What you need to know about news headlines claiming flu causes heart attacks

  Joy Victory is deputy managing editor of HealthNewsReview.org. She tweets at @thejoyvictory.

The big news of the day is a Canadian study looking at patterns in hospital data that link the timing of hospitalization for heart attacks and flu infections.

illustraion of someone in bed with flu for article, What you need to know about news headlines claiming flu causes heart attacksThis study zeroed in on the medical records of people who, over a two-year period, had both confirmed diagnoses of heart attacks and flu during that time window.

They found that during the first week following a positive flu test, heart attacks were more common than in any other week of the two-year timeframe that they looked at. Twenty heart attacks occurred in that first week, compared with an average of 3.3 heart attacks for all other weeks (a “six-fold increase”). The timing of those twenty heart attacks suggests that the flu may have played a role, the researchers suggest, and that link is what most news headlines reporting on the study latched onto.

By including the comments from an independent source, STAT News did a good job of explaining why this six-fold risk is newsworthy, but doesn’t translate to the general population. They pointed out that people who are sick enough to see a doctor and get tested for the flu virus are likely different in important ways from people who don’t get so sick from the flu. Results from these people may not generalize to the rest of us.

Many news organizations didn’t provide any counter-balance, and NBC News’s write-up was especially worrisome, because its headline jumped beyond the capabilities of the study to pronounce “flu virus can cause heart attacks.” The study wasn’t designed to show cause and effect; all it could do was find notable patterns in medical charts.


Eric Topol’s Top 10 Tech Advances Shaping Medicine


January 11, 2018

Each year, I look back at the top 10 tech advances that made headlines the previous year, and these technologies promise to revolutionize medicine in the coming year. Here they are, not in any particular rank order.

1 and 2. Gene Therapy and Gene Editing

These two biotechnologies are being used in clinical trials for diseases that once were deemed untreatable but now are believed to be curable someday, largely due to these important new tools. First, let me differentiate the two because there is considerable conflation and confusion about what they mean.

Gene therapy scored some rapid-fire successes this past fall[1,2,3] after a 20-year “winter” during which things looked pretty bleak and even some advocates feared that there might never be a comeback. On December 19, 2017, the US Food and Drug Administration (FDA) approved the first gene therapy that targets a disease caused by mutations in a specific gene. The treatment, voretigene neparvovec-rzyl (Luxturna™; Spark Therapeutics), is delivered surgically via subretinal injection to treat a rare form of inherited vision loss that can lead to blindness.

As for genome editing, ex vivo manipulation of T cells for leukemia[4] and HIV[5] has been used for several years, but the first case of in vivo editing was performed just this past November in a 44-year-old man with Hunter syndrome. We do not yet know the outcome.

3. Deep Learning of Skin Cancers

Esteva and colleagues at Stanford University created a deep-learning algorithm to diagnose skin cancer, and then tested it against 21 board-certified dermatologists. As they reported in Nature ,[6] the algorithm matched the clinicians’ ability to correctly identify malignant and benign lesions.

This represents an “in silico” demonstration or computer modeling of a biological process; a prospective real-world study in patients will be necessary to assure that the very high accuracy of the deep-learning algorithm is clinically validated. If it is, the developers hope that it can then be transitioned to mobile devices and that the visual diagnosis technology will be used in other fields as well.

4. “Panoromic” Cancer Evaluation

Last year I was able to visit Tempus Labs, a Chicago enterprise operated by Eric Lefkofsky, the co-founder of Groupon. He launched Tempus in 2015 after his wife developed breast cancer and they were unable to find a place for her to undergo a comprehensive evaluation.

Now, Tempus is collaborating with most of the National Cancer Institute’s comprehensive cancer centers in the United States and providing across-the-board cancer testing: sequencing of patients’ tumors and germline DNA; liquid biopsy of cell-free DNA; RNA sequencing of tumors; immune system characterization of tumors and patients; organoid cultures of tumor cells with drug testing; machine learning of all of these layers of information with the electronic medical record; pathology reports; and all medical imaging.

Previously, some companies offered isolated tests, but this is the first one to do them all. We await publications that spell out whether this rigorous, multilayered information approach will change patient outcomes.


