The Associated Press/NPR reports: "The Montana Supreme Court said Thursday that nothing in state law prevents patients from seeking physician-assisted suicide, making Montana the third state that will allow the procedure. Patients and doctors had been waiting for the state's high court to step in after a lower court decided a year ago that constitutional rights to privacy and dignity protect the right to die. The Montana Supreme Court opinion will now give doctors in the state the freedom to prescribe the necessary drugs to mentally competent, terminally ill patients without fear of being prosecuted, advocates said" (1/2). The Los Angeles Times reports on the effects of a recent state appellate court's ruling on health insurers ability to end policies for sick patients: "California's health insurance companies may have hoped that the more than $13 million in fines they paid to regulators would put an end to the scrutiny of their practice of rescinding the policies of sick patients. But a recent appellate court decision suggests that scrutiny over rescission, as well as other health insurance business practices, will continue and may even expand, legal experts say.
The San Diego Union-Tribune reports that an elderly care program is allowing senior citizens to retain their independence by providing medical care and home assistance through a nonprofit program. The program, St. Paul's Program of All-Inclusive Care for the Elderly, "functions like a health maintenance organization, is the only one of its kind in the county and one of 70 nationwide." Officials with Medicare and California's Medicaid program, Medi-Cal, "have praised these programs for working to save money not only by emphasizing preventive care but also by making it convenient. Studies have shown that aggressive and proactive case management cuts down on expensive hospitalizations and intensive stays in a nursing home." The program links medical and long-term care services and serves 105 clients, but because "PACE operates in the HMO model, participants must give up some or all of their previous physicians and switch to doctors affiliated with the program. Membership is limited by geography: PACE participants must live within several miles of the program's main care center" (Darce, 1/4).
A molecular receptor pivotal to the action of male hormones such as testosterone also plays a crucial role in the body's ability to heal, report scientists in the December issue of the Journal of Clinical Investigation. In studies in mice, scientists at the University of Rochester Medical Center found that this receptor - the androgen receptor - delays wound healing. When scientists used an experimental compound to block the receptor, wounds healed much more quickly. Scientists say that while the results in mice offer new insights into a potential new way to help the body heal faster, they stress that more research must be done before considering whether to explore the treatment in people whose wounds are slow to heal. "This is a very interesting observation, " said Edward Messing, M.D., a urologist and surgeon at the University of Rochester Medical Center who was not involved in the study. "For people at the marginal end of health - the elderly, or people who have impaired healing for other reasons, such as diabetes - maybe blocking the androgen receptor in certain cells could speed up wound healing and help prevent infections.
Vitamin C Reverses Abnormalities Caused By Werner Syndrome Gene, Including Cancer, Obesity, Diabetes, Heart Failure And High Cholesterol
A new research discovery published in the January 2010 print issue of the FASEB Journal suggests that treatments for disorders that cause accelerated aging, particularly Werner's syndrome, might come straight from the family medicine chest. In the research report, a team of Canadian scientists show that vitamin C stops and even reverses accelerated aging in a mouse model of Werner's syndrome, but the discovery may also be applicable to other progeroid syndromes. People with Werner's syndrome begin to show signs of accelerated aging in their 20s and develop age-related diseases and generally die before the age of 50. "Our study clearly indicates that a healthy organism or individuals with no health problems do not require a large amount of vitamin C in order to increase their lifespan, especially if they have a balanced diet and they exercise, " said Michel Lebel, Ph.D., co-author of the study from the Centre de Recherche en Cancerologie in Quebec, Canada. "An organism or individual with a mutation in the WRN gene or any gene affected by the WRN protein, and thus predisposes them to several age-related diseases, may benefit from a diet with the appropriate amount of vitamin C.
Falls are the main cause of injuries among elderly people, but until now doctors have had few ways of effectively monitoring and counteracting mobility problems among patients. Work by European researchers is set to change that. Mobility problems, ranging from frequent accidental falls to difficulty standing up or walking, affect millions of Europeans both young and old. Elderly people in particular become more liable to trip due to poor eyesight or poor balance, while health complications, such as strokes and circulatory problems, or debilitating diseases like Parkinson's and Alzheimer's can make performing everyday tasks even reaching into a cupboard difficult or even dangerous. Injuries caused by falls among the elderly range from mild scrapes and bruises to serious complications requiring long-term treatment. Nine out of ten hip fractures, for example, occur in people over 50 and 80 percent of them women. "Falls and other mobility problems have a major societal and economic impact, " says Lorenzo Chiari, a researcher at the University of Bologna, Italy.
