Listening to the political debate about health care, and in conversations with patients and health professionals across the country, I get the sense that some people that feel their choice of doctors–and hospitals–is threatened and that people are losing their regular doctors as insurers narrow provider networks to lower costs. Critics have blamed the Affordable Care Act; in a recent campaign rally in Iowa, Sen. Ted Cruz charged that Obamacare is "taking our doctors." Data from the Kaiser Family Foundation's January health-tracking poll, however, indicate that this problem is smaller than conventional wisdom and critics have suggested.
Instead of looking for love, Delray Medical Center physicians were looking for patients at a recent Physician Speed Dating event at the Cascades of Boynton Beach. Organized by Mickey Victoria, outgoing president of The Pap Corps Champions for Cancer Research's Cascades chapter, the event was inspired by speed dating for singles. More than 13 physicians of all specialties, including David Buchalter and Brian Coleman, orthopedic surgeons from South Palm Orthopedics, and Brijeshwar Maini, an interventional cardiologist, each had seven minutes to give their spiel and more than 100 attendees and potential patients to ask questions about their specialties.
For the past two years, Joseph Richardson has been trying to figure out how to keep young black men with knife and gunshot wounds from turning up again with similar injuries at Prince George's Hospital Trauma Center outside Washington, D.C. Richardson is director of the Violence Intervention Research Project at the trauma center. When these men are admitted, he shows up at their rooms to ask them to take part in his ongoing study on risk factors for repeat violent injuries. Sometimes he finds them handcuffed to a hospital bed, guarded by a police officer or two. Richardson has to walk away. The patients are under arrest and off-limits to him.
I heard the other day that war has been declared on cancer for the third time in the last 40 years. The first time was when President Richard Nixon declared war in 1971 and it was due to be won 20 years later. Then one of the directors of the National Cancer Institute declared war and that was due to be completed in 2015.
The rise of immunotherapy topped all other advances in oncology during 2015, according to an annual research report from the American Society of Clinical Oncology (ASCO).
A systematic review of observational studies represents the most robust evidence yet that legislative action banning smoking in public places may be improving health outcomes. From MedPage Today.
Smoking bans aimed at reducing secondhand smoke exposure appear to have a positive impact on cardiovascular disease rates and outcomes across the globe, according to an updated Cochrane review of 77 observational studies from 21 countries.
The systematic review represents the most robust evidence yet that legislative action banning smoking in public places may be improving health outcomes, Cecily Kelleher, MD, of the University College Dublin, and colleagues wrote in the Cochrane Database of Systematic Reviews 2016.
The report updates a 2010 Cochrane review, which found smoking bans in work places and public spaces had a positive impact on secondhand smoke exposures. Since 2010, the research emphasis has shifted from smoke exposures to health outcomes in places that have enacted smoking bans, Kelleher told MedPage Today in a telephone interview.
She said most studies in the updated review showed declines in hospital admission rates due to cardiovascular disease following the initiation of smoking bans.
"It is clear that cardiovascular disease admission rates have been falling in temporal association with the bans," she said, adding that the impact appears to be greatest among nonsmokers.
The systematic review included studies designed to investigate the effect of smoking bans on any measure of health or on smoking behavior, conducted in nations, states, and municipalities with smoking bans in place for at least 6 months. Sixty-five of the 77 identified studies were new and 12 were included in the 2010 review.
Seventy-two studies reported health outcomes, including cardiovascular (44), respiratory, (21) and perinatal (7) outcomes. Eleven studies reported death rates, and none were randomized controlled trials.
"We found consistent temporal trends with evidence of significant reductions in acute myocardial infarction (AMI)/acute coronary syndrome (ACS) admissions following the introduction of national smoking bans," the researchers wrote. "Significant reductions in rates of admissions and discharges were evident in 12 studies."
Results from several studies suggest the greatest health benefits occur in nonsmokers.
A registry study from Germany, published in 2014, showed a 26% decline in hospital admissions due to ST-elevation MI in nonsmokers after smoking bans went into effect and a 16% decline overall, Kelleher noted.
"The evidence signifies that legislative smoking bans are justified, given that we are looking at a significant degree of consistency in these findings," she said.
She added that there is a need for more high-quality studies examining the impact of smoking bans on respiratory and neonatal health outcomes and smoking-related mortality.
The review found "low quality evidence" of reduced mortality for smoking-related illness, and the researchers concluded that the evidence of an association between smoking bans and improved respiratory and perinatal health outcomes is lacking.
"We need research on the continued longer-term impact of smoking bans on the health outcomes of specific subgroups of the population, such as young children, disadvantaged, and minority groups," the researchers wrote. "More robust research on the impact of smoking bans is warranted, especially in relation to respiratory and perinatal health outcomes."