Even kids can get by with a single dose of swine flu vaccine, says the World Health Organization. But the U.S. is not so sure just yet.
WHO previously recommended two shots for kids younger than 10. But the new one-shot deal contradicts current U.S. policy, which calls for two shots (or nasal spritzes) in this age group.
After a two-day meeting in Geneva, WHO officials acknowledge data are sparse on whether a single dose protects younger kids against the new H1N1 virus. But vaccine shortages have forced them to reconsider.
"The priority is to give...one dose rather than vaccinate half the number of children with two doses," says Dr. Marie-Paule Kieny, director of WHO's Initiative for Vaccine Research.
You may not have noticed, but we've been having an H1N1 epidemic without America's Top Doctor.
Will Benjamin use the bully pulpit on swine flu? (Charles Dharapak/AP
)
That may change soon. The Senate has confirmed the appointment of Dr. Regina Benjamin as Surgeon General. Medically speaking, 53 year old Benjamin has a lot of street cred. She's a family doctor who founded the Bayou La Batre Rural Health Clinic in Louisiana. She became nationally known for getting it back up and running after Hurricane Katrina.
The SG famously doesn't have any kind of budget. All it has is what former Surgeon General Everett Koop firmly established as a "a bully pulpit" -- a chance to jawbone people about public health.
The plastic additive bisphenol A (BPA) may not be so bad after all, according to results from a new animal study funded by the federal government.
(David McNew/Getty Images)
Some earlier research in rodents suggested BPA, which is found in polycarbonate plastics, could act like the hormone estrogen. Those studies found that exposure to even tiny amounts of BPA could cause abnormal sexual development.
The latest work, published in the journal Toxicological Sciences, reached a very different conclusion.
When it comes to revamping the nation's health system, President Obama drew a $900 billion budget line in the sand for getting the job done.
A billion here and a billion there starts to add up. (iStockphoto.com)
The unified bill from House Democrats walks right up to the line but doesn't cross it, with a net cost of $894 billion over 10 years, the Congressional Budget Office estimates. It may also seem pretty close to the $829 billion Sen. Max Baucus' bill would add to the federal tab.
But with all that money riding, we figured it was worth taking another look. First off, there's just no doubt that insuring more people will cost a lot of money. The net spending exceeds more than $1 trillion over a decade.
If the 1,990-page health bill trotted out Thursday isn't hefty enough for you, just wait a little while. There's more material on the way.
House Minority Whip Roy Blunt warns there could be surprises in an amendment to the House health bill. (Brendan Smialowski/Getty Images)
Up next is a "manager's amendment" from House Democratic leaders that could run 800 pages or more and contain all sorts of surprises that nobody will know about until shortly before lawmakers have to vote on it, Rep. Roy Blunt, a Missouri Republican, warned Thursday.
"This won't be the bill that comes to the floor," Blunt said at news conference where a copy of the House Democrats' plan was piled on the podium. At the session, Republicans said the measure would raise taxes, cost jobs and deepen the federal deficit, charges House Speaker Nancy Pelosi of California and her Democratic colleagues dispute.
The notion that Americans spend $700 billion a year on health care that doesn't leave them healthier is Exhibit A in the Obama team's case that health costs can be cut without rationing.
Budget director Orszag testifies at a June hearing. (Mark Wilson/Getty Images)
White House budget director Peter Orszag often plays first fiddle in the efficiency ditty, writing in his blog last spring that such spending "subjects you and me to tests and procedures that aren't necessary and are potentially harmful -- not to mention wasteful."
Now an independent report by a unit of Thomson Reuters appears to back that up. A white paper, released this week, estimates that the nation wastes between $600 billion and $850 billion a year. It fingers specific categories of waste, such as administrative inefficiencies ($100 billion to $150 billion), unneeded medical services ($250 billion to $325 billion), fraud and abuse ($125 billion to $175 billion), and others. The paper had no outside sponsors.
On Election Day last year, the Government Accountability Office sent investigators to 720 polling places around the country to see if people in wheelchairs, or who were blind deaf or had other disabilities, could easily cast a ballot.
A Los Angeles polling station in 2008. (iStockphoto.com)
The results were mixed. There was some barriers, from the parking lot to the voting booth, in more than two-thirds of the polling places. But it turns out this was a significant improvement over what GAO investigators had found when it did a similar survey in 2000.
The findings prompted us to call Jim Dickson, an activist who's taught a lot of people about the problem of polling places that often exclude people with various disabilities. Dickson, with the American Association of People with Disabilities, knows a lot about this because of his own advocacy, and because he's got personal experience. He's a blind man and, for years, he had to rely on others to help him fill out a ballot.
The Justice Department alleges a medical technology company and several of its execs fraudulently marketed bone-growth products for unapproved uses. They've been charged with five counts of wire fraud and one count of conspiracy.
Not to be confused with an approved medical treatment. (iStockphoto.com
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The charges against Stryker Biotech, a unit of orthopedics giant Stryker, and some of its executives, say sales managers told customers to use bone-growth putty in all sorts of home-brew "recipes" for patient treatment.
In a statement, Stryker said it is "disappointed with this action and still hopes to be able to reach a fair and just resolution of this matter."
Down in Florida this week, visiting with seniors in a place called Sunrise, House Speaker Nancy Pelosi adopted a shiny new name for the "public option" -- the issue on which hangs the fate of the health care overhaul.
She called it "a consumer option," adding that her moniker was more accurate because "public" implied it would be taxpayer-paid. "Which it is not," she added. But the new lingo will get a lot of use now that the Democrats have unveiled the House's new health bill. (See all 1,990 pages of the bill here.)
But will the new name stick? Not if history has much to say about it.
Today is the day House Speaker Nancy Pelosi is set to unveil the Democrats' unified bill to overhaul health care.
What's in the proposal, which melds the work of three different House committees over the summer? Some form of public option and an expansion of Medicaid for the working poor, allowing people making up to 150 percent of the poverty level to qualify for it, the Washington Postreports.
How much will it cost? The Post writes the House legislation would run up a tab just shy of $900 billion over a decade. It's not expected to add to the federal budget deficit over at least 20 years thanks to some Medicare cuts and new taxes, for what that's worth.
NPR's Julie Rovner says the biggest issue for House Democrats wrangling votes is the flavor of public option to include.
When EMTs brought the 68-year-old man to the Boston hospital, he was in a deep coma. Suspecting a brain hemorrhage, doctors ordered a CT scan and were startled by what they saw. The New England Journal of Medicinereproduces the picture in its current issue, and we feature it here with their permission.
A hemorrhage in an elderly man's brain revealed itself in a startling way. (The New England Journal of Medicine
(c)2009 )
After the scan showed a massive hemorrhage, surgeons decided there was nothing they could do to save the man's life, and his family decided to withdraw respirator care. He died shortly after.
We talked about the spectral image with neurologist Joshua Klein of Brigham and Women's Hospital, who was involved in the case. Here's an edited version of our conversation.
Antipsychotic drugs used in kids can carry a steep health cost. Many children gain an unhealthy amount of weight after just a few months on the medicines.
Research just published in JAMA found the drugs led to weight gains ranging from about 10 to 19 pounds, depending on the medicine, in about 11 weeks. The analysis looked at popular brand-name drugs Abilify, Risperdal, Seroquel and Zyprexa.
The findings confirm what doctors pretty much already knew about the medicines. So why bother? For one, to tell doctors exactly what they can expect to see. Doctors have been prescribing these drugs more and more to kids -- not just for schizophrenia and bipolar disease, but also for attention deficit disorder.
In the battle against obesity, doctors and patients are short on weapons.
Reinforcements may be on the way for the fight against the belly bulge. (iStockphoto.com)
Eating better and exercising more are, of course, the best first choices for shrinking one's waistline. But often they're not enough to get the job done, and stomach-shrinking surgery remains a daunting and costly option.
Now, three small drugmakers are looking to boost the odds of success for dieters with a new crop of medicines the Food and Drug Administration could start assessing by the end of the year. If all goes well, they could be available late next year or in early 2011. But the history of weight-loss medicines is littered with failures and disappointments.
There hasn't been a new prescription-strength drug for weight loss approved by the agency in a decade. But results of large clinical tests of the new medicines show promise, though that's tempered by reports of side effects and historical safety questions.
Want to build muscle, not fat? Forget bellying up to a man-sized sirloin or salmon steak at dinner. New research from physiologists in Texas suggests you'll build more brawn with daintier portions of protein scattered across different meals.
