In the News 2024 - Sandweg & Ager PC

In the News 2024


Here we address interesting and important issues affecting the delivery of medical care and related topics from 2024.

We cover additional, related issues and discuss them in more depth on our blog.

In The News: 2020, 2021, 2022, 2023, 2024

April 19, 2024

I have written often about the rise of antibiotic resistant bacteria.  Medicine has developed some new drugs to address some of these resistant, hard-to-treat infections.  New research shows that not all patients who are sick with the resistant infections are receiving the newer, more effective drugs.  Many patients are receiving older, less effective, less safe drugs and the question is why.  Cost may be a factor as the new drugs are close to 10 times as expensive as the old drugs.  Lack of good information about the effectiveness of the new drugs may be inhibiting doctors from ordering them.  Statistically, if you are hospitalized in a rural hospital or a smaller urban hospital, you are less likely to get the newer drugs.

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April 17, 2024

Good news for those who received the Shingrix vaccine to prevent shingles.  The vaccine has been found to be 82% effective 11 years after administration.

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April 16, 2024

Going to have to stuff two important news stories in today’s post.  The first is that fraudsters are selling counterfeit Botox and weight loss drugs.  People are ending up in the emergency department.  As usual, where there is a dishonest dollar to be made fraudsters will flock to the opportunity.

The second is that 75% of doctors in the United States are now employees of hospital groups or health systems.  That is startling and does not bode well for the future of good health care.

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April 15, 2024

I guess it should not be a surprise, but there was a sharp increase in the number of younger adults undergoing permanent sterilization procedures following the Supreme Court’s decision to remove Constitutional protections for abortion access.  The increase was twice as high among women as men.  In an era of declining population, this is probably not a good thing.

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April 11, 2024

A day of reckoning may be coming for Medicare Advantage plans.  Although they are popular with many Medicare eligible patients, the methods by which they save themselves money are very unpopular with hospitals and doctors.  The plans save money by often requiring plan approval before treatment.  The approval may never come or it may take a while to get, both of which affect the ability of a provider to deliver good and timely care.  Payments to providers are slow to arrive as well and sometimes the plan refuses to pay for one reason or another.  Finally, the rates paid by some plans are too low for the provider to make a fair profit.  For all of these reasons, some hospitals and doctors have already refused to provide care to patients who are in certain Medicare Advantage plans.  Wall Street analysts predict that more and more hospitals and doctors will follow suit, which will make getting the care they need progressively more difficult for patients enrolled in these plans.  The plans will have to change their ways or run the risk that so many providers will dump them that they won’t be able to offer their enrollees access to care.

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April 10, 2024

The latest on the battle to reduce LDL, aka the bad cholesterol, levels comes from South Africa where researchers have developed a small, once-a-month shot, which reduces LDL levels by 50%.  The convenience and efficacy of the shot make it likely to be used by cardiologists to control LDL levels.

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April 9, 2024

The FDA has a program to grant accelerated approval for drugs that demonstrate early promise of saving lives.  Originally developed for AIDS drugs, the program today is used mostly for cancer drugs.  In an interesting finding on review of cancer drugs given accelerated approval, researchers found that less than half of them were found to be effective in confirmatory trials conducted over the years following approval.  Some of the drugs went on to obtain regular approval, some were withdrawn and some continue to be studied for overall effectiveness.

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April 5, 2024

A mental health facility in Illinois was just hit with a $535M jury verdict.  The allegation was that the facility did not adequately protect its patients and, as a result, a 13 year old girl was raped by another patient.  The award was $60M in compensatory damages to the girl and her mother and $475M in punitive damages.  No surprise, the defendant intends to appeal the verdict.

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April 4, 2024

Sepsis is a life-threatening body wide blood infection.  Of the patients who die in a hospital, one in three has sepsis.  It is critically important for doctors to recognize the onset of sepsis and also to recognize patients whose condition makes them more likely to develop sepsis.  Enter Artificial Intelligence (AI).  The FDA has just approved an AI program that automatically considers 22 separate biomarkers from a patient’s electronic medical record to develop a risk score for possible sepsis development.  This is a significant and welcome development.

