Whooping cough is an extremely contagious bacterial disease. Symptoms begin as a sore throat that manifests into severe coughing. More often than not a "whooping" sound is heard with the cough. The disease is extremely dangerous to infants and small children. A similar epidemic in California claimed the lives of seven babies.

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It has become a trend in the United States for those with little or no insurance to use ERs as primary care physicians. This trend has overcrowded emergency rooms, placed extreme pressure on ER staff and unfortunately harmed patients who did not need to be harmed. In an effort to reduce ER visits, President Obama and Congress passed health care reform. The reform offered millions of previously uninsured Americans insurance.

Hospitals have also devised ways to reduce emergency room crowding. In some hospitals have placed ER doctors and triage nurses in the emergency room entrance to diagnose and treat patients with less severe injuries before they can be admitted to a hospital bed. Hospitals have also experimented with "hallway medicine." Patients were placed on gurneys in hospital wings to wait for rooms rather than waiting in the emergency room.

Some hospitals have decided to post wait times on hospitals billboards and text potential patients the wait time. Hospitals are hoping that patients will avoid long wait times and drive farther to attend emergency rooms with a shorter wait time. Those with the most severe injuries will still be attended to first but patients with less severe injuries can weigh their options and choose an ER with a shorter wait time.

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A new study released in JAMA shows that the number of annual emergency department visits between 1997 and 2007 increased from 94.9 million to 116.8 million -- nearly twice as much as would be expected for population growth.

Also published recently was the Department of Health and Human Services' 2007 Emergency Department Summary (.pdf file here). Lots of interesting statistics.

Most of the increase in ED visits were due to Medicaid patients. One quarter of the 117 million visits to the emergency department in 2007 were made by patients with Medicaid or SCHIP. Seventeen percent of visits were covered by Medicare. In other words, 42% of hospital ED visits (50 million or so) are paid for by the state or federal government.

The graph to the right from the San Francisco Chronicle shows how emergency department use by Medicaid patients is now more than five times the rate of emergency department use by patients with private insurance - and since they are from 2007, these numbers don't include the impact from the recession.

Further breakdowns in demographics from the DHHS report include high ED utilization rates for children less than 1 year old (88 visits per 100 US infants), patients older than 75 (62 visits per 100 US persons), homeless persons (72 visits per 100 population), blacks (74.6 visits per 100 black persons), and nursing home residents.

In addition, the number of "safety net" hospitals - defined as those who treat patients regardless of the ability to pay - increased by more than 40% from 2000 to 2007.

Before you start blaming Medicaid patients for health care crisis, think about why there is a disproportionate use of emergency departments by Medicaid patients. If you or your child has a medical problem and few private physicians will accept your insurance, what are you supposed to do? You go to a place where they will accept your insurance and you get relatively timely care (as opposed to an appointment 4 months in the future). Although there are undoubtedly people that abuse the Medicaid system, in general, it isn't the patient's fault for having Medicaid. It is the fault of the government for failing to adequately fund and monitor the Medicaid program.

With the increase in visits, there are longer waits and less availability of medical care.

An IVC filter is a cage like device that is inserted in a major vein to prevent clots from reaching the heart or lungs. The filters are meant to be temporary but for many patients they become permanent. If an IVC filter is left in the patient for an extended period of time, the filter can grow into the vein making it impossible to remove. A permanent filter can fracture or splinter sending a piece of it to the heart or lungs, instantly killing the patient.

The FDA is putting the filters under further review but has received hundreds of reports of patients living permanently with temporary IVC filters. Some of the complaints have ended in death. IVC filters are implanted into patients with a high risk of clotting. Patients who are immobile due to a spinal cord or traumatic brain injury may also have an IVC inserted into a vein.

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New Jersey FamilyCare provides health insurance coverage to low income families for little to no cost. According to the company families will receive coverage up to one month after submitting claims to get coverage; however some families are waiting longer than six months.

Unfortunately, those families and individuals without health care coverage do not receive optimal care when they visit emergency rooms. Health care reform was passed to address this problem but many families across the country are met with piles of paper work that lead to nothing but heart break and aggravation.

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After reports of heart risk surfaced in 2007, GlaskoSmithKline agreed to conduct an extensive study on the medication that would enroll 16,000 patients. So far only 1,100 patients have volunteered for the study and the FDA is refusing to let any new patients volunteer.

A "partial clinical hold" has been placed on the study after an FDA panel agreed Avandia increases the risk of heart problems for diabetes patients taking the medication. The same panel ruled to leave Avandia on the market and to allow the study to continue. The hold was issued to allow researchers time to digest the recent information released by the FDA on the dangerous side effects associated with the drug.

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FDA issues hold on Avandia study

Avastin was approved in 2008 for breast cancer after a study showed that it delayed the progression of the cancer by five months. The approval was controversial because it did not show to extend patients' lives. In a caveat to approval, the manufacturer of Avastin, Roche, was obligated to conduct two follow up studies.

