U.S. readies for Yemen President Saleh, refuses to divulge details
Washington, D.C., United States (AHN) – The United States on Monday confirmed issuance of visa to ailing Yemeni President Ali Abdullah Saleh for a limited time to undergo medical treatment but refused to divulge time-period for which the visa is issued.
“We have issued a visa for Ali Abdullah Saleh,” said Victoria Nuland, the State Department spokesperson, adding, “It is strictly for medical treatment, and our expectation is that he will leave the United States when his medical treatment is complete.”
Asked to comment on the time period for which this visa is issued, Nuland said, “He’s got a visa for the period that he anticipated the medical treatment would last. If the treatment goes on longer and he needs to apply for an extension, he would do that with Homeland Security.”
Yemeni political players are expecting to utilize President Saleh’s absence to move the country “on a concrete transition plan to a more democratic Yemen,” said Nuland, adding, “We do believe that Saleh’s absence from Yemen at this critical juncture might, in fact, facilitate that dialogue and facilitate the transition process.”
Agreeing that, “it might be helpful to the transition process that he’s out of the country now,” Nuland reiterated, “It (the visa application) was not approved for political purposes. It was approved for medical treatment. The timing, we think, is fortuitous, however, and we hope that the Yemenis will use the time well.”
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Hepatitis B vaccine recommended for diabetic adults
Washingotn, D.C., United States (AHN) – New government guidelines recommend the hepatitis B vaccine for all unvaccinated adults, aged 19 to 59, with type 1 and type 2 diabetes.
The U.S. Advisory Committee on Immunization Practices says the immunization should be done as soon as possible after adults in this age group are diagnosed with diabetes. Unvaccinated adults older than 59 can receive the hepatitis B vaccination at the discretion of their doctor.
Between 700,000 and 1.4 million people in the U.S. are infected with the hepatitis B virus, the Centers for Disease Control and Prevention reports.
Chronic HBV infection damages the liver and can lead to serious illness and death. More than 15 percent of adults with chronic HBV infection develop cirrhosis and liver cancer.
People with diabetes are at an increased risk for HBV infection, which can occur through minute amounts of blood from an infected person who has shared a medical or glucose monitoring device.
The hepatitis B virus thrives outside the body and is easily transmitted. Transmission is possible if finger-stick devices or blood glucose monitors meant for one person are used by more than one person without appropriate cleaning or infection control measures.
The new recommendations for hepatitis B vaccination for diabetics is outlined in the Dec. 23 issue of the CDC’s Morbidity and Mortality Weekly Report.
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Few women get breast reconstruction after mastectomy
New York, NY, United States (AHN) – Despite the known cosmetic and psychological advantages, few women undergo breast reconstruction after a mastectomy.
Researchers from Columbia University Medical Center say that fewer than one in four women with invasive cancer opt for the immediate reconstruction of their breast, while more than one in three with early stage cancer opted for and received the procedure.
For the study, the researchers looked at data representing 15 percent of U.S. hospitals. They found 108,992 women with invasive breast cancer who underwent a mastectomy, and 14,710 women with early stage cancer who did.
From 2000 to 2010, 23.4 percent of those women with invasive cancers got immediate reconstructive surgery, and 36.4 percent of those with early stage cancers did.
Women younger than 50, with commercial health insurance, were most likely to get the surgery.
Along with older women, blacks and rural residents were less likely to get reconstructive surgery.
The biggest predictor of whether women got immediate reconstruction was insurance.
Doctors noted that the findings are surprising. While they acknowledge that many women opt not to go through more surgery, they say some women may not be aware of the option or the insurance coverage for it.
The findings were presented Thursday at the San Antonio Breast Cancer Symposium.
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CDC: U.S. teens not eating enough fruits, vegetables
Atlanta, GA, United States (AHN) – U.S. teens are not eating enough fruits and vegetables, according to a new study by the U.S. Centers for Disease Control and Prevention.
The findings, based on data complied from nearly 10,800 students in grades nine through 12 who took part in the National Youth Physical Activity and Nutrition Study 2010, found median consumption was 1.2 times per day for both fruits and vegetables.
Median fruit consumption was much higher among males than females, and much higher among grade nine students than among students in grades 10 and 12.
A little more than 28.5 percent, or one in four, of the high school students ate fruit less than once a day, and 33.2 percent ate vegetables less than once a day.
Only 16.8 percent of students ate fruit at least four times a day, and only 11.2 percent ate vegetables at least four times a day.
Vegetable consumption was lowest among Hispanic and black students, the study found.
Researchers said the findings show that most high school students do not meet the daily fruit and vegetable recommendations, and more needs to be done to see the recommendations are met.
