Drug coverage for seniors far from guaranteed

There may be a hitch in Congress’ plans to provide Medicare beneficiaries prescription drug coverage through private insurers. Not one company has said it would participate, reports Amy Goldstein in today's Washington Post.

"In interviews, industry officials said that, broadly speaking, they are glad the government is working to carve out older markets for them at a time when the nation's population of the elderly is about to soar. Privately, they acknowledge they are unsure, even at this late stage in the government debate, whether signing up Medicare patients would be sound business,” Goldstein writes. Read the story.

Great quote

"The magic pill I would really like to see is one that would motivate our patients to diet, exercise and stop smoking."
--Dr. Paul M. Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital in Boston

The quote appears in today's New York Times in a story on a hypothetical "polypill" that would contain six drugs and lower the risk of heart attack by 88 percent. A paper proposing the polypill appears in the current issue of the medical journal BMJ.

Read an abstract of the BMJ article and rapid responses to it.

Read the New York Times article.

Blood donors needed before holiday

With the Fourth of July holiday on a Friday, emergency room trauma teams are gearing up for a potentially busy weekend.

“All of the conditions are right for us to have a huge trauma weekend,” says Dr. Paul Lin, trauma medical director at Sacred Heart Medical Center.

The Inland Northwest Blood Center is getting ready, too, with a blood drive beginning Monday in Spokane and Coeur d'Alene. The center provides blood and blood products to more than 30 Inland Northwest medical facilities.

The center's Spokane headquarters, 210 W. Cataldo, and the Coeur d'Alene center at 1341 Northwood Center Court, Suite B, will be open extended hours, from 8 a.m. to 6 p.m. Monday through Thursday.

For information, call (800) 423-0151. Or make an appointment online.

Where there's fuel, heat and oxygen ...

Fires in operating rooms break out about 100 times a year, resulting in up to 20 serious injuries and one or two patient deaths, according a bulletin issued today by the Joint Commission on Accreditation of Healthcare Organizations.

The group says the fires are under-reported and preventable. The combination of heat from surgical tools, flammable materials including alcohol-based prepping agents and oxygen contributes to the problem.

The group recommends staff education and adequate time for patient prep.

Glimpse your future in older relatives

A friend has two uncles, Robin and Jerome. The men are brothers. Robin exercises regularly and eats his vegetables. Jerome sits around and won't touch veggies.

My friend is in his 30s, loves hamburgers and, so far, has stayed trim with a little basketball. But when he looks at his uncles' abs (a stark contrast apparently), he starts thinking long term. "I want to look like Robin," he says.

Healthy steps for people with diabetes

Adults with diabetes should take regular walks if they want to live longer. That’s the suggestion of a study published today in the Archives of Internal Medicine.

Researchers at the U.S. Centers for Disease Control and Prevention looked at 2,896 adults with diabetes. Compared to people with inactive lifestyles, those who walked at least two hours each week had a 39 percent lower all-cause death rate and a 34 percent lower cardiovascular disease death rate.

One death per year could be prevented for every 61 people persuaded to walk at least two hours per week, the researchers wrote.

If you're interested in diabetes, check The Spokesman-Review's Web site Wednesday at noon. I’ll be hosting an online chat with Laura Wintersteen-Arleth, diabetes education coordinator for Spokane’s Community Health Education and Resources. To submit a question in advance, click here.

News media too eager for cures

A cure for the common cold. It was too good to be true.

Indeed, the drug, pleconaril, was rejected in 2002 by a U.S. Food and Drug Administration committee and its manufacturer stopped testing it. It didn't work all that well and it had side effects.

But no fewer than 982 stories in U.S. newspapers and on television appeared in the years before that. The news media deemed pleconaril a wonder drug, a super drug, a medical first and a cure.

Journalism professor and former TV reporter Gary Schwitzer writes about what went wrong and how journalists can avoid being swept into a drug company's hype campaign. The article appears in the current issue of the medical journal BMJ.

First steps for heartburn sufferers

I wanted to know more about heartburn after working on the item below and a longer story on the topic that will be printed in the newspaper Tuesday.

