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VNA of Care New England

Health Highlights: April 18, 2014

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Treatment Costs New Focus for Medical Groups
Doctors need to consider the expense of treatments when making decisions about patient care, a number of major American medical groups now say.
This change in thinking is being driven by rising health care costs, experts told The New York Times.
"We understand that we doctors should be and are stewards of the larger society, as well as of the patient in our examination room," Dr. Lowell Schnipper, who chairs a task force on value in cancer care at the American Society of Clinical Oncology, told the newspaper.
A number of influential medical groups are developing new guidelines that could lead doctors to prescribe one medication over another based on cost, or to decide that certain treatments are too expensive to use on a particular patient.
The rising prices of cancer drugs has led the American Society of Clinical Oncology to begin creating a scorecard that rates medicines based on the cost, effectiveness and side effects. It's due for release in the fall, according to the newspaper.
The American Heart Association and American College of Cardiology also announced recently that they will start to use cost to evaluate the value of treatments in their shared guidelines, the Times reported.
And other groups are bringing cost into the medical care equation. A 2013 review found that 17 of 30 clinical guidelines issued by some of the largest physician specialty societies integrated treatment costs into their guidelines, according to the newspaper.
However, this redefined role for doctors is a controversial issue within the medical community. Some critics contend that cost-based treatment decisions are a type of medical rationing.
"There should be forces in society who should be concerned about the budget, about how many MRIs we do, but they shouldn't be functioning simultaneously as doctors," Dr. Martin Samuels, chairman of the neurology department at Brigham and Women's Hospital in Boston, told the Times.
He warned that doctors risk losing the trust of patients if they tell them, "I'm not going to do what I think is best for you because I think it's bad for the health care budget in Massachusetts."
Other experts believe doctors have to be involved in keeping treatment costs under control because too few others are doing anything about it.
"In some ways, it represents a failure of wider society to take up the issue," Dr. Daniel Sulmasy, a professor of medicine and ethics at the University of Chicago, told the newspaper.
Scientists Create First Embryo Clones Using Cells From Adults
For the first time, scientists say they have used material from cells from two adults to create early stage cloned embryos. They then used those embryos to create tissue that was an exact genetic match of the donors.
The aim of the research is to be able to grow tissue in the laboratory from patients' own cells that could be used to treat a wide range of diseases, the Wall Street Journal reported.
The study, published April 17 in Cell Stem Cell, is the first to create cloned embryos with adult cells -- last year, similar results were achieved using infant and fetal cells.
"The proportion of diseases you can treat with [lab-made tissue] increases with age. So if you can't do this with adult cells, it is of limited value," Robert Lanza, co-author of the study and chief scientific officer at Advanced Cell Technology Inc. of Marlborough, Mass, told the WSJ.
In the latest research, funded by the government of Korea and performed at a lab in California, the adult cells used came from one 35-year-old man and one 75-year-old man.
Shoukhrat Mitalipov, a development biologist at Oregon Health and Science University, in Portland, was the leader of the 2013 study that produced cloned embryos from infant or fetal cells. He told the WSJ that he was "happy to hear that our experiment was verified and shown to be genuine."
According to the newspaper, the embryos resulting from Lanza's research may have limitations that prevent them from ever producing a human clone, even if they were implanted in a womb. And experts stress that the creation of a human clone is certainly not on the horizon -- researchers have unsuccessfully tried to create a cloned monkey for years.
Still, this line of research has some worried. "If we're closer to some rogue scientist or fertility doctor using published techniques to create cloned humans, it certainly ups the stakes and means we should be moving to put a federal law in place," Marcy Darnovsky, executive director of the Center for Genetics and Society, a nonprofit public interest group in Berkeley, Calif, told the WSJ.
Lowe's Agrees to Stricter Oversight of Lead Paint Renovations: EPA
The nationwide home-improvement retailer Lowe's Home Centers has agreed to adopt a "comprehensive, corporate-wide compliance program" to minimize lead paint dust created during home renovations, the U.S. Environmental Protection Agency (EPA) announced Thursday.
The program will govern contractors that Lowe's hires to do home-repair work through its more than 1,700 stores, the agency said in a news release.
Lead dust problems can surface when lead paint breaks down or is dislodged during home renovation work. Exposure to lead can cause a variety of health problems, ranging from behavioral disorders and learning disabilities to seizures and death. Young children are most vulnerable because their nervous systems are still developing, according to the EPA.
Lead-based paint was banned in the United States in 1978, but it can still be found in many houses and apartments.
The settlement includes a $500,000 civil penalty, the largest of its kind. It was prompted after EPA inspectors discovered violations of the federal Lead Renovation, Repair, and Painting Rule, the news release said.
The violations were linked to Lowe's stores in Arkansas, Connecticut, Idaho, Illinois, Ohio, New Hampshire, New York, Tennessee and Vermont, the EPA said.
Guinea Ebola Outbreak Caused by New Virus Strain: Researchers
The Ebola outbreak in West Africa is being caused by a new strain of the virus that did not spread there from other regions of Africa, researchers say.
Most of the more than 120 deaths in the outbreak have been in Guinea, the Associated Press reported.
The international team of scientists analyzed blood samples from 20 Ebola patients in the current outbreak and concluded that they had a unique strain. The findings were published online Wednesday in the New England Journal of Medicine.
"The source of the virus is still not known," but it did not come from neighboring countries, said Dr. Stephan Gunther of the Bernhard Nocht Institute for Tropical Medicine in Hamburg, Germany, the AP reported.
Previously, health officials said the Ebola outbreak in Guinea and surrounding countries was caused by a Zaire strain. Zaire is the former name of the Democratic Republic of Congo.
But Gunther said the Guinea Ebola is not from the Democratic Republic of Congo or from Gabon, where Ebola has also occurred, the AP reported.
The researchers believe that the Guinea outbreak began last December or earlier and may have gone unrecognized for some time. Efforts to pinpoint "the presumed animal source," are continuing, they wrote.
There is no cure or vaccine for Ebola.
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