Shadow Of Death

Unidentified Respiratory Virus Likely to Hit Kids Across Country

Unidentified Respiratory Virus Likely to Hit Kids Across Country - A respiratory illness that has already sickened more than a thousand children in 10 states is likely to become a nationwide problem, doctors say.

The disease hasn't been officially identified but officials suspect a rare respiratory virus called human enterovirus 68. According to the U.S. Centers for Disease Control and Prevention_" target="_blank">Centers for Disease Control and Prevention, the virus is related to the rhinovirus, which causes the common cold.

According to Mark Pallansch, director of the Division of Viral Diseases at the CDC, similar cases to the ones in Colorado have been cropping up across the U.S. At least 10 states -- Missouri, Kansas, Illinois, Kentucky, Iowa, Colorado, Ohio, Oklahoma, North Carolina, and Georgia -- have reported suspected outbreaks of human enterovirus 68 and requested CDC support.

Potentially Deadly Mystery Virus

"Viruses don't tend to respect borders," ABC News Chief Health and Medical Editor Dr. Richard Besser said. "It is only 10 states now, but it's going to be across the country. So if your state doesn't have it now, watch for it, it's coming."

Doctors say they are not even sure yet how this particular virus spreads, though the back-to-school season is a normal time for illnesses to spread among children.

"This is a very common time for outbreaks. Kids come back to school, they like to share things, they bring them home to their little brothers and sisters, and enteroviruses tend to occur in the summer," Besser said. "But this one, this particular Enterovirus 68, is very rare and they have no idea why it showed up this year."

At Children's Hospital Colorado in Denver, officials say that between Aug. 18 and Sept. 4, doctors saw more than 900 pediatric patients with symptoms of the respiratory virus in the emergency room. Of those who came in, 86 were admitted into the hospital and a handful ended up in the intensive care unit.

"It can start just like a cold -- runny nose, sneezing, coughs -- but it's the wheezing you have to watch out for," Besser said.

Dr. Christine Nyquist, a pediatrician at Children's Hospital Colorado, said the virus usually ends up appearing similar to a severe cold but can be particularly dangerous for children with asthma because of how it affects the respiratory system.

"The kids are coming in with respiratory symptoms, their asthma is exacerbated," Nyquist said. "Kids with no wheezing are having wheezing."

At Rocky Mountain Hospital for Children, Dr. Raju Meyappan, a pediatric critical care physician, said he's seen at multiple children end up in the pediatric intensive care unit after being infected with the virus and that children under the age of 5 or those with asthma appear to be most at risk.

In one particularly severe case, Meyappan said a 13-year-old asthmatic patient ended up in the emergency room just one day after showing basic cold-like symptoms, including cough and runny nose.

His asthma became so severe on the second day the teenager turned blue and was rushed to the emergency room, where doctors gave him an emergency breathing tube.

The patient was one of multiple asthmatic pediatric patients who ended up sedated in the intensive care unit with a breathing tube, Meyappan said. Patients who needed breathing tubes spent between four to seven days sedated and intubated as they recovered, he said.

"As a pediatric ICU doctor, we try our best not to intubate kids with asthma at any point in time," said Meyappan, who added that only the most severe cases warranted intubation. "They all needed it. The onset [of the virus] is severe."

Meyappan said currently four patients were in the pediatric ICU recovering.

There are multiple reasons why the outbreak was hitting Denver now, instead of later in the fall or winter when flu.htm" id="ramplink_cold and flu_" target="_blank">cold and flu infections start to rise, Nyquist said.

In addition to school starting, Nyquist said, some children with asthma could have seasonal allergies that are exacerbated by the virus.

"Any kind of viral infection can kick off wheezing and asthmas," she said. "People with asthma know what triggers their asthma. A viral infection is one thing and this is the one that is circulating."

To stay healthy, the CDC recommends basic sanitary practices to avoid spreading the virus, including washing hands, avoiding those who are sick, and covering the nose and mouth during sneezes or coughs.

Meyappan said parents of asthmatic children should make sure that their children's inhalers are easily accessible and that there is a treatment plan in place if an asthma attack continues to get worse.

