Report: Bounce-house injuries to children have skyrocketed

A new report out today in the journal Pediatrics warns that, on average, 31 children a day are transported to U.S. emergency departments for treatment of bounce-house injuries, including fractured bones and muscle damage. "If this was an infectious disease, we'd call it an epidemic and it would be on the front pages all over the country," said study co-author Dr. Gary A. Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. (Associated Press photo)

Randy Dotinga of HealthDay reports that in the 15-year period between 1995 and 2010, the rate of bounce-house injuries jumped 15-fold, with the number escalating in the last few years of the study. In the new study, published online Monday and in the December print issue of Pediatrics, researchers found the most common bounce-house injuries were fractures, strains and sprains. Concussions and cuts were more common in boys. The average age of those hurt was 7.5 years old. (Read more) 

A new report out today in the journal Pediatrics warns that, on average, 31 children a day are transported to U.S. emergency departments for treatment of bounce-house injuries, including fractured bones and muscle damage. "If this was an infectious disease, we'd call it an epidemic and it would be on the front pages all over the country," said study co-author Dr. Gary A. Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. (Associated Press photo)

Randy Dotinga of HealthDay reports that in the 15-year period between 1995 and 2010, the rate of bounce-house injuries jumped 15-fold, with the number escalating in the last few years of the study. In the new study, published online Monday and in the December print issue of Pediatrics, researchers found the most common bounce-house injuries were fractures, strains and sprains. Concussions and cuts were more common in boys. The average age of those hurt was 7.5 years old. (Read more) 

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Experimental concentrated breast cancer radiation therapy offers new options for women who live far away from treatment facilities

A study at the University of Louisville James Graham Brown Cancer Center designed to make  radiation treatment more accessible to women who face obstacles such as distance, transportation problems and time constraints is proving promising. The idea is to cut daily trips to the cancer center to once a week, says Dr. Anthony Dragon, a radiation oncologist at U of L. It also has the added benefit of cutting treatment costs by better than half.

Laura Ungar of The Courier-Journal in Louisville reports that Dragun led a previous study that found that "about a third of Kentucky women with early-stage breast cancer didn’t get recommended radiation treatments after lumpectomy surgery. Among those least likely to get radiation were rural Kentuckians, the elderly, African Americans and women in the Appalachian region of the state. Women who did not get recommended radiation were 60 percent more likely to die during the time they were studied."

Dragun told Ungar that the folks at U of L were not satisfied with just gathering those numbers, they wanted solutions to the problem. Dragun said the new experimental regimen is yielding good results, with women who get weekly radiation reporting similar levels of side effects as those getting radiation every day. Ungar notes that some outside experts say the approach does seems promising, but one critic was concerned about breast appearance results after the once-a-week treatments.

According the National Cancer Institute, more than 3,070 new cases of breast cancer were diagnosed in Kentucky in 2009 and was responsible for 614 deaths.  (Read more) 

A study at the University of Louisville James Graham Brown Cancer Center designed to make  radiation treatment more accessible to women who face obstacles such as distance, transportation problems and time constraints is proving promising. The idea is to cut daily trips to the cancer center to once a week, says Dr. Anthony Dragon, a radiation oncologist at U of L. It also has the added benefit of cutting treatment costs by better than half.

Laura Ungar of The Courier-Journal in Louisville reports that Dragun led a previous study that found that "about a third of Kentucky women with early-stage breast cancer didn’t get recommended radiation treatments after lumpectomy surgery. Among those least likely to get radiation were rural Kentuckians, the elderly, African Americans and women in the Appalachian region of the state. Women who did not get recommended radiation were 60 percent more likely to die during the time they were studied."

Dragun told Ungar that the folks at U of L were not satisfied with just gathering those numbers, they wanted solutions to the problem. Dragun said the new experimental regimen is yielding good results, with women who get weekly radiation reporting similar levels of side effects as those getting radiation every day. Ungar notes that some outside experts say the approach does seems promising, but one critic was concerned about breast appearance results after the once-a-week treatments.