The researchers wrote in the Nov. 25 issue of the CDC’s Morbidity and Mortality Weekly Report, “The infrequent fruit and vegetable consumption by high school student highlights the need for effective strategies to increase consumption.”
Steps have already been taken at schools throughout the country to remove sugary snacks, sodas, high fat, high salt and low nutrient dense foods. New programs such as farm-to-school initiatives, school gardens and salad bars aim to improve access to both fruits and vegetables.
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New blood thinner cuts down repeat heart attacks
Orlando, FL, United States (AHN) – A new anti-clotting drug reduces the risk of heart-related death, heart attack and stroke in patients who have been hospitalized with a heart attack or unstable chest pain.
The findings were presented Sunday at the annual meeting of the American Heart Association.
The drug, rivaroxaban, is marketed by Johnson & Johnson with Bayer AG under the brand name Xarelto. If approved for such use, the drug would open up a major new market and hopefully save scores of lives.
About 1.2 million people in the United States alone are discharged from hospitals each year after a heart attack or heart-related unstable chest pain.
Currently, the only anti-coagulant prescribed for such patients when they leave the hospital is warfarin. But difficulties in managing the 50-year-old medicine means it is not often used to prevent heart attacks. Numerous other trials have attempted to find a better alternative, but have failed.
Two doses were tested in the trials–a 2.5-milligram dose and a 5-milligram dose, each given twice daily.
When all patients taking the drug were analyzed, researchers found that 8.9 percent of those on rivaroxaban either died of heart causes or suffered a heart attack or stroke within two years, compared with 10.7 percent who were taking a placebo.
The 2.5-milligram dose was associated with a 34 percent reduction in the risk of heart-related death, 2.7 percent on the drug in comparison with 4.1 percent on the placebo, and a 32 percent reduction in death from any cause.
The study specifically excluded patients who had suffered a prior stroke or had a mini stroke. Such patients should not be candidates for treatment with the drug, the researchers say.
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More American patients seek treatment abroad to escape high medical costs
Washington, D.C., United States (AHN) – The number of Americans heading abroad for medical care rose sharply last year amid high health care costs and a poor economy in the United States, according to medical tourism industry figures.
Some of their preferred locations for life-saving surgeries and other procedures are India and Mexico, the health information company Health Digital Systems reported.
Surgeries like hip replacements, dental implants and heart bypasses can cost half as much in Southeast Asia and Latin America compared with the United States.
Among the six million Americans who traveled abroad for medical care last year, 45 percent traveled to Asia, 26 percent to Latin America and 2 percent to the Middle East, according to industry statistics.
Health care officials in the countries treating foreigners are upbeat about their patients. Medical tourism, primarily from the United States and Europe, represents a nearly $100 billion a year industry.
Mexico’s Health Ministry recently produced a report saying “the globalization of health services can offer excellent medical care at lower costs than developed countries.”
The health ministry has developed a strategic plan to encourage medical tourism by continuing “the effort to improve the perception of public safety and promote [Mexico's] image as a global capital of culture and entertainment.”
Any success by Mexico’s health providers in reaching American patients is most obvious in border cities like Monterrey, Tijuana and Chihuahua, according to the Health Digital Systems. Pharmacies, hospitals and medical specialty practices have sprung up to take care of them.
However, patients also assume risks by trusting their health care to foreign medical standards.
Only 2 percent of Mexico’s hospitals have earned “Joint International Commission” certification.
The certification means a hospital and its staff have met international standards that would allow them to be reimbursed by foreign medical insurance companies.
India’s medical tourism industry is losing patients to competing hospitals in Singapore, Thailand and Malaysia amid concerns about poor sanitation.
Indian hospitals have been struggling with a “superbug” that is resistant to disinfectant.
As a result, some patients are reporting they become sick when they enter Indian hospitals for other treatments.
Nevertheless, the discount price of foreign medical treatment is creating a backlog of patients for hospitals with good reputations.
Mediescape, an Indian medical tourism company, reports that India’s hospitals offering medical services to patients from the United States and Europe say their booked up to December.
Between 15 percent and 20 percent of India’s hospital income now comes from medical tourism, according to industry data.
There were 800,000 foreign patients in India last year. They are expected to generate a $3 billion a year industry for India by 2015, up by more than a third from 2010.
Behind the figures on rising medical tourism is the desperation of patients who cannot afford health care in the United States, where about 40 percent of the population lacks adequate medical insurance, according to U.S. government statistics.
Some Americans are even treating themselves for serious ailments, not always with successful outcomes, according to a recent survey by TMD Limited, a medical tourism company.
