Jump to content
  • articles
    6,986
  • comments
    73
  • views
    5,383,842

Contributors to this article

About this News

Articles in the news

USA: For uninsured people with cancer, access to care can be "very random"

Eighteen months after April Adcox learned she had skin cancer, she finally returned to Charleston's Medical University of South Carolina last May to seek treatment.

Adcox had first met with physicians at the academic medical center in late 2020, after a biopsy diagnosed basal cell carcinoma. The operation to remove the cancer would require several physicians, she was told, including a neurosurgeon, because of how close it was to her brain.

But Adcox was uninsured. She had lost her automotive plant job in the early days of the pandemic, and at the time of her diagnosis was equally panicked about the complex surgery and the prospect of a hefty bill. Instead of proceeding with treatment, she attempted to camouflage the expanding cancerous area for more than a year with hats and long bangs.

If Adcox had developed breast or cervical cancer, she likely would have qualified for insurance coverage under a federal law that extends Medicaid eligibility to lower-income patients diagnosed with those two malignancies. For female patients with other types of cancer, as well as pretty much all male patients, the options are scant, especially in South Carolina and the 11 other states that haven't yet implemented Medicaid expansion, according to cancer physicians and health policy experts who study access to care.

In the face of potentially daunting bills, uninsured adults sometimes delay care, which can result in worse survival outcomes, research shows. The odds of patients getting insurance to help cover the cost of treatment play out a bit like a game of roulette, depending upon where they live and what type of cancer they have.

"It is very random — that's, I think, the heartbreaking part about it," said Dr. Evan Graboyes, a head and neck surgeon and one of Adcox's physicians. "Whether you live or die from cancer shouldn't really be related to what state you live in."

Read full story

Source: CBS News, 7 April 2023

 

Read more

USA: FDA could approve over-the-counter purchase of first birth control pill

The Food and Drug Administration will consider an application for the first birth control pill to be sold without a prescription.

The application from HRA Pharma would seek to make Opill – an every day, prescription-only hormonal contraception first approved in 1973 – available over-the-counter. Such an approval from the FDA would allow people to purchase “the pill” without a prescription for the first time since oral contraceptives became widely available in the 1960s.

The application will also cast oral contraceptives into a fraught political moment in the US. The US supreme court ended federal protection for abortion rights late last month, throwing into question the future of birth control.

“This historic application marks a groundbreaking moment in contraceptive access and reproductive equity in the US,” said HRA Pharma’s chief strategic operations and innovation officer, Frédérique Welgryn. “More than 60 years ago, prescription birth control pills in the US empowered women to plan if and when they want to get pregnant.”

Making birth control available without a prescription will “help even more women and people access contraception without facing unnecessary barriers”, said Welgryn, whose company has already submitted the application.

Read full story

Source: The Guardian, 11 July 2022

Read more

USA: ED boarding at crisis levels, Mass General says

Boston-based Massachusetts General Hospital is requesting permission from the state to add more than 90 inpatient beds amid what it says is an "unprecedented capacity crisis." 

The hospital's emergency department has experienced critical levels of overcrowding nearly every day for the past six months, Massachusetts General said in a news release. The hospital boards between 50 to 80 ED patients every night who are waiting for a hospital bed to open. On 11 January, Massachusetts General had 103 patients boarding in the ED, representing one of the most crowded days in the hospital's more than 200-year history.

"While hospital overcrowding has significantly affected patient care for many years, COVID-19 and the post-pandemic demand for care has escalated this challenge into a full-blown crisis – for patients seeking necessary emergency care, as well as for staff who are required to work under these increasingly stressful conditions," David F.M. Brown, president of Massachusetts General, said in a news release.

Massachusetts General's request comes as hospitals across the state grapple with capacity issues, workforce shortages and a jump in respiratory illnesses this winter. On 9 January. the Massachusetts Department of Public Health issued a memo urging hospitals to expedite discharge planning amid the capacity crunch. Some health plans have also waived the need to obtain prior authorisation for short stays in post-acute care facilities. 

Read full story 

Source: Becker Hospital Review, 19 January 2024

Read more

USA: Eating disorder group pulls chatbot sharing diet advice

A US organisation that supports people with eating disorders has suspended use of a chatbot after reports it shared harmful advice.

The National Eating Disorder Association (Neda) recently closed its live helpline and directed people seeking help to other resources, including the chatbot.

The AI bot, named "Tessa," has been taken down, the association said. It will be investigating reports about the bot's behaviour.

In recent weeks, some social media users posted screenshots of their experience with the chatbot online.

They said the bot continued to recommend behaviours like calorie restriction and dieting, even after it was told the user had an eating disorder.

