A new Johns Hopkins University study is validating the potential of smart phones in medical care. Since the debut of the iPhone, one of the most-often demonstrated medical uses of the device are radiological applications which allow physicians to view x-rays, CT scans and MRIs wirelessly. However, are these images comparable to the high-end workstations found in the radiologist’s office? Are pictures displayed on such a small screen sufficient for physicians to make accurate diagnoses? According to this current study, it appears radiologists were able to just as accurately diagnose an appendicitis on an iPhone 3G as on their office computers, with one major difference – portability. Fifteen of the 25 study patients were correctly identified as having acute appendicitis on 74 of 75 interpretations. Being able to accurately diagnose a medical emergency, such as an appendicitis, without having to be tied to a workstation may save valuable time, especially in areas where radiologists may not be available immediately. Perhaps it’s just a matter of time until someone writes a program which will allow computers to automatically detect an appendicitis without the radiologist. [via Medical News Today]
University of Chicago researchers estimate that over the next 25 years the number of Americans with diagnosed and undiagnosed diabetes will soar from 23.7 million to 44.1 million. Not only that, medical spending related to diabetes care and management will climb from $113 billion to $336 billion annually. Diabetes is a chronic illness which often requires daily medication, insulin, glucose monitoring supplies, lab tests and frequent visits to the doctor. It is also a disease which could be potentially prevented, which is why primary preventative care is so important (and sorely lacking) in the U.S. As the researchers state, “Without significant changes in public or private strategies, this population and cost growth are expected to add a significant strain to an overburdened health care system.” With these new figures, the study will hopefully influence policymakers during this time of uncertainty in the future of U.S. healthcare. [via Medical News Today]
It’s time again for the annual dispelling of that old Thanksgiving myth: turkey contains tryptophan which can make one sleepy. While turkey certainly contains tryptophan (an amino acid used by our bodies to make serotonin, a neurotransmitter in the brain which helps to regulate sleep), so do most other meats. Surprisingly, gram for gram, cheddar cheese contains even more tryptophan than turkey! So, why does turkey get the dubious honor of sleep-inducing meat of the year? Probably because it is the centerpiece of what’s typically the largest meal of the year, full of fat and carbohydrates which increase the caloric content of the average Thanksgiving meal to upwards of 3,000 calories. After consuming more than the daily recommended amount of calories in a single meal your body will work hard to digest it, thus making you sleepy. Furthermore, alcohol is often involved, which has a sedative effect on most people. So, if not falling asleep after this year’s Thanksgiving meal is your goal then eating in moderation, as always, would be your best bet.
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The Genetic Information Nondiscrimination Act (GINA) is a federal law that protects Americans from being treated unfairly due to differences in their DNA which may affect their health. The parts of the law pertaining to employers took effect Saturday November 21, 2009. The act prohibits employers from requesting genetic testing or using an employee’s genetic background when making decisions about hiring, firing or promotions. It also protects Americans from being forced by their employers to undergo genetic testing. In addition, it makes it illegal for health insurance companies and group plans to use a customer’s genetic information – such as a family history of a certain disease – to deny coverage or to set premiums and deductibles. [via Health Day]
If you’re considering Botox injections to diminish wrinkles or other cosmetic procedures, such as liposuction or face lifts, to turn back the hands of time, now would be a good time to do it if you don’t want to pay a 5% tax on these services. The $848 billion health care bill unveiled this past week by the Senate includes a 5% tax on aesthetic procedures and surgeries which is estimated to raise $5 billion over the next decade to fund the health care bill. Plastic surgeons are, not surprisingly, against such a tax due to its potential effect on income. On the other hand, proponents of the tax reason that some cosmetic procedures are luxury services and should be taxed as such. Approximately 12 million cosmetic procedures and surgeries (which are usually not covered by insurance) were performed last year, at a total cost of $10.3 billion, according to the American Society of Plastic Surgeons. [via Kaiser Health News]
The following were the most popular cosmetic procedures of 2008, and their costs:
Earlier this month the US Preventive Services Task Force (USPSTF), an independent panel of respected experts in primary care and prevention, caused an uproar when they presented evidence that routine mammogram screening for breast cancer should not begin until the age of 50. The group based their recommendation on evidence showing that the “additional benefit gained by starting screening at age 40 years rather than at age 50 years is small, and that moderate harms from screening remain at any age”. Essentially, the number of women we need to screen in order to extend one woman’s life is far higher for the group between the ages of 40 to 49 than for the group aged 50 to 59. However, current US Health and Human Services secretary, Kathleen Sebelius, issued a statement yesterday stating that there will not be any changes to government policy on mammography: screening mammograms should continue to start at the age of 40. [via Medical News Today]
Additional USPSTF recommendations include:
Regular biennial screening mammography for women aged 50 to 74.
