I-Team In-Depth

The Unknown Puts Offspring At Risk Of Sickle Cell Disease

By |

Most Connecticut residents who carry a trait for sickle cell disease don’t know it, resulting in thousands of people unwittingly risking having a child born with the debilitating illness, according to sickle cell disease specialists. The reasons for this vary: there’s a lack of knowledge about results of newborn testing for the trait, parents don’t always convey test results to their children, gaps in state record keeping, and state records that identify people with the disease or trait only go back to 2012. Also, doctors typically only test for the trait when a patient requests it. And people often don’t know they can have the trait even when sickle cell disease isn’t in their family. Dr. Biree Andemariam, director of the New England Sickle Cell Institute at UConn Health, said physicians should include trait testing in routine exams. “It should be standard care,” she said.

Generation Health

Communication, Trust Needed To Reassure The Vaccine-Resistant

By |

The Community Health Center Inc. set up shop inside the Boys and Girls Club of Greater Waterbury on a Friday in mid-July. Armed with 24 doses of the Pfizer COVID-19 vaccine, the team of six staff and volunteers sat ready for patients from 9 a.m. to 12 p.m.

Not one person showed up. The turnout was not surprising, according to the vaccination site leader and nurses at the mobile clinic. Last month, new vaccinations across Connecticut fell to the lowest numbers since January, a predictable outcome when nearly 65% of the total state population has received at least one vaccine dose. But in Waterbury, only 46% of residents are fully vaccinated against the coronavirus.

Failed Flavored-Tobacco Ban May Produce A Silver Lining For Teen Prevention Efforts

By |

The state’s failure to pass a ban on flavored tobacco products may have put it in a better strategic position to prevent and combat teen tobacco use. Legislators could not agree on the ban in June, but a new—albeit small—study by Abigail Friedman, assistant professor of health policy at the Yale School of Public Health, found that after San Francisco banned flavored tobacco products in 2018, including flavored e-cigarettes, cigarette smoking increased among the city’s high school students. In comparatively similar school districts across the country with no flavor ban, cigarette smoking continued to decline, according to Friedman’s study, published in May in JAMA Pediatrics. “This raises concerns that reducing access to flavored electronic nicotine delivery systems may motivate youths who would otherwise vape to substitute smoking,” Friedman wrote. The results of the Yale study may be a case of correlation rather than causation.

I-Team In-Depth

Can Independent Primary Care Doctors Survive Dominance of Hospital Health Systems?

By |

Every day, Dr. Leslie Miller of Fairfield thinks about selling her practice to a hospital health system. “Everybody who is in this environment thinks every day of throwing in the towel and joining a hospital,” said Miller, a sole practitioner in primary care for 20 years. “The business side is the problem,” she said, referring to expensive and time-consuming requirements of medical insurance and government regulations. Dr. Khuram Ghumman took the unusual route of working in a hospital system first, then going into private primary care practice because he objects to the “corporatization” of health care. He said conflicts of interest can arise if an owner and its employed physicians have different objectives.

Disparities

HPV-Related Cancer Rates Outpace Vaccine Rates

By |

Cancers linked to the human papillomavirus (HPV) rose dramatically in a 15-year period, even as the rates of young people being vaccinated climbed, the Centers for Disease Control and Prevention (CDC) reported. The 43,371 new cases of HPV-associated cancers reported nationwide in 2015 marked a 44 percent jump from the 30,115 cases reported in 1999, according to a CDC analysis. HPV vaccination rates have improved over the years, but not fast enough to stem the rise in cancers, the CDC said. Oropharyngeal (throat) cancer was the most common HPV-associated cancer in 2015; accounting for 15,479 cases among males and 3,438 among females, the CDC data show. HPV infects about 14 million people each year and between 1999 and 2015 rates of oropharyngeal (throat) and vulvar cancer increased, vaginal and cervical cancer rates declined, and penile cancer rates were stable, according to the CDC.

