Opioid Implant Cuts Positive Urine Screens. An implantable formulation of the opioid addiction drug buprenorphine (Probuphine) kept more patients “clean” over six months than did a sham implant, according to drug maker Titan Pharmaceuticals.

AIDS Drugs Can Prevent Infection, Studies Show. Two new studies show that AIDS drugs can prevent heterosexuals from acquiring HIV, adding to a growing number of methods to slow the spread of the virus. Many researchers now believe that we have developed sufficient tools to contain the pandemic, though tight budgets may limit their deployment.

Antipsychotic Drugs Used Commonly for Parkinson’s Disease. Despite warnings about the risks of using antipsychotics to treat older patients at risk for dementia, the powerful drugs are routinely prescribed to elderly Parkinson’s patients.

Stinky Foot Odor May Prevent Malaria Deaths. Researchers at the Ifakara Health Institute in Tanzania are developing traps using natural and artificial foot odors to lure mosquitoes and prevent them from spreading diseases like malaria, in a project funded by the Bill & Melinda Gates Foundation.

Small Physician Practices Not Using Key EHR Features. Few small and midsize physician practices use electronic health record system functions that are seen as essential components of patient-centered medical home model of care, according to a study. Features include care coordination, electronic disease registries, e-prescribing and online communication with patients.

Docs Averse to Sharing Patient Data, Even for Public Health. When it comes to disclosing identifiable patient information, family doctors are reluctant to do so – even for public health purposes such as tracking influenza, according to a recent study.

The Hype on Hypoallergenic Dogs Is Just That, Study Warns. So-called hypoallergenic dogs do not produce fewer allergens like dander and fur, and are hence are no less likely to make you sneeze than other dogs, a new study says.

Fitview Gives Personal Trainers A Comprehensive Fitness And Coaching Platform. The new startup launched yesterday, hoping to help personal trainers better connect with their clients and the general public.  Fitview is launching as a comprehensive SaaS for fitness trainers to upload a fitness curriculum, keep track of client progress and more.

Tennessee’s Telehealth Program in Disarray amid Fraud Investigation. A non-profit charged with managing Tennessee’s telehealth network is shutting down amid claims that two former executives stole or misused more than $1 million in grant funding.

Survey Finds High Rate of Spanking in Kids under Age 2. Thirty percent of North Carolina mothers of children less than 2 two years old say they have spanked their children in the last year, a concern since being spanked is associated with poor self-esteem, mental health problems and substance abuse.

It was nice while it lasted, but the brief surge in optimism surrounding debt-reduction negotiations died Sunday, when Speaker of the House John Boehner announced that his party wouldn’t swallow President Obama’s proposed $800 billion tax increase as part of a package designed to save $4 trillion.

If nothing else, the collapse of the negotiations made it clear that Republicans don’t care about the deficit per se. What they care about is cutting federal spending and taxes, and they’ll do that even if it means partially dismantling popular entitlement programs in the process.

One would think the GOP would have gotten the message that this was a bad idea when a reliably Republican district in upstate New York elected Democrat Kathy Hochul to fill a vacant House seat in a special election last month. Hochul’s entire campaign revolved around preserving Medicare and denouncing a plan by Republican Paul Ryan to transform it into a voucher program, cutting benefits in the process.

In fact the draconian spending cuts envisioned by GOP deficit hawks would impact the health of American citizens far more profoundly than the Ryan plan envisions.

That’s because, as I argued here and here, public health isn’t a medical problem at all. It is a socioeconomic one, and cuts to many programs other than those proposed for our health entitlement programs will affect national well-being and health as a result.

Take Canada for example. That country provides universal, free access to health services for all citizens. If poor access to health care (a problem that would be exacerbated by GOP cuts to health entitlement programs) was the only factor driving poor health outcomes, then we shouldn’t see poor, or less educated people experiencing poor outcomes in Canada. But these differences do exist, in spades. In a recent study of 15,000 Canadian adults for example, participants in the lowest income group were nearly 3 times more likely to die of any cause than those in the highest income group. They were also more likely to have diabetes, high blood pressure, cancer, cataracts and many other conditions. The study revealed similar disparities when participants were stratified by educational level.

