Hour's activity 'offsets sedentary day'

Hour’s activity ‘offsets sedentary day’

By Caroline Parkinson
Health editor, BBC News website
  • 27 July 2016
  • From the section Health

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Office workers are advised to take regular breaks from their desks

An hour’s “brisk exercise” each day offsets the risks of early death linked to a desk-bound working life, scientists suggest.

The analysis of data from more than a million people is part of a study of physical activity published in the Lancet to coincide with the Olympics.

Watching TV was found to be worse than sitting at a desk, probably because of associated habits like snacking.

Current NHS guidelines recommend 150 minutes of moderate exercise a week.

Being inactive is known to increase the risk of conditions such as heart disease, diabetes and some cancers.

It has been linked to 5.3 million deaths globally a year – compared with 5.1 million linked to smoking.

A cheat’s guide to staying active

The Lancet research says the global cost, for healthcare and lost productivity, is estimated at $67.5bn per year.

To look at the the impact of activity and inactivity, researchers went back to the authors of 13 existing papers and asked all of them to reanalyse their data.

Media captionStruggling to fit exercise into your day? Here are some tips from personal trainer Lauretta Johnnie and Lucy Wilkinson from the British Heart Foundation

People were classed depending on how active they were – from the least active who did less than five minutes a day, up to 60-75 minutes a day for the most active.

Researchers then looked at how many people died during the follow-up period – between two and 14 years.

Those who sat for eight hours a day, but were physically active, had a much lower risk of premature death compared with people who sat for fewer hours a day, but were not active.

Sitting for a long time as well as being inactive carried the greatest risk.

Prof Ulf Ekelund, of the Norwegian School of Sports Sciences and the University of Cambridge, led the study.

He said: “For many people who commute to work and have office-based jobs, there is no way to escape sitting for prolonged periods of time.

“For these people in particular, we cannot stress enough the importance of getting exercise, whether it’s getting out for a walk at lunchtime, going for a run in the morning or cycling to work.

“An hour of physical activity per day is the ideal, but if this is unmanageable, then at least doing some exercise each day can help reduce the risk.”

But he admitted: “One hour’s moderate activity is substantially higher than current recommendations.”

TV time

Watching TV for more than three hours was associated with an increased risk of premature death for all but the most active.

The researchers suggest this is likely to be because people might snack while they watch, or because they are more likely to watch TV after eating their evening meal which might affect their metabolism.

It could, they say, also be a sign of a more unhealthy lifestyle in general.

Dr Pedro Hallal of Brazil’s Federal University of Pelotas looked at the effect of the Olympics on the general public’s activity levels.

He said that, despite a blip around the Games where people temporarily take up a sport, there is no long-term legacy.

“There’s been no health legacy of the Olympics reported ever, but it’s the perfect time to talk about human movement.”

The scientists said governments should ensure their policies encouraged physical activity – citing the example of a bus scheme where stops are placed further apart to encourage walking – and employers should make it easier for staff to be active during their working day – such as flexible lunch breaks and the provision of showering facilities.

Lisa Young, a physical activity specialist at the British Heart Foundation said: “Although we recognise the link between sedentary behaviour and poor health, we do advocate further research in this area to establish categorical statistics in relation to cardiovascular morbidity and mortality.”

Dr Mike Loosemore, from the English Institute of Sport, said: “An hour of brisk walking is hard work this is essentially moderate exercise, I suspect not many people would be able to manage that amount of moderate activity a day.

“So if you change the guidelines then it puts them even further out of reach of the people who would benefit most from increasing their physical activity, which are those that do very little.

“For the vast majority of people while the best way to stay healthy would be to do an hour of moderate activity a day, realistically the best place to start is reducing your sedentary behaviour at work by sitting less and try to increase whatever physical activity you are doing.”

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New crop of robots to vie for space in the operating room


Even though many doctors see need for improvement, surgical robots are poised for big gains in operating rooms around the world.

Within five years, one in three U.S. surgeries – more than double current levels – is expected to be performed with robotic systems, with surgeons sitting at computer consoles guiding mechanical arms. Companies developing new robots also plan to expand their use in India, China and other emerging markets.

Robotic surgery has been long dominated by pioneer Intuitive Surgical Inc, which has more than 3,600 of its da Vinci machines in hospitals worldwide and said last week the number of procedures that used them jumped by 16 percent in the second quarter compared to a year earlier.