(iStockphoto.com)
In their study, Douglas Paddon-Jones and his colleagues at the University of Texas Medical Branch in Galveston asked healthy adults, old and young, to eat different amounts of lean beef.
They found that there seems to be a cap in the amount of protein that the typical body can use in a single sitting to make muscle. Only the first 30 grams of pure protein in a meal -- or about the amount in four ounces of lean beef, chicken, soy, or dairy -- gets turned into muscle.
"There's so much of this 'more-is-better' mentality in this country," says Douglas Paddon-Jones of the University of Texas Medical Branch in Galveston. "But the message of our research is one of moderation."
Catholics in Boston and many surrounding areas won't be sharing wine during Communion anymore -- at least until threats of swine flu ease a bit.
Not so fast! That communal chalice is a hotbed for germs. (iStockphoto.com)
The Roman Catholic Archdiocese of Boston issued a recommendation to churches yesterday to suspend the sipping of wine from a shared cup during Communion. They also suggest avoiding the traditional hugging or kissing of those in neighboring pews when passing the peace.
Changes to religious rituals have been rumored since the first outbreak of the H1N1 virus. NPR investigated the reaction of several individual places of worship back in September, but yesterday's formal movements by the Catholic Church seem to be some of the strongest strides towards containing the virus in public places. And the recommendations are straight out of the government's playbook.
Figuring out ahead of time what a particular medical procedure will cost is one of the most intractable of problems for consumers.
Fire up your computer for help navigating health costs. (iStockphoto.com)
Hunting around online may help you get a rough idea, though. The Wall Street Journal's Anna Wilde Mathews points to 23 Web sites that can help.
Depending on the procedure, you could save some pretty big bucks by shopping around. One family Mathews talked with trimmed more than $3,000 from the cost of the wife's outpatient surgery by finding a place that charged a lower facility fee than some other centers.
Another reason to start saving your money, or at least consider spending your Golden Years on the Great Plains, is the rising cost of long-term care.
A fresh survey from the health insurance industry shows the cost of all sorts of care--from nursing homes to assisted living communities--continues to climb. Care in some states costs a lot more than others, too.
(iStockphoto.com)
The Mature Market Institute, the research arm of insurer MetLife, just released a survey that shows North Dakota's assisted living costs are the lowest in the nation -- about $2,000 a month, in 2009. The same care in Wilmington, Delaware, where our grandmother lives, averages $5,219 a month. Ouch. We have some questions for the Veep.
With all the questions floating around about swine flu cases and vaccine shortages, we wondered what the Centers for Disease Control and Prevention might tell us at a briefing today.
(CDC)
Turns out, nothing new really. That's because not all that much has changed on the swine flu front. The vaccine is being made by the same companies, the same way, in the same factories as the seasonal flu vaccine that's been used safely for years. And it's still true that the new H1N1 virus has established itself throughout the country, which most of us had sort of figured out just by talking with the neighbors.
So we reflected instead on some of the question we keep getting from NPR listeners and readers of this blog.
Courtesy of Morning Edition host Steve Inskeep, we have a preview of Bill and Melinda Gates' big talk tonight in Washington, D.C., before lawmakers, administration officials and foreign policy experts. The Gateses are in town to drum up government support for global health initiatives, as well as promote their new Living Proof Project.
Bill and Melinda Gates at the International Center for Diarrheal Disease Research in Dhaka, Bangladesh. (Courtesy Gates Foundation)
"Out of 6 billion people, there's about 2 billion that are still outside of that positive cycle of improvement and need the generosity of the U.S. government to get on it," Bill Gates told Inskeep.
A big problem with foreign aid, they told Inskeep, was that Americans don't know that aid does make a difference. "When we travel in places like Africa, we see incredible changes, and incredible signs of hope -- particularly in the area of AIDS or childhood vaccinations," said Melinda Gates. But most Americans, she said, have no idea that their money is having an impact at all. "We hear more the negative stories, and we want to make sure people understand, no, these have been incredible investments."
Senate Majority Leader Harry Reid says he's always looking for Republicans to support his party's policy initiatives but they're hard to find. Yet the move he made Monday may chase away Sen. Olympia Snowe, the only Republican who has so far supported Democrats' efforts to overhaul the nation's health care system.
Sen. Max Baucus talks health care with Sen. Olympia Snowe earlier this month. (Alex Wong/Getty Images)
Reid, who has been trying to merge two Senate committees' health overhaul plans, said he intends to include a version of the "public insurance option" that would allow states to opt out by 2014 if they don't like the program.
But Snowe, the senior senator from Maine, says a public option should kick in only if affordable coverage proved unavailable to 95 percent of residents in any state. She voted earlier this month with Senate Finance Committee Democrats to support chairman Max Baucus's health care legislation, but she said that was not guarantee of her future support.
As a good, caring parent, I decided I should provide my 12-year-old son with the H1N1 vaccine. The District of Columbia Department of Health was kind enough to set up free flu clinics in each of the eight wards that make up this city.
If you look closely, you will not see Joe Palca and his son in this line for a H1N1 vaccine clinic. (Rick Roach/AP/The Reporter)
So last Saturday morning, I dragged myself and my surprisingly agreeable child out of bed at 7:30 so we could go to the clinic in my ward at Wilson Senior High School. I figured if we get there by 8 a.m. when it opened there wouldn't be much of a line. Who gets up at 7:30 on Saturday morning to get a vaccination?
The first hint I had miscalculated were the cars parked a quarter mile from the school entrance. My fears were confirmed when I saw two traffic wardens directing the flow of cars to side streets away from the school.
After the jump: Will Joe Palca's son get his vaccine?
Well, the public option just got another lease on life.
Sen. Harry Reid of Nevada says the public option is back on. (Chip Somodevilla/Getty Images)
Senate Majority Leader Harry Reid of Nevada has now confirmed publicly what's been flying around as rumor for a few hours. A unified Senate bill to overhaul the nation's health system will include a government-sponsored program in the insurance market. In a nod to critics, states that don't want to go that route can opt out.
Reid said a public option is "an important way to ensure competition" and polls show Americans support the approach. Within a few hours the proposal will go to the Congressional Budget Office for the verdict on cost, and we could see the details in a day or two.
Importantly, Reid said he had the support of Montana Democrat Max Baucus and the White House in making the change, signaling the Democrats may now calculate they have a better chance of getting 60 votes in the Senate with the public option than without it.
I liked the way a 74-year-old New York lawyer once described his older years: He told me he was in "the third half of his life." He retired but wanted to find purpose in this new phase of his life. So he ended up starting a legal services group that was providing important help to kids with disabilities.
Purpose Prize winner Tim Will brought broadband to Appalachia. (Encore Careers)
The Purpose Prize recognizes similar people, 60 or older, who have found new purpose in the third half of life by tackling social problems. Sponsored by the nonprofit think tank Civic Ventures, the prizes have become a kind of MacArthur "genius award" for retirees. This year's prizes -- which range from $50,000 to $100,000 -- were announced this week.
Tim Will, 61, was one of this year's 11 winners. The retired teacher moved to a rural North Carolina town and was surprised to see how cut off his new community was from basic Internet service. He helped get a grant to pay for 100 miles of fiber-optic cable that brought broadband service to Rutherford County, including its schools, police and fire departments. Then he started Farmers Fresh Market. It uses that Internet connection to let local farmers sell their heirloom tomatoes and kudzu blossom jelly direct to consumers and Charlotte restaurants. With that, farmers found new markets and urban dwellers got locally grown food.
The Government Accountability Office and the Food and Drug Administration are at it again.
A report from GAO scolds FDA for not following up on studies for some drugs that get approved after data suggest they are effective on a marker that stands in for the course of disease.
This accelerated approval process, established for drugs treating serious illnesses like cancer and HIV/AIDS, is supposed to move medicines along that could save or extend patients' lives. The catch is that these drugs are then supposed to go through "postmarketing studies" to confirm the drugs are safe and effective, so they can stay on the market.
Federal stimulus spending meant to bolster the uptake of electronic medical records could wind up shortchanging hospitals that treat more poor patients, deepening a "digital divide" between the rich and the impoverished.
Plugging into stimulus funds may be tricky for hospitals serving the poor. (iStockphoto.com)
At issue is whether cash-strapped state governments will ante up their share of the money, says a study just published online by the journal Health Affairs. As part of the stimulus package, $30-billion-plus in money for improvements to health IT is available from Washington, but states have to shell out for overhead costs in order for hospitals with lower-income patients to get their piece of the pie.
