There are now
officially 70,000 ways to get sick or die
There are 70,000 ways to get sick, hurt or mortally injured, and the U.S. is
making them official.
On Thursday, U.S. hospitals, doctors and other care providers had to start
using internationally developed standards called ICD-10 codes to bill
government programs and private insurers in the nationâ€™s $2.9
trillion-a-year healthcare system. The codes cover everything from parrot
bites to getting sucked into a jet engine.
Doctors have already begun mocking the diagnostic list, picking out the most
absurd and arcane, such as Z63.1, â€śProblems in relationship with in-laws,â€ť
or V91.07XA, â€śBurn due to water skis on fire.â€ť Yet for healthcare providers
who have payments at stake, the complex change is no joke.
Health insurers and government programs stopped accepting the old set of
ICD-9 codes in the early morning hours Thursday, completing the switch.
In a study released last month, the Government Accountability Office, said
â€ślittle is knownâ€ť about how much it will cost the healthcare system to make
the transition. HCA Holdings Inc., the Nashville, TN-based hospital chain,
said 2015 costs for the transition to the new codes will be about $30
Insurers began preparing for ICD-10 in 2010 and have been ready since the
government first delayed implementation in 2012, said Clare Krusing, a
spokeswoman for Americaâ€™s Health Insurance Plans, a Washington-based
Concerns about the changeover grew as the possibility loomed that Congress
might not pass a spending bill and cause a shutdown of the federal
government. The administration, which mandated adoption of the new codes,
has said itâ€™s ready, despite any political or technical challenges.
Administration officials, who have already delayed the codesâ€™ debut twice,
say the system will help identify efficient ways to manage all kinds of
conditions, from heart disease to roller-skating injuries.
Some hospitals and physician groups are putting aside reserves in case of
interruptions in reimbursement, said Lana Cabral, senior director of case
management services for Conifer Health Solutions, a unit of the hospital
company Tenet Healthcare Corp. Conifer, which processes bills for doctors
and hospitals, has set up a â€ścommand centerâ€ť to manage the transition, she
And if, even after all the efforts to get the transition right, doctors and
hospitals are still dealing with problems, thereâ€™s an ICD-10 code for that
-- F43.22: â€śAdjustment disorder with anxiety.â€ť
Visit Bloomberg for the story.
injuries cost the US $671 billion in 2013
The total cost of injuries and violence in the United States was $671
billion in 2013, according to two Morbidity and Mortality Weekly Reports (MMWR)
released by the Centers for Disease Control and Prevention (CDC).
The cost associated with fatal injuries was $214 billion; nonfatal injuries
was $457 billion. Each year, more than three million people are
hospitalized, 27 million people are treated in emergency departments and
released, and more than 192,000 die as a result of unintentional and
violence related injuries.
The two studies include lifetime medical and work loss costs for
injury-related deaths and injuries treated in hospitals and emergency
departments and break down costs by age, gender, and injury intent. Other
key findings include:
Males accounted for a majority (78 percent) of costs for injury deaths
($166.7 billion) and nonfatal injury costs (63 percent; $287.5 billion);
More than half of the total medical and work-loss costs of injury deaths
were from unintentional injuries ($129.7 billion), followed by suicide
($50.8 billion) and homicide ($26.4 billion);
Drug poisonings, which includes prescription drug overdoses, accounted for
the largest share of fatal injury costs (27 percent), followed by
transportation-related deaths (23 percent) and firearm-related deaths (22
The cost for hospitalized injuries was $289.7 billion in 2013; the cost for
injuries treated and released in hospitals and emergency departments was
$167.1 billion; and
Falls (37 percent) and transportation-related injuries (21 percent)
accounted for a majority of the costs associated with emergency department
treated non-fatal injuries.
To review the full report and the study
New test detects
all the viruses that infect people, animals
Unlike standard tests, the ViroCap tests for the viruses and all of their
variations at the same time, making it faster and far less expensive.
Researchers have developed a new test that can detect nearly any virus known
to infect humans and animals, offering the potential to help doctors
diagnose infections even without a clue of what they are looking for.
