HealthNet News

November/December 2017

Linking Connecticut Patients and Families to Reliable Health Information

In this issue: Payments for journal editors; new blood pressure guidelines; surprise ambulance bills, and more!

Editors of Top Medical Journals Get Healthcare Industry Payments

Editors at some of the most influential medical journals in the U.S. accept payments from drug or medical device companies. Many of these journals do not clearly identify these conflicts of interest. According to Michael Joyce a writer for "HealthNewsReview.org"  this practice is very disturbing because these editors "are primary gatekeepers in determining which studies get published...and which studies will be covered by the media." Studies focusing on payments to medical journal editors were recently published in BMJ, and  PeerJ Preprints (a non-peer-reviewed journal). 

FDA Warns Biotin May Interfere with Lab Test Results

Biotin (aka Vitamin B7), a popular dietary supplement can significantly interfere with certain lab tests causing incorrect test results. Biotin is commonly found in supplements for hair, nails, and skin. It is also added to multivitamins including prenatal vitamins. These supplements have levels of biotin up to 650 times higher than the FDA recommended daily intake. 

Biotin may produce lab results that are too high or too low. Inaccurate test results could cause misdiagnosis and inappropriate patient management. Biotin has been shown to interfere with a test used to diagnose heart attack.

What can you do as a patient? Make sure you include all of your supplements in the list of medications you give to your physician. If your physician is concerned about your lab test results, ask her if biotin supplements could be the cause.

CT Scans for Chest Pain Don't Improve Outcomes

Patients arriving at the emergency department (ED) with chest pain are likely to receive a CT scan  which evaluates blood flow in the arteries feeding the heart or a cardiac stress test that measures heart function during exercise. The use of these tests to rule out a heart attack is controversial. A new study published in JAMA Internal Medicine found that patients with chest pain who received CT scans and stress tests did no better than patients who just received a simple battery of tests that included blood work and an electrocardiogram. Patients who received CT scans and stress tests were exposed to more radiation, had additional testing after discharge, and a paid an average of $500 more  for their ED care. An estimated $10 billion dollars is spent annually on the evaluation of chest pain in EDs. Eliminating unnecessary CT scans and stress tests may be a good way to reduce healthcare spending. You can read a summary of the study's findings here.

New High Blood Pressure Guidelines - What Do They Mean for You?

According to new guidelines from the American Heart Association and the American College of Cardiology anyone having a blood pressure of 130 over 80 and above is considered to have high blood pressure. 130 over 80 is a significant drop from the previous threshold of 140 over 90. As a result, millions more Americans now qualify for a diagnosis of high blood pressure.  Articles in the New York Times, STAT News, Health News Florida and the "WBUR" website offer answers to questions many consumers are asking. 

FDA Warns of the Potential Health Risks of Kratom

The Food and Drug Administration (FDA) issued a public health advisory for the herbal supplement kratom. According to the FDA, people who use the herb in place of opioids to treat pain or to wean themselves off of opioids are exposing themselves to an unregulated product that has not been proven safe or effective. In the U.S. there are many devoted kratom users who claim the herb is their only option in managing pain, anxiety and other conditions. Kratom is a plant from Southeast Asia that uses the same neural pathways as opioids. It has psychoactive properties and appears on the National Institute of Drug Abuse's "Commonly Abused Drugs Charts." According to an article in STAT News, kratom can be easily ordered online and is available in vending machines in Arizona. Products containing kratom are linked to 36 deaths and have seen a 10-fold spike in calls to poison control centers between 2010 - 2015. 

Marijuana Edibles - A Poison Risk for Children

Emergency Department (ED) physicians warn that marijuana edibles manufactured to look like commercially available candies and baked goods can easily lead to accidental poisoning in children.  Because the symptoms of marijuana intoxication - drowsiness, vision problems, and respiratory difficulties- can look like other conditions, ED physicians must keep this possibility in mind when making a diagnosis in children. Adults may not be forthcoming about their marijuana use.

