Tests & Treatments

Information and new research about advances in discovering and treating diseases and conditions.

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Vaccine Exemption Bill Stalls in Sacramento; Vote Next Week

(Kevork Djansezian/Getty Images)

(Kevork Djansezian/Getty Images)

A bill that would eliminate the vaccine personal belief exemption stalled before the Senate Education Committee Wednesday in Sacramento. Lawmakers were deeply concerned that the bill would bar too many children from school. The bill’s co-author, Sen. Richard Pan (D-Sacramento), asked the committee to delay a vote until next Wednesday after the committee chairwoman warned him he did not have enough votes to pass.

Pan said he will use the time to address their concerns, possibly adding amendments to the bill.

Under the bill, SB277, California would no longer permit any vaccine exemptions except a medical one, meaning virtually all children would have to be vaccinated in order to attend public or private school. Even home-schoolers who group together would be affected under the current language, one of the committee’s complaints.

While several committee members expressed their support for vaccines, they were worried that the bill goes too far. “I’m looking for the compelling state interest in doing something (this) draconian,” said state Sen. Loni Hancock (D-Berkeley). “If I’m reading the bill correctly, there’s nothing you can do if you choose not to vaccinate your child,” except home-school and then only with your own children. Continue reading

Hidden Side Effect of Cancer Treatment: Big Bills

Anne Koller closes her eyes as an oncology nurse attaches a line for chemotherapy to a port in her chest. Koller typically spends 3 to 6 hours getting each treatment. (Sarah Jane Tribble/WCPN)

Anne Koller closes her eyes as an oncology nurse attaches a line for chemotherapy to a port in her chest. Koller typically spends 3 to 6 hours getting each treatment. (Sarah Jane Tribble/WCPN)

By Sarah Jane Tribble, Kaiser Health News

Anne Koller was diagnosed with late-stage colon cancer in 2011 and has been fighting it since.

“We talk about hair loss. Should we also talk about ‘chemotherapy is expensive?'”    

But it’s not just the cancer she’s fighting. It’s the bills.

“Think of those old horror flicks,” she says. “The swamp creature … comes out and is kind of oozy, and it oozes over everything.”

Koller, who just turned 65 years old, is petite, and sports a stylish auburn wig. When she was able to work, Koller was in the corporate world and safely middle-class, with health insurance and plenty of savings.

At first, she was too sick to deal with the bills. They piled up.

“You start looking at these bills,” Koller says, “and, as much as you know it’s expensive, the shock itself is like, ‘What?'” Continue reading

The Hidden Cost of Mammograms: More Testing and Overtreatment

Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)

Instead of having mammograms according to age, some doctors think screening should be based on a woman’s overall risk for breast cancer. (Getty Images)

By Patti Neighmond, NPR

There’s no question mammograms can save lives by detecting breast cancer early. But they can also result in unnecessary testing and treatment that can be alarming and costly.

In fact, each year the U.S. spends $4 billion on follow-up tests and treatments that result from inaccurate mammograms, scientists report in the current issue of Health Affairs.

That’s a “stunning number,” says the study’s lead author, Dr. Kenneth Mandl, at Harvard Medical School’s Center for Biomedical Informatics.

Mandl and a colleague analyzed the insurance records of more than 700,000 women from 2011 to 2013. The women were between the ages of 40 and 59, and they all had routine mammograms to screen for breast cancer during that time period. Continue reading

Panel Votes To End Vaccine Exemption in California

By David Gorn, California Healthline

Lawmakers took step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California. (Centers for Disease Control and Prevention's Public Health Image Library)

Lawmakers took step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California. (Centers for Disease Control and Prevention’s Public Health Image Library)

On Wednesday, lawmakers took the first step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California.

The Senate Committee on Health on Wednesday voted to approve SB 277 by state Sen. Richard Pan (D-Sacramento). It would stop California parents from opting out of immunizations for their schoolchildren unless there is a medical reason to refuse vaccination.

