Suit alleging unnecessary procedures at London hospital is the 31st by plaintiff's attorney in past year

More than 300 former heart patients at the Saint Joseph London hospital have sued it, its cardiologists and agencies involved with its operation and billing services, alleging the patients were subjected to unnecessary medical procedures.

"The lawsuit was filed by Louisville attorney Hans Poppe, who has previously filed similar lawsuits," 30 in the past year, Nita Johnson reports for The Sentinel-Echo of London. "This last lawsuit is a compilation of 339 cases that Poppe has had investigated."

Claims in a lawsuit state only one side of a case. A hospital spokesman said, "We are aware of the lawsuits and take the allegations seriously, but we cannot comment any further on pending litigation." (Read more)

More than 300 former heart patients at the Saint Joseph London hospital have sued it, its cardiologists and agencies involved with its operation and billing services, alleging the patients were subjected to unnecessary medical procedures.

"The lawsuit was filed by Louisville attorney Hans Poppe, who has previously filed similar lawsuits," 30 in the past year, Nita Johnson reports for The Sentinel-Echo of London. "This last lawsuit is a compilation of 339 cases that Poppe has had investigated."

Claims in a lawsuit state only one side of a case. A hospital spokesman said, "We are aware of the lawsuits and take the allegations seriously, but we cannot comment any further on pending litigation." (Read more)

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CNN's fact-checking of 'Medicare's impending bankruptcy' shows the program is not likely to go under soon, or ever

That giant whooshing sound you just heard may have been the sound of millions of baby boomers letting out of sigh of relief. That's because CNN.com did some much needed fact checking on the often-cited and often-fretted about claim of Medicare’s “impending” bankruptcy. What they found is was startling -- and in a good way, for a change.

Trudy Lieberman, writing in the Columbia Journalism Review, notes that the Democrats used the B word at their convention, claiming that if Republicans repealed the Affordable Care Act and thus its efforts to prolong the Medicare Hospital Trust Fund, "Medicare could go broke in 2016.” Republicans, when asked to respond to the charge, promptly B-worded back, saying “Medicare will go bankrupt in 2024." Lieberman reports that CNN then "did some old-fashioned reporting, read some financial reports, and found sources that could really give the financial skinny on Medicare. And it didn’t go for that 'mostly true' or 'partly misleading' stuff that some other fact checking pieces resort to, which can confuse readers more than it enlightens them.

"First, CNN reported, as CJR has urged news outlets to do, that only one part of Medicare is in potential trouble—the Hospital Trust Fund, which is financed by payroll taxes. The other parts of Medicare, including Part B, which finances doctor visits, lab tests, and outpatient services, 'are adequately financed for now,' Medicare trustees have said. Jonathan Oberlander, a health policy expert at the University of North Carolina, told CNN that repealing the health reform law “would in fact worsen Medicare’s financial condition,” but even so, he added, “Medicare is not going bankrupt. Medicare would still have most of the necessary funds to pay those expenses and other parts of the program would be unaffected. Medicare won’t go bankrupt in the literal sense in 2016 or 2024 or 2064 -- or ever.

The Centers for Medicare and Medicaid Services noted this year, "In practice, Congress has never allowed a Medicare trust fund to exhaust its assets." (Read more)

That giant whooshing sound you just heard may have been the sound of millions of baby boomers letting out of sigh of relief. That's because CNN.com did some much needed fact checking on the often-cited and often-fretted about claim of Medicare’s “impending” bankruptcy. What they found is was startling -- and in a good way, for a change.

Trudy Lieberman, writing in the Columbia Journalism Review, notes that the Democrats used the B word at their convention, claiming that if Republicans repealed the Affordable Care Act and thus its efforts to prolong the Medicare Hospital Trust Fund, "Medicare could go broke in 2016.” Republicans, when asked to respond to the charge, promptly B-worded back, saying “Medicare will go bankrupt in 2024." Lieberman reports that CNN then "did some old-fashioned reporting, read some financial reports, and found sources that could really give the financial skinny on Medicare. And it didn’t go for that 'mostly true' or 'partly misleading' stuff that some other fact checking pieces resort to, which can confuse readers more than it enlightens them.

"First, CNN reported, as CJR has urged news outlets to do, that only one part of Medicare is in potential trouble—the Hospital Trust Fund, which is financed by payroll taxes. The other parts of Medicare, including Part B, which finances doctor visits, lab tests, and outpatient services, 'are adequately financed for now,' Medicare trustees have said. Jonathan Oberlander, a health policy expert at the University of North Carolina, told CNN that repealing the health reform law “would in fact worsen Medicare’s financial condition,” but even so, he added, “Medicare is not going bankrupt. Medicare would still have most of the necessary funds to pay those expenses and other parts of the program would be unaffected. Medicare won’t go bankrupt in the literal sense in 2016 or 2024 or 2064 -- or ever.