According the National Cancer Institute, more than 3,070 new cases of breast cancer were diagnosed in Kentucky in 2009 and was responsible for 614 deaths.  (Read more) 

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Expanding Medicaid in Kentucky would add 5 percent to the state's cost over the next 10 years, national study predicts

Expanding Medicaid to people making up to 138 percent of the poverty level under federal health reform and its heavy subsidies would cost Kentucky about 5 percent more for Medicaid over the next 10 years than doing nothing, the Kaiser Family Foundation said in a state-by-state analysis today.

According to the study done by the Urban Institute for the foundation's Commission on Medicaid and the Uninsured, the state would spend $25.1 billion from 2013 to 2022 if it and no other state expanded the program. If all states expanded it, Kentucky's cost would be $26.4 billion, the study estimated.

Under the Patient Protection and Affordable Care Act, the federal government would pays the full cost of the expansion from 2014 to 2016. The federal government’s share would drop to 95 percent in 2017 and to 90 percent by 2020. In the 2013-14 fiscal year, the state budget calls for $1.48 billion in state funds to be spent on Medicaid benefits. The federal government pays about 72 percent of the program's cost in Kentucky.

In human terms, the report says the law will reduce the number of people in Kentucky without health insurance in 2022, no matter what happens. It says that if the act had never passed, 740,000 Kentuckians would have been uninsured in 2022. It will reduce that number to 513,000 even if Medicaid is not expanded anywhere. If all states expand Medicaid, the number of uninsured Kentuckians would drop to 332,000, the study estimates.

The Kaiser report is an update of a study done before the U.S. Supreme Court ruling ruled that the law was constitutional but made Medicaid expansion optional for states. So far, eight states have indicated their unwillingness to participate in the expansion, though more are expected to opt out but are waiting until legislatures return in January to discuss the matter.

See the entire report here.

Expanding Medicaid to people making up to 138 percent of the poverty level under federal health reform and its heavy subsidies would cost Kentucky about 5 percent more for Medicaid over the next 10 years than doing nothing, the Kaiser Family Foundation said in a state-by-state analysis today.

According to the study done by the Urban Institute for the foundation's Commission on Medicaid and the Uninsured, the state would spend $25.1 billion from 2013 to 2022 if it and no other state expanded the program. If all states expanded it, Kentucky's cost would be $26.4 billion, the study estimated.

Under the Patient Protection and Affordable Care Act, the federal government would pays the full cost of the expansion from 2014 to 2016. The federal government’s share would drop to 95 percent in 2017 and to 90 percent by 2020. In the 2013-14 fiscal year, the state budget calls for $1.48 billion in state funds to be spent on Medicaid benefits. The federal government pays about 72 percent of the program's cost in Kentucky.

In human terms, the report says the law will reduce the number of people in Kentucky without health insurance in 2022, no matter what happens. It says that if the act had never passed, 740,000 Kentuckians would have been uninsured in 2022. It will reduce that number to 513,000 even if Medicaid is not expanded anywhere. If all states expand Medicaid, the number of uninsured Kentuckians would drop to 332,000, the study estimates.

The Kaiser report is an update of a study done before the U.S. Supreme Court ruling ruled that the law was constitutional but made Medicaid expansion optional for states. So far, eight states have indicated their unwillingness to participate in the expansion, though more are expected to opt out but are waiting until legislatures return in January to discuss the matter.

See the entire report here.

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FIV in African lions

Maas M, Keet DF, Rutten VP, Heesterbeek JA and Nielen M. Assessing the impact of feline immunodeficiency virus and bovine tuberculosis co-infection in African lions. Proceedings Biological sciences / The Royal Society. 2012; 279: 4206-14.

South Africa has about 2,700 free-ranging lions, living mostly around Kruger National Park (KNP). Bovine tuberculosis (BTB), caused by Mycobacterium bovis, is a disease that was introduced relatively recently into the KNP lion population, probably through domestic cattle brought by European settlers at the end of the 18th century. About 25 lions die of BTB every year in KNP.
 