health disparities

Sickle Cell Patients Suffer As Disparities In Care And Research Persist

By |

When 9-year-old Jeremy Brown is in pain, it feels like he is being stabbed, while the pain experienced by Deborah Oliver, 40, is like a hundred simultaneous charley horses. Brown, of Bridgeport, and Oliver, of New Haven, have sickle cell disease (SCD), a genetic blood disorder that causes excruciating pain, life-threatening complications and a shortened life expectancy. Almost one-half of sickle cell patients die in their 40s. The disease affects some 100,000 Americans, about one in 365 African Americans and one out of 16,300 Hispanics; and in lesser numbers, people with Middle Eastern, Indian, Caribbean and Mediterranean ancestries. An estimated 2,000 people in Connecticut have SCD.

Clinical Trials In Need Of Diversity

By |

Edith Baker of Plainville faced a devastating reality that patients with advanced cancer inevitably confront. She had stopped responding to conventional treatment. Radiation and chemotherapy could no longer contain her stage 4 bladder cancer. But there was a ray of hope. Baker’s oncologist at Saint Francis Hospital and Medical Center referred her to a clinical trial at UConn Health involving two immunotherapy drugs: the FDA-approved Keytruda (pembrolizumab) from Merck & Co., credited with successfully treating former President Jimmy Carter’s melanoma; and Epacadostat (IDO1 inhibitor), an experimental drug from Incyte Corp.

Fines & Sanctions

Med Board Fines Doc For Improper Opioid Prescribing; Another For Stealing Drugs

By |

The state Medical Examining Board Tuesday disciplined a Fairfield pulmonologist for improperly prescribing opioids and a former UConn Health doctor who had stolen medication from the health center for his private practice. Dr. Igal Staw, who works at Respiratory Associates in Fairfield, was reprimanded, fined $7,500 and has been permanently restricted from prescribing opioids, under a consent order he agreed to. He also must hire a supervisor to monitor his drug prescriptions and will be placed on two years of probation if his state registration to prescribe controlled substances is ever reinstated, the order said. In 2012 and 2013, Staw prescribed opioids to eight patients with chronic pain, including some who may have been abusing the medicine, the order said. He also failed to document the reasons for the prescriptions or justify in the patients’ medical charts why he was increasing the doses, state records show.

I-Team In-Depth

OSHA Penalties Drop Nearly 50 Percent In Five Years

By |

Penalties levied against Connecticut companies for violations of occupational safety rules dropped by more than half between 2011 and 2015, and the number of cases with penalties fell by 40 percent in the same time period, according to a C-HIT analysis of federal Occupational Safety & Health Administration (OSHA) data. Data from the agency’s offices in Bridgeport and Hartford show initial penalties against Connecticut employers totaled $10.86 million in 2011 and dropped to $5.07 million in 2015. Companies were able to negotiate settlements, lowering penalty payments to $6.26 million in 2011, and $3.51 million in 2015. For the first nine months of 2016, the downward trends in cases and fines are continuing, the data show. Reasons for the declines vary: Government officials point to safer workplaces and more compliance with regulations.

I-Team In-Depth

Disclosure Rules Don’t Stem Flow Of Pharma Cash To State’s Doctors

By |

Dozens of Connecticut doctors accepted six-figure payments from drug and medical device manufacturers in 2015 for consulting, speaking, meals and travel, with six of the 10 highest-paid physicians affiliated with academic institutions, new federal data show. The top 10 doctors – less than 0.1 percent of the 11,000 who received payments – took in $3.6 million, or nearly 15 percent of the total $24.9 million paid out. Among them is the dean of the Yale School of Medicine, Dr. Robert Alpern, who received $445,398 in 2015 from two companies – Abbott Laboratories and AbbVie – in consulting fees, meals and travel expenses for serving on the boards of both companies. In 2014, he received $458,194 from the two companies. The Yale medical school began a research partnership with AbbVie in 2013, after the pharmaceutical company spun off from Abbott Laboratories.