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    <recommendedItem id="20100101_19_459"
                     title="Murtha Dead at 77"
                     score="0.013"
                     href="http://www.medpagetoday.com/Washington-Watch/Washington-Watch/tb/18388?impressionId=1265778730563"
                     
      &lt;p&gt;Representative John P. Murtha (D-Pa.), 77, long-time chairman of the House Appropriations Subcommittee on Defense, died yesterday afternoon from complications following a planned laparoscopic cholecystectomy, according to a statement from the congressman&apos;s office.&lt;/p&gt;
&lt;p&gt;He had been admitted to the intensive care unit at Virginia Hospital Center in Arlington on Jan. 31, days after surgeons at the National Naval Medical Center in Bethesda, Md., accidentally nicked his intestine during the operation, according to a report in &lt;em&gt;The Washington Post&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;In that same report, Rep. Bob Brady (D-Pa.), a close friend of Murtha&apos;s, said the congressman developed an infection and fever.&lt;/p&gt;
&lt;p&gt;Citing a request for privacy from the Murtha family and patient privacy laws, a spokesperson for the National Naval Medical Center declined to provide information on the operation.&lt;/p&gt;
&lt;p&gt;In a statement, Virginia Hospital Center said Murtha died &quot;despite aggressive critical care interventions.&quot;&lt;/p&gt;


  &lt;p&gt;Mark Malangoni, MD, surgeon-in-chief at MetroHealth Medical Center in Cleveland, told &lt;em&gt;MedPage Today&lt;/em&gt; that serious complications, including bowel damage and death, are not common following cholecystectomy. More complicated patients, such as the obese and diabetics, have a greater risk of complications and of a switch to an open procedure.&lt;/p&gt;
    &lt;p&gt;Death is extremely rare in healthy individuals, occurring in no more than one per 1,000 patients, according to the American College of Surgeons (ACS).
    &lt;p&gt;More common, but still infrequent, are bleeding and leakage of bile, both of which can be treated fairly easily, said Malangoni, a regent of the ACS.&lt;/p&gt;


&lt;p&gt;When the bowel is damaged, as reportedly occurred in Murtha&apos;s case, it typically occurs in two ways -- either from a sharp injury when the trocars used for a laparoscopic procedure are inserted or from a cautery burn.
    &lt;p&gt;Both types of injury can go unnoticed by the surgeon and may not become apparent for days after the operation, Malangoni said.&lt;p&gt;
    &lt;p&gt;Although he did not know the details of Murtha&apos;s case, Malangoni said a patient would usually be admitted right away, at least overnight, if the surgeon realized that an injury had occurred. The procedure likely would have switched from a laparoscopic one to an open one as well.&lt;/p&gt;


&lt;p&gt;A 2009 Cochrane Review comparing laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis found no difference in mortality in 38 trials. No patients died in the laparoscopic group and only 0.09% died in the open group.&lt;/p&gt;
&lt;p&gt;Severe complications were reported in 2.2% of the laparoscopic patients and 6.8% of the open patients.&lt;/p&gt;


 &lt;p&gt;Malangoni said most surgeons become experienced with performing laparoscopic cholecystectomies before completing their residency; most will perform 40 or 50 by the end of training.&lt;p&gt;
    &lt;p&gt;&quot;It is a very common operation, so once out into practice, most general surgeons are doing dozens of these each year,&quot; he said. &quot;So your experience comes about pretty quickly.&quot;
    &lt;p&gt;It is unclear how much experience Murtha&apos;s surgeon had.&lt;/p&gt;

&lt;p&gt;Murtha had recently become the longest serving member of Congress in Pennsylvania state history.&lt;/p&gt;
&lt;p&gt;First elected in 1974, Murtha, a former Marine, was the first Vietnam War combat veteran to serve in Congress, and he served as an advocate for the military throughout his career. He was also a prominent critic of the Iraq War.&lt;/p&gt;
&lt;p&gt;Murtha is survived by his wife, Joyce, and three children.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_440"
                     title="Soft Drinks Linked to Pancreatic Cancer Risk (CME/CE)"
                     score="0.012"
                     href="http://www.medpagetoday.com/HematologyOncology/OtherCancers/tb/18354?impressionId=1265778730563"
                     
