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VA gets it right on ALS?
December 2008
WASHINGTON - MedPage Today disclosed Amyotrophic Lateral Sclerosis (ALS) now is considered a compensable illness, the Veterans Affairs (VA) stated.
The decision was based on a November 2006 Institute of Medicine finding there’s "limited and suggestive evidence" of a tie of military service and later development of ALS."
Vets are getting ALS at "rates higher than the general population; it was appropriate to act," Dr. James B. Peake, VA secretary, stated.
He said the decision will make ALS patients' claims easier to process.
ALS progresses rapidly, so easier processing will enable vets and their families to be compensated quickly, he said.
The report summarized a 2005 study by Dr. Marc Weisskopf, of the Harvard School of Public Health, and his team - Prospective Study of Military Service and Mortality from ALS, published in Neurology - that found vets from World War II, Korea, and Vietnam were at a significantly greater risk of developing ALS versus civilians.
WASHINGTON - MedPage Today disclosed Medicaid spending will outpace economic growth by more than 60% over the next 10 years, states the first fiscal report from the federal/state program since it began 42 years ago. Total Medicaid costs will reach $674 billion annually by 2017, an annual growth rate of 7.9%, Michael O. Leavitt, HHS secretary, said. The U.S. economy is seen with an annual growth rate of 4.8% over the same period. Total healthcare costs are expected to rise 6.7% per year. "This report should serve as an urgent reminder the current path of Medicaid spending is unsustainable for federal and state governments," said Leavitt. "If nothing is done to reign in these costs, access to healthcare for the nation's most vulnerable citizens could be threatened." In 2006, Medicaid was 40% of federal spending on health services. The report noted Medicaid spending will rise 7.3% in 2008, to $399 billion. In the 10 years ending in 2017, total Medicaid spending is seen at almost $5 trillion. Federal Medicaid spending averages 57% of the states' spending.
ST. LOUIS - "The increasing number of veterans with posttraumatic stress disorder (PTSD) raises the risk of domestic violence and its consequences on families and children in communities across the United States," says Dr. Monica Matthieu, an expert on veteran mental health and assistant professor of social work at Washington University. "Treatments for domestic violence are very different than those for PTSD. The Dept. of Veterans Affairs (VA) has mental health services and treatments for PTSD, yet these services need to be combined with the specialized domestic violence intervention programs offered by community agencies for those veterans engaging in battering behavior against intimate partners and families." Matthieu and Dr. Peter Hovmand, domestic violence expert and assistant professor of social work at the university, are working to design community prevention strategies to address this emerging public health problem. "The increasing prevalence of traumatic brain injury and substance use disorders, along with PTSD among veterans, poses some unique challenges to existing community responses to domestic violence" says Hovmand. "Community responses to domestic violence must be adapted to respond to the increasing number of veterans with PTSD. This includes veterans with young families and older veterans with chronic mental health issues."
OAKLAND, CA - The Wall Street Journal reported that using a fan while a baby sleeps appears to cut significantly the risk of Sudden Infant Death Syndrome, or SIDS, new research suggests. Scientists at the Kaiser Permanente Division of Research compared 185 babies who died from SIDS in 11 California counties May 1, 1997-April 30, 2000 with 312 normal infants from similar socioeconomic and ethnic backgrounds living in the same counties. Mothers were asked several questions about fan use, pacifier use, room location, sleep surface, type of covers over the baby, bedding under the infant, room temperature, and whether a window was open. The study in the Archives of Pediatrics & Adolescent Medicine found using a fan cut the risk of SIDS by 72%. Fan use in a room with a temperature higher than 69 degrees Fahrenheit was tied to a 94% lower SIDS risk versus no fan use. Lead researcher Dr. De-Kun Li says fan use boosts air movement in a baby's bedroom that could protect babies from re-breathing carbon dioxide. "If parents want to take an extra measure, they should consider using a fan," he said. Dr. Li, a reproductive and perinatal epidemiologist, stressed using a fan isn't a substitute for placing babies on their backs to sleep.
