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Research Report

Why the Age of Your Doctor May Matter

by Angela Sams

If you need some sort of serious medical procedure done or find yourself in the hospital for another reason, you would probably want the best, most experienced doctor, right? To the contrary, a recent New York Times op-ed article by Dr. Ezekiel Emanuel indicates that the opposite may be true. The article explores a recent research paper published in JAMA Internal Medicine, which analyzed ten years of data regarding hospital admissions. The research shows “that patients with acute, life-threatening cardiac conditions did better when the senior cardiologists were out of town.” This was the case at what are considered “the best hospitals in the United States, our academic teaching hospitals.” When the top senior cardiologists were absent, patients’ mortality was decreased by approximately one third. Furthermore, patients whose heart conditions are treated in a teaching hospital rather than a community hospital generally fare much better.

One would think that an older, more experienced doctor would be more adept at treating patients, but Dr. Ezekiel poses the idea that younger doctors are still fresh from training and may be better at clinical treatment, whereas older doctors are better at the research side of medicine. Senior doctors may also be more likely to try more interventions. The data in this recent paper, along with other recent studies, seem to indicate that less is better in terms of healthcare. It’s important to remember that with each new test or treatment comes the potential for side effects or something going wrong.

Perhaps doctors should be required to give patients information about a potential procedure and prevent over-medication by attempting to discontinue medications annually. Dr. Ezekiel suggests that patients can also become involved in their own care by asking four simple questions before a procedure:

  • What difference will it make, and will the test results change the treatment approach?
  • How much will this treatment improve the prolongation of my life and reduce the problem?
  • How likely and severe are the side effects?
  • Is this a teaching hospital?

Patients have a right to be as involved as possible in their care. And, while it may make a doctor uncomfortable to be asked such questions, if they truly have the best interest of the patient at heart, they will be more than happy to answer.

And The Nobel Prize Goes To…

by Jen Jenkins, Market Analyst

Three scientists have received the prestigious award this year for what the Nobel Prize committee said were “therapies that have revolutionized the treatment of some of the most devastating parasitic diseases.”

Dr. William Campbell, Dr. Satoshi Omura and Dr. Tu Youyou are the recipients of the award; the doctors originate from Ireland, Japan, and China respectively. Dr. Campbell and Dr. Omura collaborated, as well as worked on independent aspects, to develop the medicine Avermectin and will share one half of the prize money; Dr. Tu will claim the other half of the money for the medicine Artemisinin, her discovery of which was inspired by traditional Chinese medicine.

Parasitic diseases threaten approximately one-third of the world’s population today, especially in the poor areas of Africa, South Asia, and Latin America. These two newly developed medicines address the parasitic diseases transferred to humans from black flies and mosquitoes and have been included in the World Health Organization’s list of essential medicines. Both medicines are distributed to areas in need either for free or at very low cost.

“These two discoveries have provided humankind with powerful new means to combat these debilitating diseases that affect hundreds of millions of people annually. The consequences in terms of improved human health and reduced suffering are immeasurable” because parasitic diseases “represent a huge barrier to improving human health and well-being.”

-The Nobel Committee, as reported by The New York Times

Read more in depth about these fascinating scientists, their discoveries, what led to their discoveries in this New York Times article.

Hyperbaric Chambers and Helmet Sensors: Effective Concussion Treatments?

Start-ups and doctors are in zealous pursuit of new and sometimes controversial ways to prevent, detect and treat concussions, as noted in this article.

A growing industry has developed around concussions, with entrepreneurs, academic institutions and doctors scrambling to find ways to detect, prevent and treat head injuries. An estimated 1.7 million Americans are treated every year after suffering concussions from falls, car accidents, sports injuries and other causes.

While the vast majority quickly recover with rest, a small percentage of patients experience lingering effects a year or longer afterward. Along with memory issues, symptoms can include headaches, dizziness and vision and balance problems.

Since 2007 research spending has increased dramatically. At that time Congress, facing criticism that the military had ignored the psychological and physical toll on soldiers of serving in the Afghanistan and Iraq conflicts, allocated $600 million for research and treatment on traumatic brain injury and post-traumatic stress disorder (PTSD), two major conditions faced by many returning soldiers. In turn much of the traumatic brain injury research has included a look at treating concussions. Many highly publicized cases in the NFL of concussed football players have added to the call for more research and treatment options.

The search for ways to treat and prevent concussions has spawned screening tools, helmet sensors, electronic mouthpieces, diagnostic blood tests and brain imaging devices. Start-ups are marketing their products to the military, schools, hospitals, sports teams and parents, and controversial therapies like hyperbaric oxygen are being promoted to patients. But as the industry booms, medical experts are raising concerns that it is a business where much of the science is sketchy, belief frequently outruns fact, and claims of technological breakthroughs evaporate soon after they are made. Read more…

Beating Back Opioids – Now What?

