An alternative to open-heart surgery, transcatheter aortic valve replacement (TAVR) is a less-invasive heart-valve procedure for the treatment of severe aortic valve stenosis. The procedure, which involves threading a catheter through patients’ arteries to implant new aortic valves, has received high praise as a “technological leap” in treatment.
TAVR has been used as an alternative for patients where open-heart surgery is too risky. Despite the early success of the procedure, TAVR has higher rates of some serious complications, including blood vessel damage and stroke than traditional treatments.
Despite its initial praise, some doctors worry that the early excitement regarding TAVR can lead physicians to rely on the procedure even when it is not the best option. Currently the FDA requires that before patients can undergo the TAVR procedure, they must show that they “are not the right candidate” for traditional surgery. However, recent data show that more than half of Medicare patients who received catheter valves did not meet the FDA threshold for the procedure.
Since June 1st, hundreds of thousands of people have been contacted by the government regarding their eligibility for subsidized health care. Of the eight million people who signed up for healthcare through the government exchanges, two million provided information that differed from information in government records. The Obama administration has been asking those individuals for additional documentation such as birth certificates, social security cards, and driver’s licenses. The government will use the documents to correct irregularities in areas including income, citizenship, and immigration status. Consumer advocates worry that many people who fail to provide the information will be forced to repay the subsidies next April.
Representative Diane Black, Republican of Minnesota, attributes the problem to the government’s having enrolled people “before the systems were in place to accurately confirm eligibility.” Others such as Representative Joseph Crowley, Democrat of New York, say such criticism stems from Republicans’ “unending zeal to undermine the Affordable Care Act.”
In any event, the government has put thousands on notice that they “need to follow up as soon as possible” and if they don’t send the needed documents, they risk losing their marketplace coverage.
Richard J. Griffin, the Inspector General for Veterans Affairs, reported that 1,700 veterans were not placed on the Phoenix V.A.’s official waiting lists for doctors’ appointments. In fact, many of these patients may not have received medical care at all, and there are allegations that some veterans may have died while waiting for care.
Investigators found that out of a sample of 226 patients, the average wait time for an initial primary care appointment was 115 days. But the Phoenix V.A.’s reported average to the National Veterans Affairs Office was 24 days. (The average wait time is a factor in determining bonuses and salary increases. Moreover, several waiting lists were uncovered during the investigation that were separate from the “official” waiting list suggesting that criminal activity may have been involved in reporting wait times in Phoenix.
Soon, Congress will hear testimony concerning the Helping Families in Mental Health Crisis Act. Republican representative, Tim Murphy, from Pennsylvania, sponsored the bill, and, though many agree that the mental health care system requires revamping, some provisions in the bill have sparked controversy. Among the more controversial provisions is one that supports the increased use of involuntary outpatient treatment—via court-ordered therapy for “certain mentally ill people with a history of legal or other problems.” Detractors of this provision claim that it will erode trust in doctor-patient relationships, and that it presents a civil rights issue. However, 45 states have compelled treatment programs already, one of which is New York.
New York’s compelled treatment program, Kendra’s Law, was passed in 1999. Since the implementation of Kendra’s Law, studies show that the percentage of patients returning to the hospital or getting arrested has greatly decreased. The statistic is significant, as “about 350,000 Americans with a diagnosis of severe mental illness…are in state jails and prisons” and the availability of psychiatric beds meets only 10 percent of that need.
Anti-fetal homicide laws were enacted originally to protect mothers of unborn children against violent acts. Yet, in reality, “they’ve led to disproportionate prosecution against African American women who suffer miscarriages.” An ongoing case in Mississippi could set a dangerous precedent with regard to the criminalization of pregnant women for their purportedly reckless acts. Rennie Gibbs was charged with the murder of her unborn child after it was stillborn when she was 16 years old. Gibbs is being prosecuted for “depraved heart murder” because the autopsy showed that Gibbs had used cocaine during her pregnancy—but the cause of death was originally attributed to the umbilical cord being wrapped around the infant’s neck. That cause of death was never ruled out.
JAMA Internal Medicine published a research letter by authors J. Eric Oliver, PhD and Thomas Wood, MA, which indicates that almost half of the nation believes in at least one health conspiracy. For example, thirty-seven percent of Americans believe that the Food and Drug Administration is concealing natural cures for cancer in response to industry pressure from pharmaceutical companies. The authors conducted an online survey of 1,351 adults; the survey posited four health conspiracy theories. Forty-nine percent of those polled indicated that they believe at least one of the proposed theories, and eighteen percent believe in at least three. According to Oliver, the takeaway from the survey “is that people who embrace these conspiracies are very suspicious of traditional evidence-based medicine.
Recently, the CDC confirmed that females are capable of transmitting HIV to their female sex partners. Female to female transmission of HIV has been difficult to prove, though there have been reports of its occurrence in the past. Most often, this mode of transmission is difficult to substantiate because researchers are unable to rule out other risk factors, such as intravenous drug use or sexual contact with males. However, a recent case study of two women in a monogamous relationship, who did not have a history of intravenous drug use, allowed the researchers to rule out the more common risk factors. The CDC states that though this mode of transmission is rare, everyone should take appropriate preventative measures to guard against HIV.
The Joint Behavioral Health and Firearms Safety Task Force of Rhode Island approved a final report for submission to the General Assembly, which concerns how Rhode Island should submit mental-health records to the National Instant Criminal Background Check System (NICS). Ultimately, the Task Force recommends that Rhode Island submit only the names of patients committed involuntarily because a judge deemed them a danger to themselves or others. Sen. Frank Lombardi, D-Cranston, believes that the Task Force’s determination strikes the correct balance between: the right to privacy; public safety; and, “the recognition of mental health as an illness and not as a stigma.”
The primary mission of the Adolescent Medicine Trials Network for HIV/AIDS Interventions’ (ATN) is to “conduct both independent and collaborative research,” which explores the best methods for prevention and treatment of HIV/AIDS for at-risk youth, ages 12 to 24. In addition, the ATN offers a variety of treatment and preventative measures to at-risk adolescents. The National Institute of Health (NIH) conducted a study recently, which monitored the health status of the participants in the ATN. The NIH reported that over 30 percent of the young men who had sex with men were found to have high levels of HIV upon their enrollment in the study.
As a result of its findings the NIH made several recommendations. The NIH states that health care workers that work with adolescents, especially males who have sex with males, should emphasize the importance of HIV/AIDS testing. However, the NIH maintains that women should be aware of the importance of testing and early diagnosis as well. The study suggests the possibility that the men are being tested and diagnosed earlier than women. Access the CDC’s list of at-risk individuals here.
Even though HPV is the root cause of approximately 70 percent of all cervical cancers, and 50 percent of all cancers of the throat, esophagus and mouth, only “about a third of teenage girls got all three recommended doses of the vaccine” in 2012. The advent of the HPV vaccine stirred controversy, with social conservatives claiming that more girls would engage in sexual activity if they received the vaccine. However, now some maintain that the “scaremongering” tactics by social conservatives could “literally be killing” teen girls. In support of this point, advocates of the vaccine point to a new study that debunks the claim that receiving the HPV vaccine will influence a teen girl’s decision to have sex.