Sunday Medical News (FYI)

Did everyone “Fall Back” this Sunday?  (Time change)

As a retired old fart I am constantly worrying about my health as well as my wife’s…..one really bad problem and we could be ruined just like most of the American retired.

So yeah it is pretty damn important!

I read an article about the disparity of the American health care system…….

A research study on a commercial computer program used to allocate health care resources on predicted future health care costs provided a window on the ongoing pervasive impact of structural racism in our nation’s health care system.

Moreover, the research published in Science magazine reinforced how structural racism persists throughout society, including disparities in income, housing and other social and economic factors, and the impact that has on disparities in health.  

The study focuses on an algorithm used by health systems, insurers, and practitioners to predict which patients with complex medical needs should receive extra medical care. The ostensible goal is to slash costs by suggesting those patients receive “high risk management” at less expensive primary care levels.

https://www.commondreams.org/views/2019/10/29/what-algorithms-tell-us-about-structural-racism-health-care

By now just about everybody has heard of the Dems proposal known as Medicare For All…..lots of pros and just as many cons……but those that have the most to lose, the health industry, the drug industry and those that have prostituted themselves to these industries, are the loudest opponents…..

But what does the economics say about the proposal?

Medicare for All would give most U.S. workers “the biggest take-home pay raise in a generation,” two economists from the University of California, Berkeley said Friday, countering one of the main insurance industry talking points against single-payer.

In an op-ed for The Guardian, Emmanuel Saez and Gabriel Zucman directly challenged the claim that Medicare for All would “involve massive tax increases for the middle class,” an attack line centrist Democratic presidential candidates like former Vice President Joe Biden and South Bend, Indiana Mayor Pete Buttigieg have recently deployed against the popular proposal.

“Supporters of Medicare for All are right,” said Saez and Zucman, leading experts on income and wealth inequality. “Funding universal health insurance through taxes would lead to a large tax cut for the vast majority of workers.”

The two economists argued that health insurance premiums are effectively taxes taken out of workers’ paychecks and paid to for-profit insurance companies instead of the government.

https://www.commondreams.org/news/2019/10/25/two-leading-economists-say-medicare-all-would-give-workers-biggest-take-home-pay

Last bit for this Sunday…..an update on the medical procedure known as a “fecal transplant”….I have informed my readers of this medical treatment in the past……https://lobotero.com/2019/06/16/all-those-transplants/

The rain has stopped and cooler temps and now the satsuma crop is in we need to start on the tangerine crop…..

Now there is more on this health issue….

What the New York Times calls “a frank and public act of self-examination” has emerged from a Boston medical center following the death of a fecal transplant patient after receiving contaminated stool. In an article published in the New England Journal of Medicine, doctors at Massachusetts General Hospital document the events leading up to the death of the 73-year-old blood cancer patient, which was first reported by the FDA in June. He and another patient, a 69-year-old with liver disease, had been given stool last spring that hosted drug-resistant E. coli bacteria, both samples from the same donor. The liver patient became seriously ill after his fecal microbiota transplant (aka FMT), which aims to restore a patient’s microbiome, or gut organisms. That man recovered, but the cancer patient was put on a breathing machine a week after his last FMT; he died two days later from a blood infection.

One big misstep: Although the hospital had tightened screening for stool donations starting in January based on new FDA guidelines (FMT isn’t FDA approved), older samples were kept, untested, in a freezer. “It wasn’t obvious to a lot of smart people here. We didn’t think to go back in time,” Dr. Elizabeth Hohmann, the article’s lead author, says, adding to STAT that “the prevalence of these organisms in healthy individuals is so low.” Hohmann adds that “20/20 hindsight” also made them realize that antibiotics given to the two patients before their fecal transplants may have helped the E. coli bacteria flourish. The Times notes that while the Boston hospital uses fecal transplant material produced in-house, most treatments in the US use material from the OpenBiome nonprofit stool bank, which has been screening for antibiotic-resistant E. coli since 2016, with no reported cases of “serious adverse events” from FMTs.

In closing….Eeeeewwwwwwww!

The rain has stopped and cooler temps and now the satsuma crop is in we need to start on the tangerine crop…..

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I Read, I Wrote, You Know

“Lego Ergo Scribo”

Thanx for the visits this past week…I appreciate those people that participate….have a great Sunday…..

A Random Thought Saturday

I have returned to the normal FYI stuff for the weekend…..I apologize for the momentary lapse but it was news that needed reporting.

