in the United States, researchers reported.


Users of the popular painkiller who are most at risk include those with depression, chronic pain, alcohol/narcotic use, and those who take several acetaminophen-containing products at the same time, they added.


"Education of patients, physicians, and pharmacists to limit high-risk [acetaminophen] use settings is recommended," wrote Anne M. Larson, M.D., of the University of Washington, and colleagues at 21 other U.S. centers, in the December issue of Hepatology.


Acetaminophen (Tylenol and generics) is widely available in over-the-counter preparations for headaches, colds, allergies, osteoarthritis, and other conditions.


The data suggest that consistent use of as little as 7.5 g/day of acetaminophen could lead to severe hepatic injury, Dr. Larson and colleagues wrote.

As some of us have seen, innocuous Tylenol can be a real nasty medication in larger quanities. Some suggestions to avoid a problem for our patients are:

*Inform patients that acetaminophen dosing greater than 7.5 g/day could be hazardous. Reassure them, however, that acetaminophen-related liver toxicity is an uncommon occurrence, and that the drug itself is not toxic.


*Instruct patients who use over-the-counter medications to read labels carefully and look for the ingredient acetaminophen in analgesics, cold and allergy medications, sleep aids, and other products.


*Inform patients who have alcoholic liver disease that smaller amounts of acetaminophen (4-5 g/day) have been reported to cause acute liver failure.

From Med Page Today.

Implantable Accucheck

Developed by Craig A. Grimes, professor of electrical engineering and materials science and engineering at Penn State, the glucose biosensor, when placed under the skin, could provide glucose levels for diabetics without a finger prick. Diabetics must monitor the levels of glucose in their blood and adjust insulin injections to maintain normal levels and avoid the complications of the disease. The device, which measures about a centimeter by half a centimeter and is about the depth of a thin hair, is composed of an I-shaped backbone crossed by a series of 10 slightly decreasing bars. The shape vaguely resembles a miniature harp.

The backbone and crossbars are made of a magnetorestrictive metallic glass – a material that changes shape with application of a magnetic field and generates a magnetic field when it changes shape – coated with a polymer that reacts to changes in acidity. This coating is then topped with glucose oxidase, the enzyme that reacts with glucose. The acid sensitive coating makes the device swell or shrink, changing mass depending on the surrounding acidity. The acid that causes the changes comes from the reaction of glucose with glucose oxidase, which produces gluconic acid.

When a magnetic field from the outside is placed near the sensor, the sensor vibrates at a frequency dependent on the mass of the sensor. A magnetic coil can read the magnetic flux of the sensor and determine the amount of glucose in the blood.

This could be a great boon so diabetics who don't check their glucose enough. Imagine continuous monitoring capabilities. Now, this could be real tight control. Unfortunately, it's not currently available.
Some more info here.

I'll let the robot do it....

Hansen Medical, a developer of robotic medical technology, raised $30 million through a third round of funding led by Vanguard Ventures, an early-stage venture capital firm focused on financing technology and life-sciences ventures. Existing Hansen investors also participating in the round included Prospect Venture Partners, Skyline Venture Partners, Thomas Weisel Healthcare Venture Partners, De Novo Ventures and Sapient Capital.

This brings Hansen's total equity fundraising to more than $58 million.

The Mountain View company has developed a robotic catheter control system for precise catheter navigation and control within the chambers of the heart.

The technology -- which requires regulatory clearance and is not yet commercially available -- includes a robotic catheter manipulator that is designed to respond instinctively to physicians' commands entered into a workstation, allowing doctors to place ablation catheters in hard-to-reach anatomical locations within the heart.

The technology is also designed to allow physicians to maintain stability during treatment of complex cardiac arrhythmias, such as atrial fibrillation, a major cause of stroke and severe long-term disability.

So the robot can be more prcise than us. I'm not sure if we should feel threatened or not. What do you think?

Where is the flu?

A flash utility to see the latest influenza activity by each state.

C Diff- In The News

"Hospitals need to be conducting surveillance and implementing control measures. And all of us need to realize the risk of antibiotic use may be increasing" as the bacteria continue to mutate, McDonald said.

The bacterium is Clostridium difficile, also known as C-diff. The germ is becoming a regular menace in hospitals and nursing homes, and last year it was blamed for 100 deaths over 18 months at a hospital in Quebec, Canada.

"What exactly has made C-diff act up right now, we don't know," McDonald said.

The article published in the CDC's Morbidity and Mortality Weekly Report focused on cases involving 33 otherwise healthy people that were reported since 2003 in Pennsylvania, Ohio, New Jersey and New Hampshire.

Most of the 33 hadn't been in a hospital within three months of getting sick, and eight said they hadn't taken any antibiotics in that span

New Disease....Addicted to The Internet

THE waiting room for Hilarie Cash's practice has the look and feel of many a therapist's office, with soothing classical music, paintings of gentle swans and colorful flowers and on the bookshelves stacks of brochures on how to get help.

But along with her patients, Dr. Cash, who runs Internet/Computer Addiction Services here in the city that is home to Microsoft, is a pioneer in a growing niche in mental health care and addiction recovery.

The patients, including Mike, 34, are what Dr. Cash and other mental health professionals call onlineaholics. They even have a diagnosis: Internet addiction disorder.

These specialists estimate that 6 percent to 10 percent of the approximately 189 million Internet users in this country have a dependency that can be as destructive as alcoholism and drug addiction, and they are rushing to treat it. Yet some in the field remain skeptical that heavy use of the Internet qualifies as a legitimate addiction, and one academic expert called it a fad illness.

Skeptics argue that even obsessive Internet use does not exact the same toll on health or family life as conventionally recognized addictions. But, mental health professionals who support the diagnosis of Internet addiction say, a majority of obsessive users are online to further addictions to gambling or pornography or have become much more dependent on those vices because of their prevalence on the Internet.

But other users have a broader dependency and spend hours online each day, surfing the Web, trading stocks, instant messaging or blogging, and a fast-rising number are becoming addicted to Internet video games.

Dr. Cash and other professionals say that people who abuse the Internet are typically struggling with other problems, like depression and anxiety. But, they say, the Internet's omnipresent offer of escape from reality, affordability, accessibility and opportunity for anonymity can also lure otherwise healthy people into an addiction.

I'm not sure if I would really categorize it as a disease. The best part is these therapists are getting paid cash to "treat" these patients. Is Donald Trump addicted to making money? I don't see anyone treating him for it.