Morning Rounds: Lyme disease, PSAPs and tuberculosis treatments

CBS News chief medical correspondent Dr. Jon LaPook and CBS News contributor Dr. Tara Narula join "CBS This Morning: Saturday" to discuss a new type of bacteria that can cause Lyme disease, PSAPs (personal sound amplification products), and the search for tuberculosis treatments in ocean life.

From: http://www.cbsnews.com/videos/morning-rounds-lyme-disease-psaps-and-tuberculosis-treatments/

Flesh-eating bacteria warning issued in Ala.

Health officials warned residents that Vibrio cases have been reported along Alabama's Gulf Coast

From: http://www.cbsnews.com/news/flesh-eating-bacteria-warnings-confirmed-in-alabama/

Playground sandbox can be breeding ground for germs

New study shows many sandboxes contain a particularly nasty bacteria that can make people very sick

From: http://www.cbsnews.com/news/sandbox-breeding-ground-for-germs/

Sheriff won't let deputies carry Narcan, citing safety

The state is among the hardest hit by the opioid crisis, but one county sheriff refuses to allow deputies to carry the overdose-reversal drug​

From: http://www.cbsnews.com/news/ohio-sheriff-wont-let-deputies-carry-narcan-citing-safety/

Update on Senate Healthcare Bill

Since passage of the American Health Care Act (AHCA) in the House, all eyes have been on the Senate as they consider legislation to repeal the Patient Protection and Affordable Care Act (ACA). As you may have seen recently in the news, Senators returned home for their annual July 4th recess without passing legislation to repeal and replace the ACA. However, the Senate returns to Washington on July 10, and a vote on ACA repeal could happen within their first week of session.

Earlier this year, we published a blog post highlighting our efforts around the AHCA. Here is an update of the actions we have taken as the Senate considers their legislation:

1. The Senate bill

In June, Senate leadership released their draft legislation entitled the Better Care Reconciliation Act (BCRA). In many ways, the BCRA is worse than the bill passed by the House. The BCRA would make drastic cuts to Medicaid coverage and benefits. It would change the essential health benefits rule, which would put people with diabetes at risk of being unable to get the care and services necessary to successfully manage their disease. The BCRA would also allow insurance companies to charge older Americans five times more than younger Americans for coverage. Finally, the BCRA would repeal the Prevention and Public Health Fund, which provides funding for proven prevention initiatives like the National Diabetes Prevention Program, and would be a drastic step backward for type 2 diabetes prevention.

Equally troubling was the Congressional Budget Office analysis of the Senate legislation. The CBO, a nonpartisan federal agency that provides legislative analysis, estimated that the BCRA would cause 22 million people to lose their insurance coverage over the next decade. The CBO analysis also projected increased premiums and deductibles for those Americas who rely on insurance coverage through the ACA’s marketplace exchanges.

2. Raising our voices on Capitol Hill and across America

After careful analysis, we determined that the Senate bill would negatively impact people with or at risk for diabetes. Prior to the scheduled vote in the Senate, we issued a statement expressing our opposition to the BCRA and urged all Senators to vote no. On June 26th, when CBO released its analysis of the bill, we joined 11 other patient organizations in a joint statement expressing our concern that this misguided legislation would cause 22 million Americans to lose health coverage in a decade. We also joined other leading healthcare organizations in a series of local events around the country to highlight the dangerous changes proposed in this legislation. We participated in town hall events in Cleveland, Ohio and Denver, Colorado to address how this bill would impact people in those states, and to urge Senators from those states to oppose the BCRA. You can read more about the Cleveland event here, and the Denver event here. Finally, we have continued to activate our advocates to contact their Senators and ask them to oppose the bill.

The day before the Senate was scheduled to debate their proposed bill, Association advocacy volunteers Gina Gavlak and Greg Paul joined volunteers from over a dozen other patient groups in Washington, D.C. to meet with their Senators and advocate for people with diabetes. Gina also appeared on a panel on the local CBS affiliate in Washington, D.C. to discuss how damaging the proposed legislation would be for people with diabetes. You can watch Gina’s interview here.

On June 27th, the same day that our volunteers met with their Senators, it was announced that a vote on the BCRA would be delayed. It was clear that the bill did not have enough support to pass the Senate and that our efforts made a difference in the decision to postpone the vote.

3. What happens next?

The Senate’s announcement to postpone the vote is a temporary victory–there will likely be a vote on the bill in July. Senators have announced their intention to continue negotiating the draft legislation until they have secured enough votes for passage. Recent news reports have indicated that they are working to hash out an agreement that could include harsh penalties for those who do not maintain continuous insurance coverage, and rolling back protections for those with pre-existing conditions like diabetes.