Hospitals with wealthier patients aren't likely to have funding problems because they'll get plenty of bonus money from the federal Medicare program to cover overhead. Poorer hospitals, though, tend to have fewer Medicare patients, and their stimulus money will be tacked on to payments from the state-run Medicaid programs, which cover the poor. States would have to pay 10 percent of the administrative costs of distributing the stimulus money.
What was supposed to be vaccination time has become finger-pointing time.
Good luck finding some of this. ( Mark Boster/Getty Images)
Day by day, we're learning more about why supplies of a vaccine against swine flu, expected to be a centerpiece of public health, are coming up short. But explanations are small consolation for people who took the vaccination message to heart and have been unable to get immunized against the new H1N1 virus.
As NPR's Richard Knox reports on Monday's Morning Edition, the makers of vaccine didn't realize just how badly production was going until very recently, when they got test kits they needed to assess the potency of the vaccine being churned out--it's been low.
If all the good advice about coughing and sneezing into your sleeve to prevent the spread of flu hasn't sunk in, please take a look at this gripping video from NPR's Robert Krulwich and medical animator David Bolinsky.
Now, you can see how the flu virus--any flu virus--propelled by one man's sneeze--any man's sneeze--infects another poor guy, hijacking a cell to make a whole bunch more virus which could infect you.
The new H1N1 virus is doing a lot of this lately. The Centers of Disease Control and Prevention said Friday that since April, when swine flu first hit, the multiplying bug has caused more than 1,000 deaths and put more than 20,000 people in the hospital. Here's how that gets rolling.
Bonus protection: Flu spreads through handshakes, too, so we offer some alternative greetings that might help curb the pandemic. Personally, we hope the Snap and Flick catches on.
With the Food and Drug Administration cracking down on food claims, the folks behind the controversial Smart Choices logo are taking it off grocery store shelves. The manufacturer-sponsored program, which slaps Smart Choices check marks on the fronts of all sorts of processed foods, is voluntarily suspending operations.
Froot Loops used to be a "Smart Choice."(iStockphoto)
Smart Choices chief Mike Hughes says the decision was triggered by the FDA's recently announced push for a standardized system for front-of-the-package food labeling. Hughes maintains that his group is ready to work with the FDA and that they share the "exact goal" of helping consumers make informed choices for healthy diets.
The Centers for Disease Control is just as unhappy as the rest of us about the tight supply of swine flu vaccine, we heard today.
Nurses in Indianapolis prepare the swine flu vaccine for another overwhelmed clinic.(Darron Cummings/AP)
In an afternoon briefing today, CDC Director Dr. Thomas Frieden talked about the problems, saying the means of vaccine production aren't exactly modern and are definitely not suited to responding to this pandemic.
In short, manufacturers are having more trouble growing the virus for the vaccine than they originally expected. But, Frieden said, the method is the "tried and true" way that seasonal vaccines are produced, so at least we know it's safe.
We're new here in Washington, so most of the political folkways are lost on us. Much of what happens seems like "dynamic equilibrium," one of the few things we remember from high school chemistry class. Lots of little things change, canceling each other out, so nothing big seems to budge.
House Speaker Nancy Pelosi continues to push for a public option.(Lauren Victoria Burke/AP)
So, we wonder, is there really progress on adding a "robust public option" to health overhaul, after a key Senate committee seemed to send the idea to its doom? During the day yesterday, it sure seemed like it, with House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid talking it up.
Today? Not so clear. As Politico's Mike Allen writes today, Pelosi isn't so sure she can get the votes for the government-sponsored alternative she prefers.
Be careful putting iPod headphones and pacemakers on the same playlist.
Keep those earbuds where they belong, for safety's sake. (iStockphoto.com)
The tiny yet powerful magnets that make the big noise in those earbuds and headphones for personal electronic devices can make implanted defibrillators and pacemakers go haywire.
Dr. William Maisel, a cardiologist who founded the Medical Device Safety Institute, and some colleagues tested a bunch of portable headphones, some cheap and some expensive, from local electronics stores. To their surprise, the magnets inside the headphones were up to 20 times the strength needed to interfere with a pacemaker.
In a sign of just how tight the supply of swine flu vaccine is, New York officials said yesterday they are backing down on mandatory vaccination of health-care workers.
People line up for swine flu vaccine in Indianapolis on Thursday. (Darron Cummings/AP)
A controversial state regulation, already blocked temporarily by a New York judge's ruling, has been made moot by the fact that there isn't enough vaccine to get the job done anyway. Now New York will concentrate on vaccinating pregnant women and children, the New York Timesreports. Less than one-quarter of the vaccine expected in New York by the end of October is now on track to arrive.
Same story out west in California, where flu cases are surging and vaccine is scarce. The state is supposed to get 20 million doses of swine flu vaccine this season. So far just 1.7 million doses have made it, the Los Angeles Timesreports, and seasonal flu vaccine is also hard to come by. "It has been an abomination," Marcy Zwelling, a Los Alamitos doctor, told the paper.
Spinach, tomatoes and peanut butter that sickened people across the country in recent years put a spotlight on tainted food as a growing public health problem. The disease outbreaks also revealed gaps in the Food and Drug Administration's ability to ride herd on food safety.
Does one bad tomato spoil the whole bunch? (iStockphoto)
Now Congress is kicking around legislation to boost FDA's authority over food. In Senate testimony today, FDA Commissioner Dr. Margaret Hamburg said the proposal that would help the agency prevent foodborne illness represents a "historic moment for food safety in the United States."
She asked Congress to push ahead with the new law, which has broad support from both political parties, consumers and industry groups.
We've all done it: Sent our kids to school when their noses are still a little bit runny, or gone to work ourselves with a low-grade fever. "It's just a little cold," we tell ourselves. "We'll get over it."
We know we should stay home, but last-minute childcare arrangements and the pileup of work awaiting us if we dare break routine for a day or more seem more daunting than just soldiering on into work or school, armed with decongestant and a box of tissues.
Should I stay home or should I blow at school?
(iStockphoto.com)
But now we're in the H1N1 world, and the risks of soldiering on seem higher. What if our family has been exposed to the new virus but nobody's sick yet? What if we think we're healthy and we're still shedding the virus and able to infect others?
Or even worse, what if we don't have paid sick leave and have to go to work sick because we need to pay the rent?
We want to hear from you for future stories. Have you faced this dilemma and what did you do? Email us your story at:
shots@npr.org.
So where are we today on the question of screening for cancer?
The white arrow points out cancer in this mammogram. (NIH via Wikimedia Commons)
Well, the American Cancer Society is emphatically saying it's not changing its stance on the risks and benefits of screening, contrary to a front-page story in Wednesday's New York Times that said the group is "quietly working" on changes to its Web site that would emphasize "a real risk of overtreating" breast, prostate and some other cancers.
Putting a point on it, Dr. J. Leonard Lichtenfeld, deputy chief medical officer at the group, wrote on his blog:
The American Cancer Society is not working on any stealth project to change commentary on our website to emphasize the shortcomings and risks of screening. If we are, I would know about it, and I haven't heard anything about such a plan. We don't have to. You see, we already discuss these issues right there in plain view, including on this blog.
If your office is anything like ours, more folks and their families are out of commission with the swine flu.
People wait to be vaccinated against swine flu in Rockville, Maryland. (Saul Loeb/Getty Images)
Most places in the country now have widespread cases of the new H1N1 virus, the Centers for Disease Control and Prevention's latest map shows.
We took the threat of swine flu seriously from the start, but now we're fretting just a little bit more as vaccine supplies remain tight, new research indicates people can spread the virus a little longer than first thought and kids keep getting hit especially hard by the bug.
How would doctors across the country actually like an overhaul that brought health coverage to the uninsured? Pretty well, if it rolls out anything like the one in Massachusetts.
Three years after the state enacted a law mandating health coverage for just about everyone, less than 3 percent of people there are uninsured.
So far, so good, doctors say. Seventy percent of more than 2,100 Massachusetts physicians polled recently gave the reform law a thumbs-up. Just 13 percent opposed it; 16 percent didn't know or wouldn't answer the question.
Yes, we know the numbers add up to 99 percent, but that's because of rounding, the pollsters at Harvard School of Public Health say. The results just went up on the Web site of the New England Journal of Medicine.
When a food claims to be a "Smart Choice" or "Heart Healthy," and it's written right there on the front of the package, should you believe it? Not all the time, says the Food and Drug Administration.