The Centers for Medicare and Medicaid Services noted this year, "In practice, Congress has never allowed a Medicare trust fund to exhaust its assets." (Read more)

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Study finds 'the link between cholesterol and cancer is clear'

University of Rochester Medical Center scientists have verified a link between cholesterol and cancer with new genetic evidence, raising the possibility that cholesterol medications such as statin drugs could be used for cancer prevention or to augment existing cancer treatment.

"The link between cholesterol and cancer is clear," senior study author Hartmut Land said, "but it's premature to say that [cholesterol-lowering drugs] are the answer." Still, The Times of India reports that the data gathered by the research team at the James P. Wilmot Cancer Center at URMC "supports several recent population-based studies that suggest individuals who take cholesterol-lowering drugs may have a reduced risk of cancer, and, conversely that individuals with the highest levels of cholesterol seem to have an elevated risk of cancer." 

Millions of Americans take cholesterol-lowering drugs prescribed by physicians. The drugs work by blocking the action of key enzymes in the liver, which synthesizes cholesterol. The Times story explains that "clinical trials also are evaluating statins as a tool against cancer, and some previous studies suggest that when used in combination with chemotherapy, statins might make chemotherapy more effective by sensitizing certain cancer cells to chemotherapy-induced cell death. Land, however, urges caution and further study. Doctors do not know the appropriate statin dose for cancer prevention or treatment of cancer-related conditions. Side effects cannot be ignored either, and little research has distinguished between the responses among people who take statins."

See the study in the online journal Cell Reports by clicking here. 

University of Rochester Medical Center scientists have verified a link between cholesterol and cancer with new genetic evidence, raising the possibility that cholesterol medications such as statin drugs could be used for cancer prevention or to augment existing cancer treatment.

"The link between cholesterol and cancer is clear," senior study author Hartmut Land said, "but it's premature to say that [cholesterol-lowering drugs] are the answer." Still, The Times of India reports that the data gathered by the research team at the James P. Wilmot Cancer Center at URMC "supports several recent population-based studies that suggest individuals who take cholesterol-lowering drugs may have a reduced risk of cancer, and, conversely that individuals with the highest levels of cholesterol seem to have an elevated risk of cancer." 

Millions of Americans take cholesterol-lowering drugs prescribed by physicians. The drugs work by blocking the action of key enzymes in the liver, which synthesizes cholesterol. The Times story explains that "clinical trials also are evaluating statins as a tool against cancer, and some previous studies suggest that when used in combination with chemotherapy, statins might make chemotherapy more effective by sensitizing certain cancer cells to chemotherapy-induced cell death. Land, however, urges caution and further study. Doctors do not know the appropriate statin dose for cancer prevention or treatment of cancer-related conditions. Side effects cannot be ignored either, and little research has distinguished between the responses among people who take statins."

See the study in the online journal Cell Reports by clicking here. 

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Volunteer State becoming Salad State? CDC report shows Tennessee is getting less obese, leaving U.S.'s top 10

It can be done. A determined state can move the needle on its obesity numbers. Heidi Hall of The Tennessean reports that widespread efforts to change Tennesseans’ diet and exercise habits mean that the state’s percentage of obese residents have dropped for two consecutive years – something that hasn’t happened in more than a decade. "A new report from the Centers for Disease Control and Prevention moves Tennessee out of the top 10 most obese states for the first time since 1999 – it’s now ranked 15th – and," Hall notes, "is prompting cautious optimism in leaders charged with slimming down the state." (Associated Press photo)

The question, writes Hall, is what pellets of the state's shotgun approach are working. In a state that added bike lanes and sidewalks, altered its school lunches, and added fresh produce to convenience stores, where should credit go? “I think the biggest success is that we increased awareness around the issue,” said Ted Cornelius, the Tennessee Obesity Task Force’s co-chair. “We have the capacity to analyze barriers people face -- cost, access to healthy food and places to be active -- and we keep bringing those up to leaders in communities.”

