10.30.07
Posted in Uncategorized at 9:35 pm by Pit
WASHINGTON (AP) -- A large new study found no sign that vitamin D lowers the overall risk of dying from cancer, injecting a note of caution to the latest vitamin craze. The exception: People with more vitamin D in their blood did have a significantly lower risk of death from colorectal cancer, supporting earlier findings.
Getting enough of the so-called sunshine vitamin - the skin makes it from ultraviolet rays - is vital for strong bones. But vitamin D has made headlines in recent years because of research saying it may be a powerful cancer fighter, sparking a push for people to get more than currently recommended amounts, either through diet or sun exposure.
The first-of-a-kind government study released Tuesday shows the issue is far from settled.
National Cancer Institute researchers analyzed vitamin D levels measured in almost 17,000 people as part of a national study that tracked their health. About a decade after enrolling, 536 of those people had died of cancer. Whether people had low or high vitamin D levels played no role in their risk of dying from cancer in general, they reported Tuesday in the Journal of the National Cancer Institute.
Then the researchers examined different types of cancer. There were just 66 deaths from colorectal cancer. Still, people with high levels of vitamin D appeared 72 percent less likely to die of colorectal cancer than people with the lowest vitamin D levels.
"While vitamin D may well have multiple benefits beyond bone, health professionals and the public should not, in a rush to judgment, assume that vitamin D is a magic bullet and consume high amounts," Johanna Dwyer, a dietary supplement specialist at the National Institutes of Health, cautioned in an accompanying editorial.
Indeed, there are numerous risk factors for colorectal cancer, including obesity and low physical activity, and it's unclear if low vitamin D levels play an independent role or are just a marker for those other risks, she said.
Scientists have been interested in vitamin D's effects for decades, since noticing that cancer rates between similar groups of people were lower in sunny southern latitudes than in northern ones. A handful of studies since then have found people given vitamin D supplements have less risk of developing certain cancers, but much of the evidence is circumstantial.
Experts are cautious because other vitamins and nutrient supplements once widely thought to prevent cancer didn't pan out when put to rigorous testing.
The NCI's study is the first to compare blood levels of vitamin D to cancer mortality, and "it's the best research we have on this topic," said Dr. Len Lichtenfeld of the American Cancer Society.
But a big weakness: It measured vitamin D at just one point in participants' lives, when levels can vary widely with dietary changes and especially the seasons.
Overall, most research "seems to be pointing in the direction that there is a role of vitamin D," Lichtenfeld said. Tuesday's study "puts a note of caution in there that says with all the explosion of information and advocacy on behalf of vitamin D, we need to be cautious. ... We really need some further studies that are well done to answer the question."
© 2007 The Associated Press.
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Posted in Uncategorized at 9:35 pm by Pit
CHARLESTON, W.Va. (AP) -- West Virginia is hoping that a little wheel can make a big difference in the state's obesity problem. The wheel is a body mass index calculator, a low-tech tool that will be distributed to doctors across the state as part of a new effort to get physicians to recognize obesity early in their patients.
The largest provider of Medicaid coverage in the state, the health benefits group UniCare, began offering training Tuesday to doctors and their staffs in obesity prevention and body mass index measurement.
UniCare's parent company, Indiana-based WellPoint Inc., currently offers the training only in California. But it hopes to use West Virginia as the starting point for an expansion into the 13 other states where it provides benefits.
"We all know somebody that would have given everything to have their health," Gov. Joe Manchin said at a news conference last week announcing the UniCare plan. "And they could have, if they had taken the right precautions."
West Virginia is the third-heaviest state in the nation. According to the state Bureau for Public Health, more than 30 percent of adults in West Virginia are obese. A national study earlier this year by the Trust For America's Health ranked West Virginia second in the percentage of children who are obese.
Manchin has made improving the health of residents one of his primary goals. The governor has been lobbying federal officials to allow West Virginia to use some of its state Children's Health Insurance Program money to do obesity screening for children in kindergarten and the second, fifth and eighth grades.
"That way, we can track them across a number of years and measure their progress, and our progress," Manchin said.
The body mass index test that doctors will be trained to use is a simple calculation based on a person's height and weight.
Joking that the small paper wheel used to make the calculation is a "miracle of modern technology," West Virginia University pediatrician Dr. Stephen Sondike said the test is especially crucial for young people.
It can be hard to tell if a child's weight is a sign of early obesity or normal growth, said Sondike, who attended the program's announcement.
