Health and Disability

The study, from Eastern Virginia Medical School in Norfolk, Va., reported some remarkable success in treating patients who were at high risk of sudden death.

The story began in January, 2016, when Dr. Paul Marik was running the intensive care unit at Sentara Norfolk General Hospital. A 48-year-old woman came in with a severe case of sepsis — inflammation frequently triggered by an overwhelming infection.

"Her kidneys weren't working. Her lungs weren't working. She was going to die," Marik said. "In a situation like this, you start thinking out of the box."

Marik had recently read a study by researchers at Virginia Commonwealth University in Richmond. Dr. Berry Fowler and his colleagues had shown some moderate success in treating people who had sepsis with intravenous vitamin C.

Marik decided to give it a try. He added in a low dose of corticosteroids, which are sometimes used to treat sepsis, along with a bit of another vitamin, thiamine. His desperately ill patient got an infusion of this mixture.

"I was expecting the next morning when I came to work she would be dead," Marik said."But when I walked in the next morning, I got the shock of my life."

The patient was well on the road to recovery.

Marik tried this treatment with the next two sepsis patients he encountered, and was similarly surprised. So he started treating his sepsis patients regularly with the vitamin and steroid infusion.

After he'd treated 50 patients, he decided to write up his results. As he described it in Chest, only four of those 47 patients died in the hospital — and all the deaths were from their underlying diseases, not from sepsis. For comparison, he looked back at 47 patients the hospital had treated before he tried the vitamin C infusion and found that 19 had died in the hospital.

Protect MI Care joins in the call for “better healthcare for more people at less cost.”

The clinical outcomes of a new integrated model of care for frail seniors that bridges housing and healthcare are so significant that researchers believe the program has the potential for substantial Medicare cost savings.

The model provides residents with onsite, comprehensive therapy, medical care, pharmacy, and lab services. Key components to the program include a care navigator who coordinates the residents’ total care and high-tech/high-touch communications that transfer the resident’s information to ancillary and acute care services through an electronic health record.

Although Juniper Communities’ residents were older and more cognitively impaired than the overall Medicare population with similar conditions, independent researchers from Anne Tumlinson Innovations looked at 2012 Medicare Beneficiaries Survey, as well as those living in senior housing that didn’t provide an integrated healthcare program, and found Juniper's Connect4Life program had:

50% lower inpatient hospitalization rates

80% lower readmission rates

15% lower rate of emergency department use

“The results show when you provide supportive housing and services and integrate with clinical care services you can avoid high utilization of the highest cost services,” said Katzmann, noting that it has the potential to address population health among the 5% who use 50% of healthcare resources.

In a new clinical trial to observe a new method of injecting islet cells into a patient with Type 1 diabetes, doctors from the University of Miami’s Diabetes Research Institute have confirmed that their first trial patient no longer needs insulin therapy. Wendy Peacock, their first patient, has been giving herself insulin injections and following a strict daily schedule to take care of her diabetes since she was diagnosed with Type 1 diabetes at 17. Now 43, Peacock has undergone the surgery in this new trial and no longer needs injections because her body is producing insulin naturally. Since the minimally-invasive procedure in August 2015, she also no longer has the dietary restrictions that coincide with having Type 1 diabetes.

Wendy Peacock, a 43 year old female was suffering from Type 1 diabetes when she was 17 to her forties. But now the doctors have claimed that she is the first patient that doesn’t need to undergo insulin therapy anymore. Wendy has been treating herself with daily insulin injections which are controlling her diabetes level in the body. Insulin injections were the only diagnosis present in the world for controlling diabetes before the discovery of this new method. Now at the age of 43, she has made her mind and agreed for the surgery. After the surgery the doctors have discovered that her body was producing the insulin naturally which means she doesn’t need to treat herself from any kind of treatment. Now, she is free to eat any kind of food and all the food restrictions that are imposed on her have been removed by the doctors. Improper food and lifestyle causes diabetes problem in most of the people.

As a headache specialist, the topic of sinus headache is a frequent point of discussion. Many patients deny that they have migraines, believing sinus problems are the cause of their headaches. Some of the more tech-savvy patients believe that they have both migraines and sinus headaches after consulting with “Dr. Google.” The reality of the situation is that 86% or more of patients who suspect that they have sinus headaches in fact have migraines.

An incorrect diagnosis of sinus headaches can also serve to skew a patient’s family history. Migraine is a genetic disorder that is passed down through family members. Patients often deny that any of their family members have migraines, but when asked about sinus headaches, they will often respond, “Actually, my mother had sinus headaches.” When questioned about the mother’s sinus headache behavior, the same patients frequently respond, “She would lay down, and insist that the room be dark and quiet. She would also ask for a bucket to be placed by the head of the bed even though she rarely ever threw up.” Such responses tend to lead the physician and patient to the conclusion that migraines actually do run in the family, as sinus headaches are not typically accompanied by light sensitivity, sound sensitivity, and nausea. The same patients will also return for a follow-up appointment noting, “It turns out that my sister, cousin, and aunt all have migraines, which they thought were due to sinus problems.” In a jocular way, I at times reply, “Discovering family members that suffer from migraines can be both unfortunate and comforting, but such discovery is not as devastating as routinely encountering a family member who regularly causes headaches, which I refer to as ‘mother-in-law syndrome.’”

While I was lecturing on distinguishing sinus headache from migraine with some Harvard medical students, they came up with the phrase Mathew’s Sinus Triad to encompass three features that are more suggestive of sinus headache than migraine. These are:

1. Thick, infectious looking mucous. A little clear drainage can be seen with a number of conditions, and is not necessarily indicative of a sinus infection.
2. Fever. It would be very unusual for migraine to present with fever, but fever is a primary symptom of a sinus infection.
3. Imaging. If an imaging study or evaluation with an endoscope looking up the nose shows a sinus problem, then the headaches are likely related to that — unless the headaches continue after the sinus problem is successfully treated.

The American Association of Poison Control Centers (AAPCC) has launched a new interactive online tool, www.poisonhelp.org, to provide quick, expertly vetted answers to questions about poisoning -- the leading cause of injury-related death in America. This alarming trend of poison-related deaths and injuries – especially in children – is directly linked to the increased prevalence and use of opioids and other prescription pain relievers, coupled with emerging poisoning hazards such as marijuana edibles, liquid nicotine, and single use laundry detergent packets increasingly found in homes, nationwide.

It is when one begins to consider the causes of Medicaid’s exponential growth that it begins to dawn on the observer just how complicated reforming the program can get. Medicaid size and scope are a reflection of profound drivers:

• escalating poverty especially among families with children;
• population demographics and an aging society;
• the widespread erosion of employer coverage, particularly for lower income workers;
• infant mortality and child development;
• major advances in life-saving technology; and
• public health crises both natural and manmade.

Over a half century, federal and state policymakers alike have turned to Medicaid because its flexible structure repeatedly has offered the ability to nimbly respond to social problems as they emerge—for example, ramping up relatively quickly in the face of immediate need, such as a recession, and then scaling back. When the Zika crisis hit, states turned to Medicaid to immediately fund the intensive outreach and case management needed to help identify women and families at risk. Medicaid accounts for nearly half of all births, covers over one-third of all children, and accounts for nearly half of all long-term care spending. The program has enabled children with severe disabilities to attend school and adults with severe disabilities to work.

Thus, how to change Medicaid’s growth trajectory without weakening its unique and indispensable qualities represents perhaps the most significant of all U.S. health policy challenges. The rest of the nation’s intensely market-driven system, as well as Medicare, rests on Medicaid’s features and capabilities.

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