“Today we are seeing many breast cancer patients that self-treated for years,” said Antonio Jimenez, a doctor raised in New Jersey who now runs the Hope4Cancer Institute in Mexico’s Baja California. “Unfortunately, cancer treatment is not a do-it-yourself project.”
Many of the women search for treatments on the Internet.
“We see more and more women who have spent thousands of dollars on supplements and wonder cures they used at home,” Jimenez said. “When those treatments fail, they look for a clinic that can help.”
The American Cancer Society reports that 230,480 American women will be diagnosed with breast cancer this year. Of those, 39,520 will die.
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Oakland clinic provides medical care to ex-offenders
Oakland, CA, United States (KaiserHealth) – Most former inmates leave California prisons with no consistent place to get medical care. Instead, they rely on a scattershot of county-funded clinics or end up at county emergency rooms. But in California, that’s beginning to change.
The state negotiated with the Obama administration to gain early access to funds available under the federal health law. Starting last month, counties began enrolling all low-income residents — including ex-offenders — into a version of Medi-Cal.
Ex-convict Darren Thurmond wears a prison-issued grey sweat suit, stretched tightly over his large belly and carries a crumbled brown paper bag, as he climbs out of the prison van stopping just outside the metal gates of San Quentin.
Waiting for him is Don Williams – a counselor from a local health clinic who’s here to give Thurmond a ride to Oakland.
“I’m not sure how many times I can do this, man,” Thurmond says to Williams.
Thurmond has been in and out of prison in the last twenty years for cocaine and methamphetamine possession. Now at age 45, all the drug use and hard living has damaged his heart.
Like many ex-convicts, he says hasn’t had health insurance since he was a kid, and his heart problems were first diagnosed and brought under control in prison. But each time Thurmond gets out, he’s left with a 4-week supply of medication and no insurance. Now that’s changing.
With the early expansion of health coverage this summer, former inmates will be covered for preventive care, prescription drugs, specialty visits and mental health and substance abuse. One place where Thurmond will now get care is at the non-profit Healthy Oakland, his first stop after his release from prison.
This is one of the few clinics in the state that offers medical care to ex-convicts who have typically been excluded from public insurance programs like Medi-Cal.
Thurmond sits down for a full medical checkup with George Pearson, the clinic’s physician assistant. They discuss his heart problems, his weight and the painful arthritis that’s overtaking Thurmond’s hips.
Pearson says a 45-year old ex-convict will often have the ailments of someone 10 years older. They have higher rates of almost all chronic conditions, like high blood pressure, diabetes and asthma. To be sure, these ailments stem from living a hard life, but it’s also because they have common medical problems that go untreated.
“So the hypertension becomes heart failure. The diabetes becomes diabetic neuropathy, which can lead to amputation, even blindness,” Pearson says.
Researchers say that when these pervasive problems are left untreated, they can lead right back to prison or jail, and that giving ex-offenders health insurance and assigning them a regular doctor brings some order to their chaotic lives.
“Their whole life is transitional. And it lacks stability. You need a facility that’s going to be the home of their records, [that's] going to know them as a person,” Pearson says. Having a regular health care provider can prevent ex-offenders from over utilizing the ER.
Expansion of Care in Some Counties
Some county health departments are using the new federal money to re-structure their safety nets to provide a fuller array of services. For example, Alex Briscoe of the Alameda County public health department says he’s adding mental health specialists to primary care clinics.
“Historically, services for this population are fragmented and tend to be episodic. And what we’re trying to do is prepare for health reform by assigning all consumers in our system, all clients in our system, to a medical home.”
Those preparations are especially important as California begins to comply with a court order to reduce its state prison population. To relieve overcrowding, tens of thousands of lawbreakers are expected to be put on probation in their home towns instead of going to state facilities. That means even more ex-offenders signing up for the expanded health coverage.
However, health researchers say the new enrollees will likely only add to a maxed out Medi-Cal system. Wait times for specialists have long plagued Medi-Cal across California, largely due to the state’s low reimbursement rate.
Still, providing coverage is important for public health, experts say. Emily Wang of the Yale School of Medicine says many former inmates return home with communicable diseases.
“Treating substance abuse, HIV, hepatitis C will reduce the disease rates in our communities,” she says.
But Wang and others say health insurance though is no magical cure for a group of people with more pressing, every day needs.
After Darren Thurmond finished his doctor’s visit at Healthy Oakland, this reporter drove him to a pharmacy to pick up his many prescriptions. By bus, this trip would’ve taken an hour, plus a painful walk with his arthritic hips.