“There is no scientific controversy about vaccine safety and vaccine effectiveness. This is not open to dispute among mainstream doctors and scientists.”

Pan, a pediatrician, said the recent outbreaks of measles and whooping cough could be prevented if a higher percentage of children were immunized against the diseases.

“I’ve personally witnessed the suffering caused by vaccine-preventable diseases,” Pan said. “All children deserve to be safe at school. The personal belief exemption is now putting other schoolchildren and people in our community in danger.”

Continue reading

More Californians Visiting ER For Chronic Medical Conditions

Millions of Californians visit emergency departments for help with non-injury related  health problems -- and that number is rising.

Millions of Californians visit emergency departments for help with non-injury related health problems — and that number is rising.

Traditionally people think of a hospital emergency room as a place to go for injuries: someone gets in a car accident, has a heart attack, or falls out of a tree and breaks his leg. But the ER also plays a large role in treating medical patients.

Millions of Californians visit emergency departments for help with non-injury related health problems — and that number is rising, according to a study recently published in the April edition of Health Affairs.

“The study gives you kind of a bird’s eye view of what’s happening in the health care system overall.”

The study, led by the University of California, San Francisco, shows the rate of emergency room visits for non-injury related problems rose 13.4 percent in the state, from 10.1 million visits in 2005 to 11.9 million visits in 2011. The largest increase in non-injury related ER visits were for gastrointestinal diseases, abdominal pain and nervous system disorders.

Renee Hsia is a professor of Emergency Medicine and Health Policy Studies at UCSF, and the lead author of the study. She says hospital admissions rates are a window into California’s health care system.
Continue reading

Cow’s Milk Found in Breast Milk Sold Online

A recent study shows 10 percent of human breast milk purchased online is contaminated with traces of cow’s milk.

A new study shows 10 percent of human breast milk purchased online is contaminated with cow’s milk. (Justin Sullivan/Getty Images)

Most doctors agree that ‘breast is best.’ Breastfed babies have lower rates of respiratory infections, ear infections, asthma, digestive problems, childhood obesity, asthma and Sudden Infant Death Syndrome (SIDS). The public health message is being heard: in 2011 almost 80 percent of newborn U.S. infants were initially breastfed.

But sometimes mothers can’t breastfeed. They may not have sufficient milk production, or maybe their child is allergic to the ingredients in infant formula, so they seek an alternative: buying breast milk on the Internet.

“For an infant who is allergic to cow’s milk or failing to thrive because of formula, this is a huge public health problem.”

The FDA doesn’t approve. Breast milk purchased online isn’t always properly screened for infectious diseases, and it has a chance of being contaminated — with things like cow’s milk.

A study published Monday in the journal Pediatrics reveals 10 percent of breast milk purchased online is contaminated with cow’s milk. A team at The Research Institute at Nationwide Children’s Hospital in Ohio anonymously purchased 102 samples of milk advertised as breast milk online. They found 10 percent of bovine DNA in 10 of the samples.

Continue reading

Planning On Getting An Annual Physical Exam? Maybe You Shouldn’t

By Jenny Gold, Kaiser Health News

The Society for General Internal Medicine even put annual physicals on a list of things doctors should avoid for healthy adults. (Joe Raedle/Getty Images)

The Society for General Internal Medicine put annual physicals on a list of things doctors should avoid for healthy adults. (Joe Raedle/Getty Images)

It’s a warm afternoon in Miami, and 35-year-old Emanuel Vega has come to Baptist Health Primary Care in Miami.

Vega, a strapping man with a thick black beard, is feeling good, but he came to see the doctor today because his wife thought he should – she even made the appointment. It is free to him under his insurance policy with no co-pay, as most preventive care is under the Affordable Care Act.

“I would argue that we should move forward with the elimination of the annual physical.”

