Merry Christmas: Mistletoe extract being used for colorectal cancer treatment in Europe, could be a great boon for Kentucky

Kentucky has one of the highest rates of colorectal cancers in the nation, with about 50 of every 100,000 Kentuckians being diagnosed with the disease each year. The state also ranks among the worst in colorectal cancer deaths, with 18-20 deaths per 100,000 annually. So perhaps Kentuckians should care more about some research that was announced as seasonal fare: using mistletoe extract in chemotherapy. (Wikipedia image)

At the University of Adelaide, scientists found that an extract from mistletoe grown on ash trees was found to be highly effective against colon-cancer cells in cell cultures and was gentler on healthy intestinal cells compared with chemotherapy. In fact, the extract was found to be more potent against cancer cells than the chemotherapy drug. It has been authorized for use by sufferers of colon cancer in Europe, but has not been allowed yet in some countries such as Australia and the United States due to a lack of scientific testing. (Read more)

We should note that the leaves and berries of some mistletoe species are mildly toxic. The plant is parasitic, growing on trees and forming green clumps that are highly visible this time of year and popular as Christmas decorations, especially at the top of doorways, where tradition calls for anyone standing under the mistletoe to be kissed.

American Lung Association calls state's tobacco-cessation benefit inadequate now that Medicaid is under managed care

Kentucky added a robust tobacco cessation benefit to its Medicaid program, only to lose much of it in 2011 by putting the program under managed care by insurance companies, the American Lung Association notes in its annual report. Not only do their plans offer fewer treatments, explained the report, but information was confusing to patients and healthcare providers alike. The report also notes that the state -- which is not alone in this -- offers its smokers who desire to quit inadequate access to medications and counseling.

Robert Preidt of HealthDay reports that the U.S. Department of Health and Human Services late last month published a proposed rule that requires tobacco cessation as an essential health benefit under the Patient Protection and Affordable Care Act. The lung association report how states could put that rule to maximum use. "Giving all smokers access to a comprehensive cessation benefits is not only the right thing to do, it's the smart thing to do," Billings said. "The bottom line is that quitting smoking saves lives and saves money." One recent study, reports Preidt, showed that providing smokers with help to quit has a three-to-one return on investment, meaning $3 is saved for every for $1 spent. (Read more)

To see more about how Kentucky's tobacco cessation coverage rates, according to the American Lung Association, go here.

Health coalition asks Nickelodeon to stop marketing sugary and fatty snacks to children

A coalition of health groups thinks maybe it's time to enlist SpongeBob in the childhood obesity fight. Earlier this week, the groups asked the Nickelodeon Channel to stop airing commercials that promote unhealthy foods with the help of the doofy adorable sponge, among other lovable characters the children's channel employs. The letter the groups signed asked that Nickelodeon's parent company, Viacom, put in place strong nutrition standards for the foods marketed by it and by its characters. Their sentiment was strongly backed by the American Academy of Pediatrics.

Elise Viebeck of The Hill's Healthwatch blog quotes the letter: "Research shows that food marketing is an important factor contributing to children's poor diets and obesity. The majority of foods marketed to children remain of poor nutritional quality. The [federal Institute of Medicine] concluded that marketing puts children's health at risk." The letter went on to shake its finger at Nickelodeon for being behind Disney and other prominent child marketers on this front. (Read more)

This comes on the same day that the University of Missouri-Kansas City and the University of Kansas Medical Center release study results that found obese children may be more susceptible to food advertising than healthy-weight children, suggesting at least one reason the nation's childhood obesity rate could continue to climb as feared. (Read more)

Northern Kentucky included in Medicaid's pilot program to increase data about quality of health care

The Health Improvement Collaborative of Greater Cincinnati, which includes much of Northern Kentucky, is included as one of three regions to participate in a program designed to bolster availability of information about doctors, hospitals and health care providers, the federal Centers for Medicare & Medicaid Services has announced. According to the Robert Wood Johnson Foundation, the new program will match private data with Medicare claims data to create comprehensive reports on provider performance.  The other two organizations selected are Kansas City Quality Improvement Consortium and the Oregon Health Care Quality Corporation.