Should snacks like these be considered health foods? (Joe Raedle/Getty)
The FDA is taking a long, hard look at companies that tout their products as healthy eating options. The agency is also thinking about a unified healthy label system, maybe like a voluntary one relying on eating "traffic lights" in the UK.
We dug through lists of the purported healthy foods out there now, and you can do the same by searching the online guides for Smart Choices and even the American Heart Association.
Many of the foods seem just fine. But more than a few struck us as misplaced. We compared notes with Michael Jacobson, head of the Center for Science in the Public Interest, an advocacy group that spends a lot of time looking at food issues. Here's a list of six "healthy" foods you might think twice about.
The big challenge in health care isn't always finding a new cure but instead getting doctors to use the ones already out there.
(iStockphoto.com)
Take, for instance, a generic drug to help patients with serious heart failure. Despite advice issued by two leading professional societies for heart doctors in 2005, two years later less than a third of hospitalized heart failure patients who could benefit from drugs called aldosterone antagonists were on them when leaving the hospital. In Europe, about half of such patients are taking the drugs at discharge.
The findings, published in the current issue of JAMA, underscore the continuing challenge of getting doctors to incorporate evidence-based treatments into everyday practice.
To screen or not to screen is becoming a hot question in cancer again. Has the push for early detection of prostate and breast cancer, in particular, been oversold?
A blood test can detect a prostate cancer like this one, but can't necessarily tell whether the cancer is dangerous or not. (Visuals Unlimited/Corbis)
The American Cancer Society is rethinking its stance and working on a more nuanced message that would say screening for breast, prostate and some other cancers carries its own risks: overtreating small and fairly unthreatening cancers and overlooking some deadlier varieties, the New York Timesreports.
Take a listen to ACS's Chief Medical Officer Otis Brawley, whose job is to promote "cancer prevention, early detection, and quality treatment." He tells the Times, "people shouldn't panic over the change, " 'But I'm admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.' "
Press conferences at the Centers for Disease Control and Prevention usually go like this. First, to get onto the CDC's massive campus in Atlanta, stop your car at the security gate. Very serious inspectors then circle about, looking underneath your car with a camera, checking the trunk, and peaking under the hood.
This can occasionally pay off for the reporter. While I was holding up the hood (otherwise it tends to fall on people's heads) before my first CDC press conference, I noticed my radiator fluid level was low. Thanks, CDC!
Once you get into the Tom Harkin Global Communications Center (thanks, Sen. Harkin!), and convince even more serious inspectors to let you in, you walk down a nice, airy hallway to a room with a podium, a lovely midnight-blue backdrop, and black-out shades pulled down so the camera people will be happy.
Today, the room was illuminated by something other than good TV lighting. Travis Stork was there.
Dr. Travis Stork, right, makes a guest appearance on the CBS show Three Rivers. (CBS via Getty Images)
Travis Stork?
OK, you may know him. I didn't. He's on TV. But my TV hasn't worked since stations switched off their analog signals.
Nothing stirs debate quite like the proposition that exposure of young children to mercury might explain the rise of autism and related disorders in recent years.
(iStockphoto.com)
A while back the Institute of Medicine concluded that the mercury-containing vaccine preservative thimerosal couldn't be blamed for autism. Some advocates rejected that finding and have pressed for further investigation.
So we offer, for your consideration, a pretty thorough set of mercury measurements in hundreds of preschoolers that showed no difference between the kids with autism and the kids who were judged to be normal. The findings were just published online by the journal Environmental Health Perspectives.
The government isn't going to kill your Grandma in the new health overhaul bill, but if she's rich, she better get ready to pay more for her Medicare.
Some Medicare beneficiaries may be on the hook higher premiums. (iStockphoto.com)
That's the word that came out, very quietly, from officials at the Centers for Medicare and Medicaid on Friday. Buried in a Federal Register notice (and in a press release that somehow didn't get posted to the agency's website until this morning) is the official news that premiums for Medicare Part B (the coverage for outpatient and physician services) are rising to $110.50 per month next year, up from this year's $96.40.
Now the vast majority--73 percent--of Medicare beneficiaries won't face higher bills. That's because Social Security isn't granting a cost-of-living increase next year, for the first time in more than three decades. The two are connected because the vast majority of Medicare enrollees have their Medicare premiums deducted from their Social Security checks, and, by law, Medicare increases can't result in a net deduction in the amount of that check.
It's dangerous enough to deal with a chronic illness like diabetes or cholesterol. But Americans who don't have health insurance often have these conditions and don't even know it.
Chronic health problems can lurk undetected for the uninsured. (iStockphoto.com)
The result is that the uninsured often don't get the medical care they need to maintain their health, says a study just published online by the journal Health Affairs.
Researchers found that about half of all uninsured people who have diabetes (46 percent) or who have high cholesterol (52 percent) had no idea they had those diseases. By contrast, among the insured, only about a quarter were unaware when they had those chronic diseases (23 percent for diabetes; 30 percent for high cholesterol).
Everybody who works in a hospital should wash his hands frequently. But some hands are more important than others.
A few dirty hands can mess up a whole hosptial. (iStockphoto.com)
One careless health-care worker who has fleeting contact with a lot of patients can undermine everybody else's conscientious handwashing, a group of French researchers has found using a mathematical model to simulate infections in a hospital ICU.
An infection "superspreader" can be a radiologist, a physical therapist, or a specialist who consults on many wards. The key thing is that superspreaders are "peripatetic," roaming a wide territory. Other hospital workers who are more rooted to a particular unit don't do as much damage when they forget to wash their hands between patients.
The time has come for school meals to join the modern nutritional age.
This lunch tray features healthy choices that could become more common. (Peter Cosgrove/AP)
Pile on the fresh fruit, vegetables and whole grains; cut the salt, saturated fat and trans fat, recommends the National Academy of Science's Institute of Medicine.
A report just put out by the IOM offers a roadmap for upgrading the nutritional standards for lunches and breakfasts served under the federal program that subsidizes meals for needy kids. Perhaps the most profound piece of advice is placing a limit on calories, which would be a first.
Guys, if you ask your doctor for one of those heavily marketed pills to treat impotence, the chances are good the answer will be yes.
Internists back use of impotence pills, such as Pfizer's Viagra, for men who seek treatment. (Liu Jin/Getty Images)
It's not just because of all the ads for Viagra, Cialis and Levitra, though we know it's impossible for you or your doctor to avoid them.
As of today, the American College of Physicians, the leading professional group for internal medicine docs, says the medical evidence supports a "strong recommendation" in favor of the medicines as a front-line treatment in men who seek help and don't have medical problems with the pills.
When it comes to our pets' health, out-of-pocket expenses have been just about the only kind until pretty recently. But now there's health insurance for your pet.
For Harriet's owners, the health insurance premiums were worth it. (Kristin Zorbini Bongard)
Who needs it? Well, maybe you, NPR's David Kestenbaum reports. Vets can do so much more for your dog, cat or hedgehog these days, and the bills can pill up pretty quickly.
Your dog can run up a $7,000 tab for reconstructive knee surgery. Brace yourself for the hedgehog's cancer treatment bills, which could hit $2,700.
The appeal of those little pet turtles escaped us, even before we first heard about their role as carriers of disease. Give us a dirty rat any day.
Little pet turtles, like these being inspected at an Atlanta airport in 2006, pose a big salmonella risk--especially for kids. (Ric Feld/AP)
Now our low opinion is bolstered by an in-depth report on a 34-state outbreak of salmonella infections linked to those slimy little reptiles back in 2007 and 2008. Researchers talked with 78 patients or their parents to find out more about the role of turtles in the spread of the dangerous infections. Not a pretty picture.
Most of the folks who got sick--60 percent--were around turtles the week before they fell ill. Sixteen, or 34 percent, said the turtles came from a pet store.
If you had any doubt that President Obama's Food and Drug Administration would take a tougher stance on regulation, you better wrap your mind around the appointment of one of the agency's toughest critics to a top policy position.
Public Citizen, founded by Ralph Nader, has been one of the loudest and most persistent critics of FDA. Lurie has been particularly tough lately on the way FDA reviews medical devices.
In a big switch from the last administration, the Obama Justice Department won't go after users or suppliers of medical marijuana who comply with state laws.