For patients already struggling with stigma around their weight, further encouragement to shed pounds can lead to disordered eating behaviours like bingeing, restricting or purging, according to the American Academy of Family Physicians.

Read full story

Source: BBC News, 2 June 2023

Read more

USA: Drug shortages near an all-time high, leading to rationing

Thousands of patients are facing delays in getting treatments for cancer and other life-threatening diseases, with drug shortages in the United States approaching record levels.

Hundreds of drugs are on the list of medications in short supply in the United States, as officials grapple with an opaque and sometimes interrupted supply chain, quality and financial issues that are leading to manufacturing shutdowns.

The shortages are so acute that they are commanding the attention of the White House and Congress.

The Biden administration has assembled a team to find long-term solutions for shoring up the pharmaceutical supply chain, at a time when the United States remains heavily reliant on medicines and drug ingredients from India and China. And in recent weeks, generic drug makers, supply-chain experts and patient advocates have appeared before lawmakers to discuss the problems.

The scarcity of generic forms of chemotherapy to treat lung, breast, bladder and ovarian cancers has only heightened concerns.

“This is, in my opinion, a public health emergency,” said Dr. Amanda Fader, a professor at the Johns Hopkins School of Medicine and a president-elect of the Society of Gynecologic Oncology, “because of the breadth of the individuals it affects and the number of chemotherapy agents that are in shortage right now.”

Read full story (paywalled)

Source: New York Times, 17 May 2023

Read more
 

USA: Drop boxes are making it easier to get rid of old medication

What do you do with bottles of expired or no-longer-needed medications? That’s a problem, according to Elizabeth Skoy, an associate professor at North Dakota State University’s School of Pharmacy in the USA.

“In recent years, there’s been a spotlight on medication disposal, because of the opioid epidemic,” she said. “It’s important to get rid of any medication when you are done with it to prevent misuse or having it fall into the hands of others.” Plus, having old medications in the home increases the chances of accidental poisoning of children or pets.

But while many of us might be aware that we shouldn’t toss pill bottles in the trash or flush medication down the toilet, we’re less knowledgeable about safe alternatives. And there haven’t been many options beyond the USA's Drug Enforcement Administration’s semiannual National Prescription Drug Take Back Day.

In the past decade, however, pharmacies, hospitals and law enforcement agencies have been stepping up to help clean out medicine cabinets year-round. One of the most accessible solutions is medication collection bins, which are being added to convenient locations such as retail stores, health clinics, police stations and other easily accessed sites.

“We decided in 2016 we wanted to be part of the solution,” said Kurt Henke, ambulatory pharmacy manager for Colorado’s Denver Health hospital system, which has collection bins in each of its eight pharmacies. Drugstore chain CVS began putting units in police departments in 2014 and adding them to its more than 9,000 retail locations in 2017; so far it has deployed more than 4,000 of the bins. States are taking the initiative, as well. In North Dakota the state’s Board of Pharmacy provides MedSafe, a take-back box, to any pharmacy that wants one; at this point, about 120 are participating.

The DEA maintains a searchable database of controlled-substance collection sites. Simply type in your Zip code or city to find the nearest one.

Read full story (paywalled)

Source: The Washington Post, 15 March 2022

 

Read more
 

USA: Doctors are more likely to describe black patients as uncooperative, studies find

Medical records contain a plethora of information, from a patient’s diagnoses and treatments to marital status to drinking and exercise habits. They also note whether a patient has followed medical advice. A health provider may add a line stating that the patient is “noncompliant” or “non-adherent,” signalling that the patient has been uncooperative and may exhibit problematic behaviours.

Two large new studies in the US found that such terms, while not commonly used, are much more likely to appear in the medical records of Black patients than in those of other races.

The first study, published in Health Affairs, found that Black patients were two and a half times as likely as white patients to have at least one negative descriptive term used in their electronic health record. About 8% of all patients had one or more derogatory terms in their charts, the study found. The most common negative descriptive terms used in the records were “refused,” “not adherent,” “not compliant” and “agitated.”
 
The second study, published in JAMA Network Open, analysed the electronic health records of nearly 30,000 patients at a large urban academic medical centre between January and December 2018. The study looked for what researchers called “stigmatising language,” comparing the negative terms used to describe patients of different racial and ethnic backgrounds as well as those with three chronic diseases: diabetes, substance use disorders and chronic pain.
 
Overall, 2.5% of the notes contained terms like “nonadherence,” “noncompliance,” “failed” or “failure,” “refuses” or “refused,” and, on occasion, “combative” or “argumentative.” But while 2.6% of medical notes on white patients contained such terms, they were present in 3.15% of notes about Black patients.
 