Here's what Dr. Douglas Robertson, assistant professor of medicine at Dartmouth Medical School, wrote me by e-mail:

"Lifestyle modifications can be an effective first step in the
management of heartburn. For example, avoiding foods that promote acid
reflux like caffeine and alcohol can be effective. Eating smaller meals and
avoiding late night snacks can also help alleviate some of the nocturnal
bouts of heartburn. Finally, smoking cessation and weight loss can not only
help alleviate heartburn, but may well have other important health benefits."

He also recommended the Web sites of the American Gastroenterologic Association and the National Institute of Diabetes & Digestive & Kidney Diseases.

A purple pill by any other color ...

The "purple pill," Prilosec, took prescription drug marketing to a whole new level.

Now as Procter & Gamble prepares for federal approval of its over-the-counter version of the heartburn drug, the company is rolling out its marketing machine. In Spokane, that marketing will include a heartburn screening event on June 27.

Non-prescription Prilosec will be pink, although the packaging will be purple. P&G anticipates sales of $200 million to $400 million.

The drug will be marketed as a treatment for "frequent heartburn" -- heartburn that occurs two or more days a week. The Spokane screening event will take place June 27 at two locations: 6 to 9 a.m. at Spokane Firefighters Local 29 Union Hall, 911 E. Baldwin, and 6 to 10 p.m. at the Spokane Shadow soccer game at Joe Albi Stadium.

A Spokane gastroenterologist cautions that frequent heartburn can mask other health problems. “If you have frequent heartburn, you need to let your doctor know about it,” Dr. Klaus Gottlieb says.

Hey, it's a contest!

Yesterday, I told you about new research showing the Y chromosome, the one carrying the gene that makes a man a man, talks to itself in palindromes. It's the chromosome's way of repairing genetic errors.

Headline writers elsewhere had fun with the story:

Every man a Mr. Fix-It, genetically speaking
Kansas City Star

Male Y chromosome not perfect, but able to change
Chicago Sun-Times

I know there's a limerick in the story somewhere. "Chromosome" and "palindrome" are just too good to pass up. I'll post any halfway decent attempts at a limerick ... or a haiku, for that matter. E-mail me by clicking on my name below. I'll come up with a suitable prize.

Poetry in the Y chromosome

The human Y chromosome speaks to itself in palindromes, exchanging genes between its two arms. The discovery, announced today and published in the current issue of Nature, relied on gene sequencing achieved through the Human Genome Project. Researchers identified the Y’s chromosome’s self-talk as its unique way of editing out genetic errors.

Let's review what we learned in junior high school, shall we? Palindromes are phrases that read the same backward and forward, such as "Madam, I’m Adam" and "Do geese see God?" The Y chromosome is the one that distinguishes males from females and is the only chromosome that doesn’t go around in a matched pair. All other chromosomes preserve their genetic integrity by exchanging genetic information between the matched pairs.

Don't believe everything that's forwarded

A friend recently sent me a forwarded e-mail that's been circulating on the Internet for years. It's called "Kathy's Story" and it recommends that women insist their doctors screen them for ovarian cancer using the CA-125 blood test.

In reality, the test yields too many false positives and could lead to unneeded surgery. That explains why doctors are reluctant to order it routinely.

Want to know more? Click on these fact-filled sites: snopes' Urban Legends and the National Cancer Institute. The bottom line from NCI: "The available evidence suggests that using CA 125 alone, particularly at a reference value of 35 U/mL, does not have a sufficiently high sensitivity to be recommended for routine screening of ovarian cancer."

If you could design a perfect baby, would you?

Ethical questions in genetics, plus a history of genetic research and the Human Genome Project are subjects for an online exhibit sponsored by the National Institutes of Health.

"Revolution in Progress: Human Genetics and Medical Research" examines how genetic research may lead to disease prevention and treatment. It also reviews the roles of DNA, genes, and chromosomes in the body.

