Health and Human Services Secretary Kathleen Sebelius announced on Friday a new funding opportunity to help states continue their work to implement the health care law – the Affordable Care Act.
When the law is fully implemented in 2014, the affordable insurance exchanges will provide people and small businesses with one-stop shops to find, compare and purchase affordable, high-quality health insurance.
Friday’s announcement makes more funding available to build all models of affordable insurance exchanges available to states.
HHS also issued further guidance Friday to help states understand the full scope of activities that can be funded under the available grant funding as they work to build exchanges.
“The federal government and our state partners are moving forward to implement the health care law,” Secretary Sebelius said. “This new funding opportunity will give states the resources they need to establish affordable insurance exchanges and ensure Americans are no longer on their own when shopping for insurance.”
The funding opportunity announced today will provide states with 10 additional opportunities to apply for funding to establish a state-based exchange, state partnership exchange, or to prepare state systems for a federally facilitated exchange.
To date, 34 states and the District of Columbia have received approximately $850 million in Exchange Establishment Level One and Level Two cooperative agreements to fund their progress toward building exchanges.
Under the new announcement, states can apply for exchange establishment cooperative agreements through the end of 2014. These funds are available for states to use beyond 2014 as they continue to work on their exchanges. This ensures that states have the support and time necessary to build the best exchange for their residents.
The guidance HHS issued Friday provides information on the exchange-building activities that states can fund with establishment cooperative agreements.
The guidance can be found at http://cciio.cms.gov/resources/factsheets/hie-est-grant-faq-06292012.html .
HHS will conduct regional implementation forums in coming months to assist states and stakeholders on the work to be done in building exchanges, and to address their questions.
HHS will also engage with tribes, tribal governments and tribal organizations on how exchanges can serve their populations.
For more information on exchanges, including fact sheets, visit http://www.healthcare.gov/news/factsheets/2011/05/exchanges05232011a.html .
SACRAMENTO – California Department of Public Health (CDPH) Director Dr. Ron Chapman on Wednesday warned people not to eat Banner Mountain Organic Alfalfa Sprouts, Organic Clover Sprouts, and Organic Sprout Blends containing alfalfa or clover sprouts, because these products may be contaminated with Salmonella.
To date, no illnesses have been reported.
Banner Mountain Sprouts Inc. of Sacramento initiated a voluntary recall after learning that a routine company surveillance sample of its sprouts tested positive for Salmonella.
The recalled sprouts have “sell by” dates between June 17, 2012 and July 6, 2012 and were distributed to retail and wholesale locations throughout California.
The recalled sprouts were packaged in clear four- and five-ounce plastic “clamshell-type” containers, and one- and two-pound plastic bags with labels applied to each.
The following product labels are currently being recalled by Banner Mountain Sprouts:
Consumers in possession of these recalled sprout products should discard or return to the store of purchase for refund.
Symptoms of Salmonella infection include fever, abdominal cramps, and diarrhea which may be bloody. Most infected people recover within a week.
Some may develop complications that require hospitalization. Infants, the elderly, and people with weakened immune systems are at highest risk for more severe illness.
CDPH recommends consumers experiencing any ill effects after consuming these products should consult their health care provider.
Consumers that observe the product being offered for sale are encouraged to report to the CDPH toll free complaint line at 800-495-3232.
ROCHESTER, Minn. – Mayo Clinic researchers have discovered an association between a commonly prescribed blood pressure drug, Olmesartan, and severe gastrointestinal issues such as nausea, vomiting, diarrhea, weight loss and electrolyte abnormalities – symptoms common among those who have celiac disease.
The findings are published online June 22 in the medical journal Mayo Clinic Proceedings.
From 2008-11, Mayo Clinic physicians treated 22 patients with symptoms similar to celiac disease, including intestinal inflammation and abnormalities.
Patients came from 17 states, and some had been diagnosed with celiac disease. They had chronic diarrhea and weight loss; the median weight loss was 39 pounds, and one patient lost 125 pounds.
Fourteen of the 22 were hospitalized because of the severity of their symptoms. When given a blood test, however, these patients didn’t come back with results typical of celiac disease. They also didn’t respond to treatments such as gluten-free diets.
After examining their medications, Mayo Clinic gastroenterologist Joseph Murray, M.D., pulled several of the patients off Olmesartan. Their symptoms dramatically improved.