Feline immunodeficiency virus (FIV) infects domestic cats and at least 20 other species of non-domestic felids around the world. FIV subtype Ple is thought to have been endemic in lions for a much longer time than BTB and infection is common. There is concern that these infections, especially when they occur together, may increase disease and affect lion conservation programs. These researchers collected data from lions in KNP from 1993-2008. BTB was more common in lions in the south of KNP than the north, but infection rate increased over time in the north. A large percentage (31%) of lions were infected with both pathogens. Both infections caused changes in blood test results, with FIV having a greater impact than BTB. However, it did not appear that these co-infections were synergistic (i.e., making disease worse), unlike the situation in humans infected with HIV and M. tuberculosis. This may be due to a different pathogenesis of FIV in African lions than HIV in humans. [MK]

See also: Troyer JL, Roelke ME, Jespersen JM, et al. FIV diversity: FIV Ple subtype composition may influence disease outcome in African lions. Vet Immunol Immunopathol. 2011; 143: 338-46. [Free, full text article]

Related blog articles:
Feline immunodeficiency virus in African lions: October 2009
FeLV and FIV affect blood values in cats: October 2009
Risk factors for FIV infection: July 2009

More on cat health:
Winn Feline Foundation Library
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Maas M, Keet DF, Rutten VP, Heesterbeek JA and Nielen M. Assessing the impact of feline immunodeficiency virus and bovine tuberculosis co-infection in African lions. Proceedings Biological sciences / The Royal Society. 2012; 279: 4206-14.

South Africa has about 2,700 free-ranging lions, living mostly around Kruger National Park (KNP). Bovine tuberculosis (BTB), caused by Mycobacterium bovis, is a disease that was introduced relatively recently into the KNP lion population, probably through domestic cattle brought by European settlers at the end of the 18th century. About 25 lions die of BTB every year in KNP.
 
Feline immunodeficiency virus (FIV) infects domestic cats and at least 20 other species of non-domestic felids around the world. FIV subtype Ple is thought to have been endemic in lions for a much longer time than BTB and infection is common. There is concern that these infections, especially when they occur together, may increase disease and affect lion conservation programs. These researchers collected data from lions in KNP from 1993-2008. BTB was more common in lions in the south of KNP than the north, but infection rate increased over time in the north. A large percentage (31%) of lions were infected with both pathogens. Both infections caused changes in blood test results, with FIV having a greater impact than BTB. However, it did not appear that these co-infections were synergistic (i.e., making disease worse), unlike the situation in humans infected with HIV and M. tuberculosis. This may be due to a different pathogenesis of FIV in African lions than HIV in humans. [MK]

See also: Troyer JL, Roelke ME, Jespersen JM, et al. FIV diversity: FIV Ple subtype composition may influence disease outcome in African lions. Vet Immunol Immunopathol. 2011; 143: 338-46. [Free, full text article]

Related blog articles:
Feline immunodeficiency virus in African lions: October 2009
FeLV and FIV affect blood values in cats: October 2009
Risk factors for FIV infection: July 2009

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

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How the FDA is Recklessly Abandoning Drug Safety

Shocking Story Reveals FDA Not Concerned With Drug Safety

 In the wake of shocking reports on how the FDA, terrified of being outed for its questionable practices, spied on its own employees in the hopes of rooting them out before they could become whistleblowers, a new story has emerged on how deep the deceit goes. From marginalizing safety reports to not reading them at all―and then going ahead and approving the drugs in question―the FDA once more stands accused of being little more than a rubber-stamping agency for Big Pharma.

Explosive revelations of an intensive spy operation by the FDA on its own scientists emerged last month. Using sophisticated spy software, the agency tracked and logged every move made by the targeted individuals. The program even intercepted personal emails and copied documents on their personal thumb drives.
The targeted scientists had expressed concern over the agency's approval of dangerous medical imaging devices for mammograms and colonoscopies, which they believe expose patients to dangerous levels of radiation. Now, another whistleblower has stepped forward, and what he has to say about the agency's drug safety reviews is shocking even to the jaded...