The anticipated future growth – and perceived weaknesses of the current generation of robots – is attracting deep-pocketed rivals, including Medtronic Inc and a startup backed by Johnson & Johnson and Google. Developers of the next wave aim to make the robots less expensive, more nimble and capable of performing more types of procedures, company executives and surgeons told Reuters.

Although surgical robots run an average of $1.5 million and entail ongoing maintenance expenses, insurers pay no more for surgeries that utilize the systems than for other types of minimally-invasive procedures, such as laparoscopy.

Still, most top U.S. hospitals for cancer treatment, urology, gynecology and gastroenterology have made the investment. The robots are featured prominently in hospital marketing campaigns aimed at attracting patients, and new doctors are routinely trained in their use.

Surgical robots are used in hernia repair, bariatric surgery, hysterectomies and the vast majority of prostate removals in the United States, according to Intuitive Surgical data.

Doctors say they reduce fatigue and give them greater precision.

But robot-assisted surgery can take more of the surgeon’s time than traditional procedures, reducing the number of operations doctors can perform. That’s turned off some like Dr. Helmuth Billy.

Billy was an early adopter of Intuitive’s da Vinci system 15 years ago. But equipping its arms with instruments slowed him down. He rarely uses it now.

“I like to do five operations a day,” Billy said. “If I have to constantly dock and undock da Vinci, it becomes cumbersome.”

SURGEONS’ WISH LIST

To gain an edge, new robots will need to outperform laparoscopic surgery, said Dr. Dmitry Oleynikov, who heads a robotics task force for the Society of American Gastrointestinal and Endoscopic Surgeons.

Surgeons told Reuters they want robots to provide a way to feel the body’s tissue remotely, called haptic sensing, and better camera image quality.

New systems also will need to be priced low enough to entice hospitals and outpatient surgical centers that have not yet invested in a da Vinci, as well as convince those with established robotic programs to consider a second vendor or switching suppliers altogether.

“That is where competitors can differentiate,” said Vik Srinivasan of the Advisory Board Co, a research and consulting firm that advises hospitals.

Developers say they are paying attention. Verb Surgical, the J&J-Google venture that is investing about $250 million in its project, said creating a faster and easier-to-use system is a priority.

Verb also envisions a system that is “always there, always on,” enabling the surgeon to use the robot for parts of a procedure as needed, said Chief Executive Scott Huennekens.

Intuitive said it too is looking to improve technology at a reasonable cost, but newcomers will face the same challenges.

“As competitors come in, they are going to have to work within that same framework,” CEO Gary Guthart said in an interview.

Device maker Medtronic has said it expects to launch its surgical robot before mid-2018 and will start in India. Others developing surgical robots include TransEnterix Inc and Canada’s Titan Medical Inc.

An RBC Capital Markets survey found that U.S. surgeons expect about 35 percent of operations will involve robots in five years, up from 15 percent today.

J&J, which hopes to be second to market with a product from Verb, has said it sees robotics as a multibillion-dollar market opportunity. Huennekens said Verb’s surgical robot will differ from another Google robotics effort, the driverless car, in one important aspect.

“There will always be a surgeon there,” he said.

(Reporting by Susan Kelly; Editing by Michele Gershberg and Lisa Girion)


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New crop of robots to vie for space in the operating room


Even though many doctors see need for improvement, surgical robots are poised for big gains in operating rooms around the world.

Within five years, one in three U.S. surgeries – more than double current levels – is expected to be performed with robotic systems, with surgeons sitting at computer consoles guiding mechanical arms. Companies developing new robots also plan to expand their use in India, China and other emerging markets.

Robotic surgery has been long dominated by pioneer Intuitive Surgical Inc, which has more than 3,600 of its da Vinci machines in hospitals worldwide and said last week the number of procedures that used them jumped by 16 percent in the second quarter compared to a year earlier.

The anticipated future growth – and perceived weaknesses of the current generation of robots – is attracting deep-pocketed rivals, including Medtronic Inc and a startup backed by Johnson & Johnson and Google. Developers of the next wave aim to make the robots less expensive, more nimble and capable of performing more types of procedures, company executives and surgeons told Reuters.