Eventually, all 22 were taken off the drug, and all showed improvement. Eighteen of the 22 patients had intestinal biopsies after stopping the medication and showed improvement.
“We thought these cases were celiac disease initially because their biopsies showed features very like celiac disease, such as inflammation,” says Dr. Murray, the lead author. “What made them different was they didn’t have the antibodies in their blood that are typical for celiac disease.”
Olmesartan – prescribed for the treatment of hypertension, or high blood pressure – works by blocking substances that tighten blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently, according to the U.S. National Library on Medicine.
“It’s really an awareness issue. We want doctors to be aware of this issue, so if they see a patient who is having this type of syndrome – they think about medications as a possible association,” Dr. Murray says. “We’ve reported an association. What needs to be known next is the science to understand why there is such an association.”
Preventing diabetes or delaying its onset has been thought to stave off cognitive decline – a connection strongly supported by the results of a nine-year study led by researchers at the University of California, San Francisco (UCSF) and the San Francisco VA Medical Center.
Earlier studies have looked at cognitive decline in people who already had diabetes.
The new study is the first to demonstrate that the greater risk of cognitive decline is also present among people who develop diabetes later in life. It is also the first study to link the risk of cognitive decline to the severity of diabetes.
The result is the latest finding to emerge from the Health, Aging, and Body Composition (Health ABC) Study, which enrolled 3,069 adults over 70 at two community clinics in Memphis, TN and Pittsburgh, PA beginning in 1997. All the patients provided periodic blood samples and took regular cognitive tests over time.
When the study began, hundreds of those patients already had diabetes. A decade later, many more of them had developed diabetes, and many also suffered cognitive decline. As described last week in Archives of Neurology, those two health outcomes were closely linked.
People who had diabetes at the beginning of the study showed a faster cognitive decline than people who developed it during the course of the study – and these people, in turn, tended to be worse off than people who never developed diabetes at all.
The study also showed that patients with more severe diabetes who did not control their blood sugar levels as well suffered faster cognitive declines.
“Both the duration and the severity of diabetes are very important factors,” said Kristine Yaffe, MD, the lead author of the study. “It’s another piece of the puzzle in terms of linking diabetes to accelerated cognitive aging.”
An important question for future studies, she added, would be to ask if interventions that would effectively prevent, delay or better control diabetes would also lower people’s risk of cognitive impairment later in life.
Yaffe is the Roy and Marie Scola Endowed Chair of Psychiatry; professor in the UCSF departments of Psychiatry, Neurology and Epidemiology and Biostatistics; and Chief of Geriatric Psychiatry and Director of the Memory Disorders Clinic at the San Francisco VA Medical Center.
Diabetes and cognitive decline
Diabetes is a chronic and complex disease marked by high levels of sugar in the blood that arise due to problems with the hormone insulin, which regulates blood sugar levels. It is caused by an inability to produce insulin (type 1) or an inability to respond correctly to insulin (type 2).
A major health concern in the United States, diabetes of all types affects an estimated 8.3 percent of the U.S. Population – some 25.8 million Americans – and costs U.S. taxpayers more than $200 billion annually.
In California alone, an estimated four million people (one out of every seven adults) has type 2 diabetes and millions more are at risk of developing it. These numbers are poised to explode in the next half century if more is not done to prevent the disease.
Over the last several decades, scientists have come to appreciate that diabetes affects many tissues and organs of the body, including the brain and central nervous system—particularly because diabetes places people at risk of cognitive decline later in life.
In their study the scientists looked at a blood marker known as “glycosylated hemoglobin,” a standard measure of the severity of diabetes and the ability to control it over time.
The marker shows evidence of high blood sugar because these sugar molecules become permanently attached to hemoglobin proteins in the blood.
Yaffe and her colleagues found that greater levels of this biomarker were associated with more severe cognitive dysfunction.
While the underlying mechanism that accounts for the link between diabetes and risk of cognitive decline is not completely understood, Yaffe said, it may be related to a human protein known as insulin degrading enzyme, which plays an important role in regulating insulin, the key hormone linked to diabetes.
This same enzyme also degrades a protein in the brain known as beta-amyloid, a brain protein linked to Alzheimer’s disease.