Former FDA Reviewer Speaks Out About Systemic Suppression of Safety

Ronald Kavanagh was a drug reviewer for the FDA in the Center for Drug Evaluation and Research from 1998 to 2008. In a recent interview he reveals how the FDA bypassed or ignored safety issues on major drugs approved during his employment. In an interview for the online news magazine Truth-Out, he tells Martha Rosenberg¹:

"In the Center for Drugs [Center for Drug Evaluation and Research or CDER], as in the Center for Devices, the honest employee fears the dishonest employee.
There is also irrefutable evidence that managers at CDER have placed the nation at risk by corrupting the evaluation of drugs and by interfering with our ability to ensure the safety and efficacy of drugs. While I was at FDA, drug reviewers were clearly told not to question drug companies and that our job was to approve drugs. We were prevented, except in rare instances, from presenting findings at advisory committees.
In 2007, formal policies were instituted so that speaking in any way that could reflect poorly on the agency could result in termination. If we asked questions that could delay or prevent a drug's approval - which of course was our job as drug reviewers - management would reprimand us, reassign us, hold secret meetings about us, and worse. Obviously in such an environment, people will self-censor."

According to Kavanagh, people would be shocked if they knew just how malleable safety data is. As examples, he points out that human studies are typically too short and contain too few subjects to get a clear picture of potential risks. In such a scenario, even a single case of a serious adverse event must be taken very seriously, and data from other longer term safety studies also need to be carefully analyzed. Kavanagh claims he has seen drug reviews where the medical safety reviewer completely failed to make such evaluations prior to the drug's approval.

How the FDA is Recklessly Abandoning Drug Safety

Shocking Story Reveals FDA Not Concerned With Drug Safety

 In the wake of shocking reports on how the FDA, terrified of being outed for its questionable practices, spied on its own employees in the hopes of rooting them out before they could become whistleblowers, a new story has emerged on how deep the deceit goes. From marginalizing safety reports to not reading them at all―and then going ahead and approving the drugs in question―the FDA once more stands accused of being little more than a rubber-stamping agency for Big Pharma.

Explosive revelations of an intensive spy operation by the FDA on its own scientists emerged last month. Using sophisticated spy software, the agency tracked and logged every move made by the targeted individuals. The program even intercepted personal emails and copied documents on their personal thumb drives.
The targeted scientists had expressed concern over the agency's approval of dangerous medical imaging devices for mammograms and colonoscopies, which they believe expose patients to dangerous levels of radiation. Now, another whistleblower has stepped forward, and what he has to say about the agency's drug safety reviews is shocking even to the jaded...

Former FDA Reviewer Speaks Out About Systemic Suppression of Safety

Ronald Kavanagh was a drug reviewer for the FDA in the Center for Drug Evaluation and Research from 1998 to 2008. In a recent interview he reveals how the FDA bypassed or ignored safety issues on major drugs approved during his employment. In an interview for the online news magazine Truth-Out, he tells Martha Rosenberg¹:

"In the Center for Drugs [Center for Drug Evaluation and Research or CDER], as in the Center for Devices, the honest employee fears the dishonest employee.
There is also irrefutable evidence that managers at CDER have placed the nation at risk by corrupting the evaluation of drugs and by interfering with our ability to ensure the safety and efficacy of drugs. While I was at FDA, drug reviewers were clearly told not to question drug companies and that our job was to approve drugs. We were prevented, except in rare instances, from presenting findings at advisory committees.
In 2007, formal policies were instituted so that speaking in any way that could reflect poorly on the agency could result in termination. If we asked questions that could delay or prevent a drug's approval - which of course was our job as drug reviewers - management would reprimand us, reassign us, hold secret meetings about us, and worse. Obviously in such an environment, people will self-censor."