NEW ORLEANS - MedPage Today noted spending 30 minutes a day listening to rhythmic music - from classical to Celtic to Indian - has a beneficial effect on blood pressure, researchers found. The key was to combine listening with breathing exercises, said Dr. Gianfranco Parati, of the University of Milan-Bicocca. The music, he said, helps patients focus on slow, abdominal breathing. Dr. Parati presented results of a small, randomized trial at the American Society of Hypertension meeting. Dr. Parati wasn’t a study investigator. It was done by Dr. Pietro A. Modesti, of the University of Florence, and colleagues. Dr. Modesti was unable to attend the meeting. The study recruited 48 volunteers, 45-70, with mild hypertension. All patients were receiving pharmacological treatment. Researchers randomized 20 patients (mean age 65) to the control group and 28 (mean age 60) to 30 minutes a day of music with the breathing exercise. After three months, daily music/breathing therapy was tied to a significant reduction in systolic blood pressure versus the control group.
CALGARY, CANADA - A study provides the most direct evidence of a link between smoking during pregnancy and Sudden Infant Death Syndrome (SIDS). Other contributing factors include disturbed breathing/heart rate regulation, impaired arousal responses, thermal stress, and sleeping belly-down. "Since the advocacy of ‘back to sleep position,’ smoking during pregnancy has become the principal risk factor for SIDS," said Dr. Shabih Hasan, staff neonatologist and associate professor of pediatrics at the University of Calgary, and the principal of the study in the American Journal of Respiratory and Critical Care Medicine. "Our results provide some of the most direct evidence suggesting prenatal cigarette smoke exposure can contribute to the destabilizing effects of hypoxia and thermal stress on neonatal breathing," said Dr. Hasan. Researchers exposed pregnant rat pups to either room air (control) or mainstream cigarette smoke equivalent to that a pack-a-day smoker would experience.
DURHAM, NC - A drug that attacks Parkinson's disease from a unique angle helps reduce tics, spasms, or tremors that people with Parkinson's have after their primary meds wear off, stated a study in the journal Neurology. Researchers identified 395 people with Parkinson's already taking levodopa, a popular Parkinson's drug that targets dopamine receptors in the brain. Participants were given either 20 or 60 mg per day of istradfeylline, or they got placebo for three months. They recorded "off" time in a home diary. Off time is when symptoms return as drugs wear off. The study found people who used istradefylline had 24% less "off" time than at the start of the study. Those who took placebo had a 10% cut in "off" time. "These results suggest istradefylline is effective as an add-on therapy to other drugs that treat symptoms of Parkinson's. This medication seems to improve 'off' time in a population in which more than 90% of patients are being treated with two or more drugs," said study author Dr. Mark Stacy, of the Duke University Medical Center.
PROVIDENCE, R.I. - Reuters Health reported estradiol, a form of estrogen, sprayed on the skin is a safe, effective, and convenient way for post-menopausal women to relieve hot flushes, a study shows. Evamist, marketed by Ther-Rx Corp., is the first transdermal estradiol spray to be approved by the U.S. Food and Drug Administration for treating moderate-to-severe menopausal symptoms in healthy women, states a report in Obstetrics & Gynecology. "This estradiol 'spray-on-patch' is a treatment option for women who will benefit from the advantages of transdermal estradiol delivery but are intolerant of or aren’t inclined to use patches, gels, or emulsions," wrote Dr. John E. Buster, of Brown University, and colleagues. The spray has estradiol in ethanol, plus a skin-penetrating agent, and is delivered in a precisely-metered dose, and is formulated to be retained beneath the skin's surface, released slowly over 24 hours.
NEW YORK - CNN noted women listen to their bodies and visit the doctor when something isn't right. Men tend to seek a doctor when they're at death's door - or when their wives prod them into going. "I think it's a macho thing," says Dr. Barron Lerner, professor of medicine and public health at Columbia University. "Or, maybe it's denial. Maybe they think if they deny a problem, it doesn't exist." "I call it the ostrich phenomenon," says Dr. Harvey Simon, associate professor of medicine at Harvard Medical School and editor of Harvard Men's Health Watch. "Guys are very prone to sticking their head in the sand and hoping when they emerge everything will be back to normal. It's a very, very bad idea." While the list, say these physicians, is endless, here are the top five symptoms men ignore - sometimes until it's too late: chest pain, big belly, unenthusiastic penis, more frequent urination, and prescription drug addiction.