Cigarette sales down, ad spending up

The Federal Trade Commission's 2001 report on cigarette sales and advertising shows sales down 3.8 percent from 2000 levels. Advertising and promotional spending, however, rose significantly. The six largest cigarette makers spent $11.22 billion on advertising and promotions in 2001, a 17 percent increase over ad spending in 2000.

Full disclosure: Some of that went to newspapers, though less than the previous year. The cigarette industry's spending on newspaper ads was $31.7 million in 2001, a decrease of 38.7 percent from 2000.

But it looks so pretty and sparkly ...

You’ve got to be skeptical when a product is promoted as prevention for anthrax, allergies, cancer, diabetes and SARS. That’s the case with colloidal silver, a suspension of silver particles in liquid, currently promoted on numerous Internet sites.

The toxic effects of ingesting silver are fairly wild. They include the nails, skin and whites of the eyes turning blue. Silver also can damage organs and lead to neurological disorders, according to an article on Consumer Reports’ Web site.

On a related note, the U.S. Food and Drug Administration and the Federal Trade Commission are cracking down on the makers of Coral Calcium Supreme. Claims that the product can treat or cure cancer and other diseases, such as multiple sclerosis and heart disease "go far beyond existing scientific evidence regarding the recognized health benefits of calcium," the agencies say.

Office workers, stick out your tongues!

The June issue of Business 2.0 magazine offers up a list of health tips designed to ward off stress, fatigue and other common office ailments.

One stress-busting exercise involves making funny faces. So stick out your tongue at the boss and say you're getting healthy.

Surgeon general goes out on a limb

Let the backpedaling begin.

According to today's Washington Post, "Surgeon General Richard H. Carmona said yesterday that he supports the banning of tobacco products -- the first time that the government's top doctor and public health advocate has made such a strong statement about the historically contentious subject."

Carmona was testifying at a House subcommittee hearing on smokeless tobacco and "reduced risk" tobacco products, and was answering a question about whether he would "support the abolition of all tobacco products."

"I would at this point, yes," the Post quotes him as saying.

The article, by Marc Kaufman, goes on: "Bush administration officials quickly distanced themselves from the comments, saying that they represented Carmona's views as a doctor rather than the position of the administration."

The Canada connection

A story in today’s New York Times by Gardiner Harris profiles a new industry – discount stores that connect Americans with Canadian pharmacies and low-cost prescription drugs. The U.S. Food and Drug Administration is taking action against these stores, saying they’re a danger to health because they usually operate without a licensed pharmacist.

The stores, according to the article, are "the latest manifestation of the conflict created by the enormous differences in prescription drug prices around the world. Even as governments in almost every industrialized country mandate steep cuts in drug prices, American consumers are paying among the highest prices in the world, and those prices are increasing annually.”

More expensive, not necessarily better

Researchers found no significant difference in outcomes between patients with low back pain who had rapid MRIs and similar patients who had X-rays. A study in The Journal of the American Medical Association, released today, also finds that MRIs appear to increase the number of spine operations and increase costs.

Dr. Jeffrey Jarvik of the Department of Radiology, University of Washington, and colleagues conducted the study, a randomized controlled trial of 380 patients.

An accompanying editorial states: "as a result of this randomized controlled trial, rapid MRI joins the ranks of appealing innovations that have proved illusory."

A new favorite site

One state over to the right, my Idaho Internet colleague Dr. Tom Heston is running an excellent health site that emphasizes prevention. Heston, a Spokane native, has practiced family medicine and nuclear medicine in the Silver Valley since completing his residency in 1997.

Heston’s site is The Internet Medical Journal. It’s geared toward regular folks, but docs will get a lot out of it too. Besides Heston's summaries of recent research, the site from time to time broadcasts live talks from medical conferences.

On the site today, he has an item about the effects on newborns of smoking during pregnancy.

For visual learners

Want help visualizing the SARS coronavirus or how a stroke happens in the brain? Hybrid Medical Animation creates animated illustrations for tradeshows, trainings, television and the Web.

Here's their animation for the SARS coronavirus.

And one that shows the genesis of a stroke.

They're large files, and can take a while to download even with a fast connection. But they're worth it.