Although surgical robots run an average of $1.5 million and entail ongoing maintenance expenses, insurers pay no more for surgeries that utilize the systems than for other types of minimally-invasive procedures, such as laparoscopy.

Still, most top U.S. hospitals for cancer treatment, urology, gynecology and gastroenterology have made the investment. The robots are featured prominently in hospital marketing campaigns aimed at attracting patients, and new doctors are routinely trained in their use.

Surgical robots are used in hernia repair, bariatric surgery, hysterectomies and the vast majority of prostate removals in the United States, according to Intuitive Surgical data.

Doctors say they reduce fatigue and give them greater precision.

But robot-assisted surgery can take more of the surgeon’s time than traditional procedures, reducing the number of operations doctors can perform. That’s turned off some like Dr. Helmuth Billy.

Billy was an early adopter of Intuitive’s da Vinci system 15 years ago. But equipping its arms with instruments slowed him down. He rarely uses it now.

“I like to do five operations a day,” Billy said. “If I have to constantly dock and undock da Vinci, it becomes cumbersome.”

SURGEONS’ WISH LIST

To gain an edge, new robots will need to outperform laparoscopic surgery, said Dr. Dmitry Oleynikov, who heads a robotics task force for the Society of American Gastrointestinal and Endoscopic Surgeons.

Surgeons told Reuters they want robots to provide a way to feel the body’s tissue remotely, called haptic sensing, and better camera image quality.

New systems also will need to be priced low enough to entice hospitals and outpatient surgical centers that have not yet invested in a da Vinci, as well as convince those with established robotic programs to consider a second vendor or switching suppliers altogether.

“That is where competitors can differentiate,” said Vik Srinivasan of the Advisory Board Co, a research and consulting firm that advises hospitals.

Developers say they are paying attention. Verb Surgical, the J&J-Google venture that is investing about $250 million in its project, said creating a faster and easier-to-use system is a priority.

Verb also envisions a system that is “always there, always on,” enabling the surgeon to use the robot for parts of a procedure as needed, said Chief Executive Scott Huennekens.

Intuitive said it too is looking to improve technology at a reasonable cost, but newcomers will face the same challenges.

“As competitors come in, they are going to have to work within that same framework,” CEO Gary Guthart said in an interview.

Device maker Medtronic has said it expects to launch its surgical robot before mid-2018 and will start in India. Others developing surgical robots include TransEnterix Inc and Canada’s Titan Medical Inc.

An RBC Capital Markets survey found that U.S. surgeons expect about 35 percent of operations will involve robots in five years, up from 15 percent today.

J&J, which hopes to be second to market with a product from Verb, has said it sees robotics as a multibillion-dollar market opportunity. Huennekens said Verb’s surgical robot will differ from another Google robotics effort, the driverless car, in one important aspect.

“There will always be a surgeon there,” he said.

(Reporting by Susan Kelly; Editing by Michele Gershberg and Lisa Girion)


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Critics of weight-loss device urge U.S. regulator to reverse approval


Lotta Bosnyak takes extra time to chew the blueberries in her yogurt. Otherwise, she said, the device she credits with saving her life will not work.

The tube Bosnyak is referring to has been implanted into her stomach. She turns a valve and, standing over a toilet, drains out the yogurt.

The 52-year-old Delray Beach, Florida, resident was one of the first people to try the “AspireAssist” device four years ago in Sweden, where she is from.   

“It’s one of the best ways to change your relationship to food because it does require a lot of work on the patient’s part,” said Dr. Christopher Thompson, director of therapeutic endoscopy at Brigham Woman’s Hospital in Boston.

“It’s not just a procedure that’s done and then they’re off and they don’t think about it anymore,” he added.

The device, made by Pennsylvania-based biomedical company AspireBariatrics, was approved for use in the United States in June.

However, critics are urging the Food and Drug Administration to reverse its decision, saying the device mimics, promotes and could lead to potentially life-threatening disorders such as bulimia and binge-eating.

“This will likely prove to be yet another in a long line list of misguided, unsuccessful and dangerous products for losing weight,” wrote Dr. Eva Trujillo, president of the Academy of Eating Disorders, in a draft of a letter to be submitted the FDA next week.  

“Such a device may carry very serious physical and mental health consequences, including life-threatening situations, and should not be approved by the FDA,” said the draft, which Reuters saw.

