News

Boston Globe

“Dr. Leslie Cho, a modern doctor, sometimes summons the wisdom of Hippocrates, an ancient healer, when encountering patients whose blood vessels silently harbor the flourishing signs of heart disease.

“Yes, she tells them, we could give you a passel of pills to keep a heart attack or stroke at bay. Or we could try something else, guided by a maxim from the great Greek physician: Let your food be your medicine, and your medicine be your food.

“I’m a firm believer that we have to have patients try diet and exercise, because you can’t take pills at a higher and higher and higher dose,” said Cho, chief of preventive cardiology at the Cleveland Clinic.”

Source:  Boston Globe, September 17, 2008

News

Beta News

“Internet connections lead the pack at 44 percent among technologies that are not working for home users, says a study released today. In one intriguing result, cell phones pose more problems for 18-to-29-year-olds than for senior citizens.

“Some 44 percent of adult Americans with home Internet access claim that their connections failed at some point over the past 12 months, says a new survey by Pew Research, which also points to significant problems with the operation of PCs, cell phones, and PDAs.

“The results weren’t all that different across the four age groups studied — which ranged from 18-to-29-year-olds, sometimes referred to as “Millenials,” to senior citizens in the 65-plus bracket — except that, surprisingly, people under age 39 are a lot more likely to experience cell phone failure than the two oldest groups examined.In terms of the devices studied, iPod and MP3 players were the least likely to fail, with only 15% of respondents using these products reporting problems with them over the past year.

“On the other hand, 26% of those with “BlackBerrys, Palm Pilots, or other personal digital assistants” pointed to difficulties with their devices. The same held true for 39% of desktop and laptop computer users asked about those machines.

“Among all cell phone owners studied, 29% said their devices have failed to work properly over the previous 12 months.”

Source:  Beta News, September 17, 2008

Citation Source:  Pew Research, November, 2008

News/Commentary

By Cheree Cleghorn, Editor

This story is about more than a state with a relaxed view of who’s old enough to have a few cold ones.

It is a story about culture and how culture affects our health choices. No state even comes close to Wisconsin in its permissiveness about alcohol, likely, says the story, to the state’s being home to breweries.

It also leads the nation in binge drinking.

When you look at it, the natives no doubt thought that, within their beer-focused world, they were being responsible. A parent or legal guardian can give consent for a 15-year-old to get a beer but bartenders have wide discretion.

Any place which is shaped by a large number of immigrants early on, has a single business focus which employs many of the people who live there or which has a location that offers opportunities for excess have powerful cultural norms influencing their health choices.

What are yours?

New York Times

“If they’re 15, 16, 17, it’s fine if they want to sit down and have a few beers,” said Mr. Whaley, who owns the tavern in this small town in southern Wisconsin.

“While it might raise some eyebrows in most of America, it is perfectly legal in Wisconsin. Minors can drink alcohol in a bar or restaurant in Wisconsin if they are accompanied by a parent or legal guardian who gives consent. While there is no state law setting a minimum age, bartenders can use their discretion in deciding whom to serve.

“When it comes to drinking, it seems, no state keeps pace with Wisconsin. This state, long famous for its breweries, has led the nation in binge drinking in every year since the Centers for Disease Control and Prevention began its surveys on the problem more than a decade ago. Binge drinking is defined as five drinks in a sitting for a man, four for a woman.

“People in Wisconsin are more likely than anywhere else to drive drunk, according to the National Survey on Drug Use and Health. The state has among the highest incidence of drunken driving deaths in the United States.”

Source: New York Times, November 15, 2008

News

Sen. Edward Kennedy’s brain tumor is a glioblastoma. This research story shows how scientists “stumbled” across information about how this particular form of brain cancer develops.

This only is the first study but it is significant in that a blood test may be able to reveal the presence of cancer before it can be seen on an image.

Again, do not expect this to be available any time soon. However, it is exciting and may point to new ways of thinking about how cancers grow.