No teaching of breast self-examination (BSE).
There is not enough evidence to assess whether clinical breast examination (CBE) does more harm than good, beyond screening mammography in women 40 years or older.
Current evidence is not enough to assess whether digital mammography or magnetic resonance imaging (MRI) would be better or worse than film mammography.
In the midst of the U.S. healthcare debate comes another reason why everyone of us should have basic health coverage. A new study by Harvard University researchers found that uninsured patients with traumatic injuries (such as car crashes, falls and gunshot wounds) were almost twice as likely to die in the hospital as similarly injured patients with health insurance. Taking into account injury severity, race, gender and age uninsured patients were still 80% more likely to die than those with insurance, including Medicaid. It’s shocking and unclear just why the uninsured fare worse in terms of ER care, since it’s largely assumed – and federally mandated – that all unstable patient receive equal care in ERs. One reason this might occur is that private hospitals can transfer uninsured patients to public hospitals once patients are stable. A transfer could then worsen a patient’s condition by delaying treatment. The findings are based on an analysis of data from the National Trauma Data Bank, which includes more than 900 U.S. hospitals. [via New York Times]
Here’s some good news for patients with chronic obstructive pulmonary disease (COPD) and other conditions with chronic mucus production. A new device called the Lung Flute, which has just been approved by the FDA, can vibrate away mucus by simply blowing into it. Blowing into the instrument sends a steady 16-hertz vibration into the user’s chest which breaks up mucus and allows the body to better expel the sticky substance. Although there are other devices that also use vibration to loosen mucus, the Lung Flute costs a great deal less at $40 a piece, making it much more accessible. See a video of the device in action here. [via PopSci.com]
Swedish researchers are reporting positive outcomes in a study examining the use of a device called RhinoChill, which cools the brains of heart attack patients by pumping coolant into the patient’s nose during CPR. In patients where resuscitation efforts began within 10 minutes of cardiac arrest researchers found that 59.1% of cooled patients and 29.4% of standard care patients survived to hospital discharge; 45.5% of cooled patients and 17.6% of standard care patients were neurologically intact at hospital discharge. The results also suggest that the earlier the cooling is started the better. When cooling efforts were delayed, there was no significant difference in survival when compared to those who did not receive nasal cooling. During a heart attack the heart is unable to properly pump blood to the brain (and other vital organs) which can lead to subsequent brain injury. [via Medline Plus]
On November 13, 2009 the FDA issued notification to 30 manufacturers of caffeinated alcoholic beverages that it intends to look into the safety and legality of their products. “The increasing popularity of consumption of caffeinated alcoholic beverages by college students and reports of potential health and safety issues necessitates that we look seriously at the scientific evidence as soon as possible,” said Dr. Joshua Sharfstein, principal deputy commissioner of food and drugs. The problem is that caffeine has not been approved by the FDA to be added to alcoholic beverages. However, some substances which are Generally Recognized As Safe (GRAS), or have been subject to prior sanction, are legality able to be used as food additives. For a substance to be GRAS, there must be evidence of its safety at the levels used and a basis to conclude that this evidence is generally known and accepted by qualified experts. Thus, the FDA is giving these companies 30 days to produce data to support that the use of caffeine in their products is GRAS or have been previously sanctioned. Click here for a full list of companies and products affected. [via FDA]
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About Dr. Steven Chang
Dr. Steven Chang, the author of DailyDose, is a staff physician with Kosmix RightHealth. Dr. Chang practices Family Medicine at the University of California Davis Medical Center, where his medical interests include both pediatric and geriatric care, public health, gay and lesbian health, and sleep medicine. Dr. Chang trained at the Stanford University affiliated O'Connor Hospital, and was a research fellow at the National Institute of Health. He holds an M.D. from McGill University and a BA in Public Health from Johns Hopkins University.
Dr. Steven Chang, the author of DailyDose, is a staff physician with Kosmix RightHealth. Dr. Chang practices Family Medicine at the University of California Davis Medical Center, where his medical interests include both pediatric and geriatric care, public health, gay and lesbian health, and sleep medicine. Dr. Chang trained at the Stanford University affiliated O'Connor Hospital, and was a research fellow at the National Institute of Health. He holds an M.D. from McGill University and a BA in Public Health from Johns Hopkins University.