"Make sure [parents] talk to all their caregivers about what to do if [the child has] an asthma attack and where to go if they need help," Meyappan said. "I think having a game plan in place helps." ( Good Morning America )

Need surgery? Good luck getting hospital cost info

Need surgery? Good luck getting hospital cost info - Good luck getting hospital cost info; study finds answers often elusive and costs vary widely - Want to know how much a hip replacement will cost? Many hospitals won't be able to tell you, at least not right away — if at all. And if you shop around and find centers that can quote a price, the amounts could vary astronomically, a study found.

Routine hip replacement surgery on a healthy patient without insurance may cost as little as $11,000 — or up to nearly $126,000.

Sean Toohey, a grains broker at the Chicago Board of Trade, who had hip replacement surgery last summer ,walks home from work Monday, Feb. 11, 2013, in Chicago. Routine hip replacement surgery on a healthy patient may cost as little as $11,000 _ or up to nearly $126,000. Toohey said he has good health insurance that covered most of the costs, and it didn't occur to him to ask about price beforehand. (AP Photo/M. Spencer Green)

That's what researchers found after calling hospitals in every state, 122 in all, asking what a healthy 62-year-old woman would have to pay to get an artificial hip. Hospitals were told the made-up patient was the caller's grandmother, had no insurance but could afford to pay out of pocket — that's why knowing the cost information ahead of time was so important.

About 15 percent of hospitals did not provide any price estimate, even after a researcher called back as many as five times.

The researchers were able to obtain a complete price estimate including physician fees from close to half the hospitals. But in most cases, that took contacting the hospital and doctor separately.

"Our calls to hospitals were often greeted by uncertainty and confusion," the researchers wrote. "We were frequently transferred between departments, asked to leave messages that were rarely returned, and told that prices could not be estimated without an office visit."

Many hospitals "are just completely unprepared" for cost questions, said Jaime Rosenthal, a Washington University student who co-authored the report.

Most hospitals aren't intentionally hiding costs, they're just not used to patients asking. That's particularly true for patients with health insurance who "don't bother to ask because they know insurance will cover it," said co-author Dr. Peter Cram, a researcher at the University of Iowa's medical school.

But he said that's likely to change as employers increasingly force workers to share more health care costs by paying higher co-payments and deductibles, making patients more motivated to ask about costs.

The study was published online Monday in JAMA Internal Medicine. A California study published last year about surgery to remove an appendix found similar cost disparities.

Commenting on the study, American Hospital Association spokeswoman Marie Watteau said hospitals "have a uniform set of charges. Sharing meaningful information, however, is challenging because hospital care is unique and based on each individual patient's needs."

She said states and local hospital associations are the best source for pricing data, and that many states already require or encourage hospitals to report pricing information and make that data available to the public.

U.S. insurance companies typically negotiate to pay less than the billing price. Insured patients' health plans determine what they pay, while uninsured patients may end up paying the full amount.

The study authors noted that Medicare and other large insurers frequently pay between $10,000 and $25,000 for hip replacement surgery.

Sean Toohey, a grains broker at the Chicago Board of Trade, had hip replacement surgery last summer at Loyola University Medical Center in Maywood, Ill. An old sports injury had worn out his left hip, causing "horrendous" pain on the job, where he's on his feet all day filling orders.

Toohey, 54, said his health insurance covered most of the costs, and it didn't occur to him to ask about price beforehand. He was back at work two weeks later and is pain free. That's what matters most to him.

"I never really looked or paid attention" to the cost, he said.

He paid about $7,900, but wasn't sure what the total bill amounted to.

The average charge for hip replacement surgery at Loyola is about $42,000, before the negotiated insurance rates. The most expensive items on a typical hip replacement bill include about $11,000 for the hip implant, said Richard Kudia, Loyola's vice president of patient financial services

Kudia said some patients do ask in advance about costs of surgery and other medical procedures, and those questions require "a little bit of research" to come up with an average estimate. Costs vary from center to center because "there is no standard pricing among hospitals across the country. Each hospital develops its own pricing depending on its market," he said.

An editorial accompanying the hip replacement study said "there is no justification" for the huge cost variation the researchers found.

A few online sites provide price comparisons for common medical procedures, but the editorial said that kind of information "is of almost no value" without information on hospital quality.

A proposed federal measure that would have required states to force hospitals to make their charges public failed to advance in Congress last year but could be revived this year, the editorial says.