The results of the follow-up studies were not promising. When added to conventional chemotherapy, the drug no longer delayed the progression of cancer and had no impact on the lifespan of patients. Alarming side effects were also discovered in the study. Patients saw an increase in blood pressure and fatigue with an abnormal level of white blood cells.

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The advisory panel agreed that Avandia does in face increase the risk of heart problems; however the panel voted 20-12 to keep the drug on the market. A similar Food and Drug Administration committee voted 22-1 in 2007 to keep the dangerous drug on the market. The panel believed that the evidence was not strong enough and further studies would be needed to make a final decision on the diabetes medication.

Avandia was approved for use by the FDA in the 1990s based a relatively small study of several thousand patients. The small study showed the drug was effective in increasing the body's sensitivity to insulin and helping patients control blood sugar levels. The small study was not able to show the side effects associated with the drug. Now the FDA will only approve drugs based on larger groups of patients that contain those at higher risks. Currently the FDA and GlaskoSmithKlie are conducting such a study on Avandia.

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Report: Avandia Maker Hid Risks For 11 Years

Internal e-mails from GlaskoSmithKline (GSK) the maker of Avandia, suggest that in 1999 the first comparative study was down between Avandia and its rival Actos. The results of that study suggested that Avandia increased the risk of heart problems in patients when compared with Actos. A top executive at GSK stated in an e-mail that the results of the study should remain internal.

Avandia is currently under heavy scrutiny from the Food and Drug Administration after numerous studies have linked the drug to an increased risk of heart problems. People suffering from diabetes are already at an increased risk of heart attacks and other serious heart problems.

In 2007, a warning label was added to the drug to inform doctors and patients of the serious heart risks associated with the medication. The FDA will convene next week to discuss the future of the drug. Some options to be considered include: pulling the drug from the market, limiting the type of physician that can prescribe the drug and/or adding more warning labels to the drug.

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The new health care bill will insure 32 million Americans and add 16 million patients to Medicaid. Medicaid patients are by far the largest consumers of emergency room and such a large addition may place a strain on the already under staffed and over worked emergency room. The study also found that there is a shortage of family care physicians in the neighborhoods where the majority of the newly insured live.

Longer wait time at the emergency can be a matter of life of death. Also the more patients using the emergency room for situations that are not an emergency can cripple the staff and send many away without proper care.

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Researchers studied the health records of 230,000 patients who take Avandia or its competition, Actos. The average age of those in the study was 74. Results showed that 27% were more likely to suffer from a stroke, 25% more likely to have heart failure and 14% were more likely to die on Avandia when compared with Actos. Doctors in study believe that if 60 people are treated with Avandia over Actos there were be one unnecessary heart attack, stroke or death.

Avandia has been linked to heart problems since 2007. It has come under recent fire from the Food and Drug Administration and may be pulled from the market. It is estimated that 100,000 have unnecessary suffered from a heart attack, stroke, or death since 1999. Many health organizations have urged those suffering from diabetes to stop taking Avandia and the FDA has scheduled a hearing on the safety risks of the popular diabetes medication.

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Lupus is a chronic disease that causes a person's immune system to attack the skin, joints, blood, kidneys, memory, and other parts of the body. There are a host of treatment options available to patients that control symptoms and side effects but no drug exists to combat the disease.

Doctors and researchers at GlaxoSmithKline have developed an intravenous medication, Benlysta, to specifically target the cause of lupus. Lupus is caused by harmful antibodies called B-cells and Benlysta treats lupus by inhibiting the stimulation of B-cells.

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The FDA approved the drug in 2000 after early trials showed the drug slowed the spread of leukemia. The drug was approved for patients over 60 with relapsed leukemia and bone marrow cancer. A study in August 2009 showed that the drug did not slow the disease from spreading but may have actually accelerated the process. More deaths were reported to the FDA of patients taking the medication in conjunction with chemotherapy when compared to those only using chemotherapy.

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Risk Factors
1. Uncontrolled High Blood Pressure raises the risk of a stroke by 250 percent. Adults need to constantly monitor their blood pressure and talk to their doctors about medications to control it.

2. Smoking raises the risk of a stroke by 200 percent.

3. A bad waist to hip ratio is the third leading risk factor of a stroke. Your waist should not more than 80 percent as wide as your hips.

4. A poor fruit and vegetable diet. Adults should consumer five to six servings of fruit and vegetables a day.

5. Laziness checks it at the 5th leading cause of a stroke. Just twenty minutes of exercise a day, even just walking, will help protect your brain from a stroke.

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The vaccine works by adding molecules to the patient's own white blood cells to train the body's immune system to fight off the cancer. Six weeks of injections creates an immune response to the cancer and the body starts killing off the cancerous tumors. It is unknown how long the body can fight the cancer but early trials are promising. Once the initial trials are complete the doctors want to use the treatment to prevent cancer rather than just fight off existing cancer.

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