CHICAGO - The Chicago Tribune disclosed that lowering blood sugar levels to near normal through intensive treatment might cut the risk of cardiovascular disease/heart attacks in people with Type 2 diabetes, but only if treatment is begun relatively soon after diagnosis and if severe episodes of low blood sugar are avoided. Veterans Administration researchers reported the findings might resolve concerns raised by two other widely-reported studies: one found no apparent benefit from such treatment and the other that intensive treatment might be detrimental. Data from all three suggest the greatest cut in risk is achieved by lowering cholesterol levels and controlling high blood pressure.
EDINBURGH, SCOTLAND - Children with lower IQs are more likely decades later to develop vascular dementia than children with high IQs, stated research online at the journal Neurology. The most common type after Alzheimer's disease, vascular dementia occurs when blood flow to the brain is impaired. The study examined 173 people in Scotland who took a test of their mental ability in 1932 when they were about 11 years old and later developed dementia. This group was compared to one set of control participants of the same age and gender. For another group of controls, researchers made sure the cases and controls came from families where the fathers had similar types of occupations. The people with vascular dementia were 40% more likely to have low test scores when they were children than people who didn’t develop dementia. This difference wasn’t true for those with Alzheimer's. "These results point to the importance of reducing the vascular risk factors that can lead to strokes and dementia," said study author John M. Starr, of the University of Edinburgh. "Risk factors include high blood pressure, high cholesterol, and smoking."
BALTIMORE, MD - When kids complain math homework won’t help them, an answer might be it could help cure cancer. In a study that joined math and medicine, scientists show patients with chronic myelogenous leukemia (CML) may be cured with a vaccine’s timing based on their immune response. In the journal PLoS Computational Biology, University of Maryland associate professor of mathematics Doron Levy, Stanford Medical School physician/associate professor of medicine Peter P. Lee, and Dr. Peter S. Kim, École Supérieure d’Électricité describe their success creating a mathematical model. It predicts anti-leukemia immune response in CML patients using the drug imatinib can be stimulated in a way that might provide a cure. By combining novel biological data and math modeling, we found rules for designing adaptive treatments for each specific patient," said Levy, of the UM Center for Scientific Computation and Mathematical Modeling. "Give me 1,000 patients and, with this math model, I can give you 1,000 different customized treatment plans." This study used the patient’s natural immune response with effects of imatinib, a drug successful in putting CML patients into remission.
LOS ANGELOS - As medical advances help more children with serious illnesses survive into adulthood, more will make the passage from pediatric physicians and payment programs to adult providers and insurance. A study suggests this transition might not always be smooth. "When they reach a certain age, children with serious medical conditions move to adult care," said lead author Dr. Debra Lotstein, assistant professor/pediatrics at UCLA’s David Geffen School of Medicine. "Yet little is known about age-related transition in care. Clinicians often have a sense kids are falling off a cliff when they switch care from the pediatric to adult systems." The authors surveyed 77 people 21-24 with ongoing health issues who had "graduated" from a public program for low-income children with special care needs in San Bernardino County. Of those responding, 46 had at least one adverse transition event affecting their ability to get care. Barriers included lacking a usual source of car, going without needed medical care, and foregoing or delaying needed care in the last six months.
