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Study finds more Americans bypassing their personal physician when immediate treatment required

Public HealthSep 07 10

Only 45 percent of the 354 million annual visits for acute care in the United States are made to patients’ personal physicians, as Americans increasingly make busy emergency departments, specialists or outpatient care departments their first point of contact for treatment of new health problems or a flare up of a chronic condition like asthma or diabetes.

The findings, which appear in the September edition of Health Affairs, do not bode well for the nation’s already busy and frequently undermanned emergency rooms. While fewer than five percent of doctors across the U.S. are emergency physicians, they handle more than 28 percent of all acute care encounters - and more than half of acute care visits by the under-and uninsured.

According to co-authors including Steven Pitts, MD, associate professor of medicine in the Emory School of Medicine and a staff physician at Emory University Hospital Midtown, and Arthur Kellermann, MD, the Paul O’Neill Alcoa Chair in Policy Analysis at the RAND Corporation and previous associate dean for health policy at Emory University, health reform provisions in the Patient Protection and Affordable Care Act that advance patient-centered medical homes and accountable care organizations are intended to improve access to acute care. However, the challenge for reform, according to study authors, will be to succeed in the complex acute care landscape that already exists.

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Memory problems more common in men?

Gender: Male • • NeurologySep 07 10

A new study shows that mild cognitive impairment (MCI) may affect more men than women. The research is published in the September 7, 2010, print issue of Neurology®, the medical journal of the American Academy of Neurology.

Mild cognitive impairment is a condition in which people have problems with memory or thinking beyond that explained by the normal rate of aging. The study found that MCI was 1.5 times higher in men compared to women. MCI often leads to Alzheimer’s disease.

“This is the first study conducted among community-dwelling persons to find a higher prevalence of MCI in men,” said study author Ronald Petersen, MD, PhD, with the Mayo Clinic in Rochester, Minn. “If these results are confirmed in other studies, it may suggest that factors related to gender play a role in the disease. For example, men may experience cognitive decline earlier in life but more gradually, whereas women may transition from normal memory directly to dementia at a later age but more quickly.”

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Exercise shoes focus attention on walking

Public HealthSep 06 10

Call them toners, shapers, or rocker bottoms, those exercise shoes with the distinctive thick, rounded soles are flying off the shelves and onto the feet of even the most clodhopper-averse walkers.

Experts don’t agree on whether these shoes are any better than regular running shows, but they concur that whatever gets you moving is a good thing.

“I tell people to make your bottom half your better half,” said Denise Austin, a fitness expert and spokesperson for Skechers Shape-ups. “They make you feel like you’re walking on sand. The second you put them on you think ‘good posture. They make you more aware than regular shoes.”

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Long-term knee function good after ligament repair

TraumaSep 06 10

People who have surgery to repair a common knee ligament injury show improvement in knee function as long as 15 years after undergoing the operation, new research shows.

Injuries to the anterior cruciate ligament (ACL), which links the thigh bone to the shin bone, are common among young people, and typically treated by repairing the ligament. But recent studies have suggested that for some people, intensive physical therapy to strengthen and stabilize the joint may be enough.

In the current study, Dr. Britt Elin Olestad of Oslo University Hospital Ulleval, Norway, and her colleagues investigated long-term knee function and osteoarthritis in 221 patients between 15 and 50 years old who were treated with ACL repair between 1990 and 1997—evaluating patients six months, one year, two years, and 10 to 15 years after the surgery.

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Robot doesn’t make cancer surgery cheaper: study

Cancer • • Gender: FemaleSep 06 10

Minimally invasive surgery for endometrial cancer is cheaper on a society-wide and hospital level than surgery done with a robotic system or a more invasive hysterectomy, according to a new study.

But the robot still has other benefits that aren’t reflected in the dollars-and-cents calculation, the authors say, such as greater ease and comfort for the surgeon.

More than 43,000 women in the U.S. will be diagnosed with endometrial cancer - cancer that forms in the lining of the uterus - in 2010, according to the National Cancer Institute. About $1.8 billion is spent on treating endometrial cancer each year in the U.S., but it’s unclear how that number will change if more of the surgeries are done robotically.

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Children Who Eat Vended Foods Face Health Problems, Poor Diet

Children's Health • • Dieting • • Food & NutritionSep 06 10

School children who consume foods purchased in vending machines are more likely to develop poor diet quality – and that may be associated with being overweight, obese or at risk for chronic health problems such as diabetes and coronary artery disease, according to research from the University of Michigan Medical School.

The study also looked at foods sold in school stores, snack bars and other related sales that compete with USDA lunch program offerings and found that these pose the same health and diet risks in school-aged children.

“The foods that children are exposed to early on in life influence the pattern for their eating habits as adults,” says lead study author Madhuri Kakarala, M.D., Ph.D., clinical lecturer of internal medicine at the U-M Medical School.

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Personalized medicine: Molecular imaging predicts treatment success in many cancers

CancerSep 01 10

A series of studies published in the September Journal of Nuclear Medicine (JNM) show that molecular imaging plays a critical role in the evaluation and treatment planning for a broad spectrum of cancers, including thyroid cancer and lymphoma.

According to researchers, molecular imaging allows physicians to identify the severity and extent of disease and, in turn, provide patients with personalized care. In addition, molecular imaging allows doctors to see how effective a treatment is early in the process so that changes can be made to ensure the best treatment for each individual patient.

“For patients with thyroid cancer, ‘one size fits all’ no longer applies,” said Ravinder Grewal, M.D., corresponding author of “The Effect of Posttherapy 131I- SPECT/CT on Risk Classification and Management of Patients with Differentiated Thyroid Cancer” and an assistant attending physician in nuclear medicine at Memorial Sloan-Kettering Cancer Center in New York. “Through molecular imaging, the paradigm is changing toward more tailored and customized management of treatment. As a result, we can see how far a disease has spread and spare the patient from additional examination, time and radiation exposure.”

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