"It is time we stopped forcing people to buy health care services blindfolded," the editorial said. ( Associated Press )

Costs of hip replacement hard to find, vary widely

Costs of hip replacement hard to find, vary widely - Many hospitals are hard-pressed to tell people needing a hip replacement how much their procedure is likely to cost, according to a new study.

Even when they can cite prices, going rates for the procedure may vary from hospital to hospital by a factor of 10, researchers found.

"It was very frustrating," said Jaime Rosenthal, a student at Washington University in St. Louis, Missouri, who led the new research.

"You got transferred to all these different people. You had to leave messages, call back."

According to the U.S. Centers for Disease Control and Prevention, about 327,000 Americans had a hip replaced in 2009.

The surgery is especially common among the elderly, who are covered by Medicare. Still, about half of all hip replacements in the U.S. are done on people younger than 65 - some of whom may not have private insurance.

For the new study, Rosenthal called 122 hospitals: two per state and two in Washington, D.C., plus the top 20 orthopedic hospitals listed in the US News and World Report rankings. During each call, she pretended to have a 62-year-old grandmother who needed a hip replaced but didn't have insurance, and asked for the total price of the procedure.

Just 45 percent of the top 20 hospitals and 10 percent of other hospitals could provide a complete cost for the hospital and doctor fees for a hip replacement, after up to five phone calls.

When Rosenthal called both the hospital and affiliated doctors separately, she did a little better. In those cases, her team was able to put together the prices of procedures at 60 percent of top hospitals and 63 percent of others.

Those totals ranged anywhere from $11,100 to $125,798, Rosenthal and her colleagues from the University of Iowa reported Monday in JAMA Internal Medicine.

She said some hospitals gave her reasons for a higher price - such as assigning her grandmother to a private room - but for others, it wasn't clear what went into the cost of care.

"It just points to the fact that most of us in the health system don't have any idea what the costs really are," said medical ethicist Dr. Ezekiel Emanuel from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, who co-wrote a commentary published with the new study.

Often, only the hospital's billing office knows how much a patient is actually charged for a procedure such as a hip replacement, researchers noted.

Some of the variation in costs has to do with how hospitals factor in overhead to each patient's bill, Emanuel told Reuters Health. And the cost of an actual hip prosthesis can vary four- or five-fold across the country, he added.

Jeanne Pinder, founder of the transparency group ClearHealthCosts, said a ten-fold difference in price for any given test or procedure isn't unusual, even within a single geographic area.

"Nobody has any idea what they will pay in healthcare because the marketplace is completely opaque," Pinder, who wasn't involved in the new study, told Reuters Health.

"When you go into the system, you're usually not there because you want to be. You're usually anxious, upset, and there's a question of when you come out on the back end, whether you'll be bankrupt or not."

That's not only a concern for uninsured people, she noted, given how high co-pays or deductibles may be for those who are covered.

For a patient looking for cost information, there aren't a lot of options right now - other than waiting for more transparency to come through legislation or other means, researchers said.

"I don't know that the information is readily available right now," Emanuel said. "You can try to call around, especially if it's elective."

Rosenthal told Reuters Health the findings do show that people willing to make lots of calls might have success shopping around for the best deal. But hospitals don't make it easy.

"Patients can take responsibility and put pressure on hospitals to make this information available," she said.

Pinder agreed. "I always recommend that people ask," she said. "If you put this information into people's hands… you can start to think like a consumer." (Reuters Health)

Could acupuncture help relieve seasonal allergies?

Could acupuncture help relieve seasonal allergies? - Acupuncture may help improve seasonal allergy symptoms in some people with runny noses and watery eyes, according to a new study - but the effect seems to be small.

Researchers found 71 percent of people reported an improvement in their allergies after eight weeks of acupuncture. But so did 56 percent of allergy sufferers who were treated with sham acupuncture instead as a comparison.

"It works, but there are a couple of caveats (for) people who might think of using it," said Dr. Harold Nelson, who treats allergies at National Jewish Health in Denver, Colorado.

For example, "This is pretty invasive, particularly when you compare it to something like spraying a nasal steroid in your nose once a morning," he told Reuters Health. It's also more time consuming, and requires finding a qualified, licensed acupuncturist, he noted.

"I wouldn't personally go that route," he said.

Previous studies have conflicted on whether acupuncture may help relieve runny noses and other seasonal allergy symptoms, researchers wrote Monday in the Annals of Internal Medicine.

