Posts Tagged ‘HIV’

CDC Wants Baby Boomers Tested for Hepatitis C

Tuesday, May 29th, 2012

A latent legacy of baby boomers’ youthful antics could be hepatitis C. The number of boomers dying from a “silent epidemic” of hepatitis C infections is increasing so quickly that federal officials are planning a nationwide push for widespread testing.  Seventy-five percent of the estimated 3.2 million people who have chronic hepatitis C — and a similar number of those who die from the ailment are baby boomers.  Hepatitis C deaths nearly doubled between 1999 and 2007 to more than 15,000, according to a Centers for Disease Control and Prevention (CDC) study.  Hepatitis C is the primary infectious cause of cirrhosis and liver cancer and is the most common reason for liver transplants, according to the CDC.  In 2007, deaths from the disease surpassed those caused by HIV, and the numbers are expected to increase.

Baby boomers typically became infected in their teens and 20s, either via blood transfusions or with experimental injection drug use. Hepatitis C is often asymptomatic while it damages the liver, according to the CDC.  “It’s a bold action that’s become necessary because there’s a large population that’s unaware of their illness, becoming ill, and dying in an era of effective treatment,” said John W. Ward, director of the division of viral hepatitis at the CDC.

One in 30 baby boomers have hepatitis C, according to the CDC.  A single test of the members of that generation has the potential to identify 800,000 people with hepatitis C, which would prevent liver cancer and perhaps save 120,000 lives.  “We believe this cost-effective public health approach can help protect the health of an entire generation of Americans,” Ward said.  “It’s the fastest-growing cause of death in the U.S. and hepatitis C is the leading cause of liver cancer here.   “Most cancer deaths are going down and this is one of the few that continues to escalate.”

Many baby boomers have a potentially dangerous ‘it’s not me’ mentality about hepatitis C,  and this survey underscores how poorly most people in that generation understand that risk factors do apply to them,” said Ira M. Jacobson, M.D., AGAF, chief, division of gastroenterology and hepatology and professor of medicine, The Joan Sanford I. Weill Medical College of Cornell University, and physician co-advisor to the , American Gastroenterological Association’s (AGA) I.D. Hep C campaign. “Given the potentially deadly consequences of allowing hepatitis C to go undiagnosed, the AGA urges all baby boomers to talk to their doctors about getting tested.”

“The disease can’t be treated if people don’t know they are infected. With treatment, the chance of a cure is greater than ever,” said Michael Ryan, M.D., clinical professor of medicine, Eastern Virginia Medical School, practicing gastroenterologist with Digestive and Liver Disease Specialists of Norfolk, VA, and physician co-advisor to AGA’s I.D. Hep C campaign.  “I see every day the devastation hepatitis C can cause, especially to those who have lived with the disease for years without knowing it.  Baby boomers shouldn’t wait – they should talk to their doctors today about getting this simple test.”

Why Aren’t Physicians Paid For Talking To Their Patients?

Tuesday, July 5th, 2011

One possible reason that more physicians do not choose family practice as their specialty could be the fact that an essential part of the job is spent talking with patients – an activity that pays less than does performing procedures.   According to a recent study published by the Journal of the American Medical Association, just two percent of medical students plan a career in general internal medicine, pediatrics or ob/gyn.

Writing on the KevinMD.com website, Jennifer Adaeze Anyaegbunam says that “Family doctors spend more time talking to patients than performing procedures, but these doctors don’t get paid much to chat.  According to Dr. Sameer Badlani, a professor at the University of Chicago School of Medicine, when physicians are paid on a fee-for-service basis, specialists have the opportunity to make four to five times as much as a family physician.  Given the increasing debt of medical students, it is no surprise that the overwhelming majority choose to specialize.  In order to increase the supply of primary-care providers and meet the anticipated demand, family physicians need to be reimbursed more for their services.  Congress is looking into legislation that includes provisions for loan forgiveness and increased Medicare/Medicaid payments to primary-care providers.  Additionally, there have been talks of expanding the National Health Service Corps, program that utilizes scholarships and loan repayment to recruit primary care professionals to work in underserved areas.”

Primary-care physicians spend more time talking to patients and helping them avoid health crises to cope with chronic and incurable diseases than they spend performing tests and procedures. These doctors ask relevant questions, about health and life circumstances, and listen carefully to their patients.  These are physicians who know their patients and the circumstances and beliefs that can make health problems worse or hamper effective treatment.  The problem is that reimbursements are dictated by Medicare and other insurers.  As a result, physicians are not compensated well for taking the time to talk to patients.  They are primarily paid for procedures – such as blood tests and surgery — and for the number of patients they see.  Most spend long hours doing paperwork and negotiating treatment options with insurers.  The payments they receive have not increased along with increases in the costs of running a modern medical practice.  To earn a reasonable income of $150,000 a year, many primary-care doctors squeeze more and more patients into the workday.  “If you have only six to eight minutes per patient, which is the average under managed care, you’re forced to concentrate on the acute problem and ignore all the rest,” said Dr. Byron M. Thomashow, medical director of the Center for Chest Diseases at New York-Presbyterian Columbia Medical Center.  In a study of more than 3,000 patients with chronic obstructive pulmonary disease, 50 to 60 percent had one or more other illnesses, and 20 percent had more than 11 other conditions that required medical attention.  “There just isn’t the time to address them all,” Thomashow said.