According to Kavanagh, people would be shocked if they knew just how malleable safety data is. As examples, he points out that human studies are typically too short and contain too few subjects to get a clear picture of potential risks. In such a scenario, even a single case of a serious adverse event must be taken very seriously, and data from other longer term safety studies also need to be carefully analyzed. Kavanagh claims he has seen drug reviews where the medical safety reviewer completely failed to make such evaluations prior to the drug's approval.

How the FDA is Recklessly Abandoning Drug Safety

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Treatment of feline colonic adenocarcinoma

Arteaga TA, McKnight J and Bergman PJ. A review of 18 cases of feline colonic adenocarcinoma treated with subtotal colectomies and adjuvant carboplatin. J Am Anim Hosp Assoc. 2012; 48: 399-404.

Adenocarcinoma is the second most common gastrointestinal tumor in cats and the most common tumor found in the colon. Colonic adenocarcinoma is both locally invasive and frequently has advanced metastasis at the time of presentation. Aggressive local surgery (subtotal colectomy) improves survival time in cats, but patients eventually succumb to metastasis, warranting adjuvant treatment with chemotherapy. Carboplatin is an alkylating platinum-based chemotherapeutic agent and has been shown to have efficacy in humans and dogs with carcinomas. Limited previous studies have shown mild to moderate efficacy and safety of carboplatin in cats with carcinomas, meriting its investigation as an adjuvant therapy for colonic adenocarcinomas.
 
This retrospective study evaluated signalment, diagnostic findings, disease-free interval, survival time, chemotherapeutic toxicoses, and prognostic factors for 18 cats with colonic adenocarcinoma treated with subtotal colectomy and monthly carboplatin. Interestingly, cats initially presenting with weight loss had a longer median disease-free interval (290 days versus 75 days), suggesting that a more chronic disease course occurs when weight loss is present. Four cats without weight loss had distant metastasis and a more acute presentation. Median survival time for all cats was 269 days, with cats without distant metastasis surviving 340 days and cats with distant metastasis surviving 200 days. For comparison, in a previous study, cats treated with subtotal colectomy alone lived only 56 days. Carboplatin toxicities reported included low-grade neutropenia, thrombocytopenia, and gastrointestinal toxicity, none of which required reduction or delay in treatment. One cat developed azotemia and carboplatin treatment was stopped after the fifth monthly dose. In conclusion, cats with colonic adenocarcinoma commonly present with colonic obstruction and usually remain patent after subtotal colectomy, but in the end, they are often euthanized due to metastasis, warranting early adjuvant chemotherapy. In this study, carboplatin was shown to have minimal toxicity and to be a viable adjunct for treating this disease. [GO]

See also: Green ML, Smith JD and Kass PH. Surgical versus non-surgical treatment of feline small intestinal adenocarcinoma and the influence of metastasis on long-term survival in 18 cats (2000-2007). Can Vet J. 2011; 52: 1101-5. [Free, full text article]

Related blog articles:
Feline intestinal cancer (March 2011)

More on cat health:
Winn Feline Foundation Library
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Arteaga TA, McKnight J and Bergman PJ. A review of 18 cases of feline colonic adenocarcinoma treated with subtotal colectomies and adjuvant carboplatin. J Am Anim Hosp Assoc. 2012; 48: 399-404.

Adenocarcinoma is the second most common gastrointestinal tumor in cats and the most common tumor found in the colon. Colonic adenocarcinoma is both locally invasive and frequently has advanced metastasis at the time of presentation. Aggressive local surgery (subtotal colectomy) improves survival time in cats, but patients eventually succumb to metastasis, warranting adjuvant treatment with chemotherapy. Carboplatin is an alkylating platinum-based chemotherapeutic agent and has been shown to have efficacy in humans and dogs with carcinomas. Limited previous studies have shown mild to moderate efficacy and safety of carboplatin in cats with carcinomas, meriting its investigation as an adjuvant therapy for colonic adenocarcinomas.
 