Looking at some 8,700 notes about patients with diabetes, 6,100 notes about patients with substance use disorder and 5,100 notes about those with chronic pain, the researchers found that patients with diabetes — most of whom had type 2 diabetes, which is often associated with excess weight and called a “lifestyle” disease — were the most likely to be described in negative ways. Nearly 7% of patients with diabetes were said to be noncompliant with a treatment regimen, or to have “uncontrolled” disease, or to have “failed.”

The labels have consequences, warns Dr. Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. 

“Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall,” Dr. Schillinger said. “Having health care providers who are trustworthy — who earn their patients’ trust by not judging them unfairly — is critical to ensuring optimal health and eliminating health disparities.”

Read full story (paywalled)

Source: The New York Times, 20 February 2022

Read more

USA: Despite decades of promises, health research still overlooks women

Women are underrepresented in clinical trials, and even lab mice are predominantly male – and the effects show up in almost every aspect of human health

Women are twice as likely as men to die from heart attacks; when a nonsmoker dies of lung cancer, it’s twice as likely to be a woman as a man; and women suffer more than men from Alzheimer’s and autoimmune disease.

Yet research into these conditions, and many more, generally fails to examine women separately. It’s even less likely to look at disparities affecting women of color – why, for instance, Black women are nearly three times more likely to die in pregnancy than white women are.

It’s been 30 years since the US Congress ordered the National Institutes of Health to make sure women were included equally in clinical trials. Despite some progress, research on women still lags, and there’s growing evidence that women and girls are paying the price.

“Research on women’s health has been underfunded for decades, and many conditions that mostly or only affect women, or affect women differently, have received little to no attention,” the first lady Jill Biden said in announcing a new White House initiative on women’s health research on 13 November.

“Because of these gaps, we know far too little about how to manage and treat conditions like endometriosis, and autoimmune diseases like rheumatoid arthritis. These gaps are even greater for communities that have historically been excluded from research – including women of color and women with disabilities.”

Not only do researchers fail to include enough women in clinical trials, they often don’t look for differences between how men and women respond to treatments.

Read full story

Source: The Guardian, 20 November 2023

Further reading on the hub

Read more
 

USA: Dentist found guilty of damaging patients’ teeth to boost profits

A Wisconsin dentist was found guilty of healthcare fraud and other charges after he intentionally damaged his patients’ teeth to boost profits, raking in millions from his scheme.

Scott Charmoli, 61, was convicted of five counts of healthcare fraud and two counts of making false claims about his clients’ treatment last Thursday, according to the Milwaukee Journal Sentinel.

With his sentencing scheduled for June, Charmoli faces up to 10 years for each healthcare fraud charge and a maximum of five years for each of the two other charges.

Prosecutors say that Charmoli had routinely drilled or broken his clients’ teeth on purpose, charging them for additional treatment services to fix the damage he had just done. As a result, Charmoli’s profits ballooned, with the dentist going from making $1.4m and installing 434 crowns in 2014 to $2.5m in 2015, installing over 1,000 crowns, reported the Washington Post.

According to prosecutors, in 2015, Charmoli began pressuring his clients into getting unnecessary crowns, a dental procedure where a tooth-shaped cap is placed on a damaged tooth. Charmoli would drill or break his client’s teeth and send X-rays of the intentional damage to insurance as “before” photos to justify the crown procedures.

One client, Todd Tedeschi, testified that Charmoli pressured him into getting two crowns in one appointment, despite Tedeschi believing that his teeth were fine.

“It seemed excessive, but I didn’t know any better,” said Tedeschi. “He was the professional. I just trusted him.”

Some of the patients that Charmoli badgered into unnecessary procedures were also vulnerable, said prosecutors.

Read full story

Source: The Guardian, 16 March 2022

Read more

USA: Dangers and deaths around black pregnancies seen as a ‘completely preventable’ health crisis

Tonjanic Hill was overjoyed in 2017 when she learned she was 14 weeks pregnant. Despite a history of uterine fibroids, she never lost faith that she would someday have a child.

But, just five weeks after confirming her pregnancy she seemed unable to stop urinating. She didn’t realize her amniotic fluid was leaking. Then came the excruciating pain.

“I ended up going to the emergency room,” said Hill, now 35. “That’s where I had the most traumatic, horrible experience ever.”

An ultrasound showed she had lost 90% of her amniotic fluid. Yet, over the angry protestations of her nurse, Hill said, the attending doctor insisted Hill be discharged and see her own OB-GYN the next day. The doctor brushed off her concerns, she said. The next morning, her OB-GYN’s office rushed her back to the hospital. But she lost her baby.