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April 2, 2024

The United States Senate Committee on Homeland Security is investigating whether the increasing presence of venture capital in the field of health care is affecting the quality of services being provided in emergency departments.  Recent estimates are that 40% of emergency departments are staffed by companies owned by private equity.  The committee has received numerous complaints from emergency department physicians that patient safety and quality of care are being affected by aggressive tactics of private equity owners.  Stay tuned.

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April 1, 2024

No joke.  The number of tuberculosis cases diagnosed in the United States was up again this past year.  TB is infectious and is usually spread by the coughing of an infected person.  It was a prime killer before the advent of antibiotics.  Most of the cases were diagnosed in people who were born outside the United States and were probably people who had been exposed years ago and in whom the disease had remained latent until something disrupted the patient’s immune system.  It is unclear what disruptions to the immune system trigger TB to reactivate, but researchers are pretty sure a bout of Covid can do it.

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March 29, 2024

One drink a day is all it takes to increase the risk of cardiovascular disease in women.

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March 28, 2024

Add another benefit to the list of benefits that have been determined to flow from exclusively breastfeeding a child for more than three months.  It significantly reduces the risk of childhood leukemia.  Doctors believe that the risk is reduced by the creation of a healthy gut biome as the result of exclusive breastfeeding.  The impact of the gut biome appears to be greater than we ever thought and new effects are being discovered almost every day.

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March 27, 2024

Big new study finds that, while there are a number of modifiable risk factors for dementia, the three biggest are diabetes, air pollution and alcohol consumption.  The impact of these three on the risk of developing dementia was twice as much as the next leading risk factor.

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March 22, 2024

Starbucks is recalling 440,000 ceramic coffee mugs sold during the last Christmas season.  The ceramic mugs are coated with metal.  Some have broken when filled with very hot liquid or when microwaved and have caused burns and lacerations.  Be careful, if you purchased or received one of these as a gift.

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March  21, 2024

New research on prostate cancer shows an unexpected role for a gene in determining the lethality of the cancer once it has metastasized.  The gene, HSD3B1, appears to act only after the initiation of hormonal therapy and to hasten the point at which the therapy is no longer effective.  The presence of the gene more than doubles the risk of death due to metastatic prostate cancer.  The results are considered to be a major leap forward in understanding the pathways by which prostate cancer develops.

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March 20, 2024

Some months ago, there was concern that the Covid vaccines might be increasing the risk of hemorrhagic stoke.  After studying larger data sets, however, medical researchers believe there is no association and no increased risk.  The increased incidence was occurring among those older people who were getting both the Covid vaccine and a high dose flu shot at the same time.  The high dose flu shot creates some increased risk of hemorrhagic stroke but the addition of the Covid vaccination did not add to it.  Vaccines are still good for you, folks.

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March 18, 2024

Cow’s milk is not bad for you, as some health faddists would have you believe.  It is a dense combination of necessary proteins and nutrients.  Low fat milk is good for you as long as you don’t have an allergy to it or a problem digesting it.  That said, nutritionists would like to get away from calling foods “healthy” or “unhealthy” as they don’t think that sends the right message or gives people enough information.  Their best current recommendation is to look at diet as a whole and not focus on the individual parts so much.  The question is whether your overall diet is a healthy one or not as opposed to whether one particular part of it is better for you than an alternative.  Eat healthy and take care of that microbiome.

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March 14, 2024

Colorectal cancer is on the rise, especially among young people.  The increased incidence is thought to be due at least in part to low fiber, highly processed food diets.  Help is on the way.  Nobody likes a colonoscopy, but there are non-invasive tests that can detect the presence of colon cancer and they are getting better all the time.  The newest generation uses DNA technology and is highly effective at detecting the presence of cancers and neoplasms.  Colonoscopy is still the gold standard for colorectal cancer detection, but, as one prominent researcher noted, the best cancer test is the one the patient completes.  If people are reluctant to have a colonoscopy, one of these non-invasive stool sample tests is a great second choice.