SAN DIEGO - Each year, women experience about 4.8 million intimate partner-related physical assaults and rapes. Women with a disability are more likely to experience intimate partner violence (IPV) than those without a disability, states a study presented at the American Public Health Association’s annual meeting. The study used data from seven states and one territory as part of the 2006 Behavioral Risk Factor Surveillance System survey, and examined disability prevalence and differences in IPV among women with and without a disability. Researchers found women with a disability were significantly more likely to report experiencing some form of IPV in their lifetime (37.3% vs. 20.6%) versus women without a disability. Women with a disability were more likely to report ever being threatened with violence (28.5% vs. 15.4%) and hit, slapped, pushed, kicked, or physically hurt (30.6% vs. 15.7%) by an intimate partner. Similarly, women with a disability were more likely to report ever experiencing unwanted sex by an intimate partner (19.7% vs. 8.2%) than those without a disability.
WASHINGTON - MedPage Today disclosed Medicaid spending will outpace economic growth by more than 60% over the next 10 years, states the first fiscal report from the federal/state program since it began 42 years ago. Total Medicaid costs will reach $674 billion annually by 2017, an annual growth rate of 7.9%, Michael O. Leavitt, HHS secretary, said. The U.S. economy is seen with an annual growth rate of 4.8% over the same period. Total healthcare costs are expected to rise 6.7% per year. "This report should serve as an urgent reminder the current path of Medicaid spending is unsustainable for federal and state governments," said Leavitt. "If nothing is done to reign in these costs, access to healthcare for the nation's most vulnerable citizens could be threatened." In 2006, Medicaid was 40% of federal spending on health services. The report noted Medicaid spending will rise 7.3% in 2008, to $399 billion. In the 10 years ending in 2017, total Medicaid spending is seen at almost $5 trillion. Federal Medicaid spending averages 57% of the states' spending.
ST. LOUIS - "The increasing number of veterans with posttraumatic stress disorder (PTSD) raises the risk of domestic violence and its consequences on families and children in communities across the United States," says Dr. Monica Matthieu, an expert on veteran mental health and assistant professor of social work at Washington University. "Treatments for domestic violence are very different than those for PTSD. The Dept. of Veterans Affairs (VA) has mental health services and treatments for PTSD, yet these services need to be combined with the specialized domestic violence intervention programs offered by community agencies for those veterans engaging in battering behavior against intimate partners and families." Matthieu and Dr. Peter Hovmand, domestic violence expert and assistant professor of social work at the university, are working to design community prevention strategies to address this emerging public health problem. "The increasing prevalence of traumatic brain injury and substance use disorders, along with PTSD among veterans, poses some unique challenges to existing community responses to domestic violence" says Hovmand. "Community responses to domestic violence must be adapted to respond to the increasing number of veterans with PTSD. This includes veterans with young families and older veterans with chronic mental health issues."
OAKLAND, CA - The Wall Street Journal reported that using a fan while a baby sleeps appears to cut significantly the risk of Sudden Infant Death Syndrome, or SIDS, new research suggests. Scientists at the Kaiser Permanente Division of Research compared 185 babies who died from SIDS in 11 California counties May 1, 1997-April 30, 2000 with 312 normal infants from similar socioeconomic and ethnic backgrounds living in the same counties. Mothers were asked several questions about fan use, pacifier use, room location, sleep surface, type of covers over the baby, bedding under the infant, room temperature, and whether a window was open. The study in the Archives of Pediatrics & Adolescent Medicine found using a fan cut the risk of SIDS by 72%. Fan use in a room with a temperature higher than 69 degrees Fahrenheit was tied to a 94% lower SIDS risk versus no fan use. Lead researcher Dr. De-Kun Li says fan use boosts air movement in a baby's bedroom that could protect babies from re-breathing carbon dioxide. "If parents want to take an extra measure, they should consider using a fan," he said. Dr. Li, a reproductive and perinatal epidemiologist, stressed using a fan isn't a substitute for placing babies on their backs to sleep.