Black women are less likely than women from other racial groups to carry a pregnancy to term — and in Harris County, where Houston is located, when they do, their infants are about twice as likely to die before their 1st birthday as those from other racial groups. Black fetal and infant deaths are part of a continuum of systemic failures that contribute to disproportionately high Black maternal mortality rates.

“This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who’s disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.”

Read full story

Source: KFF Health News, 24 August 2023

Read more
 

USA: COVID-hospitalisation numbers are as bad as they look

Many supposedly “incidental” infections aren’t really incidental, and cannot be dismissed, writes Ed Yong.

More Americans are now hospitalised with COVID-19 than at any previous point in the pandemic. The current count—147,062—has doubled since Christmas, and is set to rise even more steeply, all while Omicron takes record numbers of healthcare workers off the front lines with breakthrough infections. For hospitals, the math of this surge is simple: Fewer staff and more patients mean worse care. Around the United States, people with all kinds of medical emergencies are now waiting hours, if not days, for help.

Some reporters and pundits have claimed that this picture is overly pessimistic because the hospitalisation numbers include people who are simply hospitalised with COVID, rather than for COVID—“incidental” patients who just happen to test positive while being treated for something else. In some places, the proportion of such cases seems high. UC San Francisco recently said a third of its COVID patients “are admitted for other reasons,” while the Jackson Health System in Florida put that proportion at half. In New York State, COVID “was not included as one of the reasons for admission” for 43% of the hospitalised people who have tested positive.

But the “with COVID” hospitalisation numbers are more complicated than they first seem. Many people on that side of the ledger are still in the hospital because of the coronavirus, which has both caused and exacerbated chronic conditions. And more important, these nuances don’t alter the real, urgent, and enormous crisis unfolding in American hospitals. Whether patients are admitted with or for COVID, they’re still being admitted in record volumes that hospitals are struggling to care for. “The truth is, we’re still in the emergency phase of the pandemic, and everyone who is downplaying that should probably take a tour of a hospital before they do,” says Jeremy Faust, an emergency physician at Brigham and Women’s Hospital, in Massachusetts.

Read full story

Source: The Atlantic, 12 January 2022

Read more

USA: Covid long-haulers face grueling fights for disability benefits

Deepa Singh, 30, of Louisville, USA, has been seriously ill for two years, racked with extreme fatigue, racing heartbeat and memory problems from Long covid that she says prevent her from working. Adding to her distress, she says, has been a grueling — and so far unsuccessful — battle for disability payments.

Singh, who worked as a project manager, is among a cohort of Long Covid patients who have been denied disability benefits, either by private insurance companies, which operate benefit plans offered by employers, or by the Social Security Administration, which manages government disability benefits.

Tasked with sorting legitimate health claims from fraudulent or marginal ones, these gatekeepers now face a novel challenge as the coronavirus pandemic drags on: a flood of claims citing a post-infection syndrome that is poorly understood by the medical community and difficult to measure.

Patients cite a litany of symptoms that defy verification through basic medical tests. They become exhausted at the merest exertion. They can’t remember simple words. Their hearts feel like they are fluttering. Yet neurological exams, ECGs and chest X-rays come back clean.

Doctors said in interviews they are treating Long Covid patients who are clearly too sick to work but who have difficulty meeting the evidence threshold insurers demand: objective medical test results showing an inability to perform work.

Specialized tests can measure a few Long Covid-related problems, such as a central nervous system disorder called dysautonomia, which affects the body’s ability to regulate itself. But there are months-long waiting lists for the tests, doctors and patients said.

The challenges are similar to those faced for years by people claiming disabilities based on chronic fatigue syndrome. But the pandemic has given rise to such claims on a far greater scale.

Read full story (paywalled)

Source: The Washington Post, 8 March 2022

Read more
 

USA: Covid infection increases risk of mental health disorders, study finds

Having Covid-19 puts people at a significantly increased chance of developing new mental health conditions, potentially adding to existing crises of suicide and overdoses, according to new research looking at millions of health records in the US over the course of a year.

The long-term effects of having Covid are still being discovered, and among them is an increased chance of being diagnosed with mental health disorders. They include depression, anxiety, stress and an increased risk of substance use disorders, cognitive decline, and sleep problems – a marked difference from others who also endured the stress of the pandemic but weren’t diagnosed with the virus.

“This is basically telling us that millions and millions of people in the US infected with Covid are developing mental health problems,” said Ziyad Al-Aly, chief of research and development at the VA St Louis Healthcare System and senior author of the paper. “That makes us a nation in distress.”

The higher risk of mental health disorders, including suicidal ideation and opioid use, is particularly concerning, he said.