I attempt to find some interesting stuff to write about on weekends for my readers have had enough politics and news for at least a couple of days.

SEX!

I read an article that stated that we were in a “sex recession”……

Sex is like sleep or protein: people freak out if they’re getting too much, and they freak out if they’re getting too little. So it comes as little surprise that when a news story emerges that hints at the latter possibility, it’s guaranteed to go viral. Such was the case earlier today with a report from CBS News focusing on Japan’s “sex recession,” or the idea that Japanese millennials aren’t having sex, which comes with the ominous warning that America may — gasp! — be next.

The CBS News story appears to be pegged to Japan’s National Fertility Survey, which found that one in every 10 men in their 30s have never had sex before — a fairly high number compared to that of other industrialized nations. Experts quoted in the story blame the rising virginity rates on a fairly wide range of factors, from rising national financial instability to the advent of apps offering digital companionship. Whatever the cause, such statistics, in combination with Japan’s extremely low fertility rate, has prompted panic among public health researchers and demographic experts in the country, who predict that Japan’s population will be halved if the trend continues over the next 100 years. The story ends on the ominous note that “this problem isn’t unique to” Japan, and that the United States “could be next.” But is that actually true, and is the so-called Japanese “sex recession” going global?

Are We In the Throes of a Global ‘Sex Recession’? Eh

It sucks to be in Japan these days….and then the article said the America could be next……not if the other news is accurate……

A big number out of the CDC on Tuesday, and it’s not a good one: The health protection agency says there were 2.4 million infections diagnosed and reported from three sexually transmitted diseases in 2018, the “most cases” ever documented in a one-year span, per a CDC epidemiologist. This stat comes by way of the CDC’s newest “STD Surveillance Report,” which has found combined cases of gonorrhea, syphilis, and chlamydia rising in the US for the past five years, CNN reports. Chlamydia claims the lion’s share of these cases, with 1.8 million cases last year—a 19% increase since 2014. Meanwhile, there were more than 580,000 cases of gonorrhea, and about 38,000 cases of primary, secondary, and congenital syphilis. Untreated, these STDs could lead to everything from infertility and drug-resistant conditions to congenital syphilis, which could in turn lead to infant death.

The cases seem to most often involve teens and young adults, and three states in particular rank high: Alaska for chlamydia, Nevada for primary and secondary syphilis, and Mississippi for gonorrhea. The District of Columbia, however, had the highest rates for all three. Perhaps as unnerving as the numbers is that progress on these has “unraveled,” per Dr. Gail Bolan, head of the CDC’s STD Prevention Division. “Not that long ago, gonorrhea rates were at historic lows, syphilis was close to elimination, and we were able to point to advances in STD prevention,” Bolan writes in the report’s foreword. Factors that may be contributing to the steep numbers: a decrease in condom use, cutbacks in funding that led to fewer prevention programs, and increased screening accessibility, which generates more known cases. “Americans have stopped taking STDs seriously,” notes the Atlantic.

I have a thought on the two different takes on sex…..Japan is leading the world in “sex dolls”…..and the US could curb these disturbing numbers…..I will let Jefferson Airplane…..finish out the post…..

Once again we are getting much needed rain…..but that does not preclude a walk for MoMo…..

I Read, I Wrote, You Know

“Lego Ergo Scribo”

Peace Out!

Are You An Organ Donor?

Closing Thought–03Sep19

I am not…..an organ donor that is……my thoughts are if I donate a kidney then why should all along the medical line make money off my free kidney?

When the whole process is free then all my organs can be had.

This is a story that I wish I did not have to read or report…..

Speaking of kidneys and transplants….

Every day, 12 Americans die while waiting for a kidney transplant. In what will be an especially hard pill to swallow for the 93,000 Americans currently on the waiting list, about 10 donated kidneys are discarded in that same period, reports USA Today. A study published Monday in JAMA Internal Medicine found that 17.9% of kidneys donated in the US over the decade ending in 2014 were rejected (28,000 kidneys in all), compared to 9.1% in France. In 2016 alone, about 20% of 3,631 donated kidneys in the US were discarded, per CNN.

France, it turns out, is more willing to use kidneys from older donors or those who have an ailment such as diabetes, high blood pressure, or Hepatitis C. Researchers cite the “intense regulatory scrutiny of US transplant programs, which may lose credentials if their one-year death and graft failure outcomes exceed predicted outcomes.” Meaning, the programs don’t want to risk their credentials and opt to use only organs in the best condition. But patients “using kidneys from diabetic donors do remarkably well,” study co-author Sumit Mohan of the Columbia University Medical Center tells USA Today.

