A step towards better health care

 

step towardsToday, we live in an era of customization. Increasingly, customers can modify a product’s appearance, features, or content according to their unique needs or desires. Often, even the news we see in our newsfeeds is customized based off our preferences.

Why, then, are so many aspects of the health care industry still one-size-fits-all?

As doctors, we’ve seen firsthand how this can negatively impact patients who require more individualized care. One particular example is a practice known as “step therapy” or “fail first.”

Now, when patients visit their doctors for a prescription, the treatments they are prescribed are typically based on a variety of personal factors. These factors include their health history, underlying symptoms, and their doctor’s long-term understanding of their condition, such as whether they have already tried certain drugs under a different health insurance plan, if they have other medical conditions that might interfere with the drug’s effect, whether certain drug’s side effects will affect the patient’s ability to perform their job, or if the patient would prefer a drug that has a different ingestion method or dosage form. Treatment plans need to be based on the individual’s needs, and their doctors’ medical expertise and first-hand knowledge of their patients’ overall health.

 However, far too often, what happens next is the problem. When a patient goes to the pharmacy to fill their prescription, they may be informed that their physician-prescribed medicine will not be covered unless the patient first proves that another medication-one of the insurer’s choosing, not their doctor-will not work for them.

In such a case as this, failure is not only an option, it is the only option before getting appropriate treatment.

Under the current system, patients are left with a limited set of options: either try a medication that is not what their doctor recommended for their condition, or pay out of pocket for the treatment they need. For many people, that’s not a choice at all. They are simply forced to fail on a medication other than what their doctor prescribed.

Read More: http://snip.ly/3h8ax#http://thehill.com/blogs/congress-blog/healthcare/356083-a-step-towards-better-health-care

‘Synthetic lethality’ targets cancer cells by damaging vulnerable DNA

Synthetic lethality.png

By designing small molecules that can “turn off” kinase enzymes stuck in the “on” position, they have managed to ward off cancer’s attack. More recently, scientists have focused on ways to help the body’s own immune cells seek and destroy cancer cells.

Enter the concept known as synthetic lethality. Researchers have long known that a cancer cell hobbling along with one broken gene is vulnerable. Knock out another key gene, they have discovered, and the cell will topple.

The notion of killing cancer cells by damaging their already compromised DNA should sound familiar. Chemotherapy agents do just that, but by using a sledgehammer to smash away at DNA. Because drugs that exploit synthetic lethality act with precision, they promise to be able to discriminate between healthy and diseased cells.

“In experiments, you have a perfectly happy cell, you remove one gene and challenge it with one stress, and it dies. You think, ‘Yeah, I’ve got a target now!’ ” says [structural biologist Lance] Pearl, whose lab is working on drugs against synthetic lethal targets. “But that’s not a tumor.”

“Right now, the field is okay at the cellular level. But finding drugs and making sure they actually work in a real tumor is where they need to go.”

The GLP aggregated and excerpted this blog/article to reflect the diversity of news, opinion, and analysis. Read full, original post: Driving cancer beyond the brink

Breast cancer warning from man stunned by ‘impossible’ diagnosis

Breast cancer warning from man stunned by 'impossible' diagnosis.jpg

When you think of breast cancer, you think of a form of cancer that affects only women. It doesn’t.

While breast cancer in men is rare it’s still an issue for the 10 men on average who are diagnosed with it every year in Northern Ireland.

Ian Cranston, 70, was diagnosed with breast cancer in May. Two weeks later he had a mastectomy.

The Portadown father-of-two was given the all-clear in June and has decided to speak publicly to make men aware that it’s a cancer that doesn’t just affect women.

He said “men also need to check their breasts for changes”.

Inverted nipple

In May, Ian’s wife Elizabeth noticed something wrong when he got out of the shower.

Image copyright SPL
Image caption About 10 men in Northern Ireland are diagnosed with breast cancer each year

She told him he had an inverted nipple and needed to see his GP.

“I didn’t know what that meant,” said Ian.

“Men can’t get breast cancer, I don’t have to go to the doctor.

“I wasn’t aware I had breasts. This is my chest, men don’t have breasts, it’s impossible,” he added.

Eventually his wife persuaded him to go to his GP, who referred him to Craigavon Area Hospital.

Image caption Ian Cranston alongside breast care specialist nurse Annie Treanor

The diagnosis stunned him.