“This is really almost a perfect storm that is brewing in front of our eyes – for another opioid epidemic two or three years down the road, for another suicide crisis two or three years down the road,” Al-Aly added.

These unfolding crises are “quite a big concern”, said James Jackson, director of behavioural health at Vanderbilt University’s ICU Recovery Center, who was not involved with this study. He is also seeing patients whose previous conditions, including anxiety, depression and opioid use disorder, worsened during the pandemic.

Read full story

Source: The Guardian, 18 February 2022

Read more

USA: Congress commits funding for research to reduce diagnostic Error and improve patient safety in final FY2023 spending bill

The Society to Improve Diagnosis in Medicine (SIDM) has announced that Congress in the final FY 2023 Omnibus spending bill has doubled dedicated federal funding for research to reduce patient harm from diagnostic error. Statistically, each of us is likely to experience a meaningful diagnostic error in our lifetime.

The significant human and financial toll of diagnostic errors, which occur in all settings of care, was first highlighted in a landmark 2015 National Academy of Medicine (NAM) report, Improving Diagnosis in Health Care. The report found that missed, delayed, or un-communicated diagnoses result in more patient harm than all other healthcare-associated harms combined. The NAM report called diagnostic error "a blind spot" in health care quality and safety, and improving medical diagnosis a "moral, professional, and public health imperative."

Since the release of the NAM report, SIDM has been working hard to educate policymakers about these issues and advocating for more research funding. SIDM has assembled a coalition of dozens of groups representing health systems, patients, clinicians, and others to raise awareness and spark action. "This funding is an important signal that Congress is becoming aware of the magnitude of the public health burden, both human and financial, associated with diagnostic error and intends to tackle it," says Jennie Ward-Robinson, CEO of SIDM. 

Citing diagnosis as "the next frontier of patient safety," the NAM report summarised what is known about factors that affect diagnostic safety and accuracy at the clinician, system, and policy levels, and made recommendations at each of those levels. A few promising interventions are already emerging for specific and commonly misdiagnosed conditions, as well as for specific systems-level problems, such as failure to "close the loop" on abnormal test results. But these initiatives are tiny compared the scope and scale of the issue.   

Read full story

Source: CISION PR Newswire, 3 January 2023

Read more

USA: Cerner’s VA software rollout report cites 150 “cases of harm”

A serious revelation may derail the Cerner Millenium rollout. A draft report by the Department of Veterans Affairs (VA) Office of Inspector General (OIG) states that a flaw in Cerner’s software caused the system to lose 11,000 orders for specialty care, lab work, and other services – without alerting healthcare providers the orders (also known as referrals) had been lost. This created ‘cases of harm’ to at least 150 veterans in care. 

The VA patient safety team classified dozens of cases of “moderate harm” and one case of “major harm.” The major harm cited affected a homeless veteran, aged in his 60s, who was identified as at risk for suicide and had seen a psychiatrist at Mann-Grandstaff in December 2020, after the implementation. After prescribing medication to treat depression, the psychiatrist ordered a follow-up appointment one month later. That order disappeared in the electronic health record and was not scheduled. The consequences were that the veteran, weeks after the unscheduled appointment date, called the Veterans Crisis Line. He was going to kill himself with a razor. Fortunately, he was found in time by local first responders, taken to a non-VA mental health unit, and hospitalized.

The draft report implies that the ‘unknown queue’ problem has not been fixed and continues to put veterans at risk in the VA system.

There may be as many as 60 other safety problems. Other incidents cited in the draft report include one of “catastrophic harm” and another case the VA told the OIG may be reclassified as catastrophic. Catastrophic harm is defined by the VA as “death or permanent loss of function.”

Read full story

Source: Telehealth and Telecare Aware, 21 June 2022

Read more

USA: Care quality, safety 'worse than expected' during Covid-19 pandemic

A new CMS report reveals disparities in care quality and patient safety within US hospitals before and during the pandemic, finding "a large proportion of measures had worse than expected performance." 

CMS released its 2024 National Impact Assessment Feb. 28, which is released every three years and evaluates the measures used in 26 CMS quality and value-based incentive payment programs. This edition of the report compares quality measure scores pre-COVID-19 with hospitals' results in 2020 and 2021, the initial years of the COVID-19 public health emergency. 

Here are eight findings from the 72-page assessment:

1. During 2020 and 2021, a large proportion of measures had worse than expected performance, including significant worsening of key patient safety metrics.

2. Half or more of the performance measures in five priorities had worse results in 2021 than expected from the 2016–2019 baseline. Priorities with the highest proportions of worse-than-expected results in 2021 were wellness and prevention (69%), behavioural health (55%), safety (54%), chronic conditions (52%), and seamless care coordination (50%). 