More Evidence Links Gum Disease to Stroke Risk


     January 19, 2018

A new study has strengthened the link between gum disease and increased risk for future stroke, showing a graded relationship with the extent of gum disease and stroke risk, and in addition finding that regular dental care was associated with a lower stroke risk.

“This effort is one of the largest, US-based community studies of periodontal disease, dental care utilization, and ischemic stroke,” lead author, Souvik Sen, MD, University of South Carolina School of Medicine, told Medscape Medical News.

info graphic for gum disease stroke link for article, More Evidence Links Gum Disease to Stroke Risk“Our results show that individuals who regularly attend the dentist had half the stroke risk of those who do not receive regular dental care,” he said. “And our study of periodontal disease showed the more severe this is, the higher the risk of future stroke.”

In particular, periodontal disease characterized by increased inflammation had the strongest association with stroke risk. “The risk conferred by gum disease is similar to that of high blood pressure —  it is in the range of two to three times increased risk,” he added.

The relationship between gum disease and myocardial infarction is already well established, and previous studies have shown an association between gum disease and stroke, he said. “Our current results strengthen that link. If causal, these associations would be of great importance because of the potential that periodontal disease treatment could reduce the stroke risk.


Strengthening Workplace Health, One Resource at a Time

Use CDC Workplace Health Resource Center to help employees improve their health.

Isabel Kurita of the Boise School District in Idaho promotes healthy lifestyles among employees to lower risks like obesity that may lead to chronic diseases like diabetes. “We have the same concerns as everyone else in the country when it comes to health risks. We want to make sure we have behavior change programs to reach as many people as possible.”

The wellness coordinator for 3,200 employees and retirees, Kurita was happy to find a new place for good ideas and tools to improve her team’s health.

photo of employees in break room for article, Strengthening Workplace Health, One Resource at a TimeIt’s the Workplace Health Resource Center (WHRC), a new website CDC launched in August 2017 with more than 200 tools to help employers build their wellness programs—from breakroom posters to guides on how to reduce heart disease and stroke.

WHRC offers these free resources for organizations to help employees with high blood pressure, high cholesterol, diabetes, depression, obesity, smoking, and other health concerns.

CDC introduced the new website at the Public Health Grand Rounds, a monthly series created to encourage discussion on major public health issues like workplace wellness.

Worksite Health Scorecard logoCDC Worksite Health ScoreCard has science-based strategies to help prevent heart disease, stroke, and other conditions.

New Workplace Health Resource Center

CDC and other health and wellness experts continually screen new information to add to the website. A one-stop shop for workplace health promotion and wellness tools, the WHRC includes:

  • Tutorials on how to start a workplace health promotion program that fits each organization’s needs
  • Webinars
  • Videos
  • Case studies on what has worked for other employers when it comes to fitness, obesity, stress management, quitting smoking, and work/life balance strategies.[SEE FULL STORY HERE]

Confusion reigns on Good Morning America’s ‘complementary natural’ flu remedies report

by Kevin Lomangino, managing editor of HealthNewsReview.org.
He tweets as @KLomangino.

Talk of the widespread and dangerous flu circulating this year has the public on edge and hungry for quality information about how to protect themselves.

ABC’s “Good Morning America” isn’t helping with this segment featuring Chief Medical Correspondent Jennifer Ashton, MD, titled “3 complementary natural remedies for the flu.”

It’s a mess of conflicting messages about herbal approaches to managing flu symptoms. And it positions Ashton — an ABC physician-journalist who’s brought in to report the story — as the only expert perspective about the effectiveness of these products.

Where were the independent sources?

Is Ashton — an ob/gyn — uniquely qualified to assess the anti-viral activity of oregano oil, olive leaf, and elderberry?

If not, then why is she the only one offering an opinion about whether or not these products are effective?

A sampling of Ashton’s head-spinning statements about these products make it clear why another voice was necessary.

The segment starts out with Ashton issuing some common sense-sounding disclaimers:

  • “There’s not yet peer-review, evidence-based medicine that supports the use of alternative or complementary therapies in the battle against the flu.”
  • “…especially with children and pregnant women and children, this is not recommended without the consult and advice of your health care provider.”