      &lt;p&gt;Regular consumers of sugary soft drinks are at higher risk for pancreatic cancer than fruit juice drinkers or the general population, a new Singaporean study has found.&lt;/p&gt;
&lt;p&gt;Chinese men and women living in Singapore who drank two or more soft drinks per week were 87% more likely to contract pancreatic cancer after the researchers adjusted for factors such as smoking (95% CI 1.10 to 3.15), according to the report published Feb. 8 in &lt;em&gt;Cancer Epidemiology, Biomarkers &amp;amp; Prevention.&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;&quot;In this large prospective cohort of Chinese men and women in Singapore, those who reported regular soft drink consumption were at increased risk of pancreatic cancer when compared with those who largely abstained,&quot; Mark Pereira, PhD, of the School of Public Health at the University of Minnesota, and colleagues wrote. &quot;There was no association between consumption of juice and risk of pancreatic cancer.&quot;&lt;/p&gt;
&lt;p&gt;While pancreatic cancer is relatively rare, it is one of the most deadly cancers, with less than 5% of patients surviving five years after diagnosis. Although rates have generally plateaued in the U.S., they continue to climb in some Asian countries, including Singapore.&lt;/p&gt;
&lt;p&gt;&quot;This increase may reflect demographic and socioeconomic shifts as well as a transition towards a more westernized lifestyle and diet,&quot; the authors wrote.&lt;/p&gt;
&lt;p&gt;Research has shown that insulin promotes pancreatic cancer cell growth, and some researchers think sugary foods could result in blood sugar and insulin fluctuations that expose the pancreas to high concentrations of insulin.&lt;/p&gt;
&lt;p&gt;While fruit juices contain sugar, soft drinks are the major sources of added sugar in the U.S. diet and major contributors to hyperglycemia and hyperinsulinemia.&lt;/p&gt;
&lt;p&gt;Pereira and colleagues followed 60,524 men and women who enrolled in the Singapore Chinese Health Study between April 1993 and December 1998 and were followed for 14 years.&lt;/p&gt;
&lt;p&gt;At enrollment, the participants completed a 146-question food frequency questionnaire, which contained three items related to soft drinks and juice. The questions asked the participants how much, if any, they drank of soft drinks such as Coca-Cola and 7-Up, orange juice, and other fruit and vegetable juices.&lt;/p&gt;
&lt;p&gt;The dietary data was later cross-referenced with records from the Singapore Cancer Registry and the Singapore Registry of Births and Deaths, to determine which of the participants had died of pancreatic cancer and whether it might be related to their soft drink or juice consumption.&lt;/p&gt;
&lt;p&gt;Overall, researchers found that 140 participants had contracted pancreatic cancer.&lt;/p&gt;
&lt;p&gt;The results were largely consistent with three of four previous U.S. studies on the links between pancreatic cancer and soft drinks. Three of the U.S. studies found an association between soft drinks and cancer.&lt;/p&gt;
&lt;p&gt;The author acknowledged that soft drink consumers are more likely than abstainers to participate in other unhealthy behaviors, including smoking and overeating, which makes it difficult to determine that soft drink consumption is an independent risk factor for pancreatic cancer.&lt;/p&gt;
&lt;p&gt;For instance, smokers in their study were at higher risk for pancreatic cancer. &quot;We could not rule out the possibility of residual confounding by factors associated with the habit of drinking soft drinks or other unascertained factors such as waist circumference,&quot; they wrote.&lt;/p&gt;
&lt;p&gt;They also noted that the study was limited in statistical power because pancreatic cancer is rare, which limited the sample size of cancer cases. &quot;Also, because we were unable to collect repeated dietary measurements in this study, we were unable to account for changes in consumption of soft drinks and juices,&quot; they wrote, &quot;especially when the diagnosis of diabetes occurred after the baseline interview.&quot;&lt;/p&gt;
&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The study was funded by the National Cancer Institute.&lt;/p&gt;&lt;p&gt;The authors reported no financial conflicts of interest.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_423"
                     title="Week 31: Baucus Quotes Gandhi; Obama Wants $80 Billion HHS Boost"
                     score="0.012"
                     href="http://www.medpagetoday.com/Washington-Watch/Reform/tb/18337?impressionId=1265778730563"
                     