The percentage of Tennesseans considered obese peaked at 32.9 percent in 2009 and dropped to 29.2 percent last year. Rural areas lead the drop, moving from 70.7 percent overweight in 2009 to 64.7 percent last year, but Schlundt said it may not be time to celebrate just yet. Rural residents took a similar jump upward from 2005-06, and both could be anomalies because the CDC surveyed fewer rural residents. (Read more)

It can be done. A determined state can move the needle on its obesity numbers. Heidi Hall of The Tennessean reports that widespread efforts to change Tennesseans’ diet and exercise habits mean that the state’s percentage of obese residents have dropped for two consecutive years – something that hasn’t happened in more than a decade. "A new report from the Centers for Disease Control and Prevention moves Tennessee out of the top 10 most obese states for the first time since 1999 – it’s now ranked 15th – and," Hall notes, "is prompting cautious optimism in leaders charged with slimming down the state." (Associated Press photo)

The question, writes Hall, is what pellets of the state's shotgun approach are working. In a state that added bike lanes and sidewalks, altered its school lunches, and added fresh produce to convenience stores, where should credit go? “I think the biggest success is that we increased awareness around the issue,” said Ted Cornelius, the Tennessee Obesity Task Force’s co-chair. “We have the capacity to analyze barriers people face -- cost, access to healthy food and places to be active -- and we keep bringing those up to leaders in communities.”

The percentage of Tennesseans considered obese peaked at 32.9 percent in 2009 and dropped to 29.2 percent last year. Rural areas lead the drop, moving from 70.7 percent overweight in 2009 to 64.7 percent last year, but Schlundt said it may not be time to celebrate just yet. Rural residents took a similar jump upward from 2005-06, and both could be anomalies because the CDC surveyed fewer rural residents. (Read more)

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Leptospirosis in cats

Arbour J, Blais M-C, Carioto L and Sylvestre D. Clinical leptospirosis in three cats (2001–2009). J Am Anim Hosp Assoc. 2012; 48: 256-60.

Leptospira species are an important zoonotic bacterium harbored by some species of wildlife, including rodents. The bacteria are shed in urine from infected animals. Infection of cats with the spirochete bacteria Leptospira occurs but cats have always been thought to be resistant to development of clinical signs following infection. This report describes three confirmed cases of leptospirosis in cats with disease. All three cases were indoor/outdoor cats that were known to hunt.

All three cases presented with kidney disease, but no involvement of the liver as is sometimes seen in dogs. Symptoms included lethargy, anorexia, frequent urination, and excessive drinking. One cat had blood in the urine, and also inflammatory involvement of the right eye. Two of the cats responded well to treatment, but one continued to deteriorate and had to be euthanized.

Interestingly, these cats developed disease several months after the known exposure to rodents, implying a longer incubation period than is seen in dogs, which is usually a few days. The authors conclude that while disease due to Leptospira infection in cats is rare, it must be considered in cases of kidney disease. Further work is needed to determine the ability of cats to carry and shed the bacteria asymptomatically. [MK]

See also: Markovich JE, Ross L and McCobb E. The prevalence of leptospiral antibodies in free roaming cats in Worcester County, Massachusetts. J Vet Intern Med. 2012; 26: 688-9.

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Arbour J, Blais M-C, Carioto L and Sylvestre D. Clinical leptospirosis in three cats (2001–2009). J Am Anim Hosp Assoc. 2012; 48: 256-60.

Leptospira species are an important zoonotic bacterium harbored by some species of wildlife, including rodents. The bacteria are shed in urine from infected animals. Infection of cats with the spirochete bacteria Leptospira occurs but cats have always been thought to be resistant to development of clinical signs following infection. This report describes three confirmed cases of leptospirosis in cats with disease. All three cases were indoor/outdoor cats that were known to hunt.

All three cases presented with kidney disease, but no involvement of the liver as is sometimes seen in dogs. Symptoms included lethargy, anorexia, frequent urination, and excessive drinking. One cat had blood in the urine, and also inflammatory involvement of the right eye. Two of the cats responded well to treatment, but one continued to deteriorate and had to be euthanized.

Interestingly, these cats developed disease several months after the known exposure to rodents, implying a longer incubation period than is seen in dogs, which is usually a few days. The authors conclude that while disease due to Leptospira infection in cats is rare, it must be considered in cases of kidney disease. Further work is needed to determine the ability of cats to carry and shed the bacteria asymptomatically. [MK]

See also: Markovich JE, Ross L and McCobb E. The prevalence of leptospiral antibodies in free roaming cats in Worcester County, Massachusetts. J Vet Intern Med. 2012; 26: 688-9.