3. Specific to safety, standardised infection ratios worsened significantly in hospitals for central line–associated bloodstream infections (94% worse), MRSA (55% worse) and CAUTI (34% worse). Before the Covid-19 PHE (2015–2019), 34,455 fewer healthcare-associated infections (HAIs) were reported in acute care settings. 

4. More than 35% of measures in two priorities had better results in 2021 than expected from 2016–2019 baseline trends. Those priorities are seamless care coordination (50%) and affordability and efficiency (38%). 

5. Specific to affordability and efficiency, emergency department visits for home health patients fared 1.4 percentage points better, and acute care hospitalization in the first 60 days of home health in 2021 was 1.5 percentage points better. 

6. Accountable entities with the highest proportions of worse than expected results in 2021 were clinicians (64%), accountable care organizations (54%), and acute care facilities (54%). 

7. Wellness and prevention had the highest percentage of measures showing health equity disparities; notable examples include pneumococcal and influenza vaccinations among racial and ethnic groups.

8. Comparison racial and ethnic groups fared worse than the White reference group on 40 of 45 (88.9%) affordability and efficiency measures and 32 of 41 (78%) chronic conditions measures. For example, disparities were recorded for Black or African American patients in 32, or 71%, of the affordability and efficiency measures, mostly related to readmissions.

Read full story

Source: Becker Hospital Review, 29 February 2024

Read more
 

USA: Breast Implant Illness - Statement from President of BAAPS, Marc Pacifico

Breast implant illness (BII) is an umbrella term that has been used by some women who have breast implants to describe a wide array of systemic (affecting their whole body rather than a single body part) symptoms experienced by them. The symptoms frequently include tiredness, joint ache, brain fog, memory loss and headaches but many other symptoms have also been described.

The WHO (World Health Organisation) does not recognise “BII” as a medical diagnosis as it has not fulfilled the criteria to be classified as a disease. No scientific link between breast implants and these symptoms has yet been identified, however, many women who identify as having these symptoms experience varying degrees of relief after their implants are removed.

A huge amount of research has been done on this, and most notably, in the last few months 3 incredibly high level and well-designed research studies* have been published on this topic.

President of BAAPS, Marc Pacifico, said "My main advice is that firstly if you have implants and experience any symptoms (such as tiredness, joint ache, brain fog, memory loss etc), please do not first assume they are related to your implants. It is crucial that you see your GP to exclude other medical causes, that could range from medical diseases, infections, menopausal reasons or a host of other reasons that need to be excluded first. Secondly if undergoing implant checks, ensure that you are seeing an appropriately qualified surgeon on the GMC specialist register in either plastic surgery or general surgery with a special interest in breast surgery. Finally, you should be aware that there is no scientific evidence to support the benefit of undergoing the riskier so-called “en-bloc” capsulectomy (total intact capsulectomy) compared to other capsulectomy techniques when it comes to relieving systemic symptoms thought to be linked to breast implants or BII. This should not be presented to you as the only possible solution to your symptoms.”

Read full story 

Source: BAAPS, 12 October 2022

Read more
 

USA: Boston Scientific faces vaginal mesh lawsuit alleging Obtryx II exposed patients to unreasonable risk of problems

Women continue to file vaginal mesh lawsuits against Boston Scientific and other manufacturers, years after most products were removed from the market due to an alarming number of complications and health risks associated with the designs.

In a complaint (PDF) filed last month in the U.S. District Court for the Southern District of Indiana, Tanya Davis indicates that problems with Boston Scientific Obtryx II mesh placed in her body only four years ago has left her with severe injuries, including pelvic pain and dyspareunia, abdominal pain, urinary problems, prolapse and incontinence. The lawsuit names Boston Scientific Corporation as the defendant.

Transvaginal mesh products like the Obtryx II have been marketed and sold by Boston Scientific Corporation and a number of different companies over the past decade, for treatment of pelvic organ prolapse or female stress urinary incontinence. Most of the products were introduced under a controversial FDA “fast track” approval process, which allowed manufacturers to introduce new products based on the design of prior mesh, without conducting thorough research to evaluate the safety or effectiveness of the specific designs.

Following widespread reports of vaginal mesh complications, including infections, erosion of the mesh into the vagina and organ perforation, the FDA required manufacturers to conduct post-marketing research and most companies decided to withdraw their products.

According to the lawsuit, Davis received an Obtryx II System in May 2018, to treat her urinary incontinence. However, after experiencing painful and debilitating complications, Davis had vaginal mesh explanted in May 2020; just two years after it was implanted.