WorkComp Central published a new report,“We’re Beating Back Opioids — Now What?” this past June, by Peter Rousmaniere in cooperation with CompPharma. It narrates a 20-year story and poses some provocative recommendations, noting that we are at a turning point in treating chronic pain though the statistics remain daunting. Every workday, some 5,000 workers sustain injuries which disable them for at least a week; on any given day in the U.S. 500,000 injured workers are treated for chronic pain. The majority of treatments includes opioids, and for individuals with chronic pain, care and wage replacement can reach $1,000,000 in cost per claim.

Per the study’s author: “This report does two things. First, it chronicles the two decade-long story of how opioid use greatly expanded in workers’ comp, then halted and began to retreat in the face of fierce criticism. Workers’ comp professionals can use this story to tell their friends about a war they still are fighting.”

Rousmanier also credits several organizations in the detection and reporting on trends and solutions. They include the California Workers’ Compensation Institute, CompPharma, the National Council for Compensation Insurance, Washington State, and the Workers’ Compensation Research Institute. Read more…

 

Music Soothes the Savage Beast

It was William Congreve who wrote in 1697 “Music has charms to soothe a savage breast,” but what is the mechanism for this? A new study from Greece offers some insight.

The study focused on aortic stiffness and pulse wave reflections, two important indicators of cardiovascular risk. The subjects’ baseline measurements were taken at the start of each session. Then participants listened to either a half hour of classical music (such as Bach’s Orchestral Suites) or a half hour of rock (tracks from Led Zeppelin, Black Sabbath, and Green Day) or  experienced a half hour of silence.

Measurements were taken at the end of these half hour periods, and then again after 30 more minutes. The numbers were lower for all participants who had listened to music, whether it be classical or rock. Though the study involved just a small number of participants over a limited period of time it does suggest that listening to music positively impacts heart health.

It was also Congreve who wrote “Heaven has no rage like love to hatred turned, Nor hell a fury like a woman scorned,” in his 1697 The Mourning Bride. He also coined the phrase “You must not kiss and tell” in his 1695 Love for Love. For the moment, however, we’ll refrain from a more clinical review of these notions.

Transforming Medicine into an Information Science

Responding to data trends is not a new to the practice of medicine. A quick Google search reminds us that the scientific method itself is defined as “principles and procedures for the systematic pursuit of knowledge involving the recognition and formulation of a problem, the collection of data through observation and experiment, and the formulation and testing of hypotheses.”

But the Icahn School of Medicine at Mount Sinai, New York — along with several other major medical schools — is pushing the concept further. They’re turning directly to data science as a big part of the future of medicine and health care.

Mt. Sinai has recently added Jeffrey Hammbacher to their faculty. Hammerbacher is a number cruncher — a Harvard math major who went from a job as a Wall Street quant to a key role at Facebook to a founder of a successful data start-up. He was recruited by Eric Schadt, a computational biologist at Mt. Sinai who had concluded that medicine was ripe for a data-driven revolution.

Hammbacher leads a team whose objective is to alter how doctors treat patients someday. For example, Mount Sinai medical researchers have done promising work on personalized cancer treatments. It involves the genetic sequencing of a patient’s healthy cells and cancer tumor. Once the misbehaving gene cluster is identified and analyzed, it is targeted with tailored therapies, drugs or vaccines that stimulate the body’s defenses.

Mr. Hammerbacher’s team does not do the basic science. Other researchers do that. His group works on the “computational pipeline,” he said, with the goal of making personalized cancer treatments more automated and thus more affordable and practical. “It’s ultimately what cancer cures are going to look like,” he said. Read more…

60,000 Additional Deaths a Year Attributed to Smoking

A study entitled “Smoking and Mortality – Beyond Established Causes” appeared in the New England Journal of Medicine last week. The study followed almost a million people over the course of ten years. Researchers found that compared with people who had never smoked:

  • Approximately 17% of the excess mortality among current smokers was due to associations with causes that are not currently established as attributable to smoking.

  • Smokers were about twice as likely to die from infections, kidney disease, respiratory ailments not previously linked to tobacco, and hypertensive heart disease, in which high blood pressure leads to heart failure.
  • Smokers were also six times more likely to die from a rare illness caused by insufficient blood flow to the intestines.

The study also found small increases in the risks of breast and prostate cancer among smokers. Dr. Brian Carter, an epidemiologist with the American Cancer Society, notes that those findings were not as strong as the others, adding that additional research could help determine whether there were biological mechanisms that would support a connection.

According to the Centers for Disease Control and Prevention, about 42 million Americans smoke — 15 percent of women and 21 percent of men.

 

Worldwide Decline in Ancient Scourges

We in the US fight about our bloated health-care system and the extraordinary waste and inflated prices that are emblematic of the problems and challenges we face.

