News Headlines for January 16, 2018

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Donald Trump Is in Good Physical and Mental Health, White House Doctor Says

President Donald Trump’s doctor has recommend that he lose some weight, but said that the president is in excellent physical and mental health otherwise.

Speaking in the White House briefing room Tuesday afternoon, White House physician Dr. Ronny Jackson described the results of four hours of physical and mental health testing on Friday.

“The president’s overall health is excellent,” he said, adding “there’s no indication whatsoever that he has any cognitive issue.”

Jackson, who served presidents George W. Bush and Barack Obama as well, said he recommended that Trump lose 10 to 15 pounds over the next year through alterations in diet and exercise. Trump currently weighs 239 pounds, which at 6-foot-3 puts him just under the technical definition of obese under the body mass index, or BMI.

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California hospitals face a ‘war zone’ of flu patients — and are setting up tents to treat them
Los Angeles Times

Ana Oktay rushed to the hospital in late December struggling to breathe, with a 102-degree fever and a cough that wouldn’t let up.

​​​​​She expected doctors to tell her she had pneumonia or bronchitis.

“They were just like: ‘It’s just influenza A. It’s just what’s going around,’ ” said Oktay, 49.

An influenza A strain known as H3N2 is making people so ill in California that thousands have shown up in recent weeks at hospitals struggling to fight the infection.

“I was flat on my back and in bed for 10 days,” said Oktay, who lives in Palms. “This has been hands down the worst flu I’ve ever dealt with.”

The huge numbers of sick people are also straining hospital staff who are confronting what could become California’s worst flu season in a decade.

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New Expert Guidance on Contact Precautions for Drug-Resistant Infections
Infection Control Today

New expert guidance released today by the Society for Healthcare Epidemiology of America (SHEA) advises hospitals on determining when they can safely discontinue contact precautions for patients with multidrug-resistant bacteria. The framework, published in the journal Infection Control and Hospital Epidemiology, addresses how long hospital staff should use these safety protocols to reduce the spread of potentially deadly organisms within the hospital, in most cases ranging from one to three negative cultures prior to discontinuation. The guidance also outlines the use of molecular testing that is guiding these care decisions.

“Because of the virulent nature of multidrug-resistant infections and C. difficile infections, hospitals should consider establishing policies on the duration of contact precautions to safely care for patients and prevent spread of these bacteria,” said David Banach, MD, MPH, an author of the study, and hospital epidemiologist at University of Connecticut Health Center. “Unfortunately, current guidelines on contact precautions are incomplete in describing how long these protocols should be maintained. We outlined expert advice for hospitals to consider in developing institutional policies to more effectively use contact precautions to safely care for patients.”

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Inside The Global Race To Deliver A Vital Radioactive Isotope Used To Detect Cancer
Kaiser Health News

In a cornfield here, past the shuttered General Motors plant and the Janesville Terrace trailer home park, a facility not seen in the United States in three decades could soon rise: a manufacturing plant that will make a vital radioactive isotope used to detect cancer and other potentially fatal maladies in millions of people every year

Nuclear medicine imaging, a staple of American health care since the 1970s, runs almost entirely on molybdenum-99, a radioisotope produced by nuclear fission of enriched uranium that decays so rapidly it becomes worthless within days. But moly-99, as it’s called, is created in just six government-owned nuclear research reactors — none in North America — raising concerns about the reliability of the supply and even prompting federal scientists to warn of the possibility of severe shortages.

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Trump is hoping you won’t notice his backdoor repeal of Obamacare
Washington Post

One of the bigger, and more heartening, surprises of the past year was just how fervently it turned out Americans supported health care for low-income people.

Republican politicians, after all, had been running against Obamacare — including its Medicaid expansion and income-based subsidies for buying insurance — from the moment the law passed. And the public appeared to back this agenda: The Affordable Care Act polled terribly.

 Yet when push came to shove, and Republicans actually tried to dismantle the health-care law last year, Americans fought back. Hard.

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These Trump administration changes could make health-care coverage worse
Washington Post

Since the big Obamacare repeal-and-replace bills failed in the Senate, Congress and President Trump have sought to undermine the law in subtler ways. First, Republican lawmakers repealed Obamacare’s individual mandate, a key element of the law’s design. Now the Trump administration is rolling out rules that threaten to damage the structure further.

