HealthNet News

July/August 2017

Linking Connecticut Patients and Families to Reliable Health Information

In this issue: 

Is Your Surgeon Double-Booked?

"Double-booking," or "running two rooms," is a long-standing practice at teaching hospitals. A senior attending surgeon delegates residents or fellows to perform parts of one surgery while the senior surgeon operates on a second patient in another operating room. Double booking is most common in orthopedics, cardiac surgery and neurosurgery.  According to an article in Kaiser Health News, sometimes the senior surgeon is not even in the OR and is seeing patients elsewhere. The safety of this practice has been largely unquestioned. Hospitals are supposed to police this practice, yet patients who sign consent forms say they were not told their surgeons would be operating on another patient at the same time.

Childhood Behavior Disorders Treatment Guidelines in Spanish

The Agency for Health Care Quality and Research has published a Spanish-language summary of evidence-based recommendations for the treatment of childhood disruptive behavioral disorders (DBDs). Spanish-speakers will find information about what DBDs are, how they are treated, possible side-effects of medications, and topics to talk about with their child's physician.

Americans Lead the World's Obesity Epidemic

More than ten percent of the world's population is obese. According to a study published in the New England Journal of Medicine, obesity is even a problem in African countries that have historically been plagued by food shortages. Among high-income countries, the United States has the highest obesity rate. Over 70 percent of Americans over the age of 20 are obese or overweight; 17 percent of children aged 2 - 19 are obese.  In the U.S. children as young as five are receiving gastric bypass surgery (aka stomach stapling) to lose weight. Harvard's T.H. Chan School of Public Health has published a special report examining the obesity crisis and recommends an agenda to halt this epidemic. The website NutritionFacts.org offers a number of short videos citing the science around preventing obesity.

Gabapentin - New Target of Drug Abuse

Gabapentin is FDA-approved for the treatment of epilepsy and pain caused by nerve damage. The drug which is sold under the brand name Neurotin, acts as a sedative. Because it is considered non-addictive, the Centers for Disease Control recommends it as an alternative treatment to opiates for chronic pain. Opioid abusers have discovered that Gabapentin also enhances opioid highs and bypasses the blocking effects of medications used for addiction treatment. Gabapentin allows opioid abusers to get high while in recovery. Little is known about the long-term effects of this drug. Check out this story in STATNews.

Database of Clinics that Prescribe HIV Prevention Drug 

Aaron Siegler, an epidemiologist research professor at Emory University, has created the first national database of clinics that offer the HIV prevention drug PrEP. PrEP stands for pre-exposure prophylaxis. It is a drug combination that when taken as prescribed, is extremely effective in preventing the spread of HIV. HIV (Human Immunodeficiency Virus) is the virus that causes AIDS. PrEP protects men who have sex with men, as well as women who are partners of HIV positive men and IV drug users who share needles.  You can search the database at preplocator.org. Visit the HIV.gov website to learn more about PrEP. 

Depression is Common Among Heart Attack Survivors and Can be Deadly

Kaiser Health News reports that major depression affects one in five people hospitalized for a heart attack. This is about four times the rate in the general population.  Heart disease patients who become depressed are twice as likely to die within ten years as other patients. Depressed patients are more likely to smoke and less likely to exercise and follow a healthy diet. Sadly, few cardiologists screen their patients for depression. Many doctors also fail to refer heart disease patients to cardiac rehabilitation. Cardiac rehabilitation has been shown to reduce depression and help prevent future heart attacks and deaths.

Combo Pills Jack Up Prescription Drug Prices

A reporter from ProPublica describes how drug company Horizon combined two cheap, readily-available generic drugs into a convenience drug with a shocking price tag. Vimovo combines pain reliever naproxen, a non-steroidal anti-inflammatory drug (NSAID) with Nexium, a drug that protects against stomach upset. Stomach upset is a frequent side-effect of NSAIDs. While patients paid only $10 for a month's supply of Vimovo, their insurance companies were billed $3252! Do other drug manufacturers do this?  

Amazon Echo for Dementia

Imagine a personal assistant for a loved one with dementia that will answer the same question endlessly, talk about the news or weather, or play their favorite music or audiobook.  Caregivers are discovering that Amazon's voice-activated Echo has amazing potential to help older adults with physical or mental challenges. The Echo can entertain older adults and help to keep them safe and comfortable by delivering medication reminders, turning on lights, and regulating room temperatures. Check out the website dailycaring.com to learn more.

Novel Diagnostic Test Better at Catching Lyme Disease Early

Currently there is only one FDA-approved test for Lyme Disease. It measures antibodies our body makes in response to the disease. Because antibody levels are low in the early stages of Lyme Disease, this test is accurate only 29 - 40 percent of the time. STAT News reports on a new approach being studied by the CDC. It involves creating a Lyme Disease molecular "signature" which identifies a dramatically higher share of earlier infections. When caught early, Lyme Disease is easily treatable with a course of antibiotics. But because some clinicians will not prescribe antibiotics without a positive Lyme test, their patients may not be diagnosed until later in the disease course when they develop symptoms like severe arthritis or short-term memory loss.

Unproven Stem Cell Therapies "Marketed" on Clinicaltrials.gov 

A new study in the journal Regenerative Medicine reports that stem cell clinics are using the federal government's "Clinicaltrials.gov" database to market unproven therapies to desperate patients. Clinicaltrials.gov is a searchable registry of publicly- and privately-funded clinical trials which is maintained by the National Library of Medicine. Clinicaltrials.gov is a trusted resource for patients and families seeking new or alternative treatments. 

The process of listing a trial on Clinicaltrials.gov is largely automated. There is no close monitoring of trials to ensure that they comply with regulations or ethical guidelines. Stem cell therapies are not currently regulated by the Food and Drug Administration. Organizations sponsoring clinical trials usually pay for most of a patient's costs. Stem cell clinics, however are charging patients to enroll in their trials. The author of the study, Dr. Leigh Turner of the University of Minnesota Center for Bioethics and School of Public Health has called on the federal government to more closely screen clinical trials before they are added to Clinicaltrials.gov. Articles about Dr. Turner's research appear in the Washington Post and Wired magazine.

Arsenic Found in Rice, Chicken, Mushrooms, and Wine

You may have seen headlines in the news about arsenic found in rice and products made from rice. Although arsenic occurs naturally in the soil, it can also be the result of agricultural practices. According to the NutritionFacts.org website, factory farms use arsenic-containing drugs to kill intestinal parasites. Arsenic is absorbed into the tissues of animals fed these drugs. Chicken meat appears to contain the most arsenic. NutritionFacts.org also notes that arsenic is fed to chickens to make their flesh pinker. Arsenic containing chicken poop may be used in fertilizers used on the crops we eat. It is also added to leaf litter used in mushroom cultivation.  NutritionFacts.org has many videos on arsenic contamination on their website. Each video is a bite-size review of high quality scientific studies presented in terms consumers can understand.

Other News You Can Use:

• No cell signal? No problem! A free app from Hiking Trails offers trail maps for download so you don't need a signal.

• NIH's new interactive app lets you explore surgery tools of the future.

• Android device users can now add wheelchair accessibility details to Google Maps themselves.

• Microsoft's free "Seeing AI" iPhone app uses artificial intelligence to describe the world for the visually impaired.

• Hormone-disrupting chemicals called phthlates have been found in boxed macaroni and cheese.

• Text 572-51 with the words "send me" followed by a keyword, a color, or even an emoji. The San Francisco Museum of Modern Art will send you back a piece of art that matches your mood.