“Men having breast cancer, I couldn’t believe it,” he said.

“I couldn’t do or say anything. My wife Elizabeth cried.”

Four days later Ian said he “just broke”.

He has decided to help try and raise awareness of the disease, saying that if his speaking out helped one man, it would be worth it.

“I can understand where women are coming from because I’ve had breast cancer myself,” he said.

How We Need to Keep Growing Up: http://snip.ly/ljoxy#http://www.bbc.com/news/uk-northern-ireland-41616265

A range of exercises and medications can help with fibromyalgia

A range of exercises and

Dear Doctor: My daughter, who is in her 40s, has fibromyalgia. Is there any cure for this painful condition, or any natural remedies? I hate to see her suffer.

Dear Reader: The word “suffer” perfectly sums up fibromyalgia, and my heart goes out both to your daughter and to you, who can see the condition’s terrible effect on her. A chronic pain disorder initially termed “fibrositis syndrome” in the mid-19th century, fibromyalgia has been an official diagnosis only since 1990. The condition causes widespread musculoskeletal pain and fatigue, as well as sleep problems and difficulties in concentration and with memory.

In the United States, 2 to 3 percent of the population suffers from fibromyalgia, with women affected twice as often as men. Blood tests can’t detect fibromyalgia, so the diagnosis is based on a person’s symptoms, including the tender points identified during a physical examination. That said, people with fibromyalgia have shown abnormal biochemical responses to painful stimuli, and those responses can help guide treatment.

The first step in treating fibromyalgia is to understand the illness and what triggers a flair of symptoms. Anxiety and depression are common with fibromyalgia, and the resulting emotional stress can create a cycle of worsening pain and even lower energy levels.

Let’s take a look first at non-medical interventions. Practicing good sleep hygiene is vital because poor sleep can worsen fibromyalgia pain and fatigue, and trigger the cycle mentioned above. Relaxation techniques and therapy can relieve anxiety and depression, while meditation training can ease pain. Further, reflexology and acupuncture have each shown benefits in small studies at easing a variety of symptoms.

Exercise is a crucial component of therapy. Multiple studies have shown that it decreases pain, increases flexibility and boosts energy. Note that if exercise is too vigorous or of high impact, it may cause a flair of symptoms. The key is to start slowly with low-impact exercise, such as walking, biking, swimming or water aerobics. As symptoms improve, patients can increase their level of exercise.

Although they don’t cure the illness, various drugs and supplements can improve specific symptoms.

Read More: http://snip.ly/hdpbv#http://elkodaily.com/lifestyles/a-range-of-exercises-and-medications-can-help-with-fibromyalgia/article_39f0864b-c24a-5926-bcdd-c02488b1b52c.html

Man (35) in vegetative state for 15 years ‘showing signs of consciousness’

Man (35) in vegetative

A 35-year-old man who had been in a vegetative state for 15 years is showing signs of consciousness after receiving a pioneering treatment based on nerve stimulation.

In the month since a vagus nerve stimulator was put into his chest, the man, who was injured in a car accident, has begun responding to simple orders that had been impossible before.

The findings reported in Current Biology may help to show that by stimulating the vagus nerve “it is possible to improve a patient’s presence in the world”, according to lead researcher Angela Sirigu of Institut des Sciences Cognitives Marc Jeannerod in Lyon, France.

The researchers say it may challenge the view that a vegetative state which lasts for more than 12 months is irreversible.

“Other scientists have hailed it as “a potentially very exciting finding” but have also urged caution.

After treatment, it was reported the patient could follow an object with his eyes, turn his head on request and his mother said there was an improved ability to stay awake when listening to his therapist reading a book.

The vagus nerve connects the brain to many other parts of the body, including the gut.

It is known to be important in waking, alertness, and many other essential functions.

The patient, who was picked because he had been lying in a vegetative state for more than a decade with no sign of improvement, also appeared to react to a “threat”.

Researchers spotted that he reacted with surprise by opening his eyes wide when the examiner’s head suddenly approached his face.

