Health Business Blog

This is a guest post by Sarah Scrafford, who regularly writes on the topic of Online Ultrasound Technician Schools. She invites your questions, comments and freelancing job inquiries via email: sarah.scrafford25@gmail.com

Cancer is one of the few diseases that has always been one step ahead of medical technology and research. While we do have a large amount of information about the disease, we’ve hardly explored the tip of the iceberg – there’s still a whole lot that we don’t know, and we lack a cure. We know that chemotherapy and radiation help to kill the cancer cells and we know that detection at an early stage increases chances of survival. But we don’t know why certain people get cancer and others don’t. We don’t understand why some forms of cancer are not detectable until it’s too late to do anything about them, and we certainly are far from finding a definite cure for this dreaded disease.

One area where we have made advances though, is in the early detection of some forms of cancer. Women have been plagued by breast cancer for ages, and it’s only now that they’re waking up to the fact that they can be completely cured if only they detect the malignant growth early. While mammograms are used as a matter of routine to check if the breasts have cancerous lumps, not many people know that an ultrasound scan of the breasts can be just as effective as a mammogram if not more so.

Here’s why a breast ultrasound scores over mammography:

• Unlike mammograms that use X-rays, ultrasound does not use radiation (it uses mechanical waves) to detect the presence of cancerous tissue and cells. Radiation, in large amounts, may harm your cells and make them cancerous.
• Mammograms search your breasts for microcalcifications only, while ultrasounds detect the shape and texture of these microcalcifications as well.
• It’s relatively inexpensive and available at most hospitals and healthcare centers.
• It’s painless when compared to a mammogram, which some patients say is a little painful.
• An ultrasound can detect if a lump is benign or malignant, something that a mammogram cannot.
• It scans the whole breast while a mammogram does not cover the entire area.
• A mammogram does not work efficiently for breasts that are dense.
• Ultrasounds with color pre-processing options show contrasts in the scan pictures more sharply and are hence used for a more specific diagnosis.
• Ultrasound does not require compression of the breasts, and this is why it’s a more comfortable procedure.
• Ultrasound produces images of high quality that make the identification and localization, and hence treatment, of the cancer, easier.
• An ultrasound can differentiate between solid tumors and cysts filled with fluid.

Even with all these advantages, ultrasounds are not used frequently as a detection method for breast cancer because of the high percentage of false positives.

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I’m on vacation this week and probably won’t post (much). Enjoy the end of 2006.

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In September the Journal Nature started allowing online comments. On the surface it sounded like a promising idea –getting papers out sooner and allowing a wider range of commentary– but as I asked in Nature opens the peer review door a crack. Will anyone step through?– it didn’t get off to a promising start:

I don’t see a single comment on the 10 pages that are listed on the Nature site.

Now the program has been withdrawn due to lack of interest. It’s not as easy as it may look to generate mass use of a tool like this even for a prestigious journal. One of the problems is that Nature was too restrictive on who could post and how the comments would be moderated.

In announcing the discontinuation, Nature’s editors said they found the majority of scientist-authors were unwilling to post their papers or were unwilling to criticize peers’ work publicly by posting comments on Nature’s Web site.

Of the 1,369 short-listed papers submitted during the four-month trial, authors of 71 papers were willing to post their work online, Nature said, receiving 92 technical comments.

The Public Library of Science’s PLoS ONE is starting to ask for questions and comments as articles are posted. PLoS is much more attuned to user participation and their experiment is more likely to succeed, based on a quick look at their guidelines.

We’ll see.

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Check out the latest Cavalcade of Risk blog carnival at InsureBlog.

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A new National Institute on Drug Abuse survey reveals that 4 to 7 percent of teens report using cough syrup with dextromethorphan to get high. It’s the first time the survey has asked about this drug, so it’s hard to know whether the trend is up or down.

Bulk sales of raw dextromethorphan to consumers are in the process of being banned at the Federal level. Meanwhile  the Consumer Healthcare Products Association (the association of OTC manufacturers) is spearheading an awareness campaign about dex abuse. They quite rightly want to keep cough syrup from going the path of Sudafed.

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Jay Ragley of the National Federation of Independent Businesses makes a good case for Small Business Health Plans and other measures –such as a relaxation in mandated benefits– that would make it easier for smaller companies to provide health insurance.