An FDA spokeswoman said the agency approved the AspireAssist because 12-month clinical trial data provided by the manufacturer demonstrated that the device offered a reasonable assurance of safety and efficacy. She did not comment on the letter because the agency had not received it.

Advocates of the device say it is less invasive and more cost-effective than bariatric surgeries and a powerful new weapon in the global fight against obesity.

“There is absolutely no medical evidence to suggest the use of this device could lead to an eating disorder,” said Dr. Shelby Sullivan, director of bariatric endoscopy at Washington University School of Medicine in St. Louis, where the device has been tested.

“This isn’t the cold or the flu,” she added. “Obesity is a chronic disease that needs chronic treatment.”

AspireBariatrics Chief Executive Officer Kathy Crothall said the treatment, including the device placement, lifestyle counseling, monitoring, and follow-up, should cost $8,000 to $13,000 for the first year, depending on where the procedure takes place.

“That is three times less than the average weight-loss surgery,” Crothall said.

In the United States alone, 35 percent of the population is obese, a condition connected to heart disease, strokes, certain cancers and type 2 diabetes.

Bosnyak lost 150 pounds and rid herself of hypertension and type two diabetes over a year of using the device.

The Academy of Eating Disorders will keep trying to persuade the FDA to reverse its approval, saying the device sets a dangerous precedent. It said the agency had agreed to meetings with critics in the near future.

(Reporting by Ben Gruber; Editing by Lisa Von Ahn)

The AspireAssist System, a weight-loss device, is seen in this image supplied by Aspire Bariatrics, Inc, on July 27, 2016.  Aspire Baraitrics, Inc./Handout via REUTERS
The AspireAssist System, a weight-loss device, is seen in this image supplied by Aspire Bariatrics, Inc, on July 27, 2016. Aspire Baraitrics, Inc./Handout via

Reuters

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Critics of weight-loss device urge U.S. regulator to reverse approval


Lotta Bosnyak takes extra time to chew the blueberries in her yogurt. Otherwise, she said, the device she credits with saving her life will not work.

The tube Bosnyak is referring to has been implanted into her stomach. She turns a valve and, standing over a toilet, drains out the yogurt.

The 52-year-old Delray Beach, Florida, resident was one of the first people to try the “AspireAssist” device four years ago in Sweden, where she is from.   

“It’s one of the best ways to change your relationship to food because it does require a lot of work on the patient’s part,” said Dr. Christopher Thompson, director of therapeutic endoscopy at Brigham Woman’s Hospital in Boston.

“It’s not just a procedure that’s done and then they’re off and they don’t think about it anymore,” he added.

The device, made by Pennsylvania-based biomedical company AspireBariatrics, was approved for use in the United States in June.

However, critics are urging the Food and Drug Administration to reverse its decision, saying the device mimics, promotes and could lead to potentially life-threatening disorders such as bulimia and binge-eating.

“This will likely prove to be yet another in a long line list of misguided, unsuccessful and dangerous products for losing weight,” wrote Dr. Eva Trujillo, president of the Academy of Eating Disorders, in a draft of a letter to be submitted the FDA next week.  

“Such a device may carry very serious physical and mental health consequences, including life-threatening situations, and should not be approved by the FDA,” said the draft, which Reuters saw.

An FDA spokeswoman said the agency approved the AspireAssist because 12-month clinical trial data provided by the manufacturer demonstrated that the device offered a reasonable assurance of safety and efficacy. She did not comment on the letter because the agency had not received it.

Advocates of the device say it is less invasive and more cost-effective than bariatric surgeries and a powerful new weapon in the global fight against obesity.

“There is absolutely no medical evidence to suggest the use of this device could lead to an eating disorder,” said Dr. Shelby Sullivan, director of bariatric endoscopy at Washington University School of Medicine in St. Louis, where the device has been tested.

“This isn’t the cold or the flu,” she added. “Obesity is a chronic disease that needs chronic treatment.”

AspireBariatrics Chief Executive Officer Kathy Crothall said the treatment, including the device placement, lifestyle counseling, monitoring, and follow-up, should cost $8,000 to $13,000 for the first year, depending on where the procedure takes place.

“That is three times less than the average weight-loss surgery,” Crothall said.

In the United States alone, 35 percent of the population is obese, a condition connected to heart disease, strokes, certain cancers and type 2 diabetes.