While the ACA is not perfect, it is imperative that our Senators do not rush through a proposal that would roll back the clock to a time when people with diabetes could be denied health care coverage or forced to pay outrageously high premiums.

This is why you, your family and your friends must continue to raise your voices and reach out to your representatives in Congress. Tell them what access to health care means to you. If you haven’t already, please sign up (and ask your networks to sign up) to become an advocate and stand up for health care for people living with diabetes—and all Americans.

From: American Diabetes Association http://diabetesstopshere.org/2017/07/07/update-on-senate-healthcare-bill/

First new drug approved for sickle cell in 20 years

In a new study, the drug cut the number of pain crises, dangerous chest complications, transfusions and hospitalizations

From: http://www.cbsnews.com/news/sickle-cell-drug-endari-fda-approved-new-treatment/

"Smart" STD is getting even harder to treat

The bacteria that cause this infection are "particularly smart," experts say, and are becoming increasingly resistant to antibiotic treatments

From: http://www.cbsnews.com/news/gonorrhea-is-getting-even-harder-to-treat/

Cook walrus "well done," warn health officials

Outbreak of the foodborne parasite trichinosis leads to an unusual CDC warning

From: http://www.cbsnews.com/news/cook-walrus-meat-well-before-eating-warns-cdc-after-alaska-trichinosis-outbreak/

Mayo Clinic Minute: 6 tips to keep you motivated for exercise

From: Mayo Clinic https://www.youtube.com/watch?v=hXiGOHamI5Y

Painkiller pulled from the market at FDA request

Opana ER's maker claims the opioid is safe if used as intended, but health officials say it carries multiple risks and is widely abused

From: http://www.cbsnews.com/news/drug-opana-er-opioid-painkiller-pulled-from-the-market-by-fda/

Improving Access with Living Donor Liver Transplantation

From: Mayo Clinic https://www.youtube.com/watch?v=JCNQT1oafmQ

CME Preview: An Overview of Perioperative Medicine 2017

From: Mayo Clinic https://www.youtube.com/watch?v=qmEysxknqXo

Cancer takes a bigger toll in these parts of America

New government data shows a growing "cancer gap" between rural and urban Americans

From: http://www.cbsnews.com/news/cancer-takes-a-bigger-toll-in-rural-america-cdc-finds/

Is sense of smell linked to being fatter or thinner?

Berkeley researchers hope to learn more about about smell, hunger and weight in humans; mouse study offers clues

From: http://www.cbsnews.com/news/sense-of-smell-linked-to-being-fat-or-thin/

Mitch McConnell says limited bill might be necessary if GOP health care measure fails

The Senate majority leader made the remarks Thursday at a Rotary Club lunch during Congress's week-long recess

From: http://www.cbsnews.com/news/mitch-mcconnell-says-limited-bill-might-be-necessary-if-gop-health-care-measure-fails/

Some communities prescribe opioids at much higher rates

New government research finds a decline in the amount of opioids prescribed in recent years, but researchers say it's not nearly enough

From: http://www.cbsnews.com/news/opioid-prescriptions-certain-us-counties-prescribe-much-higher-rates/

Could you do more to cut the cost of your prescription drugs?

A new survey suggests some Americans burdened by costs could benefit by talking to their doctor or pharmacist

From: http://www.cbsnews.com/news/lowering-prescription-drugs-prices-generic-brand/

Clif Bar announces recall after nut allergy reports

Three varieties of protein bars are being recalled because they did not list nuts on the label

From: http://www.cbsnews.com/news/clif-bar-recalls-protein-bars-after-nut-allergy-reports/

Peering into the psychology of online trolls

A new study attempts to look into the hearts and minds of internet trolls for clues about what drives them

From: http://www.cbsnews.com/news/psychological-profile-of-online-trolls/

Is Shingles Tied to Heart, Stroke Risk?

More research is needed, but doctors should warn patients, researchers say

From: http://www.webmd.com/skin-problems-and-treatments/shingles/news/20170704/is-shingles-tied-to-heart-stroke-risk?src=RSS_PUBLIC

WHO Director-General Dr Tedros will lead WHO delegation at the G20 Summit in Hamburg

Dr Tedros Adhanom Ghebreyesus, WHO Director-General, will lead the WHO delegation participating in the G20 Summit taking place on 7–8 July 2017, in Hamburg, Germany. The 2017 G20 meeting is the first time that the international forum will include a comprehensive health track among its deliberations.

From: http://www.who.int/entity/mediacentre/news/releases/2017/G20-Summit/en/index.html

Popular Heartburn Drugs May Boost Death Risk: Study

Popular heartburn drugs known as proton pump inhibitors may raise the chance of death, new research shows.

