New hand-held emergency pain relief inhaler launched in the UK

http://goo.gl/htDRaS

The Royal College of Emergency Medicine (RCEM) acknowledges that ''pain is commonly underrecognised, under-treated and treatment may be delayed6.'' The RCEM Best Practice Guidelines recommend that patients in moderate to severe pain should be given pain relief within 20 minutes of arriving at an Emergency Department6, however few are managing to achieve this.

"Treatments such as IV analgesia or gas and air can be cumbersome to set up and take time to administer. Penthrox is easy to use and relieves pain quickly, freeing up healthcare professional time for a more efficient service and a better patient experience. Its availability in the UK is an important step forward in the emergency relief of acute pain", said Dr. Justin Kirk-Bayley, Consultant Intensivist and Anaesthetist at the Royal Surrey County Hospital in Guildford, Surrey.

Alongside its use in Emergency Departments, Penthrox can also be used in a variety of pre-hospital settings by appropriately trained persons, such as paramedics.

"It is fast-acting and provides relief quickly," commented Joe Emery, a paramedic and Clinical Quality Manager at the South East Coast Ambulance Service (SECAmb) where Penthrox has recently been evaluated. "We have been able to help badly injured patients in serious accidents much quicker and control their pain on their way to hospital. The benefit for the patient is obvious but by enabling us to get the patient's pain under control quickly we can work more efficiently."


Aspirin May Protect Against Staph Blood Infections

http://goo.gl/VqbLqu

Swiss scientists followed 838 cases of S. aureus infection from 2001 through 2013. From the group, they selected 157 who were taking aspirin and matched them with 157 controls, similar in age, severity of infection, treatments undergone and various other health and behavioral characteristics, but who were not taking low-dose aspirin. The study is in Critical Care Medicine.

At the end of 30 days, 27.4 percent of the controls had died, but only 12.1 percent of those on aspirin had died. After controlling for other factors, taking low-dose aspirin was associated with a 42 percent lower risk of death.

The authors did a similar analysis with 134 aspirin users with E. coli infection and 134 controls, but found no effect of aspirin on infection with that germ.


‘Conceptual Breakthrough’ Regarding the Chemicals We’re Stewing In

https://goo.gl/WHrXky

“We found definite evidence that chemicals that are unavoidable in the environment can produce a wide range of low-dose effects that are directly related to carcinogenesis. So the way we’ve been testing chemical safety is really quite out-of-date.”

“Every day we are exposed to an environmental ‘chemical soup’ and we need testing to evaluate the effects of our ongoing exposure to the mixtures in this soup.”

~ William Goodson III, a senior scientist at the California Pacific Medical Center in San Francisco.

 

“This research backs up the idea that chemicals not considered harmful by themselves are combining and accumulating in our bodies to trigger cancer and might lie behind the global cancer epidemic we are witnessing.

~ Cancer Biologist Dr Hemad Yasaei from Brunel University London

.

This would be all kinds of everyday chemicals, such as those that trigger MCS – they included chemicals found in items such as mobile phones, detergents and cooking pans, and pesticides used on fruits and vegetables!

Read the research or check out some of the media reports:


How to Expand Home Care by Streamlining Medicaid

http://goo.gl/XUu2cj

Currently, states receive waivers of federal Medicaid requirements in order to include home health and other services, and approximately 3 million individuals receive HCBS each year thanks to these waivers. Still, the amount of HCBS varies dramatically among states, in part because the process of getting waivers through state plan amendments (SPAs) is too complicated, the report states.

“Streamlining and consolidating existing waiver authority into a single SPA would assist states seeking to expand the availabilityof HCBS,” the authors write. “Combining features of existing SPAs would permit states to offer HCBS in a way that moves toward eliminating Medicaid’s bias for institutional or facility-based care, give states the flexibility and predictability they need to expand services to best address the needs of varying populations, and maintain essential provisions of federal law that allow individuals to direct their own care.”

Specifically, a streamlined waiver would encompass a number of features. These include:

Permitting states to offer services to people who do not require institutional-level care

Permitting states to cover any item or service that the Health and Human Services Secretary has approved for coverage under an HCBS waiver, including certain rehabilitative and respite care

Extend certain federal matching funds

In addition to the streamlined waiver process, HCBS services could be better supported by more affordable private insurance, the report proposes.

Lead in the Flint, Michigan Water System (LOTS of Federal and State Resources)

PDF file...

https://goo.gl/D0OQAU

Several Michigan, local, and federal agencies are responding to the presence of lead in the drinking
water in Flint, Michigan. The National Library of Medicine Specialized Information Services Division
(NLM SIS) provides information on the medical and public health aspects of chemical incidents for
health professionals, policy makers, and volunteers who may be responding to an incident and for
people living in or concerned about the affected region. The information below about health effects of
lead and safe drinking water is from the National Library of Medicine resources including the Hazardous
Substances Data Bank (HSDB); ChemIDplus, Tox Town, and MedlinePlus as well as from other federal
agencies, local agencies, and other authoritative sources. 