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March 13, 2024

Although it should come as no surprise, Big Pharma is pulling out all the stops in its efforts to prevent the Biden administration from forcing them to negotiate prices with Medicare for drugs prescribed for seniors.  Got to protect those profits, even if it forces some seniors to choose between food and medicine.

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March 12, 2024

A few months ago, when my wife and I came down with Covid, I purchased a pulse oximeter from Walgreens to monitor our blood/oxygen levels.  If they dropped too low, we were heading for the hospital.  New reporting on the accuracy of the most commonly available pulse oximeters indicates that some of them are not as accurate as they need to be.  The problems are mostly associated with accurate measurements in people with darker skin.   The Nonin Vantage 9590 and Masimo Mightysat were ultimately deemed to have the best performance, while the Biolight and Roscoe performed the most poorly.  My Walgreens pulse oximeter was somewhere in the middle.

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March 8, 2024

Good news on the pain reduction front.  Researchers looking for ways to reduce patients’ post-operative reliance on opioid pain medications have found that a three drug cocktail of over-the-counter pain medications, including ibuprofen and acetaminophen, provided adequate pain control to most patients undergoing hip replacement surgery.  Opioids were used for breakthrough pain but were not used as the primary method of pain control.  Another advance in medicine’s attempt to reduce reliance on pain medications with the potential for addiction.

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March 6, 2024

I have posted on our blog about the downside of rural living from a healthcare perspective.  A recent study has added more data on the issue.  Those people who lived in an area that had few primary care providers had a higher rate of emergency surgery than those who had better access to primary care.  Of course, emergency surgery patients very often have worse outcomes than patients whose surgery is not performed on an emergency basis so it is really important to avoid the necessity for emergency surgery.  The surgeries included in the study involved conditions which could be expected to show symptoms long before emergency surgery was necessary.  That means that, had the patients had access to primary care and used it, their conditions would likely have been diagnosed earlier and they could have had their surgeries scheduled on a routine basis.  The study also found that poorer locations were more likely to be underserved than wealthier ones.  No surprise there.

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February 27, 2024

Four more eye ointments have been recalled due to concerns about whether they are sterile or not.  No infections have been reported as a result of the use of these products but they reflect a growing scrutiny of eye products in light of eye infections reported to have resulted from contaminated products.  Here is a helpful link to the recall with a list of products involved.

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February 26, 2024

There seems to be an association between the use of Viagra and a reduced risk of Alzheimer’s disease.  Although the association appears to be clear, the reasons for it remain murky.  One hypothesis is that people who are healthy enough to want to engage in sex are less likely to develop Alzheimer’s in the first place.  A second is that those who care enough about sex to take pills for it may be more likely to take care of their bodies in the first place.  Last is the theory that Viagra’s action of expanding blood vessels in the body to promote more blood flow works in the brain as well and the more blood that flows to the brain, the lower the risk of Alzheimer’s.  They will probably figure it out eventually.

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February 23, 2024

Recent studies are showing that people exposed to fine particle air pollution from automobile traffic have higher amounts of amyloid plaques in their brains.  Patients with Alzheimer’s Disease usually have elevated levels of amyloid plaques in their brains.  These recent studies do not show that fine particle automobile pollution causes Alzheimer’s, just that there is an association.  Time will tell.

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February 22, 2024

Unsurprisingly, as the popularity of e-bikes has soared, so have emergency department visits resulting from e-bike accidents.  Studies show that most of those visiting the emergency department following an e-bike accident were not wearing helmets at the time.  Given the speeds at which these bikes can travel, this equates to a lot more head injuries.