More on cat health: Winn Feline Foundation Library
Find us on Facebook
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Is there a correlation between food-stamp use and obesity? Some say yes, and that corporations are getting fat in the process

"Who's getting fat off food stamps?" asks ABC News' Alan Farnham, reporting that a record number of Americans -- 46.7 million, or nearly 1 in 7 -- now uses the benefit, known as the Supplemental Nutrition Assistance Program. It cost $72 billion last year, up from $30 billion four years earlier. Budget hawks have targeted the program's swollen size and cost, helping prevent passage of a new Farm Bill. Now Farnham reports, "There are those who say SNAP is making two different constituencies fat -- big corporations and the poor -- the first, figuratively; the second, literally."

In Kentucky -- with its extraordinarily high rate of obesity and, as of June 2012, its 406,689 households on food stamps -- the correlation between those two bears close scrutiny.  Many health advocates who are concerned about Americans' increasing obesity argue that "food stamp purchases should be disallowed for items high in salt or fat or sugar," Farnham notes. Consumer watchdog groups such as Eat Drink Politics similarly argue that food and beverage makers are making a mint from SNAP, and are spending equal portions to oppose legislation antithetical to their interests.

Hard numbers about what the program buys are hard to come by, says the report, in part because the U. S. Department of Agriculture either doesn't have or does not release certain crucial data: "It lacks the legal authority, for example, to require retailers to report what products SNAP participants are purchasing. It knows the dollar value of transactions, but not whether the customer bought Cheesy Puffs or broccoli."

As for the increasing obesity of the poor, data on that problem are readily available, but food stamps' complicity in it is the subject of much debate. Julian Alston, professor of agricultural and resource economics at the University of California, Davis, has studied the question in depth. Alston and his co-authors conclude that food stamp participants are more likely than non-participants to be overweight or obese. Farnham writes that "they don't say food stamps are making them fat. The authors then go on to analyze whether the exclusion of certain food items from program eligibility might make participants healthier." (Read more)

"Who's getting fat off food stamps?" asks ABC News' Alan Farnham, reporting that a record number of Americans -- 46.7 million, or nearly 1 in 7 -- now uses the benefit, known as the Supplemental Nutrition Assistance Program. It cost $72 billion last year, up from $30 billion four years earlier. Budget hawks have targeted the program's swollen size and cost, helping prevent passage of a new Farm Bill. Now Farnham reports, "There are those who say SNAP is making two different constituencies fat -- big corporations and the poor -- the first, figuratively; the second, literally."

In Kentucky -- with its extraordinarily high rate of obesity and, as of June 2012, its 406,689 households on food stamps -- the correlation between those two bears close scrutiny.  Many health advocates who are concerned about Americans' increasing obesity argue that "food stamp purchases should be disallowed for items high in salt or fat or sugar," Farnham notes. Consumer watchdog groups such as Eat Drink Politics similarly argue that food and beverage makers are making a mint from SNAP, and are spending equal portions to oppose legislation antithetical to their interests.

Hard numbers about what the program buys are hard to come by, says the report, in part because the U. S. Department of Agriculture either doesn't have or does not release certain crucial data: "It lacks the legal authority, for example, to require retailers to report what products SNAP participants are purchasing. It knows the dollar value of transactions, but not whether the customer bought Cheesy Puffs or broccoli."

As for the increasing obesity of the poor, data on that problem are readily available, but food stamps' complicity in it is the subject of much debate. Julian Alston, professor of agricultural and resource economics at the University of California, Davis, has studied the question in depth. Alston and his co-authors conclude that food stamp participants are more likely than non-participants to be overweight or obese. Farnham writes that "they don't say food stamps are making them fat. The authors then go on to analyze whether the exclusion of certain food items from program eligibility might make participants healthier." (Read more)

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In wake of pill-mill regulation fight, Beshear has chance to craft a medical licensing board more to his liking

Gov. Steve Beshear

Gov. Steve Beshear is in a position to reshape a state medical board that has played a central and controversial role in recent efforts to crack down on prescription drug abuse. Mike Wynn of The Courier-Journal  reports that the terms of three members of the Kentucky Medical Licensure Board expired Aug. 31, and two other members’ terms await action after ending last year.

The licensure board drew criticism in 2011 "for not taking more aggressive action against so-called pill mills and corrupt doctors who supply Kentucky’s drug epidemic," Wynn writes. "The medical industry also has criticized the board in recent months for writing what doctors view as overly complex and excessive prescription regulations under HB 1, a landmark bill from the 2012 General Assembly that takes aim at abuse of drugs."