A customer shows medical marijuana she received free at the Roscoe Compassionate Collective in Canoga Park, Calif., in July. (Genaro Molina/AP/Los Angeles Times)
The Associated Press reports new guidelines making the change official are expected to go out to federal prosecutors today. Sellers and smokers in 14 states that allow pot to be used for medical reasons, including California and Maryland, will be able to breathe a little easier from now on.
A couple of unnamed Justice Department officials told the AP that it's a waste for the feds to arrest pot users and their suppliers when they're in compliance with state laws.
Sometimes how journalists cover a story becomes part of the story.
Click on the image for an interactive map from NPR showing the uninsured by state and congressional district.
Recently, NPR health editor Joe Neel, who sits just down the way from us, put together an email that went to member stations with some guidance on how best to characterize the number of uninsured in this country.
The email spread and led to a fair amount of chatter on Twitter and a piece by the Business & Media Institute.
So in case you're interested, we figured we'd give you the full text to chew on. The bottom line: about 46 million in the country are uninsured , but about 16 million aren't citizens.
The feds have told a company associated with alternative health guru Dr. Andrew Weil that it has crossed the line by selling an unapproved product for warding off the swine flu.
The FDA questions the evidence behind the herbal remedy astragalus as a cure-all for H1N1. (Wikimedia Commons)
In a stern warning letter, the Food and Drug Administration and Federal Trade Commission told Weil Lifestyle LLC to stop marketing a dietary supplement called "Immune Support Formula" as a product that could "diagnose, mitigate, prevent, treat or cure the H1N1 Flu Virus in people."
The regulators pointed to a bunch of health claims on the Web they say are unsupported. Take a look, they said, at a page on the site Dr.Weil.com titled, "The Swine Flu- H1N1," and subtitled, "Swine Flu and You." The original page appears to have been taken down, but you can see an screengrab of the pagehere.
Our email and calls to Weil Lifestyle LLC for comment weren't returned immediately.
What bugged the regulators? For starters, the following advice attributed to Dr. Weil:
"[D]uring the flu season, I suggest taking a daily antioxidant, multivitamin-mineral supplement, as well as astragalus, a well-known immune-boosting herb that can help ward off colds and flu. You might also consider. .. the Weil Immune Support Formula[,] which contains both astragalus and immune-supportive polypore mushrooms ...."
After a week of mounting questions about radiation overdoses at Cedars-Sinai Medical Center, the CEO of the hospital late yesterday expressed deep regret over problems with CT scans that overdosed more than 200 patients and called the situation "unacceptable."
Cedars-Sinai details steps it's taking to avoid future radiation overdoses from imaging tests. (Ric Francis/AP)
Over the last year and half, the Los Angeles hospital exposed patients with suspected strokes to about eight times the expected radiation dose during diagnostic CT scans. Only after a patient complained in August about losing hair following a scan did the hospital realize the problem.
Besides apologizing, hospital CEO Thomas Priselac detailed in a statement the steps the hospital would take to avoid future mishaps. At the heart of the radiation problem were changes hospital staff made to override standard settings of the CT machine. Now those sorts of modifications will require more stringent controls.
If you're worried about swine flu, resist the temptation to stock up on dubious medicines being hawked online.
The Food and Drug Administration ordered a bunch of stuff on the Web recently that was supposed to fight or prevent the flu and doesn't recommend you do the same.
One package from India that should have contained the flu-fighter Tamiflu, or oseltamivir, instead had some plain, white tablets that turned out to be a mixture of talc and acetaminophen. The Web site where the meds were offered "disappeared" shortly after the FDA placed its order, the agency said.
Other shipments included products that contained some oseltamivir but they weren't approved for sale in the US.
The FDA has come up with a neat little widget (check it out on the right) to help people separate the impostors from the real deals when it comes to H1N1 products.
The gas, a byproduct of some kinds of combustion, is colorless, odorless and binds to the hemoglobin in your blood so tightly that oxygen, the usual passenger on the protein, can't get on board. Breath enough carbon monoxide and you suffocate.
While high concentrations of the gas can kill you, some scientists believe a little bit, say 5 or 10 percent of the lethal level of CO might just help combat inflammation, a big problem in a wide range of diseases, the Boston Globe reports.
When health questions crop up, the first resource for answers is often the family doctor. But if eating right is on your mind, how would you feel if the doctor's professional society is taking money from the soft-drink industry?
Should Coke pay your family doctor to tell you what to drink? (Justin Sullivan/Getty)
The American Academy of Family Physicians just inked a controversial deal with Coca-Cola to develop educational material for consumers on the beverages that have made the company a mint.
It's the first corporate alliance for AAFP. President Dr. Lori Heim wouldn't disclose the exact amount involved but said the medical group would receive an amount "in the strong six figures."
For the money, the doctors' group will provide info on how people can "incorporate sweetened, unsweetened and artificially sweetened beverages into a healthy lifestyle," Heim said.
Just because mom always taught you to wash up after doing your business doesn't mean you heed her sound advice. Now some British researchers have found the next best thing to mom looking over your shoulder in the bathroom may be prompting a stranger to do it for her.
What's it going to take to get you to wash with soap? ( iStockphoto.com)
The researchers found that provocative signs posted outside bathrooms to shame people into washing their hands with soap are much more effective than traditional gentle reminders. "The good old worthy health messages don't work anymore, no one's listening," says Val Curtis, a hygiene specialist at the London School of Hygiene And Tropical Medicine. "So we're trying to do things that are a little edgy, a little rude."
Indeed, "Is the person next to you washing with soap?" was the bathroom slogan that spurred the biggest bump in soap use, according to work done by Curtis and colleagues. For both men and women, the idea of someone watching and judging was the most powerful way to boost handwashing.
Almost four decades after the Surgeon General first suggested secondhand smoke causes heart attacks, the National Institute of Medicine says there's no doubt about it.
Snuff 'em out, if you've got 'em. (iStockphoto.com)
The experts rest their case on 11 studies that looked at heart attack rates after communities banned smoking in public. They all showed the same thing--a pretty quick drop in heart attacks, ranging from 6 to 47 percent, depending on the study.
The 11-member IOM panel was especially struck by two studies -- one from Monroe County, Indiana, the other from Scotland. They showed a clear benefit of public-smoking bans on nonsmokers.
Here we go again. Another stolen laptop, and a whole bunch more personal data that could be used for no-good.
What's up, doc? Maybe your personal data online. ( iStockphoto.com)
A computer belonging to an employee of the Blue Cross Blue Shield Association got filched from a vandalized car in August, the Chicago Tribunereports. On the laptop: personal info on hundreds of thousands of doctors and their practices, including, in some cases, such details as Social Security numbers and ID numbers used by insurers to pay docs.
Nearly all practicing docs in the country, or about 800,000, have been warned about the breach.
So when the swine flu hits, should the doctors and nurses at your local hospital make do with regular old surgical masks to keep the new H1N1 virus at bay or go with a beefier and more costly respirator?
N-95 masks, like this one being demonstrated at an Oakland, Calif., clinic in April, are hot commodities. (Justin Sullivan/Getty Images)
The question has sparked heated debate between health-care workers and infection control specialists. The dispute centers on N-95 respirators.
They look a lot like ordinary surgical masks but they're thicker, they fit tighter and they filter out at least 95 percent of all viruses. The fancier masks also cost more. And they're in increasingly short supply.
Front-line health care workers and their unions want personnel to be fitted with N-95s. Now the Centers for Disease Control and Prevention has sided with them. The public health gurus just posted new advice on the best ways to protect health care workers against the new H1N1 flu virus and recommends the N-95, or equivalents, for people workig closely with "patients with suspected or confirmed 2009 H1N1 influenza."
Abortions are becoming less common around the world, even as more countries ease abortion laws.
In a report looking at abortion trends around the world, the Guttmacher Institute, a non-profit reproductive rights organization, estimates that the number of abortions worldwide dropped to about 42 million in 2003 from a little over 45 million in 1995.
The decline shows "legal abortion does not cause abortion," Sue Cohen, director of government affairs at Guttmacher tells us. "And illegal abortion does not make abortion go away."
Only after a patient complained in August about losing some hair following a CT scan did Cedars-Sinai Medical Center realize more than 200 people had been exposed to excessive radiation from diagnostic tests performed there in the last year and a half.
Cedars-Sinai Medical Center in Los Angeles, where more than 200 patients were exposed patients to excess radiation during CT scans. (Ric Francis/AP)
We first heard about the problem, involving doses as much as eight times normal, when the Food and Drug Administration issued a cryptic warning to hospitals last week, urging them to be on guard for excessive radiation doses from CT scans for stroke.