“Neither Plaintiff nor her physicians and/or healthcare providers were warned that the Obtryx II was unreasonable dangerous or of the risks of the product, outlined herein, even when used exactly as intended and instructed by Defendant,” the lawsuit indicates. “To the contrary, Defendant promoted and sold the type of product implanted in the Plaintiff and thousands of women like Plaintiff, to healthcare providers as a safe alternative to other procedures that did incorporate Defendant’s products.”

Read full story

Source: About Lawsuits, 10 May 2022

Read more
 

USA: Black adult hospitalisations reached a pandemic high during the omicron wave, CDC study finds

During the peak of the omicron variant wave of the coronavirus this winter, Black adults in the United States were hospitalised at rates higher than at any moment in the pandemic, according to a report published last week by the Centers for Disease Control and Prevention.

Black adults were four times as likely to be hospitalised compared with White adults during the height of the omicron variant surge, which started in mid-December and continued through January, the report said. In January, the CDC found, hospitalisation rates for Black patients reached the highest level for any racial or ethnic group since the dawn of the pandemic.

As the highly transmissible omicron variant usurped the delta variant’s dominance, people who were unvaccinated were 12 times more likely to be hospitalised than those who were vaccinated and boosted against the coronavirus, according to the report.

And fewer Black adults had been immunised compared with White adults, said the report, which analysed hospitalization rates in 99 counties in 14 states. 

Teresa Y. Smith saw evidence of the phenomenon outlined in the CDC’s report as she treated patients as an emergency physician at SUNY Downstate in Brooklyn.

She has felt the crush of the pandemic’s unequal impact since the pre-vaccine waves but has contended with the consequences of health disparities for much longer. Her hospital sits in a heavily Black and Latino borough, where — as in so many communities of color across the country — social, political, economic and environmental factors erode health and shorten lives.

In December, she watched as the number of cases and admissions resulting from the omicron variant “just exploded in a short, short amount of time,” saying then, “there is no subtlety to it.” And while the vaccinated patients she treated were less likely to be “lethally sick,” many still needed to be admitted to the hospital.

Read full story

Source: The Washington Post, 18 March 2022

 

Read more

USA: Best hospitals by specialty national rankings

In 2023-2024, the US News Best Hospitals ranked hospitals in the USA in 15 adult specialties as well as recognised hospitals by state, metro and regional areas for their work in 21 more widely performed procedures and conditions.

Of the nearly 5,000 hospitals analyzed and 30,000 physicians surveyed, only 164 hospitals ranked in at least one of the specialties.

Read full story

Source: US News

Read more

USA: Antibody drug to protect the vulnerable from Covid goes unused

Sasha Mallett, Sue Taylor and Kimberly Cooley all have immune deficiencies that make them especially vulnerable to Covid-19, and all have tried to get the same thing: a new treatment that can prevent the disease in people who either cannot produce antibodies after receiving a coronavirus vaccine or cannot get vaccinated at all.

Ms. Cooley, a liver transplant recipient in Duck Hill, Mississippi, got the antibody drug, called Evusheld, from her transplant team at the University of Mississippi Medical Center with no trouble. But Ms. Taylor, of Cincinnati, was denied the treatment by two hospitals near her home. And Dr. Mallett, a physician in Portland, Ore., had to drive five hours to a hospital willing to give her a dose.

As much of the USA unmasks amid plummeting caseloads and fresh hope that the pandemic is fading, the Biden administration has insisted it will continue protecting the more than seven million Americans with weakened immune systems who remain vulnerable to Covid. Evusheld, which was developed by AstraZeneca with financial support from the federal government, is essential to its strategy.

But there is so much confusion about the drug among healthcare providers that roughly 80% of the available doses are sitting unused in warehouses and on pharmacy and hospital shelves.

Interviews with doctors, patients and government officials suggest the reasons the drug is going unused are varied. Some patients and doctors do not know Evusheld exists. Some do not know where to get it. Government guidelines on who should be prioritised for the drug are scant. In some hospitals and medical centres, supplies are being reserved for patients at the highest risk, such as recent transplant recipients and cancer patients, while doses in other areas of the country are being given out through a lottery or on a first-come, first-served basis.

Hesitance is also an issue. Some doctors and other providers do not know how to use Evusheld and are thus loath to prescribe it.

Read full story (paywalled)

Source: New York Times, 6 March 2022

Read more

USA: Amid hospital 'chaos,' stick to standards to improve quality

Every time a mistake is made in a healthcare setting, there can be serious repercussions. Patients may suffer lifetime injuries or even pay the ultimate price for someone else's mistake. Hospitals may wind up paying the price literally — financially and legally — and suffer costly public reputation troubles in the aftermath. 