Afterward, we headed to a Mexican restaurant in downtown Oakland for lunch. Thurmond says he had fantasized in prison about authentic enchiladas.
He’s thankful that he now has a regular doctor, he says. But he’s homeless. Living in his van, he’s unsure how he’ll get to his appointments to get his blood work checked or his prescriptions refilled.
“Being homeless, often I have the time to do it, but I don’t have the gas to get there,” Thurmond says.
For now, Thurmond is thinking pragmatically. On his first day out of San Quentin the basics are his main concerns: finding a job, getting money for food and gas, and a place to shower. “I’m pretty resourceful,” he says with no hint of pity. “I know a few places where I can shower.”
Alex Liu contributed to this story.
– Provided by Kaiser Health News.
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Supply of flu vaccine expected to rise this year
Atlanta, GA, United States (AHN) – More flu vaccine doses are expected this year compared to last, according to the Centers for Disease Control and Prevention on Thursday.
Recommendations remain the same. The CDC says all Americans older than six months should be vaccinated each year. The vaccine is typically administered in a single dose.
New this year–people over 65 can opt for a high dose form of the flu known as Fluzone High-Dose. The CDC has not yet issued a formal recommendation that the new Fluzone High Dose be used by older patients due to the fact that it is new, and data is still being collected about its effectiveness.
The CDC also noted that while just 65 percent of health care workers, and less than half of pregnant women, got flu shots in 2010, both were improvements from previous years.
In the 2011-12 season, 166 million doses are expected to be produced versus 157 million last year.
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Former Rep. Mark Foley recovering from cancer surgery in Florida
Orlando, FL, United States (AHN) – Former U.S. Rep. Mark Foley is recovering from an operation to remove cancer cells in his prostate.
The 56-year-old lawmaker successfully underwent surgery late Friday in an Orlando hospital. He was diagnosed several weeks ago after skipping his annual check-up.
A former Lake Worth vice mayor and state lawmaker before being elected to Congress in 1994, Foley was said to have been considering running for mayor of West Palm Beach last year. He stepped down in 2006 from his congressional seat, at the time chair of the House Caucus on Missing and Exploited Children, a day after a report accused him of sending sexually explicit messages to a male House page.
The report said the congressman sent the text messages in 2004 but other House pages later came forward and accused him of inappropriate conduct as far back as his first year in office.
Upon his resignation, the six-term congressman checked into a rehabilitation facility and revealed that he is gay. He returned to the public stage in 2009 as host of a political radio talk show in North Palm Beach.
Foley was not sanctioned by the House Ethics Committee, nor was then-House Republican Speaker Dennis Hastert, who had known about Foley’s history with male pages and had faced calls to resign.
The Florida Department of Law Enforcement also did not charge the former congressman in connection with the allegations after a “thorough and comprehensive investigation.”
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Johnson & Johnson halts production of drug-coated heart stents
Bridgewater, NJ, United States (AHN) – Consumer care products manufacturer Johnson & Johnson said it would halt the production of drug-coated heath stents by the year end.
The move, announced by the firm on Wednesday, is expected to create a vacuum in the $4-billion market amid concerns over the use of stents on some patients.
Cordis Corporation, a Johnson & Johnson subsidiary, will likely shed 900 to 1,000 jobs this year and the firm is expected to take a $500 million to $600 million restructuring charge this quarter.
The decision to stop making the drug-coated heart stents is both caused by weaker sales and questions over the necessity of the device for some patients. In 2010, Cordis’ global sales of the heart stents plummeted to $627 million from $2.6 billion in 2006.
Recent research indicate that the stent – a small device inserted through blood vessels to keep arteries open in the heart, is overused by doctors. New drugs that are cheaper, safer and more effective for some patients are more effective ways for many cardiovascular sufferers to avoid heart attacks or strokes.
With Cordis’ move, the dwindling heart stent market would be left to three remaining companies.
Seth Fischer, Cordia chairman worldwide, also blamed an appellate court’s decision last week that favored unlicensed competition for eroding the firm’s pricing, sales and market share.
The 900 to 1,000 jobs to be lost are at Cordis’ facilities in Puerto Rico and Ireland.
Cordis observed its 50 years of being a leader in the development and production of breakthrough treatments for cardiovascular ailments in 2009. From a garage in Miami, Florida, Cordis has grown to a global giant with sales of $3.1 billion in 2008. About 50 percent of the sales were outside the U.S.
Cordis introduced in the 1990s the heart stent, which was named one of the Top 30 Innovations of the Last 30 Years by the Wharton Business Schools and PBS’ Nightly Business Report.
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