      &lt;p&gt;WASHINGTON  --  Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee, likes to start hearings with a quote from a famous leader. This week, he quoted Mahatma Gandhi.&lt;/p&gt;
&lt;p&gt;&quot;Every worthwhile accomplishment . . . has its stages of drudgery and triumph; a beginning, a struggle, and a victory,&quot; said Baucus, who has been an integral part of the negotiations that stalled last month with Congress apparently just weeks away from passing a healthcare reform bill.&lt;/p&gt;
&lt;p&gt;The effort to enact healthcare reform &quot;has certainly seen its struggles,&quot; Baucus said. But he said he agrees with President Barack Obama, who urged Congress during his State of the Union address not to give up on passing comprehensive reform.&lt;/p&gt;
&lt;p&gt;&quot;We have gone well past this effort&apos;s beginning,&quot; Baucus said. &quot;We have endured our share of struggle. Now let us at last bring this bill to victory.&quot;&lt;/p&gt;
&lt;p&gt;Since the election to the U.S. Senate of Massachusetts Republican Scott Brown  --  a vocal opponent of healthcare reform  --  and the president&apos;s State of the Union message, which focused strongly on job creation and improving the economy, healthcare reform has been moved to a back burner.&lt;/p&gt;
&lt;p&gt;But &quot;I&apos;m very confident we&apos;re going to pass healthcare reform this year,&quot; Baucus said during Wednesday&apos;s hearing.&lt;/p&gt;
&lt;p&gt;Obama also urged Congress again not to give up on a bill when he spoke to Democrats at a question-and-answer session on Thursday.&lt;/p&gt;
&lt;p&gt;&quot;All that&apos;s changed in the last two weeks is that our party&apos;s gone from having the largest majority in a generation to having the second-largest majority in a generation,&quot; Obama said. &quot;We&apos;ve got to remember that.&quot;&lt;/p&gt;
&lt;p&gt;Although Baucus used most of his speaking time talking about healthcare reform, the purpose of this week&apos;s hearing was to question Department of Health and Human Services secretary Kathleen Sebelius about the $80 billion increase in funding for HHS requested in the &lt;a href=&quot;http://www.medpagetoday.com/Washington-Watch/Reform/18248&quot; mce_href=&quot;http://www.medpagetoday.com/Washington-Watch/Reform/18248&quot; target=&quot;_blank&quot; title=&quot;Obama&amp;#8200;Requests&amp;#8200;$80&amp;#8200;Billion&amp;#8200;Increase&amp;#8200;in&amp;#8200;Healthcare&amp;#8200;Funding&quot;&gt;president&apos;s 2011 budget&lt;/a&gt;.&lt;/p&gt;
&lt;p&gt;Under Obama&apos;s blueprint, HHS would receive $911 billion in 2011, most of which would be Medicare and Medicaid spending. But the National Institutes of Health (NIH) would also get a $1 billion boost for medical research, and there would be money for improving food, drug, and device safety, and to intensify efforts to help Americans quit smoking and get healthy.&lt;/p&gt;
&lt;p&gt;The President&apos;s budget doesn&apos;t make any provisions for healthcare reform should it be enacted.&lt;/p&gt;
&lt;p&gt;Healthcare spending now accounts for 17.3% of the nation&apos;s total spending, according to &lt;a href=&quot;http://www.medpagetoday.com/Washington-Watch/Washington-Watch/18302&quot; mce_href=&quot;http://www.medpagetoday.com/Washington-Watch/Washington-Watch/18302&quot; target=&quot;_blank&quot; title=&quot;In&amp;#8200;Bad&amp;#8200;Economy,&amp;#8200;Record&amp;#8200;Growth&amp;#8200;in&amp;#8200;Health&amp;#8200;Spending&quot;&gt;new data&lt;/a&gt; released by the Centers for Medicare and Medicaid Services.&lt;/p&gt;
&lt;p&gt;The recession of 2009, coupled with growing use of medical services, led to the fastest one-year growth in health spending since the 1960s, according to the CMS report.&lt;/p&gt;
&lt;p&gt;By 2019, national health spending is projected to reach $4.5 trillion and account for about 19% of gross domestic product (GDP), according to the report.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_399"
                     title="In Bad Economy, Record Growth in Health Spending"
                     score="0.011"
                     href="http://www.medpagetoday.com/Washington-Watch/Washington-Watch/tb/18302?impressionId=1265778730563"
                     