NEW ORLEANS - MedPage Today noted spending 30 minutes a day listening to rhythmic music - from classical to Celtic to Indian - has a beneficial effect on blood pressure, researchers found. The key was to combine listening with breathing exercises, said Dr. Gianfranco Parati, of the University of Milan-Bicocca. The music, he said, helps patients focus on slow, abdominal breathing. Dr. Parati presented results of a small, randomized trial at the American Society of Hypertension meeting. Dr. Parati wasn’t a study investigator. It was done by Dr. Pietro A. Modesti, of the University of Florence, and colleagues. Dr. Modesti was unable to attend the meeting. The study recruited 48 volunteers, 45-70, with mild hypertension. All patients were receiving pharmacological treatment. Researchers randomized 20 patients (mean age 65) to the control group and 28 (mean age 60) to 30 minutes a day of music with the breathing exercise. After three months, daily music/breathing therapy was tied to a significant reduction in systolic blood pressure versus the control group.
CALGARY, CANADA - A study provides the most direct evidence of a link between smoking during pregnancy and Sudden Infant Death Syndrome (SIDS). Other contributing factors include disturbed breathing/heart rate regulation, impaired arousal responses, thermal stress, and sleeping belly-down. "Since the advocacy of ‘back to sleep position,’ smoking during pregnancy has become the principal risk factor for SIDS," said Dr. Shabih Hasan, staff neonatologist and associate professor of pediatrics at the University of Calgary, and the principal of the study in the American Journal of Respiratory and Critical Care Medicine. "Our results provide some of the most direct evidence suggesting prenatal cigarette smoke exposure can contribute to the destabilizing effects of hypoxia and thermal stress on neonatal breathing," said Dr. Hasan. Researchers exposed pregnant rat pups to either room air (control) or mainstream cigarette smoke equivalent to that a pack-a-day smoker would experience.
DURHAM, NC - A drug that attacks Parkinson's disease from a unique angle helps reduce tics, spasms, or tremors that people with Parkinson's have after their primary meds wear off, stated a study in the journal Neurology. Researchers identified 395 people with Parkinson's already taking levodopa, a popular Parkinson's drug that targets dopamine receptors in the brain. Participants were given either 20 or 60 mg per day of istradfeylline, or they got placebo for three months. They recorded "off" time in a home diary. Off time is when symptoms return as drugs wear off. The study found people who used istradefylline had 24% less "off" time than at the start of the study. Those who took placebo had a 10% cut in "off" time. "These results suggest istradefylline is effective as an add-on therapy to other drugs that treat symptoms of Parkinson's. This medication seems to improve 'off' time in a population in which more than 90% of patients are being treated with two or more drugs," said study author Dr. Mark Stacy, of the Duke University Medical Center.
PROVIDENCE, R.I. - Reuters Health reported estradiol, a form of estrogen, sprayed on the skin is a safe, effective, and convenient way for post-menopausal women to relieve hot flushes, a study shows. Evamist, marketed by Ther-Rx Corp., is the first transdermal estradiol spray to be approved by the U.S. Food and Drug Administration for treating moderate-to-severe menopausal symptoms in healthy women, states a report in Obstetrics & Gynecology. "This estradiol 'spray-on-patch' is a treatment option for women who will benefit from the advantages of transdermal estradiol delivery but are intolerant of or aren’t inclined to use patches, gels, or emulsions," wrote Dr. John E. Buster, of Brown University, and colleagues. The spray has estradiol in ethanol, plus a skin-penetrating agent, and is delivered in a precisely-metered dose, and is formulated to be retained beneath the skin's surface, released slowly over 24 hours.
NEW YORK - CNN noted women listen to their bodies and visit the doctor when something isn't right. Men tend to seek a doctor when they're at death's door - or when their wives prod them into going. "I think it's a macho thing," says Dr. Barron Lerner, professor of medicine and public health at Columbia University. "Or, maybe it's denial. Maybe they think if they deny a problem, it doesn't exist." "I call it the ostrich phenomenon," says Dr. Harvey Simon, associate professor of medicine at Harvard Medical School and editor of Harvard Men's Health Watch. "Guys are very prone to sticking their head in the sand and hoping when they emerge everything will be back to normal. It's a very, very bad idea." While the list, say these physicians, is endless, here are the top five symptoms men ignore - sometimes until it's too late: chest pain, big belly, unenthusiastic penis, more frequent urination, and prescription drug addiction.