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February 21, 2024

Studies of mortality due to breast cancer showed a 41% decline when women underwent annual screening between the ages of 40 and 79.

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February 20, 2024

Covid’s latest adaptation may be its most successful.  It has lulled us to sleep.  No one seems to worry about Covid any more.  Very few people wear masks.  Almost no one observes social distancing.  Despite the availability of an effective vaccine, lots of people do not get the shot.  Covid is not gone and has not lost all its punch.  It was the third leading cause of death among Americans last year, after heart disease and cancer.  We don’t have to go back to the bad old days of complete social isolation, but we need to be smarter.

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February 16, 2024

There have been persistent shortages of generic drugs in the United States.  This has led to some patients not being able to obtain the drugs they need or not being able to afford the brand name drug that the generic copies.  The Federal Trade Commission is beginning an investigation into the role pharmacy middlemen are playing in these shortages.  Hopefully, the investigation will bear fruit.  We need these generics.

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February 15, 2024

The bubonic plague, the infamous Black Death of the Middle Ages, is still with us.  Over the last 110 years, there have been a little over 1,000 suspected or confirmed cases in the United States.  There was a case recently reported in Oregon in which it is believed the female patient contracted it from her cat.  The plague is spread by a bacteria, Yersinia pestis, that can infect small mammals and humans.  Humans most often get it from the bites of fleas that have previously bitten an infected animal.  There are good treatments for the plague, but it continues to cause deaths in less developed parts of the world.  Fever, headache, chills, and painful, swollen lymph nodes are classic signs of the disease.  If not treated, the bacteria builds up in the lymph nodes and then enters the bloodstream.  Once it enters the bloodstream or the lungs, it becomes more severe and more difficult to treat.

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February 14. 2024

The FDA has approved a new drug regimen to treat metastatic pancreatic cancer.  Pancreatic cancer is one of the most deadly cancers primarily because it is rarely discovered until it has progressed to the metastatic stage, which is quite late in the process.  Survival rates are dismal.  Patients usually don’t last over a year after diagnosis.  The new medicines offer some improvement in survival rates, but it is small.  The hope, however, is that these new medicines will open the door to additional effective therapies that may produce longer survival times.

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February 13, 2024

A lengthy study in Great Britain has shown that about 10 years before signs of Alzheimer’s or dementia first appear, there are changes in certain blood proteins.  Two of the proteins are associated with a substantially higher risk of Alzheimer’s, while the other two are virtually diagnostic for the later onset of dementia.  All of which brings up the question, “Do you really want this test, if it cannot lead to avoiding the onset of dementia?”  Frankly, I don’t want to know.

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February 12, 2024

I have reported from time to time about schemes to defraud Medicare.  I have made fun of the fraudsters who only took the system for a few million dollars.  More commonly, the haul is in the hundreds of millions before the investigators descend and send everyone involved off to jail.  This definitely takes the cake, however.  A months-long investigation has uncovered a scheme that is believed to have defrauded Medicare to the tune of $2 billion.  That’s billion with a B.  Almost like a drone attack, a number of related companies simultaneously billed Medicare for low-cost urinary catheters for a large number of actual Medicare beneficiaries.  A high volume of low dollar claims is harder to detect.  Nowadays, criminals can use computer networks to do the huge amounts of paperwork necessary to process billings of this magnitude.  Keep tuned.  This is not likely to be the only scheme of this size.

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February 9. 2024

Win, win?  Researchers have found that taking erectile dysfunction medications is associated with a decreased risk of Alzheimer’s.  It is thought that the increase in blood flow caused by the drugs is good for the brain and confers some limited protective effect?

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February 7. 2024

According to a survey of members of one of the largest nurses’ union in the country, over 80% of nurses experienced at least one type of violence at work in 2023.  About 2/3’s of nurses were either physically attacked or were subjected to threats of physical violence.  Only 4% of the nurses surveyed reported that incidents of violence had decreased at their workplace over the past year.  Not a good situation for them or for us.