Inside the Belarusian Institutions for Chernobyl Radiation Victims

Institutions are still abandonment....

http://goo.gl/nYWtdR

In her photo series "The Invisible People of Belarus", photographer Jadwiga Bronteexplored the effects of the Chernobyl disaster on the people of Belarus, specifically those living in governmental institutions called "internats". These institutions are a blend of an asylum, an orphanage and a hospice, where thousands of Belarusians spend their lives, often "handed over" to the government by relatives soon after birth.

Linda Walker, Executive Director of the Chernobyl Children's Project UK (CCPUK) – who has worked in Belarus for 20 years – says the situation in the country is changing for the better. Over the last decade many of the country's orphanages have closed, with more emphasis being put on placing children with foster parents. Walker also says there is an acknowledgement from authorities that more people should be living in the community rather than in institutions. To that end, CCPUK hope to set up a new project next year where they will work with a number of institutions in organising educational visits and training to try to ensure more young people are able to live independently and integrate into society at large.

I spoke to Jadwiga about her project.

Good News: CMS Issues Final Rule Prohibiting “Homebound” Requirement for Medicaid Home Health Services

http://goo.gl/DRi0mM

On February 2, 2016, the Centers for Medicare and Medicaid Services (CMS) will issue a final rule codifying the homebound prohibition for Medicaid home health services, and clarifying the settings where homebound services may be provided. The final rule revisesMedicaid home health regulations (42 C.F.R. § 440.70(c)(1-2)) to make clear that a Medicaid beneficiary does not need to be “homebound” in order to receive home health services. In addition, CMS explains that home health services may be provided in any setting where normal life activities take place and are not limited to a hospital, nursing facility, or other institution.

Unfortunately, the final rule is limited to Medicaid’s homebound requirement and does not change the Medicare homebound requirement.

The Medicare refusal to change also affects people on spenddown.

Epigenetics drives weight differences between identical twins

http://goo.gl/qzAV9S

Having overweight parents significantly increases your risk of obesity, but the inheritance of specific mutations can't always explain why this is the case. In a study published January 28 in Cell, researchers show that differences in gene expression and not the DNA sequence play a key role in determining one's predisposition to obesity. In genetically identical mice and human twin pairs, epigenetic marks altered the activity of weight-control genes to produce distinct subpopulations of lean and obese individuals. The findings reveal a key role for an epigenetic switch in explaining individual differences in obesity.

In the end, this research could have important clinical implications. "These findings set a new playing field for disease-associated epigenetic effects," Pospisilik says. "Previously, people would have thought that epigenetics can moderately increase or decrease traits of an organism, and that epigenetic therapies could then alter or combat these shifts. Our study shows that these shifts may not only occur along a continuum, but may also have areas of high stability. This suggests the possibility that we may be able to switch physiology to produce a state that is inherently stable to stay lean or obese."


Drug Shortages Forcing Hard Decisions on Rationing Treatments

Gee, I wonder if disability affects access to drugs in shortage. Ya think?.....

http://goo.gl/NLnIvd

In recent years, shortages of all sorts of drugs — anesthetics, painkillers,antibiotics, cancer treatments — have become the new normal in American medicine. The American Society of Health-System Pharmacists currently lists inadequate supplies of more than 150 drugs and therapeutics, for reasons ranging from manufacturing problems to federal safety crackdowns to drugmakers abandoning low-profit products. But while such shortages have periodically drawn attention, the rationing that results from them has been largely hidden from patients and the public.

At medical institutions across the country, choices about who gets drugs have often been made in ad hoc ways that have resulted in contradictory conclusions, murky ethical reasoning and medically questionable practices, according to interviews with dozens of doctors, hospital officials and government regulators.

Patients’ weight can be taken into account. Obese patients, who researchers found needed up to three times the amount of an antibiotic before surgery than average-size patients, were given only the standard dose at the Cleveland hospital until a shortage subsided.

Some institutions prioritize based on age; others do not. Marc Earl, a Cleveland Clinic pharmacist, said children were not favored over adults during chemotherapy shortages. But at other hospitals, they have been, because of their potentially longer life span or because they sometimes require smaller doses of a drug.

When the study was published last year in the journal Anesthesia and Analgesia, an accompanying editorial urged health professionals to disclose shortages and their implications. “Patients want to know and they should know,” the editorial said. “There is no ethical ambiguity.”