This retrospective study evaluated signalment, diagnostic findings, disease-free interval, survival time, chemotherapeutic toxicoses, and prognostic factors for 18 cats with colonic adenocarcinoma treated with subtotal colectomy and monthly carboplatin. Interestingly, cats initially presenting with weight loss had a longer median disease-free interval (290 days versus 75 days), suggesting that a more chronic disease course occurs when weight loss is present. Four cats without weight loss had distant metastasis and a more acute presentation. Median survival time for all cats was 269 days, with cats without distant metastasis surviving 340 days and cats with distant metastasis surviving 200 days. For comparison, in a previous study, cats treated with subtotal colectomy alone lived only 56 days. Carboplatin toxicities reported included low-grade neutropenia, thrombocytopenia, and gastrointestinal toxicity, none of which required reduction or delay in treatment. One cat developed azotemia and carboplatin treatment was stopped after the fifth monthly dose. In conclusion, cats with colonic adenocarcinoma commonly present with colonic obstruction and usually remain patent after subtotal colectomy, but in the end, they are often euthanized due to metastasis, warranting early adjuvant chemotherapy. In this study, carboplatin was shown to have minimal toxicity and to be a viable adjunct for treating this disease. [GO]

See also: Green ML, Smith JD and Kass PH. Surgical versus non-surgical treatment of feline small intestinal adenocarcinoma and the influence of metastasis on long-term survival in 18 cats (2000-2007). Can Vet J. 2011; 52: 1101-5. [Free, full text article]

Related blog articles:
Feline intestinal cancer (March 2011)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
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Judge rules University of Louisville's hospital is public and subject to Open Records Act; it may appeal

The University of Louisville's hospital is a public entity, a Jefferson Circuit Court judge has ruled in a lawsuit filed to get access to the university's deals with other health providers.

Judge Martin McDonald ruled yesterday in favor of The Courier-Journal, WHAS-TV and the American Civil Liberties Union, noting that the university makes or approves all appointments to University Hospital's board of directors. The university had argued that the board, and thus the hospital, was not a public agency under the state Open Records Act.

The hospital said it might appeal the ruling. McDonald gave it 30 days to give him the records being sought, along with arguments about why they should be exempt" under exceptions to the law, reports The C-J's Andrew Wolfson. "He gave the news organizations at the ACLU 20 days to respond to any claimed exemptions." The hospital has said revealing contracts would put it at a competitive disadvantage.

The suit began after the university refused to let the plaintiffs see records related to its proposed merger with Jewish Hospital & St. Mary's HealthCare and Lexington-based St. Joseph Health Care System. Gov. Steve Beshear vetoed the merger on grounds that a public hospital should not be bound by a religious organization's health-care policies. This month the hospital announced a new deal with KentuckyOne Health, which includes the faith-based entities, but said reproductive services would not be affected despite a policy of "respect" for Catholic health directives. (Read more)

The University of Louisville's hospital is a public entity, a Jefferson Circuit Court judge has ruled in a lawsuit filed to get access to the university's deals with other health providers.

Judge Martin McDonald ruled yesterday in favor of The Courier-Journal, WHAS-TV and the American Civil Liberties Union, noting that the university makes or approves all appointments to University Hospital's board of directors. The university had argued that the board, and thus the hospital, was not a public agency under the state Open Records Act.

The hospital said it might appeal the ruling. McDonald gave it 30 days to give him the records being sought, along with arguments about why they should be exempt" under exceptions to the law, reports The C-J's Andrew Wolfson. "He gave the news organizations at the ACLU 20 days to respond to any claimed exemptions." The hospital has said revealing contracts would put it at a competitive disadvantage.

The suit began after the university refused to let the plaintiffs see records related to its proposed merger with Jewish Hospital & St. Mary's HealthCare and Lexington-based St. Joseph Health Care System. Gov. Steve Beshear vetoed the merger on grounds that a public hospital should not be bound by a religious organization's health-care policies. This month the hospital announced a new deal with KentuckyOne Health, which includes the faith-based entities, but said reproductive services would not be affected despite a policy of "respect" for Catholic health directives. (Read more)

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