Increasing Substance Abuse Levels Among Older Adults Likely To Create Sharp Rise In Need For Treatment Services In Next Decade
A new study done by the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that the aging of the baby boom generation is resulting in a dramatic increase in levels of illicit drug use among adults 50 and older. These increases may require the doubling of substance abuse treatment services needed for this population by 2020, according to the report. "This new data has profound implications for the health and well-being of older adults who continue to abuse substances, " said SAMHSA Administrator, Pamela S. Hyde, J.D. "These findings highlight the need for prevention programs for all ages as well as to establish improved screening and appropriate referral to treatment as part of routine health care services." Substance abuse at any age is associated with numerous health and social problems, but age-related physiological and social changes make older adults more vulnerable to the harmful effect of illicit drugs use. "This study highlights the fact that older Americans face a wide spectrum of healthcare concerns that must be addressed in a comprehensive way, " said Assistant Secretary for Aging, Kathy Greenlee.
As of Jan. 1, more than 1 million low-income seniors "are newly eligible for more generous prescription drug benefits under the 'extra help' program" in Medicare, The Associated Press reports. Benefiting from this change are applicants who have life insurance policies or who regularly receive money from relatives to help pay for household expenses. They were previously disqualified because of too many assets or too much income. "Income limits are $16, 245 a year for singles and $21, 855 for married couples living together. Assets such as stocks, bonds and bank accounts must be limited to $12, 510 for singles and $25, 010 for married couples. The value of homes and automobiles are excluded." About 30 percent of seniors enrolled in the prescription program, Medicare Part D, are also enrolled in the "extra help" - also known as the low-income subsidy - program. "For many, the extra help program eliminates premiums and annual deductibles and charges copays as low as $1.10 for generic drugs and $3.
"Principles of Rational Prescribing, " a web-based lesson developed by faculty at Wake Forest University School of Medicine, was voted "Educational Product of the Year" recently among products developed by 40 academic geriatrics programs in the United States. The designation was made at the national meeting of grantees of the Donald W. Reynolds Foundation, which funds comprehensive programs to strengthen physicians' training in geriatrics. "Principles of Rational Prescribing" is part of the SmartPrescribe curriculum, developed at the School of Medicine to combat the influence that increasing drug company marketing can have on physician prescribing. The 30-minute interactive "Principles of Rational Prescribing" lesson is now also featured as the Editor's Choice on the curricular clearinghouse, Portal of Geriatrics Online Education. "There is a big concern now about drugs being over marketed, and with consumer marketing being so prevalent, sometimes brand-name drugs are being prescribed too often for conditions where there is not sufficient research to support that use, " said Janice S.
USA Today reports that independent analysts are increasingly questioning whether the long-term savings promised in the health care bills being considered by Congress are realistic. "From proposed Medicare cuts to a program for seniors that would accumulate money only in its first years, the bill contains provisions that add up to billions in savings and revenue. But analysts such as Joseph Antos of the conservative American Enterprise Institute question whether they can be achieved." Among the biggest source of proposed savings are Medicare hospital and physician fees, which lawmakers say could provide 42 percent of the planned $438 billion in cuts to the program over 10 years. Some of those cuts, however, "may be unrealistic, " a Health and Human Services Department report found (Fritze, 1/12). In addition to the cuts, the bills would pull "nearly every available cost-control lever" in an effort to slow the growth of medical spending, the Associated Press/ABC News reports. "The four big ideas for slowing costs are: discouraging high-priced health insurance by taxing it;
A recent study, published in the January issue of Mayo Clinic Proceedings, demonstrates that in elderly patients undergoing hip fracture repair under spinal anesthesia with propofol sedation, the prevalence of delirium can be decreased by 50 percent with light sedation, compared to deep sedation. "These data show that, for every 3.5 to 4.7 patients treated in this manner, one incident of delirium will be prevented, " says Frederick Sieber, M.D., primary investigator of the study from the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine in Baltimore. "Therefore, interventions capable of reducing the occurrence of postoperative delirium would be important from a public health perspective." Several demographic and perioperative variables are associated with postoperative delirium in elderly patients after hip fracture repair. The most important is preoperative dementia. Other risk factors for postoperative delirium include age, systemic disease and functionality.