The program will place quality markers on those receiving Medicare claims data. For example, they must show that they can manage and process consumer-focused data, can prevent breaches of protected health information and that they are working with private insurers in order to produce comprehensive reports on provider performance. The program is also intended to protect patient privacy, enforcing strong penalties if Medicare data is misued.
(Read more)

Report: 110,000 Ky. youth 16 to 24 aren't in school or employed; state's rate of 'disconnected youth' exceeds U.S. average

Almost 110,000 teens and young adults in Kentucky are not enrolled in school and are not employed, even part-time, according to a new Kids Count report from the Annie E. Casey Foundation.  Nationwide, the number reaches nearly 6.5 million. In Kentucky between 2000 and 2011 the number of 16-19 year-olds not in school and not employed rose by 3 percent, but the number of idle young adults ages 20-24 climbed by a whopping 88 percent. Both rates exceed the national rate. (Getty Images)

The Kids Count report, "Youth and Work: Restoring Teen and Young Adult Connections to Opportunity," termed these 16- to 24-year-olds "disconnected." It found that they face many obstacles on their path to securing a stable financial future. For starters, many haven't finished high school and are competing with older Americans for the few entry-level jobs. In addition, they lack skills for higher-paying jobs. Many are poor and have attended under-performing schools. The report explains that, as such, this group can present a significant cost to taxpayers. (Read more) View the report here.

UK creates nation's first cancer-reporting system that uses electronic health records

Kentucky has the highest incidence of cancer in the United States, but it is about to be a national leader in delivering information about cancer cases to researchers.

With the help of an almost $1 million Centers for Disease Control grant, the University of Kentucky has created the nation's first working model for electronic reporting of cases to the state cancer registry. Kentucky's cancer doctors will be able to feed clinical data to the state's epidemiologists immediately so that they can see and analyze cancer statistics more quickly that ever before.

“This project is laying the groundwork for electronic reporting not only in Kentucky but across the United States,” said Eric Durbin, director of Cancer Informatics at the Kentucky Cancer Registry and one of the investigators who created the model. (Read more)

Study: Raising cigarette taxes does curb even heavy smoking

The more you raise cigarette taxes, the less people smoke. That presumption was confirmed this week in a study by the Washington University School of Medicine in St. Louis. This has some resonance in Kentucky, where just last week the state’s Blue Ribbon Commission on Tax Reform told Gov. Beshear the state should raise taxes on tobacco, to $1 per pack from 60 cents. Other forms of tobacco would get a corresponding tax hike, reports Beth Musgrave of the Lexington Herald-Leader. The changes would raise an estimated $120 million in revenue and, if the research is right, cut down on long-term health care costs.

The researchers are the most adamant about the last point. “Most clinicians and researchers thought these very heavy smokers would be the most resistant to price increases,” says study author Patricia A. Cavazos-Rehg, PhD. “But our study points out that, in fact, change can occur. And that’s very good news.” In fact, in states where taxes on tobacco products rose by at least 35 percent, heavy smokers -- who averaged 40 cigarettes a day or more -- lowered their daily smoking by 14 cigarettes, on average.  In real numbers, the price for a pack of cigarettes increased from an average of $3.96 in 2001 to $4.41 in 2004. (Read more)

In Kentucky last year, almost 30 percent of residents said they were smokers, the highest in the nation. The state also has the highest rates of diabetes and lung cancer, reports Jim Malewitz of Stateline News. Kentucky’s cigarette tax is also among the country's lowest.

Medical licensure board changing rules to focus more on painkillers; fewer urine tests for patients, fewer reports for doctors

Patients in long-term treatment with controlled substances won't have to have their urine tested for drugs unless they are on painkillers, and doctors will have wide discretion over how often to do the tests, under new rules being drafted by the Kentucky Board of Medical Licensure.

That is just one example of the changes that the board is making in regulations authorized by the "pill mill bill" the General Assembly passed this year, reports Mike Wynn of The Courier-Journal. Other changes will put more focus on medicines with the painkiller hydrocodone and exempt some medicines that have only small amounts of painkillers.

"While the bill focused largely on pain pills, the board’s regulations covered a wider range of medications, including the sleep aid Ambien and the anti-anxiety drug Xanax," Wynn notes. "The regulations also called on doctors to perform a much broader array of administrative tasks to determine the appropriateness of prescriptions and a patient’s risk for abuse or diversion." Now they will have to do less, making follow-up reports to the state drug-tracking system only when prescribing painkillers.

The board's director, Michael Rodman, told Wynn it is responding to complaints by physicians and lobbying interests who say the the rules are too complex and go too far. The board filed the new rules last month for approval by legislative committees, but says it is already using them to make enforcement decisions. House Speaker Greg Stumbo, who sponsored the bill, has endorsed the changes.