But the advisory didn't name the hospital or maker of the scanner involved. General Electric made the scanner, we later learned.
Now we know those details, but we still don't have a definitive answer on how a scanner being used to diagnose strokes delivered enough radiation to redden skin and cause hair loss in some patients. The FDA told us today that it's continuing to investigate both user errors and the scanner itself.
We've heard plenty of civilians questioning whether to get vaccinated against swine flu. The Centers for Disease Control and Prevention says the answer is pretty much, "Yes, you should." For those on the fence, new data show otherwise healthy people account for almost half the cases of swine flu that land people in the hospital.
One of these vaccine syringes has your name on it. ( Scott Olson/Getty Images)
So it's all the more mystifying to learn that large numbers of health workers--who have a high risk of catching the new H1N1 virus and passing it on to the vulnerable--are balking. These health pros are precisely the people who should know the score on vaccines, right?
Evidently not. After 40 years of talk, New York health authorities are now making vaccination against seasonal and swine flu mandatory for health workers, NPR's Richard Knox reports. Decades of a soft-selling never got even 40 percent of workers in New York to get flu shots.
There's nothing quite like a landmark Senate vote to focus the minds of folks worried about how changes to the nation's health system could hurt their livelihoods.
Karen Ignagni, president of America's Health Insurance Plans, says current plans for health overhaul would raise insurance premiums. (J. Scott Applewhite/AP)
Leaders of the attack pack: insurance companies. And the administration, which this summer cast overhaul largely as insurance reform, has been fighting back pretty hard. The Washington Postsays, "What was a tenuous truce has turned quickly into an all-out battle, with both sides ratcheting up the hostilities."
We're not against any overhaul--just this overhaul, the insurers say. Karen Ignagni, president of the trade group America's Health Insurance Plans, stopped by NPR's All Things Considered Tuesday to defend a controversial report commissioned by the industry that said premiums for just about everyone will go up, if final legislation looks like the version just passed by the Senate Finance Committee.
Good health is no guarantee swine flu won't put you in the hospital.
Swine flu can knock out just about anyone. ( Michael Krinke/iStockphoto.com)
Nearly half of adults hospitalized with swine flu didn't have asthma or any other chronic health problem, the Centers and Disease Control and Prevention has found after looking at 1,900 cases of confirmed swine flu in grown-ups and children.
The new H1N1 "virus can be serious, even in healthy people with no underlying conditions," the CDC's Dr. Anne Schuchat said in a briefing. "Some totally healthy people suffer this very rapid deterioration."
Maine Republican Olympia Snowe ended the suspense and said she would vote yes on the Senate Finance Committee's health bill.
Sen. Olympia Snowe (R, Maine) beams after saying she would vote for the Senate Finance Committee's bill to overhaul health care. (Charles Dharapak/AP)
She made Sen. Max Baucus's day, and maybe his summer and fall, too. The Finance chairman finally has a Republican vote to show for his deliberate and compromise-laden approach to remaking the health system. "When history calls, history calls," she said.
But don't get carried away, Snowe warned. She could change her mind and vote nay down the road, if health legislation takes a different shape. "My vote today is my vote today," she said.
Scan highway billboards, flick on your TV or listen very long to the radio and you'll probably come across an ad from a hospital touting robot-assisted surgery as the way to go for treating prostate cancer.
A surgeon hunches over the console of a surgical robot. ( Intuitive Surgical)
The main selling point boils down to a promise of precision. An unflappable robot allows a surgeon to operate through tiny incisions and make such careful work of prostate removal that dreaded side effects--impotence and incontinence--are vastly reduced compared with a surgeon operating alone. Right? Wrong, say researchers who analyzed years of data on experience with the gee-whiz technology.
A study just published by JAMA suggests older men whose prostates were removed with a robot's help actually have greater chances of being impotent or incontinent than if they had the surgery done the relatively old-fashioned way. After adjusting for all sorts of factors, the researchers found a diagnosis of incontinence after surgery was 30 percent more likely in the robot group and impotence was 40 percent more likely.
Just about everybody, including us, is pretty sure the Democrats on the Senate Finance Committee will all vote to move along the health bill championed by Chairman Max Baucus. That should get the procedural job done.
Sen. Max Baucus talks health care with Sen. Olympia Snowe. (Alex Wong/Getty Images)
But what about the fig leaf of bipartisanship? Baucus labored long and hard to get at least one Republican on board. His last shot is Maine's Olympia Snowe.
She's sympathetic to Baucus's aim to extend health care to the uninsured. Bloomberg weighs in with a profile of Snowe, orphaned at 9 and long known for her independent streak.
Many people thought this day would never come. And despite duelingstudies about the impact released over the weekend, the Senate Finance Committee votes on a bill to revamp the nation's health system.
The Senate Finance Committee gets down to the numbers that matter most--votes. (iStockphoto.com)
So we've assembled a few fun numbers to help you wrap your heads around the progression of events.
Eleven months ago, Senate Finance Committee Chairman Max Baucus unveiled his "white paper," outlining his vision of an overhauled health-care system.
Five months ago, Baucus went behind closed doors with a core groups of three Republicans and two fellow Democrats -- the infamous Gang of Six -- to see if he could craft the only bipartisan health bill in Congress.
Three weeks ago, he acknowledged that significant bipartisan agreement on this issue was not gonna happen and brought a more Democratic measure to the committee.
While Congress haggles over the details of a massive health-care overhaul, at least a few people will no longer have to worry about losing their health insurance if they get sick: college students who are still covered under their parents' health plans.
Standing behind a picture of her daughter Michelle, AnnMarie Morse talks about Michelle's Law with U.S. Rep. Paul Hodes, D-NH. (Jim Cole/AP)
Today a law Congress passed last year becomes effective. It's known as Michelle's law, after Michelle Morse, a New Hampshire college student who was diagnosed with colon cancer in 2004.
After her diagnosis, the Morse family discovered something sad and tragic about most health insurance policies -- young adults over 18 usually can't stay on their parents' plans unless they're full-time students. But if they develop a serious illness and drop out of school, they probably can't get their own health insurance, either.
Now we have the official number for how much reforming the nation's medical malpractice system could save: $11 billion this year.
Is 0.5% of health spending a lot or a little? (iStockphoto.com)
How you see the estimate, just issued by the Congressional Budget Office, is something altogether different.
Aha! say the advocates of caps on malpractice and other measures to rein in suits against doctors. That $11 billion is real money. And there's the $59 billion in deficit reduction over a decade, the CBO estimates."That's not chump change," Republican Sen. Chuck Grassley of Iowa said in a statement. "It's a no-brainer to include tort reform in any health care reform legislation."
As Washington wrangles over how to expand health coverage, some folks are taking direct action to help the uninsured right now.
People wait to be screened for a chance at free surgery in Pueblo, Colo. (Cameron Allen)
This Saturday in Pueblo, Colorado, more than 40 people are expected to have surgery free of charge for everything from bad gallbladders to balky knees. There will even be a few vasectomies and tubal ligations.
It's another charity treatment marathon on US soil involving groups that used to think more about helping impoverished people overseas. Similar though much larger events in Los Angeles and Virginia have shined a light on the plight of the uninsured.
We figured this would be a good time to listen in on the weekly briefing by the Centers for Disease Control and Prevention on the latest news on the H1N1 pandemic. We've got some jazzy hold music now but should be rolling shortly.
Today, we're supposed to hear from:
Dr. Anne Schuchat, Director, National Center for Immunization and Respiratory Diseases, CDC
Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases, NIH; and,
Dr. Jesse Goodman, Acting Chief Scientist and Deputy Commissioner, FDA.
Update: The CDC posted a transcript of the briefing here.
So Sen. Max Baucus and the Democrats on the Senate Finance Committee are feeling pretty good about cobbling together an overhaul bill that came in at a relatively affordable $829 billion over 10 years.
Will the young and healthy jump into an overhauled insurance pool? (iStockphoto.com)
But some of the compromises to pull that off are drawing fire now. Namely, slim subsidies for the middle class and a last-minute pullback on penalties for folks who skip buying insurance.
"You need everybody in the insurance pool to make sure that premiums are affordable," Alissa Fox, a senior vice president with the Blue Cross and Blue Shield Association, told NPR. "And lowering the penalty will mean that people will find it more advantageous to pay a very small penalty than to buy insurance."
Mandatory flu vaccination for health-care workers looks like an idea whose time has come.