You read it right 28,000 wasted kidneys in a decade.

Someone please explain that waste to me.

“Lego Ergo Scribo”

I Agree With Trump!

I know some of my more conservative readers will be reading this and having to sit down…..the old professor likes something Trump is doing?

Well yes I do….but there a several things that I approve of from the Trump admin……like bring troops home and a better infrastructure……so far neither of those have come to the forefront….only in rhetoric not reality.

As an old retired fart that depends on Medicare for his drugs and care I am always bitching about the price of my drugs….especially my insulin and pain meds…..

It appears that our president is going to do something about the high costs of prescribed medicine…..

The Trump administration said Wednesday it will set up a system to allow Americans to legally import lower-cost prescription drugs from Canada, weakening a long-standing ban that had stood as a top priority for the politically powerful pharmaceutical industry. Health and Human Services Secretary Alex Azar made the announcement Wednesday morning, the AP reports. Previous administrations had sided with the industry on importation, echoing its concerns that it could expose patients to risks from counterfeit or substandard medications. Azar, a former drug industry executive, said US patients will be able to import medications safely and effectively, with oversight from the Food and Drug Administration. The administration’s proposal would allow states, wholesalers, and pharmacists to get FDA approval to import certain medications that are also available here.

It’s unclear how soon consumers will see results. Most patients take affordable generic drugs to manage conditions such as high blood pressure or elevated blood sugars. But polls show concern about the prices of breakthrough medications for intractable illnesses like cancer or hepatitis C infection, whose costs can run to $100,000 or more. And long-available drugs like insulin have also seen price increases that have forced some people with diabetes to ration their own doses. “For too long American patients have been paying exorbitantly high prices for prescription drugs that are made available to other countries at lower prices,” Azar said in a statement that credited President Trump for pushing the idea. The administration’s move comes as the industry is facing a crescendo of consumer complaints over prices, as well as legislation from both parties in Congress to rein in costs.

This is a great idea but like all great from Trump is it a lie,  a broken promise or will it make it to the reality of my life?

“Lego Ergo Scribo”

Sick Call

Congrats to the USA Women’s soccer team which beat France 2-1 to go on to the semis against England on 02Jul19…..

My days of lounging in the garden have been curbed…..the temps here are hovering around 100 and the humidity between 80 and 90%…..so gives me lots of time to read….and that is dangerous for my readers they never know what will appear on IST…that is what gave me the idea for today’s posts.

Found memories from my days in the US Army…especially overseas…in my case it was Southeast Asia…..anyway……every morning after breakfast there would be a “sick call”…if you were feeling awful you would go and sit and wait to be called for an examination.

We would all sit around the lobby of our medical facility and people would come out an call out…shots and you would get up and go for your scheduled shots or they would call “x-rays” and you would get up and go with that person and on and on until they came to most popular of “sick call” ailments…..penicillin shots and all the VD suffers would stand and go to get their shot for the varied diseased picked up in the back street.

What on Earth got me thinking about those days and those memories?

Cases of some sexually transmitted diseases, including chlamydia, gonorrhea and syphilis, are rising in the U.S. armed forces, a trend that mirrors the general population but alarms military health officials who treat affected troops.

According to a report released earlier this year by the Armed Forces Health Surveillance Branch, incidence rates of chlamydia in service men and women more than doubled from 2013 to 2018, gonorrhea infection rates also doubled for men and rose by 33 percent for women, and diagnoses of syphilis were nearly three times the number just 10 years ago.

Defense Department officials said the increases can mean negative consequences for military readiness.

“From a military standpoint, sexually transmitted infections can have a significant impact on individual readiness, which in turn impacts unit readiness, which then leads to a decrease in force health protection,” said Maj. Dianne Frankel, an Air Force internal medicine physician, in the release.

Nearly 350,000 troops were diagnosed with a sexually transmitted illness between 2010 and 2018. According to the report, that included 212,405 cases of chlamydia, 32,987 cases of gonorrhea, 4,674 cases of syphilis, 28,295 cases of genital herpes and 71,138 cases of HPV

https://www.military.com/daily-news/2019/06/26/chlamydia-syphilis-cases-rise-among-us-military-members.html

Interesting what can be labeled a National Security issue, right?  Who knew a case of the “Clap” could be of NatSec concerns?

Amazing things you read make memories of younger days flood back into your brain…..

