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Aug 20, 2003 (United Press International via COMTEX) -- PATIENTS AND DOCTORS RARELY DISCUSS COSTS
Although patients and physicians agree discussing out-of-pocket costs is important, such discussions rarely occur. University of Chicago researchers have found though 63 percent of patients feel the need to talk about costs, only 15 percent report doing so with their doctors. A companion survey of physicians found 9 out of 10 thought they should consider a patient's out-of-pocket costs, and 4 out of 5 thought patients wanted to discuss costs, but only 1 out of 3 reported actually discussing costs with patients. Because patients pay about 20 percent of health care costs in the United States, this is an important omission. Out-of-pocket costs are a persistent concern to the public, creating enough of a burden that many patients forgo prescribed medications. "This means that patients are changing the plan of care for financial reasons without consulting their doctors," the study authors said. "Although national changes in health care financing are needed there are also things that individual physicians can do right now to help patients burdened by their out-of-pocket costs, such as using generic or less expensive medicines whenever possible. But that process has to begin with a conversation." When doctors and patients did talk, it made a difference, researchers found. Discussing out-of-pocket costs made physicians more aware of the burden on patients and may have enabled them to seek less expensive alternatives.
OBESITY AND DEPRESSION A DANGEROUS COMBO
Obesity and depression could work together to provoke the chronic low-level inflammation associated with atherosclerosis and increased risk of heart disease. Researchers studied a large group of German men ages 45 to 74 and found the obese men in the group had significantly higher concentrations of a protein called CRP compared with non-obese men. CRP serves as a signal of artery inflammation and high levels of the protein may be a good predictor of future heart disease. Furthermore, CRP levels were higher in the most depressed obese men than in the less depressed obese men, researchers found. The association between obesity and depression remained strong even after accounting for other factors that can affect CRP levels, including smoking, alcohol consumption and physical activity, according to the researchers. However, depression did not affect CRP levels among non-obese men, suggesting obesity and depression is a risky combination.
OBESITY LINKED TO ALTITUDE SICKNESS
Obese individuals traveling to high-altitude destinations should take extra precautions, new research shows. A study conducted by two Texas institutions revealed obesity may be associated with the development of acute mountain sickness, which often is caused by rapid ascent to altitudes of 8,250 feet above sea level. Symptoms include headache, nausea and vomiting, fatigue, weakness, dizziness, lightheadedness and sleep disorders. The findings also suggest impaired breathing during sleep may be related to increased levels of AMS in obese individuals. "Symptoms of altitude sickness were more severe in the obese study participants, which indicates the occurrence of AMS may be closely related to increased body weight," researchers said. "We recommend that when traveling to high altitudes obese individuals, even those without a history of AMS, take precautions to ensure a slow, gradual ascent."
SPERM MUTATIONS INCREASE WITH MEN'S AGE
By analyzing sperm from men of various ages, Johns Hopkins University researchers have discovered sperm from men over 50 is more likely to contain disease-causing genetic mutations -- and those mutations also seem to increase a sperm's chances of fertilizing an egg. The findings, emerged during efforts to explain why a rare genetic disease is more common in children born to older fathers. The disease, Apert syndrome, leads to webbed fingers and early fusion of the skull bones, which must be surgically corrected. The researchers found mutation rates in sperm increased as men aged, but not enough to account fully for the increased incidence of Apert syndrome in children born to older fathers. This led to the suspicion the disease-causing mutations benefit the sperm in some way, despite their effects on the resulting baby. "Mutations causing this disease occur more frequently in the sperm of older men, but the mutation rate isn't quite as high as the incidence of Apert syndrome," researchers said. "For some reason, a sperm with one of these mutations is more likely to be used to make a baby than normal sperm."
(Editors: For more information on DOCTOR COSTS, contact Jessica Collins at (410) 516-4570 or jcolli31@jhmi.edu. For OBESITY, Karl-Heintz Ladwig in Germany at ladwig@gsf.de. For ALTITUDE, Amy Shields at (214) 648-3404 or amy.shields@utsouthwestern.edu. For SPERM MUTATIONS, Joanna Downer at (410) 614-5105 or jdowner1@jhmi.edu)
Copyright 2003 by United Press International.