You can read his editorial in South Carolina’s Greenville News.

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The Health business blog has moved to www.healthbusinessblog.com. After almost two years and more than 1000 posts, I’ve also decided to switch from Blogger to WordPress. Blogger served its purpose, but it had a number of maddening problems that I’ll be glad to put behind me. So far I have only good things to say about WordPress.

Blogger has just launched a new version of its software, which promises to fix many of the earlier glitches. From what I’ve seen it still won’t match WordPress. In addition, Blogger is being more closely integrated into its corporate parent, Google. Google is an amazing company but I am wary of them. I’d just as soon keep my distance.

If you get the Health business blog via RSS feed and you use the Feedburner feed (http://feeds.feedburner.com/Healthbusinessblog) , you don’t need to do anything –your feed will still work. If you use the http://www.mppllc.com/pages/atom.xml feed, please subscribe to the Feedburner feed or use http://www.healthbusinessblog.com/?feed=rss2.

I’ll be leaving the old blog up, I just won’t be updating it. So if you have linked to any old posts you’ll still be able to access them.

If you have any questions or comments about any of this, send me an email: dwilliams@mppllc.com.

Thanks for your readership and I look forward to your visits to the new Health business blog.

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Babies with “short bowel syndrome” are fed intravenously to keep them alive. Unfortunately prolonged IV feeding often leads to liver failure. Doctors at Children’s Hospital in Boston haven’t been satisfied with that trade-off and have experimented with a variety of ways to avert liver problems. A particularly promising remedy is to use Omegaven, a fish-oil based formula that’s on the market in Europe (for adults) but not the US.

Omegaven’s maker, Fresenius AG doesn’t want to market Omegaven here. Basically, they’ve decided it’s not in their commercial interest. Instead Fresenius has a new product in development that they’d prefer to bring to market. Meanwhile Fresenius is happy to sell its existing product, Intralipid. That’s tough luck for babies who need treatment now. Fresenius has actively resisted efforts to allow testing of Omegaven, and the FDA hadn’t been too helpful either. The Wall Street Journal wrote an article on the topic (A Doctor’s Push For Drug Pits Him Against Its Maker) a month ago.

Now, according to another Wall Street Journal article (Trial to Test Drug for Sick Babies) the trial is going ahead. The FDA relented and The March of Dimes stepped in with funding. The trial will pit Omegaven against Intralipid. Babies who start on Intralipid will be able to switch to Omegaven if they develop liver damage. Likewise babies starting on Omegaven will be able to switch to Intralipid if they have problems.

Meanwhile Fresenius is getting a free lesson in how not to build a corporate reputation in the US.

Based on what I read in the Journal, I’m going to make a donation to the March of Dimes, and I suggest you consider doing the same. The donation link is here. (MedImmune is matching donations dollar for dollar during December, up to $50,000.)

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The Henry Ford Health System is banning free lunches and gifts by pharmaceutical and medical equipment sales reps, starting January 1, according to the Detroit Free Press. Representatives will also have to schedule appointments with physicians and pay a $100 certification fee to Henry Ford before being allowed to do so.

“The evidence shows that when physicians are exposed to pharmaceutical representatives, their decisions are different,” Dr. A. Mark Fendrick, a U-M drug price specialist, told the Detroit Free Press. “It is very unusual to find generic drugs in a physician’s sample closet.”

The program is portrayed as a way to keep industry in line, but I look at it as part of the maturation of the relationship between pharma and docs. Sales reps buy lunch and provide gifts because doctors want that to happen; many expect it as a kind of entitlement. It’s just as well to have that practice end. I’d suggest Henry Ford use that $100/rep tax to fund an education program for physicians to help them get the most out of their interaction with drug reps. Maybe an online course to explain industry economics and help doctors ask the right questions.

There are at least a couple of companies I can think of that could benefit from Henry Ford’s decision:

• PreferredTime, which schedules rep appointments with physicians
• Medvantx, which makes machines that provide generic samples in doctors’ offices

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Grand Rounds, the best of the week’s medical blogging, is up at Nurse Ratched’s Place. Check out the Christmas theme.

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