Vaccines are giving the drug business a shot in the arm. (Thierry Zoccolan/Getty Images)
Local health authorities and major hospital groups are giving up on more than a quarter-century of cajoling health workers to get vaccinated voluntarily. Increasingly they're saying: get vaccinated, wear a mask during flu season, or find another job.
So far New York State is the only state that's requiring hospital and clinic workers to get flu shots (or nasal squirts). But Hospital Corporation of America, the nation's leading hospital chain, mandates flu shots for its 120,000 workers. So do Barnes Jewish Hospital in St. Louis, MedStar Health in Baltimore/Washington, and now the UC Davis Health System does too.
Some require only seasonal flu vaccination, others are mandating vaccine against the new H1N1 virus when that's available.
Scientists have discovered a virus that might unlock the mystery of chronic fatigue syndrome, a debilitating illness that affects 1 million Americans.
Laura Hillenbrand, author of "Seabiscuit," has suffered from chronic fatigue syndrome for 23 years. (CFIDS Association of America)
Research published today in the journal Science Express found two-thirds of patients with chronic fatigue syndrome were infected with a virus called XMRV, which copies itself into cells' genetic code. Only four percent of healthy patients tested were infected with the retrovirus. While not definitive, the findings offer a promising avenue for further research and fresh hope for patients.
We checked in with writer Laura Hillenbrand, author of the best-seller "Seabiscuit," about the news. Hillenbrand, 42, has struggled with chronic fatigue syndrome since she was 19. Her symptoms, including pain and vertigo, have been so severe that she's only left her house twice in the last two years. Here are the edited highlights of our conversation.
The life-saving value of mammograms has been debated a lot, causing some women to question recommendations for annual exams.
The white arrow points out cancer in this mammogram. (NIH via Wikimedia Commons)
Skeptics might consider data researchers are presenting in San Francisco today showing higher breast cancer mortality in women who didn't have mammograms compared with those who did.
Dr. Blake Cady and his coworkers looked at nearly 7,000 Massachusetts women diagnosed with invasive breast cancer in the 1990s.
Thirteen years after diagnosis, 461 women had died of breast cancer. And this is where it gets interesting. Three-quarters of the deaths occurred among women who didn't get regular screening mammograms, the kinds of scans done to detect a cancer early. Among those who got the tests, only one in four died.
Nobody will make much progress in taming health-care spending in this country without getting doctors on board.
A medical mystery unraveled in Lewiston, Maine. (NPR/John W. Poole)
In the first installment of a series on escalating health costs, NPR's Alix Spiegel takes a look at the curious case of Lewiston, Maine, where back in the 1970s so many women were getting hysterectomies that 70 percent of female residents were likely to have had one by the time they reached 70. In a nearby town the hysterectomy rate was more like 25 percent.
How come? The big difference wasn't the patients, it was the doctors. The ones in Lewiston recommended hysterectomies far more often than their peers elsewhere.
In the end, all health care is local. Where you live continues to makes a big difference in your health status, access to care and how much that care costs.
Click on the image for an interactive map. (Commonwealth Fund)
In a state-by-state scorecard put together by the nonprofit Commonwealth Fund, Vermont comes out at the top of the heap. The Green Mountain state was the only one to score in the top quartile on five key measures: access to care, prevention and treatment, avoidable hospital use and cost, fairness, and health status.
Bottom of the list? Mississippi, which scored in the lowest quartiles across the board.
The most anticipated numbers since the tally of votes in this year's "American Idol" are out: the Congressional Budget Office score of the Senate Finance Committee's health overhaul bill.
And the news for Chairman Max Baucus (D, Mont.) is mostly good. CBO says his revised overhaul plan would cost a total of $829 billion over 10 years, well under the $900 billion goal set by President Obama. (See the CBO blog here for more info and read the letter here.)
Even better, the CBO figures the Baucus plan would reduce the federal deficit by $81 billion over the next decade. Although CBO isn't really supposed to make projections longer than 10 years into the future, the number-crunchers expect the bill would probably reduce federal deficits beyond 2019, too. All that bodes well for a committee vote by the end of the week to send the bill to the Senate floor for debate.
Depending on where you work, your weight could be an important preexisting condition that determines how much you'll have to kick in for health coverage.
(iStockphoto.com)
More and more bosses are tying employees' share of insurance costs to their BMIs. That's Body Mass Index, a number calculated by comparing your height to your weight. Experts consider a BMI of 30 or greater to qualify a person as obese. Around 19-25 is considered normal, and less than 18.5 is underweight.
NPR's Morning Edition reported Tuesday about grocery chain Safeway charging employees about $318 more a year for health coverage if their BMI scores are above 30. Alabama has already adopted a similar approach for state employees, where workers with BMIs of 35 or more face surcharges of $25 per month. North Carolina is headed down the same road.
Wondering if you have swine flu and should head to the doctor or emergency room?
This flu quiz won't hurt a bit. (Microsoft)
A few weeks ago we wrote about work on a series of questions and answers to help you puzzle out whether or not you've come down with the new H1N1 virus and need immediate help. Now the self-service quiz is ready for prime time.
Microsoft is offering it up here. So are the feds on the flu Web site here. And other sites may host it soon, too.
When you report about health and science you bump into press embargoes almost every time you turn around. In exchange for advanced notice about some scientific development, reporters agree to hold off writing about the findings until the medical journal, government agency or academic outfit fires a starting gun for everyone.
Who gets to tell medical stories first? (iStockphoto.com)
But the system, which is supposed to lead to better reporting on complicated subjects, is under attack, as some within journalism question the relevance, value and fairness of embargoes in the Internet age.
So you got the message and want to get flu vaccine for your family. That might be easier said than done--especially for the regular old seasonal flu.
Finding a shot against seasonal flu may be a challenge right now. (iStockphoto.com)
Shortages of seasonal flu vaccine and a preponderance of the new H1N1 virus are leading to the cancellation of some vaccination drives for run-of-the-mill influenza, as we just found out in our own backyard.
The health department in Montgomery County, Maryland, told parents that it's halting school-wide seasonal flu vaccination until further notice.
How come? For starters, 99 percent of the flu in Maryland right now is H1N1. There's also not enough of the FluMist nasal-spray vaccine for seasonal flu to go around. Finally, the H1N1 vaccine is coming sooner than expected, so the county wants to focus on that threat.
When we think vaccines, it's usually as a defense against infection from a nasty bug like the new H1N1 flu virus or even HIV.
(iStockphoto.com)
But researchers say they're making progress on a vaccine to fight dependence on cocaine. You read that right--a vaccine that would help people curb cocaine use.
How would it work? A vaccine could prompt the production of antibodies to grab cocaine in the bloodstream and keep it from the triggering pleasure in the brain. Do that, the researchers hypothesized, and you might dull the interest in a cocaine fix, making it easier to shake the habit.
Leafy greens, tomatoes and eggs, oh my! We were almost too scared to eat lunch today after reading a report that included those three favorites of ours among the 10 Riskiest Foods Regulated by the Food and Drug Administration.
Should this salad scare you? (iStockphoto.com)
The Center for Science in the Public Interest compiled the list , which they called the "tip of the iceberg" on foods that can spread disease. As far as risky chow goes, the other baddies are tuna, oysters, potatoes, cheese, ice cream, sprouts and berries. Gulp. Is nothing safe?
When it comes to swine flu, many people wonder if the vaccines hurried into production are safe? We only learned of the H1N1 virus early this year and now the US is bent on immunizing almost everyone in the country.
Don't worry and roll up your sleeve, WHO says. (iStockphoto.com)
This vaccine seems to have been rushed to market. Although this has been FDA approved, the FDA has a great track record of approving drugs only to have them pulled from the market due to complications. How can we be sure this vaccine will not have some major side effects as the 70's vaccine did. And do you feel that the fact that the Secretary of Health and Human Services has granted the manufacturer immunity from potential legal proceedings is any cause for alarm to Not get this vaccination?
If you feel nickled and dimed by baggage charges and overdraft fees, watch out for the bill you get for an MRI scan performed at the local hospital's imaging center.
Beware of hidden fees when you go for outpatient care. (iStockphoto.com)
Many hospitals are now levying separate charges for the use of outpatient facilities--for everything from eye exams to the removal of cysts. "It's like a barber saying, 'That'll be $20 for a haircut and $10 for sitting in my chair,' " Wisconsin state Rep. Chuck Benedict told Kaiser Health News.