Washington Post

” Researchers have stumbled across a novel mechanism by which brain tumors model their environment to nurture their own growth.

“The findings expose a fundamental biological process of which oncologists were previously unaware, and which may one day be exploited to combat glioblastoma, experts said. But just as significantly, they provide a potential means to monitor cancer progression and treatment by a simple blood test, rather than having to rely on either brain imaging or biopsies — something that currently is not possible.

“Wouldn’t it be awesome to know that a tumor is not fully treated or recurring before you ever see it on an X-ray or an MRI?” mused Dr. Paul Graham Fisher, a neuro-oncologist at Stanford University. “Or even beyond that, I mean, this gets way down the road, could you do a blood test to detect a brain tumor? That would be just awesome.”

“In findings reported in the Nov. 16 issue of Nature Cell Biology, Xandra Breakefield of Massachusetts General Hospital, and her team, led by Johan Skog, report that glioblastoma cells secrete small membrane-enclosed sacs called microvesicles. Filled with proteins and genetic material, these vesicles are picked up by neighboring cells in the brain, where they apparently induce them to alter their gene expression program to suit the needs of the tumor. Specifically, these cells can be coaxed into forming new blood vessels to supply nutrients to the growing cancer mass.

“We think the tumor cells bud off these vesicles filled with information, genetic and protein information, to actually take over their environment,” said Breakefield. “I mean, they are doing it for a purpose, and they’re doing it with a vengeance.”

News/Commentary

If you are disease free, but concerned about your heart-risks, try using both of the risk calculators available.

Compare both findings. Take these to your doctor and discuss them.

One risk calculator, the Reynolds risk calculator, as noted in the Forbes item below, assumes that the latest research study, called Jupiter, should be the new national guideline for prevention of heart disease. Patients need a blood test which measures the level of inflammation (called CRP for short). Based on that result, the patient and doctor can decide whether a statin is appropriate.

Any drug which has this much power to help you has side effects. Read all about statins first if you decide to take them so that you are familiar with both benefits and risks. This is a smart step for all medications, but especially for those you will be taking for many years.

The other risk calculator, called the Framingham risk calculator, has been used for years. It uses data gathered from the famous Framingham Study, one of the largest, longest-running studies of heart disease ever. Up until now, the Framingham risk calculator has been the one everybody used.

Forbes

“There are two computer scores that combine lots of risk factors into a single estimate of 10-year risk. If you believe that CRP is important, you can use the Reynolds risk calculator. If you’re doubtful about CRP, use the Framingham risk calculator on the Web site of the National Institutes of Health.”

Source: Forbes,  November 16, 2008

Features

Airlines do not have any rates for people who have to fly on short notice to be with very ill family members or friends. Often, there is little notice so the ticket prices are the highest the airline charges.

If you have frequent flier miles which you may want to donate to a friend or family member who is flying to and from a seriously ill patient, you might want to sign up for this.

As airline rules about the use of miles varies, check with yours first.

It is worth asking about if you don’t need the miles or wish to help someone in trouble.

This is brand-new, please note, and has not been tested by experience. It is free during this introductory test phase.

New York Times

….”Starting on Tuesday, Yapta.com will do just that. Known for alerting travelers to airfare price drops even after the ticket has been purchased, the site is testing a new service that allows travelers to receive an e-mail alert when an award seat becomes available. Travelers simply do a normal online search for airfare on Yapta.com and click “include award tickets” to begin tracking the flight. Yapta will automatically send alerts via e-mail if either the price drops or an award seat opens up. (Emphasis added)

“The service, which is being offered free in a test phase, comes at a time when travelers, faced with sky-high airfares in a tough economic environment, may be increasingly tempted to use miles for flights. But finding an award seat, while rarely easy, could be particularly challenging as airlines cut capacity. The domestic market is expected to lose 22.6 million seats in the fourth quarter as airlines slash capacity by nearly 9 percent compared with a year ago, according to data from OAG, the global airline-schedule data company. Globally, airlines will offer 20.4 million fewer seats, a 2.3 percent decline in overall capacity.

