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Obesity raises women’s risk of rheumatoid arthritis
When talking to patients about health risks associated with being overweight or obese, physicians should discuss rheumatoid arthritis, says the lead author of a recent study. People with a history of obesity have a 1.2 times greater risk of developing the autoimmune disorder than those who have maintained a healthy weight, according to the study published online April 18 in Arthritis Care & Research. The risk is greater for obese women than men, but the reason for that is unclear, said lead study author Eric Matteson, MD, MPH. The study defined obese participants as those who had a body mass index of 30 or greater. The findings come when the prevalence of rheumatoid arthritis is increasing among women after 40 years of declines, the study said. Obesity also continues to rise among Americans, with 36% of adults and 17% of children and adolescents considered obese, according to the Centers for Disease Control and Prevention. “We can add rheumatoid arthritis to the very long [Read more]
Omega-3 intake linked to lower levels of protein associated with Alzheimer’s
A diet rich in omega-3 fatty acids might help slow the surge of new Alzheimer’s disease cases expected in the next few decades as the nation’s elderly population grows, a study suggests. People who consume the most omega-3 have the lowest blood levels of beta-amyloid, a protein fragment associated with Alzheimer’s, according to the study published online May 2 in Neurology. But the cause of this relationship is not yet clear, said first study author Yian Gu, PhD. The most common sources of omega-3 among study participants were fish, margarine, nuts, poultry and salad dressing. “This is not a clinical trial,” said Gu, associate research scientist at Columbia University Medical Center in New York. “It’s an epidemiological study, so we have to be very cautious about making recommendations [for health professionals based on the results]. But physicians should stay tuned and see what we find in our follow-up study.” An estimated 5.4 million Americans, including 2 [Read more]
Massachusetts Legislature starts moving on payment reforms
Massachusetts lawmakers in the coming months will be seeking to reconcile several comprehensive health system reform bills aimed at controlling rising health care costs, a follow-up to the enactment of a near-universal coverage expansion in 2006. At this article’s deadline, several bills were in the state Legislature’s pipeline, including one introduced by the House on May 4 to cut $160 billion in health care spending over the next 15 years. The Senate, which released its own proposal on May 9, also was weighing legislation introduced in 2011 by Gov. Deval Patrick. His plan seeks to move all state-sponsored health coverage to a global fee payment system, while encouraging the growth of accountable care-type organizations, in which physicians and other health professionals would work together to improve health outcomes for patients and lower costs. “I do think it’s going to happen,” Lynda Young, MD, the Massachusetts Medical Society’s president, said of the prospect th [Read more]
Missouri high court upholds damages cap, but another challenge remains
After winning a recent lawsuit challenging the state’s non-economic damages cap, Missouri doctors continue to fight another battle threatening to overturn the recovery limit. The Supreme Court of Missouri ruled April 3 in Sanders v. Ahmed that the state’s non-economic damages cap for medical liability cases was constitutional. The cap, adopted in 1986, impacts cases in which the alleged negligence happened before 2005. The limit was enacted at $350,000 but is now at more than $600,000 due to inflation. The second suit, which the state high court has yet to decide, centers on Missouri’s latest $350,000 award limit. The cap impacts all medical liability lawsuits starting in 2005. A decision in the case,Watts v. Cox, is expected by the summer, said attorneys involved in the case. The court’s analysis of Sanders could benefit physicians’ position in the Watts case that the cap should stand, said Jeffrey Howell, legal counsel for the Missouri State Medical Assn. “Preced [Read more]
Physician gift tracking by drug companies delayed until 2013
Federal requirements for collecting information on gifts and payments to physicians from drug and device manufacturers will not begin until 2013, said a top Centers for Medicare & Medicaid Services official. Data collection was expected to begin in 2012, and the first public transparency reports on relationships between manufacturers and doctors were expected to be released in September 2013. But citing a number of operational issues, acting CMS Administrator Marilyn Tavenner has told Sen. Charles Grassley (R, Iowa) that it would not be possible to begin the information-gathering process this year. The agency instead will issue a final rule this year that implements provisions of the Physician Payments Sunshine Act, which was championed by Grassley and included in the health system reform law, and start collecting data in 2013. A December 2011 proposed rule had generated more than 300 comments from organized medicine, health industry and patient advocacy groups, Tavenner said [Read more]
Diabetes treatment guidelines stress individualized care
The American Diabetes Assn. recommends that physicians take a less prescriptive but more patient-centered approach to managing hyper-glycemic patients with type 2 diabetes. Doctors should focus on patients’ individual needs, preferences and tolerances as well as age and disease progression, say the new guidelines, developed by the ADA and the European Assn. for the Study of Diabetes. The recommendations, published in the April 19 online edition of Diabetes Care, update the two associations’ 2009 guidelines on the subject. Individualized care is key to treating patients with the disease, said Silvio Inzucchi, MD, co-guideline author and a professor of medicine at the Yale School of Medicine in Connecticut. He also is director of the Yale Diabetes Center. “In the older, more infirm patient, a more conservative, less aggressive approach may be best,” Dr. Inzucchi said in an email. “In younger, healthier patients, it may pay to be more rigorous. It all involves clinical [Read more]
Family presence does not impede pediatric trauma care
Having a family member in the trauma room does not impact the quality of care a child receives, said a study presented at the Pediatric Academic Societies Annual Meeting in April. Researchers reviewed video and audio recordings of 145 trauma evaluations of patients 15 and younger to evaluate how well physicians followed evidence-based assessment protocols. For the 86 children who had relatives in the trauma room, 97% had their abdomens examined for injury according to protocol. That compares with 98% of the 59 children with no family present. Meanwhile, the median time for assessing the children’s airway was less than a minute for both groups. The findings should help ease concerns voiced by some hospitals and physicians that having relatives in the trauma bay interferes with the medical team’s ability to do its job, said Karen O’Connell, MD, the study’s lead author. A joint policy statement adopted in 2006 by the American Academy of Pediatrics and the American College [Read more]
High court arguments did not shift public opinion on health reform
Americans remained just as divided over the national health system reform law in April as they were in March, even after the significant amount of attention paid to the U.S. Supreme Court’s consideration of the statute. The latest health tracking poll from the Kaiser Family Foundation, released April 24, found that the late March hearings before the high court did not move the needle all that much when it came to public perception of the law. The percentage of respondents who said they had a favorable view of the law went from 41% in March to 42% in April, while the unfavorable figure went from 40% to 43%. As it has for the two years the law has been in effect, perception closely tracked the political views of the respondents. Since the last Kaiser tracking poll was released in March, the percentage of respondents who said they were “very closely” or “fairly closely” following the health reform cases before the Supreme Court jumped 13 percentage points to 50%. Americans [Read more]
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