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Calif. Budget Cuts Threaten Prenatal Health Program For Women, Teens
County public health officials in California say proposed budget cuts could hurt or end the state"s Maternal, Child and Adolescent Health Program, which provides care for high-risk women and teenagers during pregnancy and up to one year after giving birth, the Riverside Press-Enterprise reports. County health departments operate the program with oversight from the state Department of Public Health. Sarah Mack, a spokesperson for the Riverside County Department of Public Health, said the program provides a safety net for women who are uncertain about how to obtain prenatal care. The program"s nurses and social workers work to identify vulnerable groups with the goal of initiating care within the first trimester of pregnancy. The program aims to reduce incidences of low birthweight, premature delivery, maternal and infant mortality, preventable childhood diseases and disabling conditions.Gov. Arnold Schwarzenegger (R) has proposed eliminating more than $20 million in funding from the program to help reduce California"s estimated $24 billion budget deficit. Last week, the state Legislature"s joint budget conference introduced a counterproposal that would lower cuts to the program to $8 million.The most recent statistics from the state public health department show that nearly 16,000 California women who gave birth in 2006 had late or no prenatal care. More than 38,500 low-birthweight infants were born that year. Jim Lindley, director of the San Bernardino County Department of Public Health, said that Schwarzenegger"s proposal would amount to the elimination of "the bulk of funding" for the program. Mack said that Riverside County officials have identified scenarios to continue providing services if the state funding is eliminated. However, without the funding, "[m]ore people could fall through the safety net," Mack said, adding, "Those who need the program the most would be the most likely to fall through."Schwarzenegger spokesperson Lisa Page has said that the governor believes the state"s budget situation leaves him with little choice about making cuts (Hines, Riverside Press-Enterprise, 6/22).
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Statement From The Minister Of Natural Res And The Minister Of Health On Extended NRU Shutdown, Canada
As Ministers of Natural Res and Health, we are disappointed with AECL"s announcement of delays to the repair of the National Research Universal Reactor (NRU) at Chalk River. We wish to be clear to Canadians. The unplanned shutdown of the NRU will result in a significant shortage of medical isotopes in Canada and in the world this summer.
News of the day
Young Adults Face Tough Time Getting Insurance
Young adults are facing tough times with limited job prospects and no health insurance. The Associated Press reports on recent college graduate Emily Weinstein as being representative of the many young uninsured Americans: "Like millions of other uninsured adults in their 20s, Weinstein is watching Congress as it advances legislation to overhaul health care. The recession has deepened young adults" career struggles. It has also sharpened their interest in health insurance. Already the least likely of any age group to have coverage, adults in their 20s face brutal job searches and more time uninsured because of the recession. Nearly 30 percent, 13.2 million, were uninsured in 2007, according to the Commonwealth Fund, a New York-based research center. Many young adults work entry-level jobs without insurance and, despite new laws in some states, they"re eventually too old to stay on their parents" policies."
Medical Devices

Joint Replacement Patients With Diabetes Greatly Benefit From Controlled Glucose

Diabetics undergoing total joint replacement often are at a higher risk of experiencing complications after surgery due to various pre-existing health conditions. According to a new study published in the July 2009 issue of The Journal of Bone and Joint Surgery (JBJS), those complications are less likely to occur when a diabetic patient has glucose levels under control. "We found that controlled glucose levels really do make a difference for the patient," said study co-author Milford Marchant Jr., MD, an orthopaedic surgeon who conducted the study with colleagues of the Adult Reconstruction Section at Duke University Medical Center. The study found that patients with uncontrolled glucose levels were: -- More than 3 times as likely to experience a stroke or death after joint replacement surgery; and -- About twice as likely to experience post-operative bleeding and infection. Dr. Marchant and his colleagues reviewed data from a national healthcare database looking at more than one million patients who had total joint replacement surgery from 1988 to 2005. They compared surgical outcomes in patients with uncontrolled glucose levels to those who had controlled glucose levels and those patients who did not have diabetes. "It did not matter if the patient had Type I or Type II diabetes," explains Dr. Marchant. "Regardless of diabetes type, we found that patients had fewer complications after surgery if their glucose level was controlled before, during and after surgery." Diabetic patients with uncontrolled glucose were more likely to experience surgical complications, infection, blood transfusions and longer hospitals stays. "The factors necessary for diabetic patients to be considered "under control" are different for each individual patient, therefore diabetic patients should have good relationships with their medical doctors," said Dr. Marchant. Study authors say that according to the American Diabetes Association, disease control is determined for each patient based on a series of laboratory blood tests and an assessment of diabetes-related illnesses. Approximately 8 percent of patients undergoing total hip and knee replacement in the United States have diabetes. "It is crucial that patients have glucose levels well managed before, during and after surgery because it reduces the potential of having a complication," notes Dr. Marchant. "This is the responsibility of both the patient and the surgeon, and it should be a priority." Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. Commercial entities (Zimmer and DePuy) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated. American Academy of Orthopaedic Surgeons


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