      &lt;p&gt;WASHINGTON  --  The recession of 2009, coupled with growing use of medical services, led to the fastest one-year growth in health spending since at least the 1960s, according to a report by the Centers for Medicare &amp;amp; Medicaid Services (CMS).&lt;/p&gt;
&lt;p&gt;In 2009, national health spending grew 5.7% to reach $2.5 trillion, according to preliminary estimates from CMS actuaries and economists published in &lt;em&gt;Health Affairs.&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;That $2.5 trillion accounts for 17.3% of total GDP, which declined by 1% in 2009. In 2008, healthcare spending accounted for 16.2% of the GDP.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;By 2019, national health spending will reach $4.5 trillion and account for about 19% of the gross domestic product (GDP), according to the report.&lt;/p&gt;
&lt;p&gt;National heath expenditures have grown faster than the GDP for years. But in 2009, the bad economy, job losses, an increasing Medicaid population, and more people seeing a doctor powered the unprecedented growth.&lt;/p&gt;
&lt;p&gt;While the 2009 numbers are preliminary, the authors singled out job losses that resulted in more people qualifying for Medicaid. Spending on Medicaid grew by nearly 10% in 2009, twice as fast as the year before.&lt;/p&gt;
&lt;p&gt;Another spending growth driver: More people utilized healthcare services in 2009, in part because so many sought H1N1 pandemic flu vaccinations.&lt;/p&gt;
&lt;p&gt;Utilization of medical services grew at a rate of 1.5% in 2009, compared with just a 0.9% growth rate in 2009. That translated into growth in spending on physician and clinical services as well: up 6.3% compared with 5% growth in 2008.&lt;/p&gt;
&lt;p&gt;The report also found: &lt;ul&gt; &lt;li&gt;Hospital spending increased 5.9 percent in 2009 compared with 4.5 percent in 2008, and reached $760.6 billion.&lt;/li&gt; &lt;li&gt;Spending on prescription drugs reached $246 billion, up by 5.2% compared with growth of 3.2% the previous year. &lt;/li&gt; &lt;li&gt;Government spending on healthcare in 2009 outpaced private insurance company spending, despite subsidies in the stimulus bill that allowed recently laid-off workers keep their private health insurance plans through COBRA. The number of people with private insurance plans declined by 1% in 2009. &lt;/li&gt; &lt;li&gt;Growth in out-of-pocket spending slowed in 2009, which the study authors attribute to the recession. &lt;/li&gt; &lt;/ul&gt;&lt;/p&gt;
&lt;p&gt;The good news is the economy is expected to grow in 2010, and analysts predict the growth rates in healthcare to be closer to the growth in GDP. Health spending is expected to decelerate to a growth of less than 4%, while GDP is anticipated to rebound to a 4% growth rate.&lt;/p&gt;
&lt;p&gt;However, that assessment may not be accurate because the estimate is based on a 21% cut in Medicare payments to physicians. Those cuts are slated to go into effect on March 1, but Congress is expected to vote at the last minute to stall the cuts  --  as it does every year.&lt;/p&gt;
&lt;p&gt;If Medicare payments for physicians hold steady  --  &lt;a href=&quot;http://www.medpagetoday.com/Washington-Watch/Washington-Watch/18094&quot; mce_href=&quot;http://www.medpagetoday.com/Washington-Watch/Washington-Watch/18094&quot; target=&quot;_blank&quot; title=&quot;AMA&amp;#8200;Pushes&amp;#8200;for&amp;#8200;Permanent&amp;#8200;Doctor&amp;#8200;Pay&amp;#8200;Fix&quot;&gt;either by Congress voting to put the cuts on hold for the next decade, or by voting to overhaul the sustainable growth rate (SGR&lt;/a&gt;)  --  healthcare spending would grow at a rate of about 4.7% in 2010.&lt;/p&gt;
&lt;p&gt;The authors point out the difficulty of forecasting future spending levels in the midst of a recession.&lt;/p&gt;
&lt;p&gt;&quot;How quickly economic growth rebounds, and to what extent, will affect the growth of healthcare spending over the next decade,&quot; the authors said.&lt;/p&gt;
&lt;p&gt;In addition, if a healthcare reform bill ultimately passes, new projections would have to be issued.&lt;/p&gt;
&lt;p&gt;&quot;Should such legislation ultimately be signed into law, there would undoubtedly be many changes in healthcare delivery and financing,&quot; they said.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_378"
                     title="First Lady and Lawmakers Discuss Childhood Obesity"
                     score="0.01"
                     href="http://www.medpagetoday.com/Pediatrics/Obesity/tb/18270?impressionId=1265778730563"
                     