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February 5, 2024

Researchers have known for some time that eating fermented foods is good for your gut microbiome.  It promotes the health and diversity of these organisms that live inside us.  Now, evidence is mounting that eating fermented foods improves brain function through the function of the microbiome.  Among fermented foods are yogurt, kimchi, tempeh, miso, sauerkraut, and kefir.  Eat away and be healthy.

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January 31, 2024

More evidence that living right is good for your brain.  Recent studies, which need to be confirmed, suggest that regular exercise, strong relationships, and a passion for something are good for the brain and help stave off the loss of brain volume that accompanies aging.  The bottom line is you should walk over to your friend’s house and discuss your hobbies.  Live long and prosper.

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January 30, 2024

“Private equity ownership . . . can lead to higher costs for patients, as well as lower quality care.”  So states an article from KFF News, a non-profit health news organization devoted to health care issues.  The observation arose in connection with the experience of a married couple who underwent what were supposed to be free colonoscopies, but who were presented after the fact with bills for “surgical trays” used in the procedure at $300 each.  The gastroenterology group, which was owned by private equity, was attempting to exploit a billing loophole with the couple’s insurance company so it could receive more money for the colonoscopies by billing separately for various parts of the procedure and supplies.  Ultimately, the insurance company was forced to make good on the “free colonoscopy” obligation and paid the surgical tray charge itself.  Morale of the story:  Watch your medical bills.  Don’t let them get away with sneak charges.

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January 29, 2024

There is a new test coming for prostate cancer.  It is called Stockholm 3.  It has just completed wide testing on a number of diverse patient groups and has been found to be at least as accurate or more accurate than the standard PSA test.  It is estimated that its increased ability to distinguish between aggressive and benign cancers will reduce the number of unnecessary prostate biopsies.  Look for the test to be in general use later this year.

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January 25, 2024

Toilet lid up or down when you flush?  Turns out it makes some difference but not that much and the best advice is to disinfect the toilet and surrounding surfaces often.  Research has shown that lowering the toilet lid before flushing does reduce the amount of bacteria in the vicinity of the toilet but does not do much to reduce the presence of viruses, which are smaller.  In both cases, there is a plume of small, aerosolized particles which escapes the toilet during flushing, even when the lid is down.  These particles settle on the walls, floor and counters in the vicinity of the toilet.  You should use disinfectant to remove the bacteria and viruses from these surfaces.

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January 24, 2024

When it comes to good health, you cannot exercise away your other bad habits.  This was one of the main conclusions of a recent Finnish study involving twins.  Exercise is important, but, in the Finnish study, it was most effective when it was coupled with other healthy behaviors, as it most often was.  Bottom line is that longevity depends on some factors we cannot change but many we can.  Good diet, good sleep habits, no smoking, being active, and keeping your weight and blood pressure under control are all factors we can control that will likely not only lengthen our lives but make them more enjoyable as well.

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January 22, 2024

The evidence is adding up that taking a daily multivitamin slows the onset of cognitive decline in older adults and improves memory.  The average advantage ranged between two and five years over those who did not take the multivitamin.  Given the low cost of a daily multivitamin and the absence of any side effects, why not add this to your daily health regimen?

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January 16, 2024

Here is the latest sign that the Apocalypse is upon us.  America is aging rapidly and we have no system in place to care for all the elderly who are going to desperately need care.  What care there is available is expensive and the people who need it don’t have the resources to afford it.  Here is a good article on the subject from Kaiser Healthcare.

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January 8, 2024

Doctors have known for a long time that exercise was good for the brain but have never been able to pin down exactly the mechanism at work.  While there is still much to learn, they have determined that one factor is the neurotransmitter dopamine.  Dopamine, also known as the feel good hormone, is produced by the body during exercise.  Recent studies have shown that the presence of dopamine improves mental functioning.  Whatever it is exactly, all you need to know is to keep exercising.