Bosnyak lost 150 pounds and rid herself of hypertension and type two diabetes over a year of using the device.

The Academy of Eating Disorders will keep trying to persuade the FDA to reverse its approval, saying the device sets a dangerous precedent. It said the agency had agreed to meetings with critics in the near future.

(Reporting by Ben Gruber; Editing by Lisa Von Ahn)

The AspireAssist System, a weight-loss device, is seen in this image supplied by Aspire Bariatrics, Inc, on July 27, 2016.  Aspire Baraitrics, Inc./Handout via REUTERS
The AspireAssist System, a weight-loss device, is seen in this image supplied by Aspire Bariatrics, Inc, on July 27, 2016. Aspire Baraitrics, Inc./Handout via

Reuters

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2 in 10 Alzheimer's Cases May Be Misdiagnosed

News Picture: 2 in 10 Alzheimer's Cases May Be MisdiagnosedBy Steven Reinberg
HealthDay Reporter

Latest Alzheimers News

TUESDAY, July 26, 2016 (HealthDay News) — Alzheimer’s disease is often misdiagnosed, possibly causing undue stress for those who don’t have the disease but are told they do, and delays in treatment for others, two new studies reveal.

Although no cure or effective treatment for Alzheimer’s disease exists, a correct diagnosis is essential because some drugs can delay its progress and help preserve quality of life for as long as possible. An early diagnosis also gives patients time to plan for their end-of-life care, experts say.

“There are drugs that are beneficial for at least a short amount of time that can be given at a very early stage and possibly boost memory,” said Dean Hartley, director of science initiatives, medical and scientific relations at the Alzheimer’s Association.

“Planning your care and finances is extremely important,” he said. “With a correct diagnosis people can also be put into a clinical trial to see if new drugs will work.”

The diagnosis of Alzheimer’s disease is made based on symptoms. No blood test or imaging test is currently available to diagnose the disease with 100 percent accuracy, which is why misdiagnoses occur. In addition, Alzheimer’s is a much more complex disease than once thought, making a correct diagnosis even harder. However, progress is being made in finding better ways to diagnose the disease, Hartley said.

In the first study, a team of researchers from the Mayo Clinic in Jacksonville, Fla., led by Melissa Murray, found that men may be misdiagnosed more often.

One reason may be that men in the study seemed to develop Alzheimer’s at a younger age than women and had a more aggressive form of the disease. Men tended to develop Alzheimer’s in their 60s, while women developed it in their 70s, 80s and 90s, said Murray, an assistant professor of neuroscience.

Men also seemed to have Alzheimer’s in different areas of the brain than women. This may account for the misdiagnosis among men, because their symptoms can be different than those of women, Murray said. She said men’s symptoms may be behavioral, or there may be language difficulty or motor problems instead of the memory problems usually associated with Alzheimer’s.

“Age and sex interact,” Murray said.

This study included information from the State of Florida brain bank. The researchers examined more than 1,600 brains of people who had Alzheimer’s. The people had ranged in age from 37 to 102.

Diagnosis is important so people can take care of financial planning and end-of-life wishes, Murray suggested.

In the second study, researchers from the Keenan Research Center for Biomedical Science at St. Michael’s Hospital in Toronto, Canada, looked at inconsistencies between clinical and autopsy diagnoses in more than 1,000 people listed in the National Alzheimer’s Coordinating Center database.

“Even with all the latest diagnostic methods, the discrepancy between the clinical diagnosis of Alzheimer’s disease and the pathological diagnosis is about 20 percent,” said senior researcher adjunct scientist Dr. David Munoz.

Munoz and his colleagues found that 78 percent of the patients had a correct diagnosis in the clinic, which was later confirmed in an autopsy of the brain. However, nearly 11 percent of those diagnosed with Alzheimer’s in the clinic didn’t have the disease. And, another nearly 11 percent who weren’t diagnosed with Alzheimer’s actually had the disease.

Those falsely diagnosed with Alzheimer’s had other conditions that accounted for their symptoms, including Lewy body dementia, brain atrophy and other types of dementia, the researchers found.

People whose Alzheimer’s diagnosis was missed also may have had other types of dementia, such as Parkinson’s disease dementia, vascular dementia or Lewy body dementia, the study authors reported.