Vega is one of more than 44 million Americans who is taking part in a medical ritual: visiting the doctor for an annual physical exam. But there’s little evidence that those visits actually do any good for healthy adults.

Caruso listens to Vega’s heart and lungs, checks his pulse in his ankles and feels around his lymph nodes. He also asks Vega about his exercise and sleeping schedule and orders blood and urine tests. As long as everything checks out, Caruso asks Vega to return for another exam in a year. Vega says he definitely will.

It was a positive experience for both doctor and patient, and they’re not alone; 92 percent of Americans say it is important to get an annual head-to-toe physical exam, according to a Kaiser Family Foundation poll (KHN is an editorially independent program of the foundation). And 62 percent of those polled said they went to the doctor every year for their exam.

Continue reading

Doctors with Cancer Join California Movement for ‘Aid in Dying’

Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)

Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)

By Anna Gorman, Kaiser Health News

Dan Swangard knows what death looks like.

As a physician, he has seen patients die in hospitals, hooked to morphine drips and overcome with anxiety. He has watched dying drag on for weeks or months as terrified relatives stand by helplessly.

“It’s very real for me. This could be my own issue a year from now.”

Recently, however, his thoughts about how seriously ill people die have become personal. Swangard was diagnosed in 2013 with a rare form of metastatic cancer.

To remove the cancer, surgeons took out parts of his pancreas and liver, as well as his entire spleen and gallbladder. The operation was successful but Swangard, 48, knows there’s a strong chance the disease will return. And if he gets to a point where there’s nothing more medicine can do, he wants to be able to control when and how his life ends.

“It’s very real for me,” said Swangard, who lives in Bolinas, Calif. “This could be my own issue a year from now.” Continue reading

Posthumous Brittany Maynard Video Supports Calif. ‘Death with Dignity’ Bill

State senators heard testimony today on a proposed bill that would allow doctors to prescribe lethal medication to terminally ill patients who request it. The testimony included a video from Brittany Maynard recorded 19 days before she took life-ending drugs.

 

In the video, Maynard implored California lawmakers to legalize “aid in dying.” Maynard, who had been diagnosed with terminal brain cancer, took lethal medication last year in Oregon, where the practice is legal.

“The decision about how I end my dying process should be up to me and my family under a doctor’s care. How dare the government make decisions or limit options for terminally ill people like me. Unfortunately, California law prevented me from getting the end-of life-option I deserved,” said Maynard, who died Nov. 1 at age 29. Continue reading

Frontline ‘Vaccine War’ Live Chat; Wednesday 3/25, Noon PT

A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)

A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)

Frontline aired an updated version of its 2008 documentary The Vaccine War on Tuesday night. The film dives deep into the debate over vaccines. While the overwhelming majority of parents vaccinate their children, a small but growing minority either under-vaccinate their children or refuse vaccines altogether.

The debate has taken a new turn in the wake of the measles outbreak which started in Disneyland in December. Public health officials believe a still-unknown person infected with measles visited the park and spread it to others. As the outbreak took hold, a new front in the debate grew: that of people who are immune-compromised.

State of Health first told the story of Carl Krawitt the father of 7-year-old Rhett who was diagnosed with leukemia when he was two and a half. Because of the treatments Rhett underwent to fight his disease, prior vaccine protection was wiped out, and he had to wait until he had been in remission for a year before his vaccines could begin again. The Krawitt family has been arguing that those unvaccinated by choice should not be able to attend public school.

Frontline producers told the story of Rhett’s family in The Vaccine War.

Now, it’s your turn. On Wednesday (March 25) at noon PT, Frontline is hosting a live chat, and I’m honored to be the moderator. ‘Vaccine War’ producer and director Kate McMahon will take your questions, along with Carl Krawitt, and Dr. Arthur Reingold, Head of Epidemiology at the UC Berkeley School of Public Health.

Feel free to leave a question now and please join us at noon for the chat!