But then she quickly pivots to discussing oregano oil’s “antiviral, antibacterial, and anti-inflammatory properties” and instructing viewers how to take it.


Success stories in driving up adult immunization rates

As we continue to lead longer and healthier lives, too many Americans aren’t taking advantage of an easily accessible set of tools that could protect their well-being into old age: adult vaccines. As a nation, we’ve embraced a regular schedule of vaccines for our children. But science shows that they are proven life-savers for us grown-ups, too.

The numbers are staggering: tens of thousands of Americans die each year from flu while another 200,000 people will be hospitalized with the disease.

Some 19,000 people over 65 will die from pneumococcal pneumonia, which also puts 200,000 people in the hospital each year and adds $5.5 billion in disease-related costs.

CDC adult immunization schedule for article, Success stories in driving up adult immunization rates
2015 Adult Combined Immunization Schedule – United States

And every year a million people in the U.S. will get shingles, a viral infection that will strike one in three Americans during their lifetime.

Every one of these diseases is vaccine-preventable. The problem is that vaccination rates for adults are way below public health targets, risking the health of hundreds of thousands of adults and threatening to drive up the nation’s health care costs.

Healthy People 2020, a 10-year initiative to improve the health of all American adults, set an immunization goal for influenza at 70 percent. But during the 2015-2016 flu season, only 42 percent of people 18 and older got the vaccine, according to the Centers for Disease Control and Prevention.

For pneumonia, the CDC found that 61 percent of adults 65 and older, the most vulnerable population for the disease, said they had ever received a shot for pneumococcal pneumonia, short of the Healthy People 2020 goal of 90 percent.

And while the CDC recommended that all adults over 60 get the vaccine for shingles, only one in five got the shot between 2007 and 2013.  Last October, FDA approved a new and far more effective shingles vaccine, and the CDC now recommends that adults 50 and get vaccinated against the disease, with the goal of driving up rates to protect more people from this painful and debilitating disease.


Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 1

Here’s the first installment from the Conference by Michael Stack , CEO of Amaxx.

January 9, 2018

“We’re about a month out from the conclusion of the National Work Comp and Disability conference held again this year in Las Vegas, back at Mandalay Bay. The general theme of the conference itself was really focusing on much of what, frankly, I teach and believe in, which is really the outcomes for the injured workers that drive down workers’ compensation costs, creating a true win-win scenario. I want to talk to you about my top five takeaways from the sessions that I attended.”



Take Away #1: Alliance of Woman in Workers’ Compensation

logo for Women's in Workers' Compensation Leadership Forum for article, Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 1Let’s talk about takeaway number one, which comes from the Alliance of Women in Workers’ Compensation Leadership Forum which was held the day before the official conference started. Now, the presentation was given by Margaret Spence. Margaret did a tremendous job at that presentation and at that leadership forum. To be frank, it had a fairly big impact on my own life in this past 30 days. Let’s talk about some of the things that she discussed and while this presentation was obviously directed towards women. Obviously, I’m not a woman, so I can’t fully appreciate and empathize with the experience of a professional woman in today’s environment or in the years past.

But I will tell you that the stories that she was describing, some of the challenges that women face, that she described both in the past and, currently, today in 2018 was a bit disheartening. It was a bit disheartening to hear that that still exists in our world, particularly, as I’m raising two young daughters. From my perspective, one of the underlying themes as it was given from the female perspective was to acknowledge and appreciate the struggles that women have come through and still face today, But having the courage and the confidence to break through it. One thing I’ll add from the male perspective and the perspective I think is very similar.

From the male perspective to appreciate and acknowledge the struggles that women have faced in the past and often continue to face today, but having the confidence and the courage to break through that, because while some of those prejudices may still exist in our world today, they should not exist in your world. If you take an honest and genuine look at yourself, and you see that those prejudices still exists in your world then you need to take the steps to correct it.