The results of both studies were scheduled for presentation July 26 at the Alzheimer’s Association International Conference, in Toronto. Findings from meetings are generally considered preliminary until published in a peer-reviewed journal.

MedicalNews
Copyright © 2016 HealthDay. All rights reserved.

SOURCES: Melissa Murray, Ph.D., assistant professor, neuroscience, Mayo Clinic, Jacksonville, Fla.; David Munoz, M.D., adjunct scientist, Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto; Dean Hartley, Ph.D., director, science initiatives, medical and scientific relations, Alzheimer’s Association; July 26, 2016, presentations, Alzheimer’s Association International Conference, Toronto, Canada

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Helping Consumers Make Care Choices through Hospital Compare

Helping Consumers Make Care Choices through Hospital Compare

July 27
by CMS

By: Kate Goodrich, MD, MHS, Director of Center for Clinical Standards and Quality

When individuals and their families need to make important decisions about health care, they seek a reliable way to understand the best choice for themselves or their loved ones. That’s why over the past decade, the Centers for Medicare & Medicaid Services (CMS) has published information about the quality of care across the five different health care settings that most families encounter.[1] These easy-to-understand star ratings are available online and empower people to compare and choose across various types of facilities from nursing homes to home health agencies. Today, we are updating the star ratings on the Hospital Compare website to help millions of patients and their families learn about the quality of hospitals, compare facilities in their area side-by-side, and ask important questions about care quality when visiting a hospital or other health care provider.

Today’s ratings include the Overall Hospital Quality Star Rating that reflects comprehensive quality information about the care provided at our nation’s hospitals. The new Overall Hospital Quality Star Rating methodology takes 64 existing quality measures already reported on the Hospital Compare website and summarizes them into a unified rating of one to five stars. The rating includes quality measures for routine care that the average individual receives, such as care received when being treated for heart attacks and pneumonia, to quality measures that focus on hospital-acquired infections, such as catheter-associated urinary tract infections. Specialized and cutting edge care that certain hospitals provide such as specialized cancer care, are not reflected in these quality ratings.

We have received numerous letters from national patient and consumer advocacy groups supporting the release of these ratings because it improves the transparency and accessibility of hospital quality information. In addition, researchers found that hospitals with more stars on the Hospital Compare website have tended to have lower death and readmission rates.[2],[3]

Prior to publishing the Overall Hospital Quality Star Rating, we paused to give hospitals additional time to better understand our methodology and data. In response, we delayed the release of the ratings. Since then, we have conducted significant outreach and education to hospitals to understand their concerns and directly answered their questions, including:

  • Hosting two National Provider Calls with over 4,000 hospital representatives. During the calls, we walked through the Overall Hospital Quality Star Rating data and the methodology in detail while responding to questions that the attendees raised.
  • Providing specialized assistance to hospitals. We held numerous meetings with the hospital associations and individual hospitals to explain their data and answer questions.
  • Posting an evaluation of the national distributions of the Overall Hospital Quality Star Rating based on hospital characteristics. The analysis shows that all types of hospitals have both high performing and low performing hospitals.
  • Subjecting the measures used to calculate the Overall Hospital Quality Star Rating to rigorous scientific review and risk adjustment. All of the measures used to calculate the Overall Hospital Quality Star Rating are based on clinical guidelines and have undergone a rigorous scientific review and testing. The vast majority are endorsed by the National Quality Forum. Most of these quality measures are already adjusted for clinical co-morbidities to account for the illness-burden of the population. Some hospitals have raised the question of making additional adjustments to account for the sociodemographic characteristics of the patients they serve. We continue to work closely with the National Quality Forum and the Assistant Secretary for Planning and Evaluation (ASPE), who is required by the IMPACT Act to study the effect of socioeconomic status on quality measures and payment programs based on measures. We will work with ASPE and determine what next steps, if any, should be taken to adjust our measures based on the recommendations in the report.

CMS will continue to analyze the star rating data and consider public feedback to make enhancements to the scoring methodology as needed. The star rating will be updated quarterly, and will incorporate new measures as they are publicly reported on the website as well as remove measures retired from the quality reporting programs.

Today, we are taking a step forward in our commitment to transparency by releasing the Overall Hospital Quality Star Rating. We have been posting star ratings for different for facilities for a decade and have found that publicly available data drives improvement, better reporting, and more open access to quality information for our Medicare beneficiaries. We will continue to work closely with hospitals and other stakeholders to enhance the Overall Hospital Quality Star Rating based on feedback and experience.