CHICAGO - The Chicago Tribune disclosed that lowering blood sugar levels to near normal through intensive treatment might cut the risk of cardiovascular disease/heart attacks in people with Type 2 diabetes, but only if treatment is begun relatively soon after diagnosis and if severe episodes of low blood sugar are avoided. Veterans Administration researchers reported the findings might resolve concerns raised by two other widely-reported studies: one found no apparent benefit from such treatment and the other that intensive treatment might be detrimental. Data from all three suggest the greatest cut in risk is achieved by lowering cholesterol levels and controlling high blood pressure.
EDINBURGH, SCOTLAND - Children with lower IQs are more likely decades later to develop vascular dementia than children with high IQs, stated research online at the journal Neurology. The most common type after Alzheimer's disease, vascular dementia occurs when blood flow to the brain is impaired. The study examined 173 people in Scotland who took a test of their mental ability in 1932 when they were about 11 years old and later developed dementia. This group was compared to one set of control participants of the same age and gender. For another group of controls, researchers made sure the cases and controls came from families where the fathers had similar types of occupations. The people with vascular dementia were 40% more likely to have low test scores when they were children than people who didn’t develop dementia. This difference wasn’t true for those with Alzheimer's. "These results point to the importance of reducing the vascular risk factors that can lead to strokes and dementia," said study author John M. Starr, of the University of Edinburgh. "Risk factors include high blood pressure, high cholesterol, and smoking."
BALTIMORE, MD - When kids complain math homework won’t help them, an answer might be it could help cure cancer. In a study that joined math and medicine, scientists show patients with chronic myelogenous leukemia (CML) may be cured with a vaccine’s timing based on their immune response. In the journal PLoS Computational Biology, University of Maryland associate professor of mathematics Doron Levy, Stanford Medical School physician/associate professor of medicine Peter P. Lee, and Dr. Peter S. Kim, École Supérieure d’Électricité describe their success creating a mathematical model. It predicts anti-leukemia immune response in CML patients using the drug imatinib can be stimulated in a way that might provide a cure. By combining novel biological data and math modeling, we found rules for designing adaptive treatments for each specific patient," said Levy, of the UM Center for Scientific Computation and Mathematical Modeling. "Give me 1,000 patients and, with this math model, I can give you 1,000 different customized treatment plans." This study used the patient’s natural immune response with effects of imatinib, a drug successful in putting CML patients into remission.
LOS ANGELOS - As medical advances help more children with serious illnesses survive into adulthood, more will make the passage from pediatric physicians and payment programs to adult providers and insurance. A study suggests this transition might not always be smooth. "When they reach a certain age, children with serious medical conditions move to adult care," said lead author Dr. Debra Lotstein, assistant professor/pediatrics at UCLA’s David Geffen School of Medicine. "Yet little is known about age-related transition in care. Clinicians often have a sense kids are falling off a cliff when they switch care from the pediatric to adult systems." The authors surveyed 77 people 21-24 with ongoing health issues who had "graduated" from a public program for low-income children with special care needs in San Bernardino County. Of those responding, 46 had at least one adverse transition event affecting their ability to get care. Barriers included lacking a usual source of car, going without needed medical care, and foregoing or delaying needed care in the last six months.
SAN DIEGO - Each year, women experience about 4.8 million intimate partner-related physical assaults and rapes. Women with a disability are more likely to experience intimate partner violence (IPV) than those without a disability, states a study presented at the American Public Health Association’s annual meeting. The study used data from seven states and one territory as part of the 2006 Behavioral Risk Factor Surveillance System survey, and examined disability prevalence and differences in IPV among women with and without a disability. Researchers found women with a disability were significantly more likely to report experiencing some form of IPV in their lifetime (37.3% vs. 20.6%) versus women without a disability. Women with a disability were more likely to report ever being threatened with violence (28.5% vs. 15.4%) and hit, slapped, pushed, kicked, or physically hurt (30.6% vs. 15.7%) by an intimate partner. Similarly, women with a disability were more likely to report ever experiencing unwanted sex by an intimate partner (19.7% vs. 8.2%) than those without a disability.