      &lt;p&gt;WASHINGTON  --  Still engaged in an intensely partisan debate over healthcare reform, the White House is ready to launch an initiative that&apos;s likely to have widespread backing: a push to combat obesity.&lt;/p&gt;
&lt;p&gt;First Lady Michelle Obama has announced a four-pronged assault on childhood obesity that focuses on increasing the number of &quot;healthy schools,&quot; adding more physical activity to youngsters&apos; lives, encouraging consumers to make smart food choices, and improving access to healthy foods, which she calls a major barrier to healthy eating.&lt;/p&gt;
&lt;p&gt;She invited a bipartisan group of lawmakers and leaders to the Old Family Dining Room of the White House Tuesday to ask for suggestions on dealing with the epidemic.&lt;/p&gt;
&lt;p&gt;&quot;One of the tougher challenges that we need to look at is improving the accessibility and affordability of foods because there are many food deserts in this nation, which makes it difficult for families trying to access good options,&quot; Obama told Senate leaders who oversee agriculture and health, as well as the Secretaries of Agriculture, Education, and Health and Human Services.&lt;/p&gt;
&lt;p&gt;By that she referred to low income areas of many cities where there are no supermarkets, and the only food outlets are neighborhood convenience stores whose inventories are high on snacks but almost devoid of fresh fruit, vegetables, protein, and other healthy foodstuffs.&lt;/p&gt;
&lt;p&gt;She said childhood obesity is a problem that is &quot;eminently solvable,&quot; adding, &quot;Anyone who has access to children in their lives is going to have to work together. And one of the things that&apos;s also very clear is that this problem won&apos;t be solved by any single federal solution. This is going to require national action.&quot;&lt;/p&gt;
&lt;p&gt;Revising federal child nutrition programs, which include school lunch guidelines, will be part the initiative, Obama said, offering &quot;an opportunity to impact more than 30 million kids.&quot;&lt;/p&gt;
&lt;p&gt;Congressional leaders pledged their support.&lt;/p&gt;
&lt;p&gt;&quot;Together with the First Lady, the secretaries of Education, Agriculture, and Health and their congressional counterparts, we are starting a dialogue to combat childhood obesity, one that holds the promise of making real progress toward addressing this public health crisis,&quot; Sen. Tom Harkin (D-Iowa) told reporters after the meeting.&lt;/p&gt;

    </recommendedItem>
</recommendedContent>