First, we had the "stroke belt," a swath of the American South characterized by those with unmanaged high blood pressure and a sedentary lifestyle. Then, we got the "obesity belt," a portion of Southern geography inhabited by a number of folks with elevated cardiovascular disease as well as a sedentary lifestyle. Now, researchers from the Centers for Disease Control and Prevention have brought us the "diabetes belt," a county-by-county census of patients with type-2 diabetes. This swath of obesity and sedentary lifestyle also girds the American South, stretching down the southeastern seaboard, 'round the silty Mississippi Delta and following the Appalachian Mountains north across Tennessee, Kentucky and West Virginia. It lessens just inside the borders of Ohio and Pennsylvania.
Two federal reports issued this week highlighted problems in several areas at John Cochran VA Medical Center in St. Louis. The improper sterilization of dental equipment uncovered last year was "a long-standing problem that went unrecognized and unaddressed" by managers, according to a report released by the VA Office of Inspector General. Investigators revisited Cochran in August and September at the request of several members of Congress after the hospital informed more than 1,800 veterans that they may have been exposed to viruses. In a routine inspection the previous March, investigators had listed 21 problems in the dental clinic related to infection control — including tools that were visibly dirty after sterilization. Hospital staff were overwhelmed and undertrained, according to the federal report.The follow-up investigation concluded that the risk of contracting any disease from the dental tools was unlikely.
Insurance premiums for Georgia state employees, retirees, teachers and school personnel could increase by as much as 67% next year because the state has a $250 million shortfall in its health benefits program. If the state makes up the newly discovered shortfall only with premium increases, costs could rise by two-thirds for employees, teachers and state government retirees. That would mean an extra $100 to $200 or more per month for many of them. House leaders learned last week of new calculations showing a $250 million hole in the program, which was already slated to cost almost $3 billion, House Speaker David Ralston told The Atlanta Journal-Constitution on Tuesday.
The federal government Tuesday granted Maine a waiver of a key provision in President Obama's health care overhaul, citing the likelihood that enforcement could destabilize the state's market for individual health insurance. The U.S. Health and Human Services department said in a letter that it would waive the requirement that insurers spend 80 cents to 85 cents of every premium dollar on medical care and quality improvement. Instead, the letter said, the state could maintain its 65% standard for three years, with the caveat that HHS intends to review the figures after two years. The decision makes Maine the first state to receive a waiver of the requirement. Similar requests are pending from Kentucky, Nevada and New Hampshire.
In testimony on a bill proposing a database on health care costs in Montana, an insurance executive Monday detailed what he said is "monopolistic, predatory price behavior" by one of the state's largest hospitals. "The truth is, most Montana hospitals operate with no competition; they are monopolies," said Eric Schindler, CEO of the Montana School Services Foundation, which oversees a health insurance trust for 136 school districts in Montana. "The trend toward an integrated model of hospitals (that also employs physicians) makes them even more of a monopoly." Schindler said Benefis Hospital in Great Falls, the second-largest hospital in the state, has increased its prices more than 30% in the past three years, both through direct price increases and by reducing the discount it gives as a "network" provider for insurance customers. The increases came in the wake of the 2006 lifting of a state ceiling on Benefis prices, which had been imposed in 1999 when two competing Great Falls hospitals merged to create Benefis, Schindler noted.
A promising "smart" cardiac catheterization device could cut catheterization procedure time for arrhythmias in half, while dramatically improving safety and efficacy new research shows.
Researchers published details about the device in the March issue of Nature Materials. The device, tested in animals at academic medical institutions in the U.S., is slated to undergo human trials in a year to 18 months, and researchers hope it will be available for the U.S. market in 2 or 3 years.
The catheter combines diagnostics and treatment ability in one device by having tools electronically "imprinted" on a standard balloon catheter. These tools give feedback to surgeons that allow them to proceed with greater precision, and enable them to eliminate tissue damage.
Researchers theorize that with the new catheter, the procedure of taking care of cardiac arrhythmias, which can take about two hours, may be reduced to an hour or less. The current treatment for patients with cardiac arrhythmias requires that doctors insert at least two catheters. One is used to map where the arrhythmias are happening, and the other is used to ablate abnormal tissue. The new device has dual functionality, offering "map and zap" technology.
"Our goal is to make the procedure as short as possible," says Dr. Rooz Ghaffari, co-founder and scientist at MC10, the Cambridge, MA-based company that is developing the product. "If you can combine sensing and therapy onto one device, that is the path to making it faster."
This is good news for hospitals, cardiologists, and patients since shorter procedures are generally safer. A longer procedure comes with a higher risk of blood clots or stroke. It also requires the patient to be sedated longer, which has its own risks.
"If you look at rates of morbidity in these procedures, they closely correlate to time," says John Rogers of the University of Illinois at Urbana-Champaign, one of the researchers who developed the stretchable electronics. "Anything that you can do to make this faster is safer. And, it requires a lot less skill on the part of the surgeon."
In addition to being significantly faster, and potentially safer, the device may also deliver greater efficacy. Since the device will be able to give the cardiologist feedback, he or she will know exactly how much tissue they need to ablate for greater precision. "We currently give a dose that we think is right," said Dr. Marvin Slepian, M.D. at the University of Arizona, and a lead researcher on the project. "Sometimes, it's too little and sometimes too much. Being able to have additional intelligence in terms of the amount of energy being dispersed would tell us about appropriate dosing, history, and control."
Dr. Slepian talked about what this kind of technology means to hospitals and practice managers. "The implication of this is huge on all levels," he said. Greater efficacy means fewer complications, more success, and fewer rehospitalizations. He adds that, on a practical level, there will be fewer catheters on the shelf taking up valuable hospital storage space, and the instant feedback from the device means less time in the lab.
Because the catheter is not technically a new therapy, but only changes the way a therapy is delivered, it will likely be considered by the FDA "substantially equivalent" to a device already on the market. That means approval could come within the next 12 to 18 months.