“That said, if the falloff in travel demand turns out to be greater than the capacity cuts, travelers could find more award availability as airlines try to fill seats any way they can. That scenario, said Tim Winship, an editor for SmarterTravel.com and the publisher of FrequentFlier.com, would be “a terrific opportunity for the airlines to reduce the liability of having the miles on their books and do so without diluting revenue” since the award seats would most likely have gone unsold anyway.”

Source: New York Times, November 16, 2008

Resources

Even if a Medicare recipient has been happy with a plan this year, it is important for anyone covered by Medicare to review the terms for next year.

There have been many changes made, officials say.

If there are specific doctors and/or medications which are considered “musts,” check to see whether those are covered before making the final choice.

Medicare Plan Information and Comparison Tools

For an overview of Medicare drug benefits, the different types of plans available and questions to consider, go to www.medicareinteractive.org.

Seniors can compare how their plan with others by going to the Medicare Drug Plan finder at www.medicare.gov or by calling 800-633-4227.

Headline News

You want, and kids need, to be citizens of the Net. However, concerns about what they see that is not age-appropriate or that are an easy sell for things that aren’t right for them have grown.

The answer, some thought, was age verification.

Now privacy experts, parents and teachers are not so sure.

New York Times

Source:  New York Times,  November 16, 2008

News

The Economist

“If growth is the carrot luring the drugs giants into emerging markets, the stick is the change in regulatory outlook in America from friendly to possibly frosty. The industry is concerned that Barack Obama, once in office, might allow cheap drugs to be imported from Canada or force Medicare, the government health-care system for the old and disabled, to negotiate big discounts with drugs firms. Peter Lawyer of Boston Consulting Group estimates that the latter reform alone could reduce the industry’s American revenues by 3-10%. In fairness, any move by Mr Obama towards universal health-coverage could boost drugs sales by giving more people insurance, but the industry nevertheless worries about a squeeze on margins.” (Emphasis added)

Source: The Economist, November 13, 2008

Features

By Cheree Cleghorn, Editor

In our continuing crusade to find a way to keep patient’s medications straight, try this.

Most pharmacies can print out a patient’s medication list with one push of a button.

However, most pharmacies will not let anyone other than the patient have the list.

If the patient can’t get to the pharmacy, then what? Patients who can’t get to the pharmacy to pick up the list really need someone paying close attention to accurate and timely dosages.

I asked the pharmacy if there were a form or other written authorization which would permit me to pick up the list.

These are great, helpful people. Still, they were baffled. Form? No, there was no form. Wait, they would call the Big Manager somewhere else. No, there was no form, said the Big Manager. They have to be careful that no one who is not authorized sees a patient’s full list for patient privacy reasons.

Since the Big Manager had ruled, they thought that was that.

I asked if a copy of the patient’s Durable Power of Attorney for Health Care would permit me to get the list.

They beamed. Yes. That would do it.

This anecdote is not to make fun of the drugstore—quite the opposite. These are people who are on top of things. Yet, either no one had asked them for such a release form before or no patient’s family member had asked if there were other ways to properly get the list on the patient’s behalf.

If a patient uses only one pharmacy, that list is current at all times.

If the patient uses more than one drugstore, then you have to get a list from each one used. This is not uncommon if patients are so ill they need special medications or compounds few stores have available. Those kinds of pharmacies tend to be near research-teaching institutions so it is not as if it will be the patient’s daily drugstore.

The pharmacy list provides a safeguard against mistakes in the pill box at home plus it will save you time.

The list can provide some peace of mind to the patient’s relative who is managing the medications.

Give it a try. I already feel better and I have only had this list for four hours.

Inquire first at the patient’s pharmacy about what they can accept for this purpose.

No one can have too many safety checks for what goes into the patient’s mouth.