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Archive for the ‘American Medical Association reports’ Category

Sunset Lake, Asbury Park. By Stephen Goldfinger, BF Asbury reporter ©

Sunset Lake, Asbury Park. By Stephen Goldfinger, BF Asbury reporter ©  April 17, 2016.

 

PATTI LuPONE    (live)   “Meadowlark”  from the (flop) Broadway show The Bakers Wife,  1976.  It’s a cult favorite.   Stephen Schwartz is the composer, and this recording is from Patti LuPone’s show “On Broadway” 1997.  (Patti chats with the audience at the end.  We will try to find the song from Oliver that she references.–PG)

“Come along,
fly with me, my meadowlark,
fly with me on the silver morning,
past the sea where the dolphins bark
we will dance on the coral beaches,
make a feast of the plums and peaches
just as far as your vision reaches
fly with me.”

Patti LuPone speaks to the audience and introduces a song which we will post shortly—from Oliver.

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From the American Medical  Association:  (Note the links below)

The AP (6/4, Tanner) reports, “Alcohol problems affect almost 33 million adults and most have never sought treatment,” according to a study published online June 3 in JAMA Psychiatry. The research conducted by investigators at the National Institute on Alcohol Abuse and Alcoholism also suggests that “rates have increased in recent years.”

NIAAA director George Koob, PhD, “said it’s unclear why problem drinking has increased but that many people underestimate the dangers of excessive alcohol.” Koob also pointed out that effective behavioral treatments and medications exist to help people overcome problem drinking. He said, “There’s a lore that there’s only Alcoholics Anonymous out there and that’s not true.”

TIME (6/4, Sifferlin) reports that the study examined “the prevalence of drinking issues based on a new definition for alcohol use disorders in the” American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). That “definition classifies problem drinkers as those who have two of 11 symptoms including continuing to drink even if it harms relationships, drinking harming performance at work of school, or inability to quit,” with problem severity being “classified by the number of symptoms a person has.”

Newsweek (6/4, Main) reports that “researchers surveyed more than 36,000 Americans and asked them about their drinking habits,” also finding that “binge drinking is becoming more common and intense.” Koob said, “There has been this cultural shift – people are drinking more when they drink.”

Yahoo! News (6/4, Chan) quotes Koob, who said, “These findings underscore that alcohol problems are deeply entrenched and significantly under-treated in our society.”

The NPR (6/4, Hurt, Shute) “Shots” blog points out that “Native Americans face the greatest risk overall” for problem drinking, “and men are still drinking more than women, with 36 percent of men reporting alcohol use disorder at some point in their lives, compared to 22.7 percent of women.” Among young people, “drinking problems were worst…with 26.7 percent of young adults under 30 saying they’d had trouble in the past year, compared to 16 percent of 30- to 44-year-olds.”

Blogfinger Medical C0mmentary:    Paul Goldfinger MD, FACC, Editor @ Blogfinger.net

The 5th edition of the DSM of the American Psychiatric Association (Diagnostic and Statistical Manual of Mental Disorders) was released in 2013.  This is the “bible” for mental health workers to use for diagnostic nomenclature.  The alcohol data was gathered in 2012 and 2013 by the National Institutes of Health, looking at adults 18 and older.   The 18-29 year old group is particularly affected, and not only do many have drinking problems, but the amount of drinking has been going  up.    DSM-5_Cover

The section on “alcohol use disorders:” —AUD is very important because it recognizes that 14% of adults in the US currently have a drinking problem  (33 million) and that 30% of the population has had an AUD at some time in their lives. They now recognize that most people with AUD have not sought treatment and that AA is not the only treatment option.   There are medications and there are behavioral therapy methods.

The devastation caused by AUD is huge:  It is disabling to individuals, and its effects harm families, work places, and, overall, the national interest.  And don’t forget the physical issues:   acute alcohol intoxication during binge drinking can cause death; even mild impairment (with alcohol level below illegal) can  cause auto accidents; and long term use can cause cancer, heart disease, brain damage, and liver disease.

A big concern is that many won’t admit that they have a problem, and those around them may not recognize a problem either.  The new criteria help define the diagnosis and the degrees of involvement—spelled out in the handbook.

You can buy a copy of the DSM-5 Handbook on line  (eg Amazon.com)

DANISH NATIONAL CHAMBER ORCHESTRA.   Drinking songs often glamorize alcohol intake—-eg all those Irish drinking songs. Here is  Verdi’s “Drinking Song—Libiamo” from the film The Quartet   (and here is ourBF  2013 movie review:  Quartet movie  )

 

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The New York Times (3/11, Pear, Subscription Publication) reports the Obama Administration said Tuesday that 11.7 million Americans now have health coverage through the Federal and state exchanges, with 86 percent receiving government subsidies. A new report showed that about three-fourths “of people with marketplace coverage — 8.8 million consumers — live in the 37 states served by HealthCare.gov, the federal insurance exchange.” HHS Secretary Sylvia Burwell “underlined the importance of subsidies for people in states using the federal exchange — subsidies that could be withdrawn if the Supreme Court rules against the Obama administration in a pending case.”

