The arteries of children that are obese or have high cholesterol look like they are 45 years old, according to the findings of a study presented last week at the American Heart Association meetings.

Dr. Geetha Raghuveer, a cardiologist at the University of Missouri Kansas City School of Medicine used a sensitive ultrasound device to measure carotid arterial inner wall thickness in such children, who were between the ages of 6-19.

Raghuveer found that the thickness of the inner 2 layers of these arteries (known as the intima and media) exceeded 0.5 mm in 52 of the 70 children tested. That’s what’s normally found in middle aged adults.

The ultrasound method used in this study is considered to be a more accurate measure of cardiac risk than cholesterol levels, blood pressure recordings and most other tests, but it is too expensive to be used in large populations.

“These findings are potentially consistent with predictions that obesity and its complications would result in cardiovascular disease becoming a pediatric illness,” David Ludwig told the New York Times. Ludwig is an associate professor of pediatrics at Harvard Medical School. He had published a study in 2005 predicting that obesity could cut short the lives of children by an average of 2-5 years.

“This is actually looking at the development of atherosclerosis, the process that we know will, if it is not dealt with, lead to heart attack or stroke,” Ludwig added.

About 16% of US children are obese, according to the CDC. Recently the epidemic had appeared to be stabilizing, but the Great Economic Crisis of 2008 may trigger a further expansion of kids’ waistlines, because inexpensive meals are often calorie-leaden.

Man-made Atmospheric Brown Clouds (ABCs or simply, brown clouds) are darkening Asian megacities from Tehran to Shanghai, reducing crop yields and killing hundreds of thousands of people each year, according to a report released last week by the United Nations Environment Program.

The report was compiled by a scientific team with research bases in China, India, Europe and the US.

Brown clouds are 2-mile thick layers of soot, black carbon, sulfates, toxic aerosols and carcinogens that result from burning fossil fuels and biomass. Coal-stoked power plants are the single biggest contributor.

Half the world’s population resides under one or another of the world’s 5 major regional brown clouds blanketing:
- East Asia, including eastern China
- South Asia including Pakistan, India, Bangladesh and Myanmar
- Southeast Asia including Cambodia, Indonesia, Thailand, and Vietnam
- Southern Africa from sub-Saharan Africa to Zimbabwe
- South America’s Amazon basin

Brown clouds reflect and absorb sunlight and have thus dimmed the skies over Tehran, Karachi, Beijing, Hanoi, Bangkok and hundreds of other major cities by 10-25% in just 30 years.

They also adversely affect food production, according to the UN report. In addition to the lost photosynthetic potential caused by dimming, brown clouds cut crop yields by 10-40% by trapping ground level ozone. Annual economic losses from crop damage exceed $5 billion in China, Japan and the Republic of Korea. 

In addition, the toxic components of brown clouds cause respiratory and cardiovascular disease. The UN report attributes 340,000 excess deaths per year in China and India to brown clouds, and estimates economic losses due to illness and disability at 3.6% of GDP in China and 2.2% in India.

And that’s not the half of it. It turns out that getting rid of the toxic clouds may accelerate global warming. Stay tuned for a post on this matter.

Federal regulators will soon swap out an antiquated medical coding system for a new one that describes modern health practices more precisely. But the transition is going to hurt.

ICD-10 is the new system. It increases by a factor of 10 the number of codes specifying medical conditions and procedures in the US health system. The increased specificity should allow insurers to assign payments that accurately reflect the complexity and intensity of medical services.

As a bonus, the improved data should facilitate quality improvement projects and retrospective studies like the one revealing an adverse interaction between heartburn drugs and Plavix.

But many worry that the transition will be costly and error-prone. Minimally, thousands of providers will have to purchase new software and train nurses, physicians and coders. In fact, the Centers for Medicare and Medicaid Services, the agency that oversees the system, expects implementation costs to top $1.5 billion.

This estimate doesn’t include waste associated with an inevitable increase in coding errors as people get used to ICD-10. It also doesn’t account for a likely increase in billing fraud and payment delays.

There’s also concern that CMS’ proposed 3-year roll-out is too aggressive.

CMS’ recent track record on large implementation projects is not reassuring. In the last two months alone it has been accused of bungling the transition to a new claims processor and called out by a US Senator for poor service on its 1-800-Medicare help line.

ICD-10 implementation dwarfs those challenges.