"Kids can grow into their weight," he said. "But if there is a risk of obesity, it's a lot easier to stop it when they're children than when they're adults."
At the training sessions, doctors will be given calculation wheels along with charts from the federal Centers for Disease Control and Prevention to help interpret the results.
Sondike said that while many doctors are aware of BMI calculations, one goal of the training is to make physicians think of it as a standard measurement for patients, like weight or blood pressure.
For state government, the concern is the health of its residents, but it also a matter of dollars and cents. The state's Medicaid agency spends about $100 million on obesity-related costs annually, while obesity cost the state Public Employees Health Insurance agency $93 million last year, about 18 percent of its budget.
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On the Net:
State Office of Healthy Lifestyles: http://www.wvohl.org/
© 2007 The Associated Press.
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Posted in Uncategorized at 9:35 pm by Pit
WASHINGTON (AP) -- The Bush administration is recruiting about 1,200 doctors nationally to remove the paperwork from their medical practice in return for higher Medicare payments.
Health and Human Services Secretary Mike Leavitt billed the project Monday as one of the administration's most important steps yet toward meeting President Bush's goal of nationwide adoption of electronic health records by 2014.
Medicare will pay the physicians extra for completing tasks online, such as when ordering prescriptions or recording the results of lab tests. The highest payments will go to those physicians who most aggressively use the technology and who score the highest in an annual evaluation.
Many health analysts believe widespread use of electronic health records will reduce medical errors and could potentially slow soaring health care expenses. Yet, only about 10 percent of doctors in solo or small-group practices use such records. Upfront costs for putting in place such computer systems can range from $20,000 to $40,000.
Many doctors see the records as helping insurance companies or patients, but don't believe the upfront investment is worth the hassle, Leavitt said.
"They are saying: 'Look, what's in this for me? My practice is working OK as it is. I need to have some benefit,' Leavitt said. "And they are right."
Officials say the program won't result in a net increase in federal spending. That's because improved care and a greater focus on prevention should make up for the initial investment paid to the doctors.
Participating doctors could see their reimbursements increase by several thousand dollars annually when they treat Medicare patients. The administration has also contacted insurance companies and asked them to consider similar rate increases for participating physicians. That way, doctors would have more incentive to participate.
Several bills have been introduced in Congress to speed adoption of electronic record keeping, but lawmakers have been unable to reach agreement on many key issues, namely the scope of the federal government's role in paying for startup costs.
Dr. Joseph Heyman of Amesbury, Mass., said he's used electronic health records since 2001. He paid for it on his own, but it helped that he was just starting his practice and didn't have to go through all the work of transferring records from paper to computer.
Heyman said he spends less on administrative expenses because of his reliance on electronic record keeping. For example, he needs no storage space for charts and no employees to pull charts.
"I have only one employee. I can spend more time with each patient because my overhead is so low," said Heyman, a member of the American Medical Association's Board of Trustees.
Heyman said he can access patient records over the Internet when he's away from the office, and patients can contact him through his Web site.
"I can go look at her chart, I can refill a prescription. I can give her an appointment, almost anything from any place that I am," Heyman said.
But many doctors believe that adopting electronic record keeping is difficult, which is why they often need more financial incentives to make the move, Heyman said.
"It takes a long time to convert. At the beginning, it's very, very slow and it interferes with your work flow," he said.
© 2007 The Associated Press.
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Posted in Uncategorized at 9:35 pm by Pit
CHICAGO (AP) -- Loyola University Medical Center on Monday announced plans to start testing all incoming patients for a drug-resistant staph germ and isolating those who carry the dangerous bacteria.
The 589-bed hospital in Maywood, just west of Chicago, is among the first in Illinois to start universal screening for the superbug.
The germ in question is called MRSA, or methicillin-resistant Staphylococcus aureus.
A new Illinois law requires hospitals to test high-risk and intensive-care patients for MRSA.
The nation's Veterans Affairs hospitals began universal MRSA testing this year. And Evanston Northwestern Healthcare has reported a substantial drop in MRSA cases at its three suburban Chicago hospitals since it began universal testing in 2005.
Loyola officials say they're launching universal screening because of recent reports suggesting the germ is becoming more widespread and success with pilot programs that have reduced infections at their hospital.
Several MRSA cases have been reported recently among students at schools in Illinois and around the nation, but health officials say intermittent cases are not unusual.
MRSA awareness has been heightened by the death of a Virginia student two weeks ago, followed by a government report estimating that more than 90,000 Americans get the most dangerous kind of MRSA infections each year.