In a recent editorial for the Journal of the American Medical Association, Steven Woolf of Virginia Commonwealth University describes how spending cuts for non-health related programs, particularly education, can affect the health of Americans as well. In 2007 for example, Woolf reports that adults who graduated a 4-year college were 4 times less likely than those who had not graduated high school to report their health as ‘fair’ or ‘poor.’ The latter group had more than twice the prevalence of diabetes, a risk of stroke that was 80% higher, and a life expectancy that was 5 years shorter than that for college graduates.

Many factors underlie the link between health disparities and educational status. Educational achievement is indirectly correlated to obesity and cigarette smoking, for example. It is also linked to jobs with better benefits (such as health insurance).

Income levels are also correlated with poor health. Poorer folks tend to skip exercise, eat unhealthy meals and forego medications in order to save money for other necessities. They must contend with pollution, pest infestations and crime (which increases stress and depression).

So What?
GOP deficit negotiators must remember that short-term plans in the name of fiscal discipline can create far larger budget problems in the long run, to the extent that they undermine the health and wellness of tens of millions of Americans. Health-related entitlement programs already consume 23% of the federal budget. Some of the cuts proposed by GOP budget hawks will cost people their jobs, cut their income and interfere with their right to pursue a good education. These cuts will increase the burden of illness for millions of people, possibly for generations. That will drive-up health spending and yes, raise the deficit to unimaginable levels before too long.

Many voters can’t see past the issue of short-term deficit reduction, but we elect officials to lead, especially when times are tough like they are now. For sure, it is hard for elected officials to make decisions that are in our nation’s long-term best interests, since they must please their constituencies in time for the next election cycle. Then again, that’s what leadership is all about.

Poor are Healthier with Medicaid. Enrolling patients in Medicaid increases their use of healthcare services, reduces financial strain on these impoverished patients and improves their sense of well-being, according to a randomized study.

Romance Novels are Bad for Your Health. The novels’ escapist fantasies can get confused with reality, leading women to make poor choices, according to psychologist Susan Quilliam. Real-life sex is not always perfect, relationships are not always smooth and pregnancies are not always trouble-free, she said.

MIT Researchers Use iPhone To Detect Cataracts. Researchers at the Massachusetts Institute of Technology have developed Catra, a cheap plastic lens that clips onto the iPhone’s screen. Catra software can provide a diagnosis within minutes and requires no training.

Scientists Fear Spread of a Gonorrhea Superbug. Scientists announced the discovery of a new, antibiotic-resistant strain of gonorrhea in Japan, raising concern among health officials worldwide.

Grand Rounds is up at InsureBlog. The “It’s Up To Us” edition focuses on personal responsibility. It features an article from Pizaazz.

Quit Smoking Drug Linked to Cardiovascular Risk. Users of the smoking-cessation drug varenicline (Chantix) who had no previous cardiac history had a small but statistically significant increase in the risk of cardiovascular events, a meta-analysis of randomized trials showed.

Tracking Public Health Trends with Twitter. Scientists studied 1.5 million health-related tweets from a public cache and claimed they were a “useful source of public health information.” Tidbits included which OTC medicines people used to treat certain symptoms, as well as intriguing patterns about allergies, flu, insomnia, cancer, obesity and depression.

Telehealth Services Could Qualify for Payment under CMS Rule. In the proposed rule, tele-stroke, tele-ICU and other established telehealth services can qualify for payment if they provide a “clinical benefit.”

Studies Examine Autism’s Link to Antidepressants, Other Factors. A study finds women who take antidepressants during pregnancy have a moderately higher risk of having a child with autism. A separate study of twins suggests that environmental factors play a significant role in its development.

HHS to Simplify Electronic Transactions for Physicians. The Department of Health and Human Services has issued an interim final rule aimed at cutting red tape for providers transmitting information electronically.

Who Pays On A Date Depends On Your Looks. A new study found that men find it easier to imagine paying for dinner if their companions happen to be pretty (duh). Here is where it gets interesting, though: the more attractive a man is, the more women expect him to pay.