The Labor Department this month proposed looser regulations on so-called association health plans, under which small businesses, professional associations and others in similar circumstances can band together and buy insurance coverage for their groups as though they were large employers.  The department argues that up to 11 million people working at small businesses or as sole proprietors lack health insurance, and that the new rules would help provide them more options.

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Health care deals could make you healthier but may not save you money
USA Today

The health care industry’s fever for consolidation has shot up with two major deals closing out 2017, but the big question is whether consumers should be feeling any better this year.

DaVita Medical Group, which has nearly 300 medical clinics​ along with about 40 surgery centers and urgent care clinics, will become part of UnitedHealth Group’s doctors’ office and outpatient clinic division.

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For CDC, Reducing Flu Spread Takes Priority Over Nuclear Attack Preparedness
National Public Radio

The Centers for Disease Control and Prevention has postponed a planned Tuesday session on nuclear attack preparedness, deciding instead to focus the workshop on influenza.

The agency announced the switch in topics late Friday, citing the spike in flu cases as the reason for the pivot.

“To date, this influenza season is notable for the sheer volume of flu that most of the United States is seeing at the same time which can stress health systems,” according to a CDC statement. “The vast majority of this activity has been caused by influenza A H3N2, associated with severe illness in young children and people 65 years and older.”

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Postcard From Sacramento: Alzheimer’s ‘Looks Like Me, It Looks Like You’
Kaiser Health News

Until last year, Jackie Coleman was a disability rights lawyer — a good one, too.

“I was an excellent attorney,” recalled the 63-year-old Rancho Cordova, Calif., resident who loved her job and was proud of the work she did.

But a little over a year ago, she started to forget appointments and details from meetings, and began to depend heavily on her secretary. Then she started making mistakes. Ultimately, one got her fired.

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From drug pricing and ‘biosimilars’ to opioids and culture — a wrap and podcast from biotech’s big conference
San Francisco Business Times

It could be weeks or a year before the deals that biotech executives and financiers started at last week’s 36th J.P. Morgan Healthcare Conference come to fruition. But here’s a quick wrap — and a BioFlash podcast — of tidbits from Bay Area companies:


McKesson Corp. (NYSE: MCK), the San Francisco-based health care products distribution company, has been a target of those looking to find a source of the nation’s epidemic of pain-killing opioid drugs. But Chairman and CEO John Hammergren said McKesson is working on a new program that uses “destruction pouches” for prescribed but unused opioids.

Opioids represent “less than 2 percent of our revenues,” Hammergren said, “but it still is a priority.”

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When You Need A Breast Screening, Should You Get A 3-D Mammogram?
Kaiser Health News

When I went to the imaging center for my regular mammogram last year, the woman behind the desk asked me if I’d like to get a “3-D” mammogram instead of the standard test I’d had in the past.

“It’s more accurate,” she said.

What do you say to that? “No, thanks, I’d rather have the test that gets it wrong?” Of course, I agreed.

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Increasing Obesity Negating Rate Of Improvement In Overall American Mortality, Study Finds
International Business Times

Even though medical science has advanced, benefiting people across a large cross-section of the United States, and smoking is on a downward trend too, positive effects from these developments — as seen in a decrease of overall mortality rates — are somewhat blunted by a corresponding increase in obesity in the country, a study found.

Researchers from University of Pennsylvania (UPenn) and Boston University looked at data from the National Health and Nutrition Examination Survey (NHANES) for years between 1988 and 1994, and from 1999 to 2010.  They also looked at mortality files linked to the NHANES data, which were followed up till December 2011. The total sample size for the study was 25,269 adults, aged between 40 and 79 years.

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Mixing Medicine & Politics: Why I Ran for Congress
MedPage Today

Throughout my 25 years of practicing medicine, like many physicians, I observed the progressive refusal of insurers to provide coverage for needed medical care. By the early 2000’s private insurers refused to sell individual policies to those who had any pre-existing condition whatsoever. Prescription drug prices were skyrocketing. If you didn’t have employer-based insurance, you were out of luck.

As a heart failure and cardiac transplant cardiologist, many of my patients who were without insurance were required to raise funds to be listed for transplant. Even those who had coverage, in many instances, were denied by their insurer because they had reached their lifetime limit of $1 million. This was especially heart breaking for young adults with congenital heart disease. Despite fund-raising, the exorbitant cost of life-long immunosuppressant therapy was a major impediment to long-term survival for those who lacked coverage. It appeared that we had become a country with several tiers of medical care — good, inadequate, and none. That’s what I called rationing.