“Lego Ergo Scribo”…..(I Read; Therefore I Write)

All Those Transplants

I am amazed at all the successes they are having with transplants these days….hearts, livers, kidneys, corneas, penal and even face transplants…and with all these successful medical procedures there is one that made me ask…… WTF?

Ever heard of Fecal Transplants?

First of all…EEEwwwwww!

Fecal Microbiota Transplantation (FMT) is an innovative investigational treatment that has – in randomized, controlled clinical trials – resolved 80-90% of infections caused by recurrent C. difficile that does not respond to antibiotics. During FMT, a fecal preparation from a carefully screened, healthy stool donor is transplanted into the colon of the patient. There are multiple routes of administration (e.g., via colonoscopy, naso-enteric tube, capsules), each of which has unique risks and benefits. 

How does FMT work?

Though the mechanism has yet to be determined, it is believed that FMT works by repopulating the patient’s microbiome with diverse microorganisms that competitively exclude C. difficile

In a healthy gut community, C. difficile is out-competed by many different bacterial species. However, receiving antibiotic treatment disrupts this ecosystem by killing those protective bacteria. C. difficile forms spores that are resistant to antibiotics. No longer outcompeted, this pathogen establishes itself in the gut and produces toxins that leave patients suffering from severe diarrhea, abdominal pain, and, often, fever. With an infusion of bacteria from a healthy donor’s stool, the C. difficile is again out-competed.  

Researchers are also exploring FMT’s potential role for treating other gastrointestinal diseases, such as IBS and Crohn’s Disease. 

I had never heard of this procedure…but then I am an old fart and new technology is slow to be absorbed…….what made me ask the question was this article that I read about a death from a fecal transplant……

Fecal transplants, though experimental, have been lifesaving, reports the New York Times, citing the cases of some patients who were being ravaged by “uncontrollable diarrhea” caused by the the bacterial infection C. difficile. But in one recent case, such a transplant was deadly. The FDA announced on Thursday a patient recently died after receiving a fecal transplant, in which healthy fecal matter from a donor is processed in a lab and given to a patient via an infusion or pills in an attempt to reset the intestine’s bacteria. The FDA said it was halting fecal transplant clinical trials until researcher can prove to the FDA that they have measures in place to verify the fecal matter is free of deadly bacteria. That was not the case with the patient who died.

That patient, along with a second patient, received stool from the same donor that had not been screened and developed infections. After they were sickened, testing of the donor’s remaining stool samples showed it contained multi-drug-resistant microbes: E. coli that produced extended-spectrum beta-lactamase. The FDA didn’t offer details on the identity of the patients, what they were being treated for, or where the transplant took place, though they did say the two had compromised immune systems and were participating in a clinical trial. Fecal transplants are typically used as a treatment for C. difficile, which per CDC stats kills 29,000 Americans yearly, reports NBC News. USA Today notes antibiotic-resistant infections kill another 23,000. The FDA emphasized all standard treatments for C. difficile should first be tried.

Just when you think that you had lived long enough to have heard everything there is….then BAM!  They hit you with something like “Fecal Transplant”….

On that note I bow out for the day…….MoMo has me scheduled for a play date in the back 40……May all my Fathers have a good day………TTFN

Image result for fathers day images

Closing Thought–04Jun19

I am an old fart, a Baby Boomer generation, and as we all know we are the problems of society now…..but with that said an adequate health care system is a must…..because by 2035 seniors will outnumber children and that means long term care will be a must by then (kinda is now but not important to the post)…..

By 2035, seniors are projected to outnumber children in the U.S. population.

Maybe then we’ll look back and credit Washington state activists for being on the forefront of tackling America’s elder care crisis. On May 13, the state became the first in the nation to adopt a social insurance program for long-term care benefits.

“This is a huge victory for organizing and people power, for care and caregiving, and for older adults and people with disabilities,” said Josephine Kalipeni of Caring Across Generations, one of more than 20 groups that formed Washingtonians for a Responsible Future to push the path-breaking legislation.

Nationally, our long-term care financing system is broken. Medicare doesn’t currently cover home care or nursing facility care, while Medicaid coverage varies widely by state. To qualify, you have to meet poverty criteria, which requires people to spend down nearly all of their savings before getting coverage.

 
Medicare For All!  We need a health care system and this is one that the machinery of policy are already in place….logic dictates we have an answer…why not use it?
 
I want to enjoy a late Spring weekend……the heat, the humidity and the hurricanes are just around the corner.