These star rating programs are part of the Administration’s Open Data Initiative which aims to make government data freely available and useful while ensuring privacy, confidentiality, and security.

For more information please see https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-07-27.html.

###

Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSgov

[1] CMS Compare websites include: Nursing Home Compare; Physician Compare; Medicare Plan Finder; Dialysis Compare; and Home Health Compare.

[2] Wang DE, Tsugawa Y, Figueroa JF, Jha AK. Association Between the Centers for Medicare and Medicaid Services Hospital Star Rating and Patient Outcomes. JAMA Intern Med. 2016;176(6):848-850. doi:10.1001/jamainternmed.2016.0784. http://archinte.jamanetwork.com/article.aspx?articleid=2513630

[3] Trzeciak, S. Gaughan, J. Mazzarelli, A. Association Between Medicare Summary Star Ratings and Clinical Outcomes in US Hospitals. Journal of Patient Experience. 2016 vol. 3 no. 1 2374373516636681 doi: 10.1177/2374373516636681 http://jpx.sagepub.com/content/3/1/2374373516636681.abstract

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Protect yourself from hepatitis

Did you know hepatitis kills close to 1.4 million people worldwide every year? Hepatitis, which is an inflammation of the liver often caused by viruses, affects millions of people worldwide. This year, you can join the global movement to eliminate hepatitis as a public health threat, and Medicare can help.

Hepatitis is contagious. For example, the Hepatitis B virus spreads through contact with the blood or other body fluids of an infected person. People can also get infected by coming in contact with a contaminated object, where the virus can live for up to 7 days. Hepatitis B can range from being a mild illness, lasting a few weeks (acute), to a serious long-term illness (chronic) that can lead to liver disease or liver cancer.

Fortunately, Medicare can help keep you protected from Hepatitis A, Hepatitis B, and Hepatitis C, the most common types of viral hepatitis in the United States.

Generally, Medicare Part D (prescription drug coverage) covers Hepatitis A shots when medically necessary.

Medicare Part B (Medical Insurance) covers Hepatitis B shots, which usually are given as a series of 3 shots over a 6-month period (you need all 3 shots for complete protection).

Medicare covers a one-time Hepatitis C screening test if your primary care doctor or practitioner orders it and you meet one of these conditions:

  • You’re at high risk because you have a current or past history of illicit injection drug use
  • You had a blood transfusion before 1992, or
  • You were born between 1945 and 1965

July 28 is World Hepatitis Day. Visit the World Hepatitis Day web page to learn about Nohep, the World Health Alliance’s global movement to eliminate viral hepatitis.

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TSRI scientists develop new dual-targeting drug candidate for treating diabetes and bone disease

In addition to its more obvious ills, type 2 diabetes is a condition closely associated with bone fractures, increasing the risk of fractures twofold. To make matters worse, certain anti-diabetic drugs further increase this risk, particularly in postmenopausal women, severely limiting their treatment options.

A new study, co-led by Patrick R. Griffin, a professor on the Florida campus of The Scripps Research Institute (TSRI), and B. Lecka-Czernik, a professor at the University of Toledo, has shown that a new class of drug candidates developed at TSRI increases bone mass by expanding bone formation (deposition of new bone) and bone turnover (a normal process of replacement of old bone). A proper balance of these two processes is critical to healthy bone maintanence), and this balance is frequently negatively affected in diabetic patients.

The result is a new dual-targeting drug candidate—or, as Griffin describes, “one drug addressing multiple therapeutic indications”—that could treat both diabetes and bone disease. The compound has been referenced as “SR10171.”

The study was published recently online ahead of print by the journal EBioMedicine.

Diabetes affects more than 29 million people in the United States, according to a 2012 report from the American Diabetes Association. Between 2010 and 2012, the incidence rate was about 1.7 to 1.9 million per year, and in 2013, estimated direct medical costs of the disease were $176 billion.

Over the past decade, Griffin and his colleague, TSRI Associate Professor Theodore Kamenecka, have focused on the details of molecules that increase sensitivity to insulin (a hormone that regulates blood sugar). Using newly discovered information, the researchers made significant advances in developing a family of drug candidates that target a receptor known as peroxisome proliferator-activated receptors gamma (PPARγ), a key regulator of stem cells controlling bone formation and bone resorption and a master regulator of fat.