FDA Issues US Sprout Warning. The Food and Drug Administration is warning against eating Evergreen Produce brand alfalfa sprouts and spicy sprouts. The sprouts are possibly linked to 20 reported cases of Salmonella Enteritidis in several states. The outbreak is not linked to the European one.

Membership in High-Deductible Health Plans on the Upswing.  Enrollment in high-deductible health plans grew from 10 to 11.4 million members in the year ending January 2011, according to America’s Health Insurance Plans. Experts worry that enrollees don’t understand limitations in their coverage.

Location-Based Services to Hit $10.3 Billion by 2015. That’s according to a report by Pyramid Research, which paints a picture of massive growth in both location-based services and location-based advertising.

Exhibit Shows Government Role in US Diet over the Years. A 1945 government food guide included a butter group and told readers that “in addition to the basic 7 [food groups], eat any other foods you want.” That old poster is part of the National Archives’ exhibition “What’s Cooking, Uncle Sam?”

Next Virus Victim: Your Doctor’s Or Nurse’s iPad? Networked devices used by medical personnel are vulnerable to viruses and security threats, requiring careful teamwork between IT and clinical engineering, experts say.

New York City’s Ban on Smoking Called ‘an Absolute Joke’. In the first month of the Big Apple’s new smoking ban in 1,700 parks and along 14 miles of beaches, the city issued exactly one ticket.

Diabetes Drug May Help Others Lose Weight. The diabetes drug liraglutide (Victoza), touted for its weight-loss effects in that patient population, may also help non-diabetic patients keep pounds off, researchers said.

Nearly 10% of the World’s Adults Have Diabetes. In addition, the prevalence of the disease is rising rapidly, researchers found. Increased obesity and inactivity are the primary reasons in wealthy nations and developing nations as well.

RunKeeper Adds New Integration to its Health Graph. The company has been building a tool to identify correlations between a user’s eating habits, workout schedule, social interactions and more, according to TechCrunch.

Some of the greatest discoveries in the history of modern medicine came from scientists who noted spatial and temporal relationships between events that had not been previously recognized, and deduced from their observations that the events were causally linked.

In 1854 for example, John Snow observed that high cholera death rates in 2 districts of Soho were linked by a common water supplier. Snow created maps (pictured) to display the link and eventually traced the outbreak to one of the supplier’s water pumps. He convinced the supplier to remove the pump handle and treat the water with chlorine, and that promptly ended the epidemic. Snow’s work was canonized as a founding event in the science of epidemiology.

Then in 1928, Alexander Fleming–already renowned as a brilliant scientist with an untidy laboratory–accidentally spilled a beaker filled with a fungus (genus, Penicillium) onto a petri dish containing the staphylococcus bacteria, just before he left on vacation.

Upon returning, Fleming noticed that staph colonies close to the spill had died. Fleming subsequently showed that the fungus produced a substance which killed staph and many other bacteria. He named the substance Penicillin. The discovery revolutionized the treatment of bacterial infections and spawned the entire pharmaceutical industry in the process.
 
Last month, Finnish scientists used similar spatiotemporal analyses to explore the purported link between mobile phone use and brain cancer. Unfortunately, their results were not nearly as clear-cut as those of Snow and Fleming.

Here’s the Story
Mobile phones produce radio-frequency electromagnetic fields. To date, no study has proven that the radiation is tumorigenic, but doubt persists because it has proven difficult to quantify the amount radiation exposure in various areas of the brain, and the long latency period before cancer first develops and becomes clinically manifest.

Taking a fresh look at the matter, Suvi Larjavaara and colleagues at the University of Tampere reasoned that if mobile phone radiation caused cancer, these tumors ought to be found in parts of the brain nearest the area where the user holds the phone. That’s because the radio-frequency field emitted by mobile phones penetrates the skull in a highly localized fashion, decreasing in intensity by a factor of 10 just 2 inches from the handset.

To investigate this hypothesis, Larjavaara’s group performed a multicenter, case-control study using data from nearly 900 patients with glioma, the aggressive form of brain cancer that some believe is triggered by mobile phones.

The scientists found that the gliomas did not cluster within the range of the radiation emitted from the devices.  In addition, people who spent more time on the phone and had used a phone for the longest period of time were no more likely than others to develop cancer near the site where they reported holding the phone.