Beshear spokeswoman Kerri Richardson said the appointments are under review but did not indicate how the governor might proceed other than noting that he will consider qualifications and recommendations. Current board members serve until Beshear makes any new appointments. (Read more)

Gov. Steve Beshear

Gov. Steve Beshear is in a position to reshape a state medical board that has played a central and controversial role in recent efforts to crack down on prescription drug abuse. Mike Wynn of The Courier-Journal  reports that the terms of three members of the Kentucky Medical Licensure Board expired Aug. 31, and two other members’ terms await action after ending last year.

The licensure board drew criticism in 2011 "for not taking more aggressive action against so-called pill mills and corrupt doctors who supply Kentucky’s drug epidemic," Wynn writes. "The medical industry also has criticized the board in recent months for writing what doctors view as overly complex and excessive prescription regulations under HB 1, a landmark bill from the 2012 General Assembly that takes aim at abuse of drugs."

Beshear spokeswoman Kerri Richardson said the appointments are under review but did not indicate how the governor might proceed other than noting that he will consider qualifications and recommendations. Current board members serve until Beshear makes any new appointments. (Read more)

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Investigating new drugs for feline diabetes mellitus

Final report, Winn grant W10-020
Pharmacokinetics of pioglitazone in lean and obese cats
Investigators: Levent Dirikolu, Margarethe Hoenig, Duncan Ferguson; University of Illinois
 
Diabetes mellitus and hepatic lipidosis (fatty liver disease) are common problems in feline medicine. Both diseases are associated with obesity and may be prevented by maintaining an ideal body weight. However, weight control is difficult in many cats and once these diseases develop, specific treatment is needed. Current treatment for diabetes mellitus in cats is either insulin or drug therapy with glipizide, along with dietary modification. The only treatment available for hepatic lipidosis is aggressive nutritional support, often with a feeding tube. In human medicine, new anti-diabetic drugs called thiazolidinediones such as pioglitazone improve insulin sensitivity and reverse fatty changes in the liver. The purpose of this project was to begin investigation of pioglitazone in cats so that it may be evaluated in clinical trials in the future.

The investigators’ objectives in this study were to evaluate the pharmacokinetics of this drug in lean and obese cats in an effort to provide a foundation for assessment of its effects on insulin sensitivity and lipid metabolism. Pioglitazone was administered intravenously (median dose 0.2 mg/kg) or orally (3 mg/kg) to six healthy lean cats and six obese cats. There were no statistically significant differences in pharmacokinetic parameters between lean and obese cats subsequent to either oral or intravenous administration. No adverse effects were noted with oral dosing in any of the cats. It appears that achieving therapeutic concentrations of pioglitazone, potentially at a dose of 3 mg/kg, appears feasible. [VT]

Clark MH, Hoenig M, Ferguson DC and Dirikolu L. Pharmacokinetics of pioglitazone in lean and obese cats. J Vet Pharmacol Ther. 2012.

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Final report, Winn grant W10-020
Pharmacokinetics of pioglitazone in lean and obese cats
Investigators: Levent Dirikolu, Margarethe Hoenig, Duncan Ferguson; University of Illinois
 
Diabetes mellitus and hepatic lipidosis (fatty liver disease) are common problems in feline medicine. Both diseases are associated with obesity and may be prevented by maintaining an ideal body weight. However, weight control is difficult in many cats and once these diseases develop, specific treatment is needed. Current treatment for diabetes mellitus in cats is either insulin or drug therapy with glipizide, along with dietary modification. The only treatment available for hepatic lipidosis is aggressive nutritional support, often with a feeding tube. In human medicine, new anti-diabetic drugs called thiazolidinediones such as pioglitazone improve insulin sensitivity and reverse fatty changes in the liver. The purpose of this project was to begin investigation of pioglitazone in cats so that it may be evaluated in clinical trials in the future.

The investigators’ objectives in this study were to evaluate the pharmacokinetics of this drug in lean and obese cats in an effort to provide a foundation for assessment of its effects on insulin sensitivity and lipid metabolism. Pioglitazone was administered intravenously (median dose 0.2 mg/kg) or orally (3 mg/kg) to six healthy lean cats and six obese cats. There were no statistically significant differences in pharmacokinetic parameters between lean and obese cats subsequent to either oral or intravenous administration. No adverse effects were noted with oral dosing in any of the cats. It appears that achieving therapeutic concentrations of pioglitazone, potentially at a dose of 3 mg/kg, appears feasible. [VT]

Clark MH, Hoenig M, Ferguson DC and Dirikolu L. Pharmacokinetics of pioglitazone in lean and obese cats. J Vet Pharmacol Ther. 2012.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

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