According to the Los Angeles Times (3/11, Levey), the report from HHS showed that up to 7.7 million could be affected if the Supreme Court rules against the ACA’s subsidies. In many states that rely on the Federal marketplace, “consumers are getting subsidies that top $300 a month on average, according to the data.” The AP (3/11, Alonso-Zaldivar, Vineys) adds that the 7.7 million Federal marketplace customers receiving subsidies “are getting an average of $263 a month to help pay premiums.” According to the AP’s estimates, that “works out to around $2 billion a month.”

McClatchy (3/11, Pugh, Subscription Publication) reports that 53 percent of people who selected plans on the Federal marketplace “were new consumers who didn’t have marketplace coverage last year.”

USA Today (3/11, O’Donnell) reports that more than 4.1 million people under age 35 “picked Obamacare health insurance plans so far in this open enrollment period, a small increase compared with the end of the 2014 period, the Department of Health and Human Services said” yesterday. The increase from 3.3 million people ages 18-34 who enrolled last year “is good news for the law, which needs more younger people to offset costlier and less healthy older enrollees.”

However, the percent of black and Latino Americans “signing up for ObamaCare remained largely the same as 2014,” The Hill (3/11, Ferris) reports.

Blogfinger Medical Commentary:   By Paul Goldfinger, MD, FACC

It’s important for everyone to try and understand what is at stake when the Supreme Court rules on its latest case regarding Obamacare.

Although the legalities that are being considered by the court seem like they are straight forward, if you get into the weeds you will find out why the court is closely divided.

But getting past the legalities, it is interesting that the average subsidy is nearly $300 per month per each person who receives a subsidy and it is also revealing that 86% who are covered through federal exchanges get subsidies.  So this decision will have huge implications for the future of the ACA.

Also, regarding affordability of insurance,  keep in mind that many of those who have gotten subsidies through ACA exchanges are facing more daunting financial challenges other than paying monthly premiums.  Many of them have deductibles that could be $5,000.00 or more per year which is out-of-pocket spending that some will not be able to afford.  The dropout rates may become substantial.

It’s also interesting that many who had no insurance before still have no coverage because they still can’t afford the costs despite the subsidies. but they do not qualify for Medicaid, which is free insurance provided by the states together with the feds.  Obamacare has been expanding Medicaid eligibility, and some states are resisting that expansion because eventually it will put a significant dent in their budgets.

If the Supreme Court rules against Obamacare, the government will have to come up with a “fix” to prevent loss of coverage for millions who are now covered through the federal exchanges.  Maybe the law could be changed to allow subsidies on all exchanges.

 

 

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The CBS Evening News (1/30, lead story) reported on Friday that “the CDC said that the flu season in much of the country appears to have peaked.” However, “the flu is now widespread in all but six states and it’s sending Americans 65 and older to the hospital at the highest rate in at least a decade.”

NBC Nightly News (1/31, story 3, 0:25, Williams) reported that the high number of hospitalizations is “being blamed on this particularly nasty strain of flu this year and a vaccine that, sadly, has proven only about 23 percent effective.”

Bloomberg News (1/31, Cortez) reported, “The annual outbreak, already in its 10th week, has extended beyond the lower bound of a normal flu season and isn’t showing signs of easing, said Lyn Finelli, chief of surveillance and outbreak response at the” CDC. In a telephone interview, she explained, “‘While the flu may have peaked in many areas of the country, there is a surge in other areas,’ including New England, the Northeast and the West Coast.”

 

Blogfinger Medical Commentary:  Paul Goldfinger, MD, FACC

The influenza pandemic 1918-1919 killed 20-40 million people worldwide.  This gives you an idea of the potential virulence of this viral illness.  During the last ten years, the CDC has been recording hospitalization rates for citizens over age 65 in the US.  The elderly are the most vulnerable group to having serious consequences after catching the “flu.”  This season, which began in the fall, is the worst in ten years.  The A(H3N2) strain is dangerous, and “genetic drift” has made it resistant to the current vaccine.   There is no cure for this illness.

The epidemic has peaked now, and although hospitalizations are still very high, outpatient visits are falling off.   Hopefully we will see a marked drop in a few weeks.  Meanwhile, if you have early symptoms  (cough, fever and sore throat,) call your doctor to see if you are eligible for an anti-viral drug such as Tamiflu  (oseltamivir). This drug should shorten the length of the illness by a day or two and may reduce serious complications. There is some controversy about the use of Tamiflu  (or the two others on the market), but the CDC has advised doctors to use the drug as needed.  I remember one recent flu season where the drug was sold out because individuals were stocking up on it, and even this season there have been spotty shortages.

 

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