While we engage in these squabbles there are millions in the world who are helped by simple, inexpensive interventions, leading to restoration of life or meaning of life.

Nicholas Kristof of the NY Times illustrates examples of these in his recent column. The column and his work are useful and enlightening, as are the comments of readers in the online version we are linking to.

The 5 Most Common Workplace Injuries

Every year thousands of employees are injured in the course of their employment.

Injuries in the workplace are costly and while it is nearly impossible to prevent every single exposure and injury in the workplace, it is important to proactive identify those that are most common in order to find possible solutions.

According to the 2012 Liberty Mutual Workplace Safety Index, the top five leading causes of workplace injuries drive 73%  of the nation’s direct workers’ compensation costs.

The study found that the top five injuries were:

1. Overexertion: Injuries from excessive lifting, pushing, pulling, holding, carrying, throwing, which accounted for $13.61 billion in costs.
2. Fall on same level: a slip, trip, or a fall in which the worker impacts either the surface or an object at the same level on which he/she is standing. This injury drove $8.61 billion in costs.
3. Fall to lower level: Which accounted to $5.12 billion in costs.
4. Bodily reaction: Injuries from bending, climbing, reaching, standing, sitting, and slipping or tripping without falling, which drove $5.28 billion in expenses.
5. Struck by object: Which accounted for $4.64 billion in costs.

The Liberty Mutual study is available here.

 

 

 

Reduce Risk of Diabetes and Hearing Loss

By John O’ Connor
Contributing Blogger

More than 40 percent of people with diabetes have some degree of hearing loss and are two times as likely to develop hearing loss according to National Institutes of Health (NIH). Most diabetes patients are aware that they can experience vision loss with diabetes, but many people are unaware that they can develop hearing loss as a result of diabetes. Thus, people with diabetes do not take preventative measures to prevent hearing loss. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), people with diabetes should consider having their hearing tested as a preventative measure.

If required, modern hearing aids can improve hearing levels and overall quality of life.  The best course of action is to avoid hearing loss by developing a healthy lifestyle to keep diabetes in check.

What is Diabetes?
Diabetes affects 21 million people in the United States and it is the major cause of heart disease, stroke, blindness, kidney failure and lower limb amputations. Diabetes patients suffer from excessively high levels of blood glucose. Prediabetes, when a person has high blood glucose levels but not enough to be diagnosed with type 2 diabetes, affects 54 million adults in the U.S. Within the next 10 years, this population is expected to develop Type 2 diabetes according to the American Diabetes Association.

Diabetes is preventable however. Many people can prevent diabetes by increasing physical activity and cutting calories. Type 2 diabetes usually affects people over the age of 40. The disease is most common in overweight and sedentary people.  With a reduced risk of diabetes, there will also be a reduced risk of hearing loss.

How Diabetes Affects Hearing
Diabetes may damage the nerves and blood vessels of the inner ear. Studies have examined diabetes patients posthumously and experts found evidence of ear damage in diabetes patients.

Diabetes affects the low, middle and high frequency hearing of patients. When evaluating a group of 399 adults with diabetes, 21 percent had mild or greater hearing impairment in the low and mid frequency sound range. By contrast, nine percent of 4,741 adults without the condition were affected with the same condition.

When evaluating high frequency hearing impairment, 54 percent of diabetes patients had some form of impairment compared to 32 percent who did not have the disease. A pure tone audiometry was used to measure hearing sensitivity across a range of frequencies.

Even pre-diabetes patients had a 30 percent higher rate of hearing loss compared to those tested after an overnight fast. According to a study of diabetes patients ages 20 to 69, diabetes patients can be affected with hearing loss as early as ages 30 to 40. The link between diabetes and hearing loss has been studied since the 1960s. The studies have also taken into account noise exposure, medications, ethnicity, income level, age and race.

Approximately, 17 percent of American adults or 36 million people are experiencing some degree of hearing loss. Hearing loss seems to get progressively worse with age. Thirty percent of adults between the ages of 65 to 74 are affected by hearing loss. By contrast, eight percent of American adults 18 to 44 years of age.

Keep Diabetes in Check to Maintain Healthy Hearing Levels
Good health can promote healthy hearing levels. Patients diagnosed with diabetes should consult with their physicians to determine what measures they can take to prevent hearing loss when they are diagnosed. In general, a healthy diet with balanced sugar levels and exercise is recommended, but it is best to receive a customized plan from a physician or nutritionist who can cater to your specific needs. Consider scheduling an appointment with your physician to ensure you are taking every precaution to prevent hearing loss and diabetes.

John O’Connor is from Stoneham, Massachusetts and is a contributing blogger to MCNtalk. He has had a strong interest in hearing loss ever since his father and grandfathers were affected by hearing loss, along with other family members and friends.  He believes there is a general lack of understanding around the issue and is passionate about spreading awareness.  For more about John O’Connor, visit bloggingwjohno.blogspot.com