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Anti-diabetic drugs known as glitazones (TZDs) target the PPARγ protein, but that interaction leads to severe bone loss and increased fractures. Stem cells in the bone marrow can differentiate either into bone cells or fat cells, and the glitazones drive them to fat at the expense of bone.

But SR10171 is designed to avoid this troubling outcome. In animal models treated with the compound, fat formation in the bone marrow was successfully blocked independent of their metabolic state (healthy or diabetic).

“Using structural biology technigues and rational design synthetic chemistry, SR10171 was constructed to engage the PPARγ protein in a unique way possessing an optimal balance with the receptor’s other family member, PPARa, to treat diabetes and, at the same time, improve bone health,” Griffin said. “This targeted polypharmacological approach demonstrates that the target isn’t the problem if you target it correctly.”

The compound increases bone mass by protecting and increasing the activity of bone cells in various stages of normal bone mantanence, utilizing mechanisms that overlap those that regulate whole-body energy metabolism.

“SR10171 improves bone mass regardless of body mass index, normal to obese,” Griffin added. “So you could use such a drug to treat osteoporosis whether patients are diabetic or not.”

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Scripps Research Institute

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Drug 'may slow' Alzheimer's brain death

Drug ‘may slow’ Alzheimer’s brain death

By James Gallagher
Health and science reporter, BBC News
  • 27 July 2016
  • From the section Health

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Patient with Alzheimer'sImage copyright
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A drug appears to slow the brain’s death and preserve mental function in patients with Alzheimer’s disease, a study shows.

Developing such a treatment is one of the biggest challenges in medicine.

But serious scientific questions remain as the drug – LMTX – inexplicably works only in patients not taking other dementia pills.

The data on 891 patients was presented at the Alzheimer’s Association International Conference in Toronto.

Overall, the trial – which treated patients for 15 months – was a flop, as there appeared to be no benefit to taking LMTX.

However, an analysis on just the 15% of the patients who had not already been taking drugs to help manage their symptoms showed a benefit.

In this tiny subset of patients, tests showed thinking power was maintained and MRI scans found the death of brain cells was reduced.

Yet there are certainly too few patients in the sub-group to be certain of the drug’s effect.

‘Encouraging’

Dr Serge Gauthier, the director of the Alzheimer’s Disease Research Unit at McGill University in Canada, said: “It is both encouraging to see improvements of this magnitude in the standard cognitive and functional tests and reassuring to see the supporting brain scan evidence of a slowing in disease progression.

“In a field that has been plagued by consistent failures of novel drug candidates in late-stage clinical trials and where there has been no practical therapeutic advance for over a decade, I am excited.”

Even the company that manufactures LMTX, TauRX, cannot explain why it might work only in patients not taking other dementia drugs.

Dr David Reynolds, the chief scientific officer at the Alzheimer’s Research UK charity, told the BBC News website: “It does worry me as a scientist why it doesn’t work with other therapies.”

Possible explanations include:

  • the drugs interfere with each other
  • there is something different about the patients not on other medication
  • the small size of the sub-group in the trial means the results may have been fluked

Dr Reynolds added: “The data suggests it is slowing down the disease, but the important caveat is these small numbers.

“It is encouraging, but we need more data and will have to run a study with it as just a monotherapy [on its own].

“It will still be a years from reaching patients even assuming it works.”

The drug targets one of the key characteristics of Alzheimeir’s disease – the build of of tangles of the protein tau inside neurons.

Image copyright
SPL

Image caption

Tau tangles (in green) build up inside brain cells

It is thought these tangles may be the final stage that leads to the death of brain cells.

The study was eagerly awaited as it was the first to present large-scale data in patients on a drug that prevents tau tangles building up.

Dr Doug Brown, director of research and development at the Alzheimer’s Society, said: “While it’s disappointing to see another large clinical trial for Alzheimer’s disease fail to meet its goal, there appear to have been some striking improvements for the subset of people who took the drug on its own.

“After years of failure, we are now starting to see glimmers of hope for dementia drug trials.

“The headway being made through research is starting to give a real sense of the possibility that we could one day stop dementia in its tracks.”

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