Medical news Obama can use to ration or change health care

Nearly 50,000 older adults are treated for injuries related to falls involving a walker or cane each year in the USA.

Cancer drugs that produce only a marginal survival benefit are much too expensive. The NIH and the NCI are urging limits on the use and pricing of such drugs.

There have been reports of impaired renal function in people taking a once-yearly infusion of zoledronic acid for the treatment of osteoporosis and Paget disease.

Removal of organs from the dead donor is the norm in the West, but internationally, that's not the case.

Diet and exercise intervention in older, long-term survivors of colorectal, breast, and prostate cancer can reduce functional decline.

"Obama has to provide strong reasons for the average individual in our society for wanting to embrace health reform," said MSU Medical Ethics Professor Dr. Leonard M. Fleck. Fleck advocates in his writings the theories of John Rawls (Karl Marx lite).

Every year in the USA tens of millions of prescriptions are dispensed and billions are spent for antithrombotic medications and acid-suppressing drugs. Elderly patients can be at risk from prolonged use.

Past use of hormone therapy with estrogen plus progestin increases the risk of dying from non-small cell lung cancer for women who develop the disease. Especially for smokers.

Thousands of veterans may have been exposed to contaminated endoscopic equipment (hepatitis B, hepatitis C and HIV).

Three health insurance companies CEOs were grilled by Congress about rescission if the information supplied at application is inaccurate or misleading (cancelling coverage of policyholders). The committee noted it is legal, but unfair, so they smacked them anyway.

Bottled water and tap water are regulated by 2 different government entities. Requirements for bottled water (FDA) are less stringent than tap (EPA).

There are 2.8 million new cases of chlamydia each year, about half in females aged 15-25. The solution seems to be more screening, not responsible behavior or education. Certainly not chastity pledges!

The Mediterranean-type diet has been associated with healthful outcomes including reduced risk of cariovascular disease, cancer, and mortality, and more recently with cognition. Mid-life obesity, diabetes and hypertension are risk factors for late-life dementia and influenced by diet.

The most common reason for referral to adult protective services by "first responders" required through Title XX of the Social Security Act, is self-neglect, not abuse by a care giver (4 to 1). Society and the health care system have failed the most vulnerable older adults. While we look for evidence and solutions, we must act NOW!

Women physicians who travelled to Chad (Africa) heard stories of women living in Farchana Camp (UN) of rape, torture, beatings and stigma after fleeing genocide in Darfur at the hands of the Sudanese Army and Janjaweed militiamen (Arab Muslim against black Muslim). The American researchers themselves were in great danger during their time in Africa.

The increase in drug-related homicides in Mexico (400 a month) is a result of the Mexican government's crackdown on drug trafficking organizations, but it's really the fault of the demand in the US, not the supply in Mexico.

Although they can't find any evidence of health benefits for "intimate partner violence" screening, it should be implemented and rigorously tested anyway. It's the thought that counts. And the grant money.

All stories taken from JAMA August 2009 issues.