Dr. Alan J. Stein, an infectious disease specialist in private practice in Brooklyn who treats many patients with HIV, described his practice as “heavily cognitive.  I spend a lot of time talking to patients — listening to them, examining them, interpreting tests and figuring out what’s wrong,” he said.  “I don’t do procedures in the office.  Over the last 10 or 15 years, the income of procedure-based physicians like cardiologists has increased significantly, whereas for those in primary care it has remained the same.”

Despite this, many physicians are reluctant to talk to their patients via e-mail.  Suzanne Kreuziger, a Milwaukee registered nurse, said.  “It makes sense to me to have the words laid out, to be able to re-read, to go back to it at a convenient time,  If I were able to ask my physician questions this way, it would make my own health care much easier.”  Her experience is shared by the majority of Americans: They want the convenience of e-mail for non-urgent medical issues, but fewer than 33 percent of doctors use e-mail to communicate with patients, according to surveys.

“People are able to file their taxes online, buy and sell household goods, and manage their financial accounts,” said Susannah Fox of the Pew Internet & American Life Project.  “The health care industry seems to be lagging behind other industries.”  Physicians have good reasons for avoiding e-mail exchanges with their patients.  Some are concerned that it will increase their workload.  Others worry about hackers compromising patient privacy.

HHS Awards $100 Million to Public Health Initiatives

Monday, October 11th, 2010

Affordable Care Act sends $100 million to public health agencies.Thanks to the Patient Protection and Affordable Care Act, the Department of Health and Human Services is awarding nearly $100 million in grants to support locally based public health and prevention services. The money will support several public health initiatives, including substance abuse; mental health; stop-smoking hotlines; HIV testing and prevention; and obesity treatment and prevention.  According to Department of Health and Human Services Secretary Kathleen Sebelius, some of the funding also will be spent on health information technology.

“From providing tools to help people stop smoking to new HIV testing and prevention programs to a critical investment in mental health, these Affordable Care Act prevention grants will help people get what they need to stay healthy and live longer,” Sebelius said.  The Centers for Disease Control and Prevention http://www.cdc.gov/ will receive $75 million of the funding for its state and local public health programs.  Approximately $26 million of the CDC money will fund epidemiology, lab and health information systems in the health departments of all 50 states, two territories and the nation’s six biggest cities.

The funding is intended to help public health departments participate in “meaningful use” of electronic health records by implementing high-tech reporting.  Another $21.7 million in CDC funds will promote HIV testing and prevention.

Researchers Using HIV Virus to Heal People

Tuesday, December 15th, 2009

French medical researchers have made a significant breakthrough in the fight against the rare genetic disease adrenoleukodystrophy (ALD), which became well-known following the release of the 1992 movie “Lorenzo’s Oil”.  What’s ironic is that the HIV virus is an important part of the new procedure.  By mixing gene therapy and bone marrow transplants in two boys, lead researcher Dr. Patrick Aubourg of the University Paris – Descartes disabled HIV virus cells so they would not cause AIDS, and then used them as couriers to insert the healthy new gene.

In the treatment, stem cells  are harvested from the patient’s soft bone tissue.  Then a correcting gene is introduced using inactivated AIDS virus cells.  These are used because they are the only ones which can penetrate into the heart of the stem cells.  Re-injected into the patients, the altered cells navigate to the brain where they permanently correct the gene deficiency which causes ALD.

Although a small first step, Dr. Kenneth Cornetta, president of the American Society of Gene and Cell Therapy, said the procedure has “exciting implications” for other blood and immune disorders.  “This study shows the power of combining gene therapy and cell therapy,” according to Dr. Cornetta, who is conducting similar research at Indiana University.

ALD is a rare genetic disease that destroys the coating nerve fibers in boys’ brains.  Without that coating – known as myelin – the neurological system breaks down and causes blindness, deafness, dementia, a loss of muscle control and, ultimately, death.

Two years after receiving the therapy, both boys are showing no sign of deteriorating brain damage.  They function well with 15 percent of their blood cells producing the healthy protein, according to Dr. Aubourg, who plans to use the procedure with additional patients.  The Stop ALD Foundation, an American advocacy group, is raising money to fund a similar study in the United States.