Additives in Foods and Drugs - Cause to Worry?

Additives are synthetic or natural substances added to foods or medications to enhance their appearance or texture, maintain their shape or increase their shelf life. In drugs they are called inactive ingredients. Allergists disagree on whether additives cause allergic reactions. A New York Times article describes several cases in which allergists attributed a patient's hives or rash to food or drug additives. You can use the Daily Med database (accessible through MedlinePlus.gov) to identify inactive ingredients in drugs.  Information about food additives and ingredients is available on the Food and Drug Administration's website. 

Timing Your Surgery for Better Outcome

A new study of patients undergoing aortic valve replacement showed that those whose surgery was scheduled in the afternoon experienced fewer perioperative problems than patients who underwent surgery in the morning. In the 500 days following their surgery afternoon patients had half the risk of a major cardiac event (e.g. heart attack) than the morning patients. One of the genes that controls our circadian clock affects our heart muscle's ability to tolerate insults resulting from surgery.  This gene may cause a patient's heart to heal more quickly in the afternoon than in the morning. The study's authors suggest that cardiac patients at high risk schedule their surgery for the afternoon; however, the study's results need to be confirmed in larger multi-institutional trials. A summary of the Lancet study appeared in STAT News.

My Cancer Genome Launches New Search Tool for Clinical Trials

"My Cancer Genome," a clinical trials database developed by Vanderbilt University's Ingram Cancer Center, has been upgraded to provide more detailed information about cancer trials available to patients. Visitors to the site can now search for clinical trials by disease, genetic variant, biomarker, study phase, and recruiting status. The database limits clinical trials to those with an interventional therapy and with biomarkers as part of the eligibility requirements. A beta version of the search engine is open to patients, physicians, and researchers.

Changing the Health Care Experience for Persons with Disabilities

The Florida Center for Inclusive Communities (FCIC) works to educate healthcare professionals to properly support and care for individuals with developmental disabilities.  FCIC also helps individuals and their caregivers to be proactive about communicating their own health needs. Among the resources on the site is "My Health Passport" a printable document individuals can bring with them to health appointments or for hospitalizations. In addition to the individual's medication list and recent medical history, it clearly states the individual's preferred way to communicate, how the individual shows he/she is in pain, and how to help the individual if she/he gets upset. 

Surprise Ambulance Bills

When the ambulance service that picks you up is out-of-network, your insurer pays what it considers fair. Then - surprise! The ambulance service sends you a bill for the rest. Kaiser Health News explains what consumers can do if they receive a surprise bill. They also offer tips about what consumers can do to avoid surprise bills.

What's Your Town's Mobility Score?

Will you need to buy a car if you take that job offer? Find out how easy it is to get around a city using MobilityScore. This new service rates a location from 0 to 100 based on its proximity to public transit (buses, trains, and taxis); as well as ride-hailing; ride-sharing; and bike-sharing services. The higher the mobility score, the more transportation options there are available. Currently only the 35 largest urban areas in the U.S. are covered.

Surge in Teen Depression and Suicide Tied to Smart Phones 

Researchers at San Diego State University and the University of Florida have linked a surge in teen depression and suicides to smartphone use. Risk factors for suicide increase significantly for teens who spend two or more hours a day online. Time spent on smartphones mean less time for face-to-face interactions and sleep. Both sleep and in-person interactions are critical to emotional health. A summary of the study appears on "The Conversation" website.

More Health Information You Can Use:

• Academic medical centers guilty of misleading stem cell therapy claims.

• MedlinePlus now offers background information on lab tests. Look for the "Lab Test Information" link on the MedlinePlus homepage.

• What's the right way to take your blood pressure? Apparently many health professionals do it incorrectly.

• Want to avoid the holiday weight gain?  Take the National Cancer Research Institute's "holiday portion quiz" to right-size your dessert plate.

• Holiday gifts seniors will be thrilled to receive. 

• Telepresence robots let kids with long-term illnesses stay connected with their peers.