Insurers often decline to pay the fees, leaving you with a hefty bill. Kaiser's Sandra Boodman reports the fees can run into the thousands of dollars.
We're all tempted, but it's generally risky to take medications that have passed the expiration date listed on the package. It's common sense.
To toss or not to toss? (iStockphoto.com)
But when it comes to swine flu, the federal government, worried about the availability of treatments, has other ideas.
HHS Secretary Kathleen Sebelius last week gave states access to 300,000 doses of liquid Tamiflu from the government's strategic storehouse, for use in children. Some of the drugs are as much as three years past their expriation date. A government official says the Food and Drug Administration has tested the expired lots and they're fine.
Rate this! Consumers Union, the nonprofit publisher of Consumer Reports, is throwing its weight behind a health overhaul.
How come? Well, take a look at the results of a national poll by CU that found 51 percent of Americans have had to make a tough choice regarding their health and cost in the past year. Those choices were such things as not going to the doctor when they should, skipping out on medical bills, or deciding not to take needed medicine because of the expense.
To make its stance clear, CU, which has an active consumer advocacy arm, is launching a TV ad in support of health reform. That's a first for a policy issue in the organization's 73-year history.
"Many Americans are one pink slip--or one major illness away--from losing their health coverage," says Consumers Union President Jim Guest in the TV spot. "Washington, the time for health care reform is now."
Swine flu is back, and the first vaccines against the H1N1 virus will soon be on their way.
What do you want to know about swine flu? (CDC)
But how's the flu pandemic shaping up as fall returns to the Northern Hemisphere? What's the difference between the sprayed and injected vaccines? Who should get immunized first and who can wait?
We'll tackle questions like those in an online chat at noon eastern time on Monday, Oct. 5. Bookmark this post and come back here then with the questions you want answered.
NPR's swine flu czar Richard Knox will be on hand after a morning segment on Morning Edition that will feature a few questions and answers.
We'll be joined by Dr. Richard Wenzel, professor and chair of internal medicine at the Medical College of Virginia, Virginia Commonwealth University, in Richmond.
How many kids have autism or related disorders? Ask parents, as federal researchers did recently, and you come up an estimate of about 1 in 100, a figure quite a bit higher than the 1-in-150 estimate from just a few years back.
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What do parents know? Well, the results from the telephone survey, published in the academic journal Pediatrics, are in line with some unpublished work by the Centers for Disease Control and Prevention that was flagged on Friday.
The prevalence of autism spectrum disorders, comprising autism, Asperger disorder and other less specific diagnoses appear to be on the rise. The Pediatrics study's estimate of the raw data boiled down to 1 in 91 kids between 3 and 17 years old and 1 in 110 when adjusted for survey technicalities like cellphone vs. land-line use.
Three Americans, two of them women, share the Nobel Prize in Physiology or Medicine this year for their work on how cells minimize damage to chromosomes when they are copied during reproduction.
Telomeres (stained yellow) cap chromosomes (stained blue) . (UCLA)
You may never had heard of telomeres (protective caps on the ends of chromosomes), telomerase (the enzyme that builds the caps), or the names of the winning scientists. But if you were a closer watcher of the Lasker Awards, the preeminent American prizes for biomedical research and a leading indicator for Nobeldom, you might have seen this coming.
Three years ago, the Lasker for work in basic science went to today's Nobel prize winners: Elizabeth Blackburn, from the University of California, San Francisco; Carol Greider from Johns Hopkins University; and Jack Szostak from Massachusetts General Hospital in Boston.
On a Kimmel dare, the musician T-Pain used his eponymous iPhone app "I Am T-Pain" to remix highlights from President Obama's speech to a joint session of Congress and some other clips for musical comic effect. Maybe the president should have thought of this himself.
People with disabilities are one-and-a-half times more likely to be the victims of violent crime than are people without disabilities, says the first national study to compare crime rates.
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The results, just released by the Justice Department, are disturbing. But they come as no surprise to those who work with people with disabilities. For a long time, they've known about this particular crime problem, at least anecdotally.
Sometimes cases get national attention, like the abuse revealed earlier this year at a state institution in Texas where workers trained and hired to care for the vulnerable adults there goaded them into fighting each other for the entertainment of the staff. Two of the staffers in the "human cock fight" case were recently found guilty and given prison sentences.
Now we can show you the little helpers Senate Finance Committee Chairman Max Baucus has leaned on during the mind-numbing mark up of his bill to overhaul health care.
As NPR's Julie Rovner wrote yesterday, the Montana Democrat has kept his bearings the last couple of weeks with two cheat sheets--one to keep him smiling and the other a reminder to beware of Republican blandishments.
Sen. Max Baucus reveals his secret cheat sheets. (Evan Vucci/AP)
If you have trouble reading them, the sheet on the left has a smiley face with a curlicue of hair and the one on the left bears the message, "Do Not Take The BAIT!!"
Finally, a health bill looks ready to head to the Senate floor from the Finance Committee, last of the five congressional panels crafting a plan to overhaul the nation's health system.
Sen. Max Baucus talks health care with Sen. Olympia Snowe. (Alex Wong/Getty Images)
Yeah, we know the Congressional Budget Office still has to crunch the figures and a final vote won't come until next week. But, the two-week markup, called a "death march" by one reporter who gets out undying respect for sitting through it all, ended a little after 2am Friday morning in Washington.
The Democrats, with a 13-10 majority on the committee, can pass the bill on no matter what the Republicans have to say about it. Soon we'll get the big-time debate of the full Senate. What will they chew over?
We admit from the start that we're torturing the numerical metaphor by comparing "Beverly Hills, 90210," a trashy TV pleasure of ours from yesteryear, with "90470" a new billing code for swine flu immunization and counseling.
Do you want counseling with the shot? (iStockphoto.com)
But the neurons linking those two ideas in our blog-addled brain were the first ones to fire when we read the American Medical Association's announcement of billing codes for swine flu vaccination. So move over "90210," here comes H1N1.
In case you didn't know, the AMA, among other things, is the keeper of the codes that docs use to document their work and get paid for it.
Among those most eagerly awaiting the swine flu vaccine due soon are college kids. And for good reason. The virus hits young people hard and is spread easily in close quarters like dorm rooms, stadium bleachers and frat parties.
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But after a quick start on many campuses, swine flu took a bit of a breather last week. The latest numbers of flu-like illnesses on campus shows a slowing pace of infection.
Last week, Sept. 19-25, only 6,527 new cases of "influenza-like illness" were reported across the country, according to the American College Health Association, which has been tracking flu since the year began. The latest figures boil down to 20.1 cases per 10,000 students--19 percent lower than the previous week's rate. And only 11 of those students had to be hospitalized.
We've been wondering if the Senate Finance Committee will ever finish putting Chairman Max Baucus's health bill through the wringer.
Why is Sen. Baucus smiling? (Win McNamee/Getty Images)
The debate may end today or tomorrow, we learned a little while ago, with a vote sometime next week after the Congressional Budget Office slices and dices the numbers on the revised bill.
So how is Baucus, a marathoner, dealing with the longest markup by the committee in 15 years? He gets help from a couple of cheat sheets he keeps in front of him on the dais.
One has a little smiley face on it, with a single curly piece of hair sticking out. He says it reminds him to "keep smiling."
As the debate over health overhaul plods along in the Senate, what are the odds something will actually get done?
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Some point to Massachusetts, a trailblazer that legislated universal coverage three years ago, as an example of what can be done. But Kaiser Health News' Jordan Rau reminds us not to forget California, where Republican Gov. Arnold Schwarzenegger tried mightily and futilely to cover the uninsured.
What went wrong? Proponents of change failed to do enough soon enough to win support from Republicans. The left wasn't on board either, arguing Schwarzenegger's proposals weren't adequate. Then there were the budget problems--California's budget woes led to tension over how much to subsidize coverage for less-well-off folks.
Coming soon: calorie counts on the front of the cans. (Justin Sullivan/Getty Images)
Answer: the classic version packs 140 calories into 12 ounces.
But soon you won't even have to turn the can around to find out. Coca-Cola says it's going to put "energy" information on the front of almost all its product packaging around the world by the end of 2011. The company is making the changes in the US now, after doing so already in Australia, Europe and Mexico.
How come? "Now more than ever, people expect facts about the products they consumers to be both readily available and visible," Muhtar Kent, Coca-Cola's CEO said in a statement. There's also more and more chatter about taxing sugary beverages to fight obesity.
