Home / Healthcare Updates / Healthcare Update — 09-25-2013

Healthcare Update — 09-25-2013

Also see more medical news from around the web over at my other blog on EPMonthly.com.

As we rely more and more upon computers to improve our health, some downsides emerge. How many of you would ever have thought that there would be medical device hackers? Hackers have the ability to wirelessly reprogram an implanted cardiac defibrillator and can instruct it to deliver a shock to a patient’s heart or to inappropriately drain its battery.
To combat the hackers, researchers at Rice University have created a device that must be in contact with a patient’s body and measuring a patient’s heartbeat before the defibrillator could be wirelessly accessed.
Interesting concept, but then come the “what if’s.” The security is obviously only as good as the encryption, though. And then what happens if the device has difficulty reading the heart rate? Probably not applicable for ventricular fibrillation since AICD data won’t be very useful in that case.
Approval of the device is still “years” away. In the meantime, maybe pacemaker patients need to begin wearing tin foil over their chests?

Whooping cough reaching epidemic levels in Texas. Many of the new infections are attributed to new vaccine that is safer but less effective and to decline in number of children being vaccinated. Of course, if you’re in the anti-vax crowd, then the increase in cases must mean that there is an increase in filthy living environments … or that Jenny McCarthy has put a curse on the entire state of Texas.
I still believe that parents who don’t vaccinate their children should be held legally responsible if their children either become infected with a preventable disease or if their children infect someone else.

Although it reads like an informercial for a certain soap manufacturer and cites a study from 2011, this recently-published article still made me do a double take. The liquid soap in those public bathroom soap dispensers is sometimes so laden with bacteria that you may be better off washing your hands in toilet water. The article noted how some soap dispensers left people’s hands with “25 times more (potentially harmful) gram-negative bacteria AFTER washing than before washing with contaminated soap”
That’s it. From now on, I’m holding it until I get home. No. Wait … I’m not using the bathroom until I get home.

Seattle Times guest columnist asks whether it is time to get rid of the FDA. Normally, I’d say “yes” and move on to the next question. But the author bolsters his argument by noting many scandals in the DEA (which seem present in many government agencies nowadays), the DEA’s data collection practices (ditto), the failure of the DEA to reschedule marijuana as a “safe” drug, and the assertion that the DEA is losing the battle on the “war on drugs”.
So let’s say we merge the DEA with the FBI as the author suggests. Will these problems get better?

Movement to cut Obamacare subsidies to lawmakers and aides gains momentum. Mitch McConnell quoted as saying “I’m totally opposed to any preferential or special treatments for members of Congress when it comes to Obamacare.” Watch this become a hotbutton issue over the next few weeks.

One more Obamacare article. Feds state that the Unaffordable Insurance Act will provide insurance to only half as many people as initially projected in 2014. Obamacare is expected to account for more than ⅔ of the increase in healthcare spending next year – which will total more than 3 TRILLION dollars.

CDC report acknowledges that agricultural antibiotics play a role in drug resistance. According to the FDA, there are more antibiotics sold in the US for agricultural use than for human use. That’s a lot of ZeePacks. The article (and CDC report) also contain a nice graphic diagram explaining how antibiotic resistance spreads from farm to people.

Another article on antibiotic resistance with a hat tip to Slashdot. An article in Science Translational Medicine shows that when bacteria become resistant to one antibiotic, they often become more resistant to other antibiotics. By cycling or combining different antibiotics, resistance to any single antibiotic is diminished significantly. An important point is that for the “collateral sensitivity” to work, the cycled antibiotics generally must have a different mechanism of action. The researchers found that switching drugs to another medication in the same class didn’t always work as well, although there were some exceptions to that rule.
Quite an interesting read if you have a medical vocabulary or can decipher science-speak.

Also cited in the article above was a recent JAMA article showing that people who lived in closest proximity to livestock centers and to fields where crops were sprayed with manure from pigs that ingested antibiotics were 30-38% more likely to develop MRSA infections.

This article doesn’t apply so much to emergency medicine, but a warning for office-based practices: the Feds are going to even more closely scrutinize some medical charges for physician services billed by midlevel providers.

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