 

Read More: http://snip.ly/sfxny#http://www.independent.ie/life/health-wellbeing/health-features/man-35-in-vegetative-state-for-15-years-showing-signs-of-consciousness-36173341.html

Healthcare’s Dangerous Fee-For-Service Addiction

Healthcare's Dangerous Fee-Fo

For its many users, healthcare’s fee-for-service reimbursement methodology is like an addiction, similar to gambling, cigarette smoking and pain pill abuse. Doctors and hospitals in the clutches of this flawed payment model have grown dependent on providing more and more healthcare services, regardless of whether the additional care adds value.

I don’t use this metaphor lightly, nor wish to trivialize our nation’s growing problem with addiction. Rather, as a physician and former healthcare CEO, I am increasingly concerned with the impact this payment structure is having on American health. And I worry about whether providers are willing to “kick the habit” before it’s too late.

Addictive Qualities

The Affordable Care Act, signed into law March 2010, included several provisions encouraging doctors to focus on increasing value (instead of simply maximizing the volume) of healthcare services. And yet, seven years later, between 86% and 95% of U.S. healthcare providers are still paid for each individual test, procedure and treatment they provide, an arrangement that continues to drive up healthcare costs with little to show for it. According to the latest Commonwealth Fund report, the United States spends more on healthcare than any other industrialized country but ranks at or near the bottom in almost every measure of comparative quality.

As with any addiction, America’s dependence on fee-for-service has dire financial and health consequences. This year, the estimated cost of care for an insured family of four will reach nearly $27,000, paid for through a combination of employer health insurance ($15,259), payroll deductions ($7,151) and out-of-pocket expenses at the point of care ($4,534). Year over year, patients are on the hook for a higher percentage of their total healthcare costs, which rose 4.3% compared to just a 1.9% increase in the U.S. GDP last year. This is a major warning sign. If medical costs continue to surge 2% to 3% higher than our nation’s ability to pay, the healthcare system will soon reach a breaking point. Businesses, the government and insurers will have no choice but to ration care or slowly eliminate coverage for the nation’s poor, middle-class and elderly populations.

As with all addictions, the fee-for-service model has mind-altering effects, distorting the perceptions of its users in ways that make them unaware of their growing dependence. When providers are paid for doing more, that’s what they do: They increase utilization of services and ratchet up the cost of care without even realizing they’re part of the problem. According to one study, just 36% of practicing physicians were willing to accept “major” responsibility for reducing healthcare costs. Of course, the first step, as with other habits, is to recognize the problem. Only then can we explore treatment options.

 

Read More: http://snip.ly/hlh5h#https://www.forbes.com/forbes/welcome/?toURL=https://www.forbes.com/sites/robertpearl/2017/09/25/fee-for-service-addiction/&refURL=&referrer=

6 Ways To Start Improving Your Gut Health Today

Brooke Lark / Unsplash

Considering the rapid rise in kombucha, sauerkraut and probiotic products, it’s pretty clear gut health is on everyone’s minds. And with good reason — more and more research is emerging showing just how important good gut health is for overall wellbeing.

“Having a healthy gut is so important,” accredited practising dietitian and sports dietitian Chloe McLeod told HuffPost Australia.

“It’s linked to a number of different medical conditions. When your gut isn’t healthy it can have an impact on mental health, weight, mood and a number of other digestive disorders. Keeping your gut nice and healthy can help keep the rest of your body healthy.”

Brooke Lark / Unsplash

How do you know if you have good gut health?

“Signs of good gut health include not getting bloating, gas, diarrhoea and constipation,” McLeod said.

“You find you feel better in general — better mood, more energy, a healthy weight and not feeling fatigued. These are all more pronounced when your gut is healthier.”

How do you know if you have bad gut health?

“If you have poor gut health you may have loose, unformed stools, or you’re really constipated, maybe your faeces are foul smelling, you feel gassy, feel foggy headed or have poor mood. These are some of the most common signs,” McLeod explained.

What can negatively affect gut health?

There are a number of diet and lifestyle-related factors which can impact the health of your gut.

“From a nutrition perspective, factors that negatively impact gut health include poor diet, alcohol and having a high fat intake,” McLeod said.

“Also, if you are someone with food intolerances, any large quantity of those trigger foods can have a negative effect on your gut health.

“Being highly stressed all the time impacts cortisol levels, and stress can be a factor for some people. Some medications can also affect gut health.”

 

Read More: http://snip.ly/r70uc#http://www.huffingtonpost.com.au/2017/09/24/6-ways-to-start-improving-your-gut-health-today_a_23218661/