Unfortunately, their results are far less conclusive than those of Snow and Fleming, because gliomas can take a decade or more to develop, and less than 5% of the people in the study had used mobile phones for 10 years.

Larjavaara’s study was considered by the World Health Organization before it released a statement this month saying that mobile phones should be classified as “possibly carcinogenic,” a group of environmental factors that also includes coffee, pickled vegetables and car exhaust.

The WHO report rattled millions since its previous position had been that there was no established evidence for a link, and since more than 5 billion mobile phones are currently in use around the world.

Certainly Larjavaara’s study didn’t support the WHO’s policy change. So what did?

In part, it was the results of another study by Elisabeth Cardis at the Center for Research in Environmental Epidemiology in Barcelona (scheduled for release next week). Cardis’ group used a different algorithm to determine the amount of energy delivered to the tumor site. They found just the opposite result: gliomas in long-term mobile phone users did occur more frequently in places of the brain receiving higher radiation levels from the phone.

Modern times, modern problems I guess. The spatiotemporal observations that led to phenomenal scientific breakthroughs in the past have yet to reveal a clear picture in the evolving story of mobile phones and brain cancer. In addition to the methodological challenges mentioned above, the main problem with this epidemiological approach is that the pathogenesis of cancer involves a decades-long process;  whereas the bacterial processes observed by Fleming and Snow occurred in minutes to hours.

All that said, let’s remember that gliomas are exceedingly rare. The annual incidence of these cancers is only 6 per 100,000 people. Even if mobile phones doubled that risk (a very unlikely result) the incidence would be less than one-tenth as high as that for cancers of the prostate and breast. I’ll use a hands-free device as much as possible ‘till the dust settles, but I’m not going to lose sleep over this.

Best Buy Leads $5.5M Investment with Valencell. The Series B investment in the mobile health company was joined by TDF and True Ventures. Valencell’s Healthset sensor tracks heart rate, calories burned, steps taken, distance traveled, speed and more through earbuds.

Once Rare, Infection by Tick Bites Spreads. Babesiosis, a potentially devastating malaria-like infection spread through tick bites, has gained a foothold in the Hudson Valley and the coastal Northeast, researchers have found.

FDA Okays New Abuse-Resistant Opioid. The regulatory agency approved a narcotic painkiller with abuse-deterrent properties, Pfizer has announced. The new drug, Oxecta, uses a “unique composition of commonly used pharmaceutical ingredients” to stop potential abusers from crushing, chewing, snorting, or injecting the opioid.

FDA Issues Draft Guidance for Artificial Pancreas. Addressed in the FDA’s document is a Low Glucose Suspend System, which can reduce the severity of hypoglycemic episodes by temporarily reducing insulin delivery. The early-stage system requires patients to manage glucose levels with a meter and give themselves insulin as needed.

Crow’s Feet Faceoff Yields Clear Winner. Crow’s feet responded significantly better to treatment with abobotulinumtoxinA (Dysport) than with onabotulinumtoxinA (Botox), according to results of the first-ever randomized comparison of the two botulinum toxin compounds.

HHS Again Turns Focus to Prevention. Once again, the federal government is rolling out a plan to make the nation healthier — this time it’s a National Prevention Strategy (Pizaazz comments on this plan next week).

Food Allergies Impact Millions of Kids. A new survey finds that one in twelve children is impacted by food allergies. The most common allergies were to peanuts, milk and shellfish. Two in 5 kids had experienced at least one severe or life threatening reaction.

Red Sox Expand Efforts to Accommodate Fans with Food Allergies. Boston’s venerable baseball team banned peanuts and crackerjacks from an entire 226-person section of Fenway Park last Sunday, for the second time this season.

Hospitals Courting Primary Care Doctors. With ACOs looming on the horizon, hospitals are trying harder than ever to lure primary care physicians from their private practices to work as salaried employees alongside specialists.

North Carolina Mulls Amends for Sterilizations. A consensus is emerging on how to compensate men and women sterilized as part of one of the nation’s largest eugenics programs. But the state’s fiscal problems mean it’s unlikely the aging victims will get paid anytime soon.