From: http://www.webmd.com/heartburn-gerd/news/20170703/popular-heartburn-drugs-death-risk?src=RSS_PUBLIC

Widening 'Race Gap' in U.S. Infant Deaths

After years of progress, there's been a recent rise in deaths for black babies, study finds

From: http://www.webmd.com/parenting/baby/news/20170703/widening-race-gap-in-us-infant-deaths?src=RSS_PUBLIC

Hepatitis C and women of childbearing age

Hiding in the shadow of the opioid epidemic is another troubling public health crisis, the precipitous increase in people whose liver is infected with hepatitis C virus (HCV).

It’s likely you have seen the drug company commercials advertising medications to treat hepatitis C. In these commercials, it appears that hepatitis C is only a problem among older Americans. Although baby boomers still represent the largest group infected with hepatitis C virus, these commercials only tell a part of the story.

The hepatitis C virus is transmitted by direct contact with the blood of someone who is infected with the virus. Most people who are infected with the hepatitis C virus do not have any symptoms. Others may have very mild, vague symptoms including fever, fatigue, joint pain, nausea, and vomiting. Although the infection often goes away on its own, more than 75% of people who get the hepatitis C virus will develop a persistent (chronic) infection. Over time, chronic HCV can lead to liver failure and an increased risk of liver cancer.

The good news is effective treatment options are available that cure hepatitis C. You are considered cured when the virus is no longer detected in your bloodstream. But because you may not develop any symptoms until it is much too late to prevent the serious liver complications of chronic hepatitis C, you need to be tested to see if you are at risk of infection.

The prevalence of HCV has been steadily rising over the last three decades since its discovery in 1989. But according to the CDC, more recently there has been a marked increase in the diagnosis of HCV, especially in those under 40. This increase parallels the rise in the misuse of opioids and heroin in this age group.

But there is another problem: HCV infection during pregnancy

About half of these young people who are injecting drugs are women of childbearing age. And although sexual transmission or transmission of HCV from infected household items is rare, it can happen. And women whose partners inject drugs are also at risk for exposure.

A pregnant woman can pass the hepatitis C virus to her baby. It is not exactly clear at what point in pregnancy HCV transmission occurs, but there is some evidence to suggest it is more likely to occur close to the onset of labor or actually during labor and delivery. This is known as vertical transmission. Luckily vertical transmission of HCV is relatively uncommon, with 6 out of 100 babies born to HCV-infected mothers ultimately testing positive for HCV.

That said, in a recent article published in the Annals of Internal Medicine, researchers from the CDC reported that cases of HCV “essentially doubled among reproductive-aged women between 2006 and 2014, from 15,550 to 31,039.” They went on to compare rates of HCV in pregnant women and anticipated new cases in children to actual reported cases of HCV in children. The results suggest that there are likely a lot of children who have the hepatitis C virus but no symptoms. The authors conclude that these results should spur thinking about whether it might be appropriate to screen children for HCV and if so, which children and when?

How do you know if you have hepatitis C?

A screening test that measures antibodies to HCV can only tell whether a person has been exposed to the virus, but it doesn’t tell whether there is active virus in the body now. To diagnosis an active infection, you need another blood test that looks for HCV RNA. This measures “viral load” (how much active virus is present).

Factors that increase a pregnant woman’s risk of passing HCV to her baby

A pregnant woman with evidence of HCV antibodies but no detectable active virus in her body is very unlikely to transmit HCV to her baby. On the other hand, pregnant women with very high viral loads are believed to be at increased risk for vertical transmission of HCV.

Babies born to women who are infected with both HIV and HCV are at increased risk of becoming infected with HCV. Although we don’t know exactly why, it may be that the HIV weakens the immune system so that there is more HCV in the blood.

HCV tends to infect a certain type of blood cell more often in women who contract the virus from injecting drugs. And it turns out that pregnant women with this type of infection are more likely to transmit the virus to their babies.

How to protect moms and babies from the effects of HCV

Although the chances are relatively low, the vertical transmission rate of HCV is significant, as is the liver disease that chronic infection can cause. And in the shadows of the current opioid epidemic, a growing number of reproductive-age women are contracting HCV, making vertical transmission of HCV even more of a concern.

Current guidelines recommend screening only “at risk pregnant women” for HCV, but some experts have started discussing the routine screening of all pregnant women for HCV.

The post Hepatitis C and women of childbearing age appeared first on Harvard Health Blog.

From: Andrea Chisholm, MD http://www.health.harvard.edu/blog/hepatitis-c-and-women-of-childbearing-age-2017070311952

Is Your Child's 'Penicillin Allergy' Real?

Follow-up of 100 kids found none were allergic

From: http://www.webmd.com/children/news/20170703/is-your-childs-penicillin-allergy-real?src=RSS_PUBLIC