The test, called ViroCap, is likely years from being used regularly with
patients because its accuracy needs to be verified in extensive clinical
trials. The technology is being made publicly available, however, to
scientists and doctors as it continues to be developed.
"With this test, you don't have to know what you're looking for," said Dr.
Gregory Storch, a professor of pediatrics at Washington University in St.
Louis, in a press release. "It casts a broad net and can efficiently detect
viruses that are present at very low levels. We think the test will be
especially useful in situations where a diagnosis remains elusive after
standard testing or in situations in which the cause of a disease outbreak
The researchers created a panel with sequences and tests DNA and RNA from
viruses in 34 organism families, and was found to be just as sensitive as
polymerase chain reaction, or PCR, assays but can test for all the viruses
at once, which traditional tests can't do. It can also test for variations
on more common viruses, offering the potential to catch infections that
doctors may never even consider.
In two sets of samples, from blood, stool and nasal secretions, researchers
compared the results of standard PCR tests against the ViroCap. The PCR
caught viruses in 10 of 14 patients, however the ViroCap detected viruses in
the other 4 patients. The viruses missed were relatively common: influenza
B, a cause of seasonal flu; parechovirus, a mild gastrointestinal and
respiratory virus; herpes virus 1, responsible for cold sores in the mouth;
and varicella-zoster virus, which causes chickenpox.
Overall, the researchers reported that ViroCap had a 52 percent improvement
over PCR tests for viruses, jumping from 21 to 32 being detected.
The study is published in Genome Research.
Visit UPI for the story.
Every 9 minutes,
someone in the world dies of rabies
A human death from rabies is a tragic but rare thing in the United
States and most developed nations. It's just as tragic but sadly common in
parts of the world where some 3 billion people are at risk of being bitten
by a rabid dog. More than 59,000 people die of rabies each year because they
cannot get the care they need. That's about 1 person dying of rabies every 9
Most of these deaths are in Africa and Asia, and nearly half of the victims
are children under the age of 15. Many of these lives can be saved if bite
victims and healthcare providers know what to do and have what they need -
rabies vaccine and immunoglobulin.
The fact that so few people in the United States and other developed nations
get rabies shows that the disease can be controlled. Canine rabies has been
eliminated in the United States, thanks to routine dog vaccinations and
licensing and better control of stray dogs. Since the control of canine
rabies in the United States, it has now been recognized that numerous wild
animals can be infected with this disease. For that reason, people still
must remain aware of the risk of rabies and seek medical care when exposed
to wildlife and unusually acting animals.
To combat rabies, CDC works with many partners, including the Global
Alliance for Rabies Control (GARC), World Health Organization, Humane
Society International, National Association of Public Health Veterinarians,
and American Veterinary Medical Association. Together, these partners have
made great strides toward eliminating rabies in countries hard hit by
For example, in Ethiopia, which has reported some of the highest rates of
human and animal rabies deaths in the world, a project is under way to
control canine rabies through activities such as education, mass dog
vaccination clinics, spay-neuter campaigns, establishment of new
laboratories to diagnose rabies in dogs, and training to show veterinarians
how to safely capture and humanely euthanize dogs suspected of having
rabies. CDC and partners are working together to establish the first
rabies-free zone in Ethiopia and ultimately end canine rabies in this
Visit PR Newswire for the release.
preparedness with new products to treat severe burns
Four novel products to treat severe thermal burns will be developed and
acquired under contracts with the U.S. Department of Health and Human
Servicesâ€™ Office of the Assistant Secretary for Preparedness and Response (ASPR).
The products are intended to enhance the available treatment options for
disaster response and are being designed to find uses in routine clinical
ASPRâ€™s Biomedical Advanced Research and Development Authority (BARDA) will
leverage authority granted under the Project BioShield Act of 2004 to
purchase one of the products currently available commercially and fund
late-stage development and procurement of the other three. These products
will be added to the Strategic National Stockpile (SNS) or managed by
vendors to help protect people from burn injuries resulting from
radiological and nuclear threats.
The detonation of an improvised nuclear device would produce intense heat,
resulting in many patients with severe burns. The treatments for such burns
require complex procedures including surgical skin grafting that is
resource-intensive and technically demanding. With only 127 burn centers
nationwide, a mass casualty incident of this scale could easily overwhelm
the nationâ€™s burn care infrastructure.