The doctors' lobby, the Kentucky Medical Association, has voiced its pleasure with the changes but says others are needed, such as parts of the law that require specific medical practices such as standards for prescribing. (Read more)

Kentucky hospitals score mostly Bs and Cs on hospital safety scorecard; most in U.S. earned an A or B

In an analysis of the nation's hospitals and their safety records, many of Kentucky's health care facilities have some shortcomings. A study by the Leapfrog Group finds that the vast majority of the state's hospitals score a B or C in overall patient safety, a term defined here by analysis of data on accidents, errors and infections as kept by the Centers for Disease Control, the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research. At least a dozen of the state's hospital earned an A rating. To check the grade of your own hospital, go here.

In this data analysis and grading system, 26 different points of criteria were used. Of the 2,618 hospitals reviewed, about 56 percent of the hospitals earned an A or B, and an additional 38 percent passed with a C grade. Only 6 percent of hospitals -- 146 total -- received a D or F. According to CBS News, at least 180,000 Americans die in hospitals every year from incidents that occur because of their stays there. (Read more)

Task force recommends changes to protect safety and health of middle school students who play interscholastic sports

The boys of North Marshall Middle
School of Benton, Ky., after winning
a Christmas tournament last year.

Beth Musgrave of the Lexington Herald-Leader reports that the state Task Force on Interscholastic Athletics at the Middle School Level announced its preliminary recommendations this week to address concerns about young athletes' health and safety. It seems that middle school sports in Kentucky have never had the advantage of being governed by a unified code of rules and policies like their counterpart in high school sports. This has led to a confusing mish-mash of guidelines that the legislature is setting out to get right in the coming year.

Preliminary task force recommendations include requiring all middle school teams to follow high school rules on physical exams, medical coverage, concussions and practicing during extreme heat, and requiring the tracking of injuries and incidents for all sports. The task force also suggested that the Kentucky Board of Education look to create a single governing body, like the Kentucky High School Athletics Association that governs high school sports, to oversee all middle-school sports. Wilson Sears, executive director of the Kentucky Association of School Superintendents and a task force member, told Musgrave that the recommendations represent "real progress." (Read more)

The world is getting fatter, but Kentucky's rate of obesity is two and a half times the world rate

Take no solace from The Economist, which proclaims in its yearly analysis-and-prognostication issue that this is the year world leaders will take on worldwide obesity because, writes Charlotte Howard, "they will realize something must be done."

So, no, it is not just you, Kentucky. In fact, Howard, the health-care correspondent for the magazine, writes that 30 percent of Mexico's adult population is obese. That is precisely the same percentage of Kentuckians that were considered obese by a Robert Wood Johnson Foundation and Trust for America's Health analysis released in August. (We ranked sixth fattest state nationwide.) It is also the same percentage of Chinese adults that are, as Howard put it, "too wide" -- a term that Howard uses here to include the overweight as well as the obese.

But there is no room to crow here. Kentucky is far ahead of the trend. Only 12 percent of the world counts as obese today. We beat that two and half times over. (The number of Kentuckians who were merely overweight was not calculated or included in the figures in the study.) A study released in September by the same group found that if trends continue, 60 percent of Kentuckians will be obese by 2030. The World Health Organization's estimate of the world's obesity was at 15 percent by 2020.

The Economist folks favors an approach that a democratic path to better health and fiscal sanity, given the health care cost ramifications of obesity. They like a tax on soda -- it's pure sugar, no real nutrition. They like subsidies to make fresh produce cheaper. And they like better school lunches and labeling, labeling, labeling so consumers will make better choices.

UK study: Old, perhaps obsolete heart drug increases deaths in patients with atrial fibrillation

A drug widely used against heart disease can increase the possibility of death when used by patients with atrial fibrillation, a common heart rhythm problem, according to a study by University of Kentucky researchers. Digoxin, a derivative of the foxglove plant, is an old yet controversial heart drug. Though considered obsolete by some, it is still widely used.

The study, published in European Heart Journal, analyzed data from 4,060 atrial-fibrillation patients. It was led by Dr. Samy Claude Elayi, associate professor of medicine at UK HealthCare's Gill Heart Institute. The results of the study indicate that further review by the Food and Drug Administration is warranted to determine if stronger warnings about its use should be required. (Read more)