Increased patient loads combined with the workforce shortage and often decreasing financial resources have created "chaos" in hospitals, said Doug Salvador MD, chief quality officer at Baystate Health in Springfield, Mass. 

Safety watchdog organizations, including The Joint Commission and The Leapfrog Group, have reported the result of that chaos: soaring cases of preventable medical errors. 

The solution, he and several other sources who spoke with Becker's said, is to create standard operating procedures in every department, at every step of the patient journey. These SOPs are more than lists of guidelines; they require strict adherence and limited room for error thanks to built-in cross-check points. And, when instituted properly, they highlight system flaws in real time by creating what Dr. Salvador called "situational awareness." 

Situational awareness, he added, keeps front-line healthcare professionals on top of their safety game. 

Read full story

Source: Becker's Healthcare, 9 May 2023

Read more

USA: Alzheimer’s drug lecanemab receives accelerated approval amid safety concerns

The US Food and Drug Administration (FDA) has granted accelerated approval for the Alzheimer’s disease drug lecanemab, one of the first experimental dementia drugs to appear to slow the progression of cognitive decline.

Lecanemab will be marketed as Leqembi, the FDA statement said. It has shown “potential” as an Alzheimer’s disease treatment by appearing to slow progression, according to Phase 3 trial results, but it has raised safety concerns due to its association with certain serious adverse events, including brain swelling and bleeding.

In July, the FDA accepted Eisai’s Biologics License Application for lecanemab under the accelerated approval pathway and granted the drug priority review, according to the company. The accelerated approval programme allows for earlier approval of medications that treat serious conditions and “fill an unmet medical need” while the drugs continue to be studied in larger and longer trials.

If those trials confirm that the drug provides a clinical benefit, the FDA could grant traditional approval. But if the confirmatory trial does not show benefit, the FDA has the regulatory procedures that could lead to taking the drug off the market.

Read full story

Source: CNN Health, 7 January 2023

Read more
 

USA: Alhambra Hospital nurses ratify a new contract with improvements for patient safety and nurse retention

Registered nurses at Alhambra Hospital Medical Center in Los Angeles, California, voted overwhelmingly in favor of ratifying a new three-year contract yesterday, winning protections to improve patient safety and nurse retention.. The collective bargaining agreement was the result of an almost six-month fight, which included an informational picket for patient safety and multiple other actions.

So Hee Park, an ICU nurse at Alhambra, said, “We are so thrilled that after months of negotiations, we have ratified an agreement that provides substantial measures to ensure nurses feel supported and can continue to provide optimal patient care, as well as numerous provisions that will improve recruitment and retention of experienced nurses.”

The contract includes several highlights that will help nurses create better outcomes for their patients, such as provisions for ensuring hospital compliance with existing registered nurse-to-patient safe staffing laws. The agreement also establishes a new Infectious Disease Task Force that will offer new protections against communicable diseases and guarantee levels of PPE supplies. The contract also expands workplace violence prevention plans for all hospital units, as well as stating that quality care be provided to all patients regardless of their immigration status.

Under the contract, nurses will also receive proper orientation when they’re floated to new hospital units, improving care for patients. And, rather than being sent home at management's whims, RNs will be able to remain at work to provide meal and break relief to other nurses, bolstering safe staffing. These measures will ensure nurses are prepared to provide patients with the highest and safest levels of care possible, resulting in improved nurse retention at Alhambra, which will benefit the entire community long term.

Read full story

Source: National Nurses United, 10 November 2022

Read more

USA: Address ‘plane-crash level’ patient harm, HHS tells hospitals

Health and Human Services (HHS) Secretary Xavier Becerra startled a recent meeting of senior health system leaders by declaring in opening remarks that a plane crash had just killed all 200 passengers. He immediately added that this hadn’t really happened; he’d said it only to illustrate the toll taken by medical error.

The 14 November meeting at which Becerra spoke signalled a renewed commitment by HHS to preventing patient harm as it launched an “Action Alliance to Advance Patient Safety.” The Alliance aims to recruit the nation’s largest health systems as participants.

“We’re losing pretty much an airline full of Americans every day to medical error, but we don’t think about it,” said Becerra. (The department’s fiscal 2022-2026 strategic plan actually estimated the death toll at roughly 550 daily, which would be a very large airliner.) “But the worst part about it is that it’s avoidable.”

Though the meeting rhetoric was rousing and the invitee list impressive, specifics remained scarce. The Alliance is described only in general terms as a partnership among health systems, federal agencies, patients and others to implement Safer Together: A National Action Plan to Advance Patient Safety. 

Read full story

Source: Forbes, 17 November 2022

Read more
×
×
  • Create New...