Employee Screening Tools

Tools employer can use to pre-qualify applicants include:

  1. Medical testing identifies applicants who have medical limitations. All testing must be done after an offer of employment is made and must be job-related. For example, a hearing test establishes a baseline if later on a hearing loss is alleged.info graphic of global employment screening practices for article, Employee Screening Tools
  2. A baseline hearing test allows the employer to practice pro-active safety by protecting employees from further hearing loss by requiring the use of sound protection devices. Pay special attention to older employees who may be more sensitive and somewhat in denial about their hearing loss. A worker may not acknowledge an inability to hear instructions from supervisors or co-workers and may need printed instructions to understand directions. Remember – hearing loss due to the workplace environment is an occupational injury and is compensable.
  3. Applicants demonstrate job abilities where all new hires show they can safely perform the job.
  4. Personality profiling provides insights into the values, ethics, and behavioral characteristics of the potential employee, including an entitlement mentality, theft, deception, cheating, drug use, dishonesty, hostility, and propensity to violence.
  5. Background Check includes hidden criminal records, drug arrest, prior employment history, prior academic achievements, prior names and addresses, prior workers’ compensation claims, and credit history.

    [More tips on reducing your Workers’ Comp costs here}

Start the New Year Off Right With an Ergonomic Review

Blog Editor’s note: You can schedule a complimentary ergonomic review with the Physical Therapy Office at Central Coast IndustrialCare at ‭(805) 922-5003‬.

January 4, 2018 by Michael Stack

The New Year provides employers an opportunity to re-examine the issue of ergonomics in the workplace.  Making sure that workplace ergonomics is in place for all employees not only improves workplace morale but can reduce the costs of workers’ compensation claims in the future.

What is Ergonomics?

Defined by Webster, ergonomics is the “the study of people’s efficiency in their working environment.”  This study includes a review of workstations and job functions to reduce muscle overuse, correct poor posture and eliminate injuries cause is repetitive work activities.  It can also include a review of policies and procedures that seek input from a varied of interested stakeholders—include the person perform a particular work function.  It is important to include a review of tools used on a daily basis and other intangibles including, but not limited to workspace lighting.

illustration of correct ergonomics for office worker for article, Start the New Year Off Right With an Ergonomic ReviewImplementing an Effective Review

A proper ergonomics review includes the use of different specialists and stakeholders.  Beyond using a qualified specialist, it is important to include input from company management and employees performing job functions.  This review can also include a review of available resources and budget constraints.

It is also essential to understand the demographics of your labor force.  Studies show that Americans are working into their later years.  This is resulting in more severe injuries from repetitive type injuries that lead to longer periods of disability.  Factors to consider when addressing this issue include:

  • Age discrimination laws that prevent employers from engaging in unlawful labor practices;
  • State and federal OSHA laws and regulations; and
  • Addressing injury and post-injury response.


The Significance of Maximum Medical Improvement in Workers’ Comp

How MMI can both reduce your Workers’ Comp costs and benefit the overall health and well being of employees.

December 13, 2017  by Michael B. Stack

The concept of “maximum medical improvement” (MMI) is an important notion in workers’ compensation claims.  This concept is based on the fact that it often triggers the discontinuance of various wage loss benefits.  In other instances, once an employee reaches MMI, cases are prime for settlement.  Failure to identify this status promptly can add unnecessary costs to claims and the bottom line of a workers’ compensation program.

doctor viewing exray on a tablet for article, Significance of Maximum Medical Improvement in Workers' CompWhat is MMI?

Maximum medical improvement (in some instances referred to “end of healing period”) is a legal concept where no further significant recovery from or lasting improvement to a personal injury can be reasonably anticipated, regardless of subjective complaints from the employee.  In essence, additional medical care and treatment may still be required to keep the employee in a stable condition, but no noticeable improvement will take place in that medical care.

Each jurisdiction has a legally defined standard for MMI.  This standard is defined in statute or rule and interpreted via case law.  Any doctor or health care provider can usually declare an injured employee to be at MMI if they have an adequate foundation to issue their findings and opinions within a reasonable degree of medical certainty.

Significance of MMI in Your Claim

Placing an employee suffering the effects of a work injury at MMI has a significant impact on the employee’s ability to receive future workers’ compensation benefits including entitlement to wage loss.  In some jurisdictions, it can reduce or limit the employee’s ability to receive future medical care via a workers’ compensation program.