Most MRSA cases are relatively mild skin infections, but the bug can become life-threatening if it invades the body and infects the bloodstream or vital organs. Those at risk for this type of MRSA infection include hospitalized patients undergoing invasive procedures or with weakened immune systems.
Many people carry the bug on their skin or in their noses with no symptoms, but they can infect others if the germ makes contact with open wounds. These carriers are the focus of the new screening at Loyola.
"It is an important component of our overall plan to improve patient safety in all aspects of care," said Dr. Paul Whelton, president and CEO of Loyola University Health System.
The program will involve nasal swabbing of all incoming patients. A rapid test will provide results within two hours. Carriers will then be isolated and treated. The program is slated to be up and running by the end of November.
While MRSA cases used to be found mainly in hospitals, they have been appearing in recent years in schools, prisons, gyms and poor urban neighborhoods.
The bug is resistant to mainline penicillin antibiotics but can often be treated with other drugs.
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Loyola: http://www.loyola.edu
MRSA: http://www.cdc.gov/ncidod/dhqp/ar-mrsa.html
© 2007 The Associated Press.
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Posted in Uncategorized at 9:35 pm by Pit
TRENTON, N.J. (AP) -- Use of cholesterol and blood pressure medicines by young adults appears to be rising rapidly - at a faster pace than among senior citizens, according to an industry report being released Tuesday.
Experts point to higher rates of obesity, high blood pressure and high cholesterol problems among young people. Also, doctors are getting more aggressive with preventive treatments.
"This is good news, that more people in this age range are taking these medicines," said Dr. Daniel W. Jones, president of the American Heart Association.
Still, he said many more people should be on the drugs that lower cholesterol or blood pressure and which have been shown to reduce risks for heart attack and stroke.
The new data, from prescription benefit manager Medco Health Solutions Inc., indicate use of cholesterol-lowering drugs among people aged 20 to 44, while still low, jumped 68 percent over a six-year period.
The rate rose from 2.5 percent in 2001 to just over 4 percent in 2006 among Medco customers. That means roughly 4.2 million Americans in that age group are now taking cholesterol medicines.
Meanwhile, use of blood pressure medicines increased 21 percent, from about 7 percent of 20- to 44-year-olds in 2001 to over 8 percent in 2006. That translates into about 8.5 million Americans in that age group taking drugs to lower their blood pressure.
"It was a surprise to us," said Dr. Robert Epstein, chief medical officer at Franklin Lakes, N.J.-based Medco. "Maybe the fact that we're seeing more young people with high cholesterol and blood pressure is indicative of the epidemic of obesity and overweight that we're seeing in this country."
Among people 65 and older, use of blood pressure drugs increased only 9.5 percent and use of cholesterol drugs by 52 percent. That's because half the seniors were already taking blood pressure drugs and more than one in four were taking cholesterol drugs in 2001.
Jones, dean of the University of Mississippi School of Medicine, said he has seen some increase in young adults with blood pressure or cholesterol problems, but not of the magnitude suggested by Medco's data.
Dr. Howard Weintraub, the heart disease prevention expert at the American College of Cardiology, said he's "thrilled" by the dramatic increase, which he says is tied to requests from patients with "a brand new sense of urgency" and referrals from other doctors to his private practice.
"If you wait until a heart attack or stroke, it's a little bit late," Weintraub said.
He and Epstein both said patients with problems should first work with their doctors on lifestyle changes - more exercise, a better diet and weight loss. But Weintraub said many people need medication to achieve and maintain the ever-lower levels of blood pressure and cholesterol that experts now recommend.
However, Dr. John LaRosa, president of SUNY Downstate Medical Center, said, "particularly for young people, lifestyle change is worth a try."
Once patients start taking these medicines, they usually stay with them and there are some side effects, LaRosa said.
"It's amazing what (losing) five or 10 pounds will do" to reduce blood pressure and cholesterol levels, he said.
Federal health statistics show that while the percentage of people with high cholesterol has dropped overall in recent years, it has risen among younger people, especially those 20 to 34 years old.
Meanwhile, the prevalence of high blood pressure was flat or up slightly among those age groups; among women in the 35 to 44 age group, the rate of high blood pressure rose significantly.
Medco processes prescription claims for about 60 million insured Americans. The report's findings are based on a representative sample of data from 2.5 million members.
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On the Net: http://www.medco.com
© 2007 The Associated Press.
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