The first product, Silverlon, could improve care for burn patients before
they reach the hospital and can receive a surgical treatment for their burn
injuries. Silverlon, manufactured by Argentum of Geneva, IL, is a
long-acting silver-impregnated nylon bandage available commercially and used
widely to cover acute wounds and first- and second-degree thermal burns. The
silver helps control bacterial growth within the dressing.
The other three products are being developed to address challenges in burn
care treatment. BARDA will fund pivotal clinical studies necessary for the
companies to submit applications for approval from the U.S. Food and Drug
Administration. While this late-stage product development takes place, BARDA
will begin procuring the products for the SNS. Wide-scale use of the
products could be permitted by FDA in a disaster response under an Emergency
Under a five-year, $40.4 million contract, MediWound of Israel will develop
NexoBrid, a topical gel made of pineapple-based enzymes and designed to
dissolve the damaged or dead skin tissue to create a clean wound-bed for
Stratatech Corporation of Madison, WI will advance its development of a
novel cell-based skin substitute made from living human cells called
StrataGraft. In addition, Avita Medical Americas, LLC of Northridge, CA will
advance the development of a device called ReCell, which produces a topical
spray derived from a small sample of the patientâ€™s own skin
With the agreements, using Project BioShield authorities, BARDA has
supported the development and procurement of 16 medical countermeasures â€“
vaccines, drugs, and other medical products needed for emergencies â€“ since
2004, including products needed to treat some of the health impacts of
ionizing radiation, as well as drugs or products to treat illness from
anthrax, smallpox, and botulism.
To learn more about ASPR and preparedness,
response and recovery from the health impacts of disasters, visit the HHS
public health and medical emergency website,
Visit HHS for the release.
HHS sponsors development of drug for hospitalized
Development of an experimental influenza antiviral drug that may be more
potent and could have a longer treatment window than existing drugs will
receive support from the U.S. Department of Health and Human Servicesâ€™
Office of the Assistant Secretary for Preparedness and Response (ASPR). The
drug is being developed for use in treating patients hospitalized with
If development is successful and the drug receives U.S. Food and Drug
Administration (FDA) approval, the drug could become the first specifically
for this use and potentially the first in a new class of influenza
The ASPR Biomedical Advanced Research and Development Authority (BARDA) will
provide technical assistance and funding to Janssen Pharmaceuticals Inc.,
one of the pharmaceutical companies of Johnson & Johnson, in Raritan, NJ,
for advanced development of the drug, JNJ-872 (also known as VX787). The
contract will provide up to approximately $103.5 million over the next four
years and three months. The contract includes options for additional work up
to a total of approximately $131 million.
While other FDA-approved influenza antiviral medications are usually more
effective if given within 48 hours of symptom onset, studies of JNJ-872 to
date suggest that the experimental drug may provide clinical benefits when
administered much later than 48 hours after symptoms begin.
JNJ872 may represent an entirely new class of influenza antiviral drugs that
has a unique mechanism of action, meaning that the drug works through
different mechanisms than currently available antiviral drugs. Having unique
mechanisms of action may be important as influenza viruses emerge that are
resistant to current antivirals drugs, particularly influenza viruses with
potential to become pandemics.
BARDAâ€™s goal in supporting JNJ872 is development of a product that can be
used not only to treat hospitalized influenza patients but also to treat
patients for whom influenza poses high risks, such as the elderly,
pediatrics, and those with chronic conditions such as COPD and heart
disease, and for use specifically in treating patients who have been
hospitalized with influenza.
The new antiviral drug development project is
part of BARDAâ€™s comprehensive integrated portfolio approach for advanced
research and development, innovation, acquisition, and manufacturing of
vaccines, drugs, diagnostic tools, and non-pharmaceutical products for
public health emergency threats. In addition to pandemic influenza, these
threats include chemical, biological, radiological, and nuclear agents,
emerging infectious diseases, and antimicrobial resistance.
Visit HHS for the report.
Doctors advised to
wait longer before diagnosing miscarriages
Doctors are being advised to wait longer before they diagnose a miscarriage
in order to avoid the risk of ending a pregnancy that might have been
Experts who have carried out a large study say the guidelines for hospitals
on diagnosing a miscarriage need to be updated, so that women always get a
second ultrasound scan two weeks after the first if the gestational sac seen
in the scan is small. It is not always possible to be sure that a very small
embryo with no detectable heartbeat is going to miscarry, they say.
A large study published in the BMJ Open journal looked at the
outcomes for 2,845 women who arrived at NHS hospitals with bleeding or pain
and had a scan that doctors felt showed the continuation of the pregnancy
was uncertain. The researchers found that 19 pregnancies out of 549 would
have wrongly been thought to have miscarried if the current guidelines had
been followed and they had not been scanned two weeks later.
The guidelines from the National Institute for Health and Care Excellence
say that a second scan should be offered if the gestational sac is over 25mm
in diameter. Many doctors will offer a second scan even for a smaller
pregnancy. But the guidelines need to state that this must happen, said Tom
Bourne, consultant gynecologist at Queen Charlotteâ€™s and Chelsea hospital,
professor at Imperial College, and the lead author of the study. â€śWhen they
are dealing with something as important as miscarriage, it has to be black
and white,â€ť he said.â€¨
The early weeks of pregnancy are an anxious time for women. About one in
five pregnancies ends in miscarriage, most within the first three months.
But establishing whether a miscarriage has taken place in the early weeks is
difficult. It rests on the size of any embryo, if it can be seen, the size
of the gestational sac and whether it appears empty, and whether a heartbeat
can be detected during an ultrasound scan.
In 2011, as a result of work by the same team of experts, it was recognized
that the guidelines that had existed were unsafe and that there was a risk
that some viable pregnancies might have been ended. That led to the 2011
update. Broadly, the guidelines were now right, the team said, but they are
not specific enough about the size of the embryo related to gestational age
and should specify the 14-day wait between scans in most cases.
â€śWomen should be able to rely on a diagnosis of miscarriage. Itâ€™s an area of
medicine where the highest levels of caution are warranted,â€ť said Bourne.
â€śJust one misdiagnosis of miscarriage is too many. We have shown that
perhaps people are being brought back too early. Most guidelines say if
youâ€™re uncertain, then come back in seven days, repeat the scan, and at that
time you should expect to see a heartbeat or, perhaps if you have an empty
sac, you should expect to see an embryo. (The Guardian)
Visit EIN News for the story.
New virus found in
blood supply â€” but don't freak out just yet
Scientists have found a new virus that can be transmitted by blood
transfusions and other blood-based products. It looks a little like the
hepatitis C virus, which can cause permanent liver damage, and a little like
the human pegivirus, which appears to be harmless, the team reports in the
They've named it human hepegivirus-1 (HHpgV-1).
"We have been able to find a new virus. It's clearly transmitted as a result
of human (blood) transfusion," said infectious disease expert Dr. Ian Lipkin,
who oversaw the study team at Columbia University. "It is the first
transfusion-associated virus that's been described in a long time. We don't
know if it is going to be a significant cause of human hepatitis," Lipkin
told NBC News.
But probably not, the researchers said.
To find it, the team sampled blood banked at the National Institutes of
Health from 46 volunteers between 1974 and 1980. They found it in two
samples. Both patients appear to have "cleared" the virus and there is no
evidence it caused any disease. All the volunteers got blood products to
treat hemophilia. The virus only showed up after they got transfusions.
Then they looked at samples from 106 people in another study, and found the
virus in two more people. One appears to have been infected for as long as
five years but both cleared the virus, too.
"We just don't know how many viruses are transmitted through the blood
supply. There are so many viruses out there, and they need to be
characterized in order to ensure that transfusions are safe," said Amit
Kapoor, an assistant professor at Columbia University who led the study.
Hemophilia was once only treated with blood products taken from people. Now
it's often treated with genetically engineered products, which do not carry
Now that the genetic sequence of this new virus is published, Lipkin said,
other scientists can start looking for it.
"More than 30 million blood components are
transfused annually in the United States alone. Surveillance for infectious
agents in the blood supply is key to ensuring the safety of this critical
resource for medicine and public health," the researchers wrote.
Visit NBC News for the article.