Led by Dr. Benno Brinkhaus from Charite-University Medical Center in Berlin, Germany, they randomly assigned 422 people with seasonal allergies to receive real or sham acupuncture or to only take antihistamines as needed.

After eight weeks and 12 treatment sessions, average allergy symptom scores dropped among people in the acupuncture group from 2.7 to 1.7 points on a 0-to-6 scale, where lower scores indicate fewer symptoms.

Among patients treated with sham acupuncture, symptom scores improved from 2.3 to 1.8 points, and from 2.5 to 2.2 in the medication-only group.

However, by another eight weeks after treatment ended, there was no longer any difference in the degree of symptom improvement between groups.

People with allergies would likely notice about a half-point change on the symptom scale in their daily lives, the researchers said - the difference between the real and sham acupuncture groups after eight weeks in the current study.

Acupuncture is generally considered safe, they noted. A typical session runs for about $100 and is often not covered by health insurance.

Researchers aren't sure why it might help people with seasonal allergies, other than its possible beneficial effect on the immune system.

Nelson, who wasn't involved in the new study, said antihistamines might not have been the best drug comparison for acupuncture - since daily use of nasal steroids is better at preventing symptoms.

For people with allergies, "I would suggest they use conventional medication on a daily basis, and I certainly prefer nasal steroids over antihistamines," he said.

But medication doesn't work perfectly for everyone, the researchers pointed out.

"We mostly saw patients in our outpatient practice who have had this disease for years," Brinkhaus told Reuters Health. "They are not very happy taking the medications every day, and some of them suffer from side effects of medications."

For those people, acupuncture could be a good add-on option, said Brinkhaus, an acupuncturist and internal medicine doctor.

"It's not an alternative. We use it firstly as some sort of complementary medicine. If the acupuncture has good results, we can reduce the anti-allergic medication," he said.

Dr. Li-Xing Man, who treats sinus and nasal diseases at the University of Rochester Medical Center, New York, said it can be challenging to find an experienced acupuncture practitioner in some parts of the U.S. And based on this study, "it's hard to know whether it's actually helpful."

Still, he told Reuters Health, there doesn't seem to be much harm in giving acupuncture a try.

"It may even be that acupuncture makes you feel better in general, and that's reflected in these questionnaires," said Man, who wasn't part of the research team. "If you find a good practitioner of acupuncture and you can afford it, then go for it." (Reuters Health)

Intense acupuncture may improve Bell's palsy

Intense acupuncture may improve Bell's palsy - Patients with facial paralysis saw greater improvements in function after a more intensive form of acupuncture in a new study from China that compared the treatment to standard acupuncture.

Researchers found that wiggling the acupuncture needles to produce a sensation called "de qi" led to a patient's having a better chance of recovering full facial function in six months than if the needles were just inserted and left alone.

De qi "should be considered to be included in clinical guidelines for acupuncture treatment," said Dr. Wei Wang at Key Laboratory of Neurological Diseases of Chinese Ministry of Education in Wuhan, Hubei.

The study did not measure how well people would have recovered without receiving acupuncture, so it's impossible to say whether the therapy worked any better than conventional, Western approaches or no therapy at all.

De qi is combination of feelings - including achiness, coolness, warmth, and tingling - which is considered by traditional Chinese medicine to ensure the best therapeutic benefit, said Wang, one of the authors of the study.

But "this long held belief has never been confirmed," he told Reuters Health.

To see whether de qi makes a difference to the effectiveness of acupuncture therapy, he and his colleagues asked 317 adults with Bell's palsy to undergo five half-hour acupuncture treatments for four weeks.

Bell's is usually a temporary facial paralysis that typically affects one side and lasts a few months.

It often results from a viral infection that inflames facial nerves, and the steroid prednisone is a common treatment. Over the counter analgesics, vitamins and physical therapy are also sometimes used to treat the condition.

About 40,000 Americans get Bell's palsy each year, according to the National Institute of Neurological Disorders and Stroke.

Wang said his group focused on this condition because recovery of the facial nerves affected by Bell's does not seem to be as susceptible to the placebo effect as other nerve conditions, such as pain.

Half of the participants were randomly assigned to receive treatments that would elicit de qi, in which the acupuncturist twisted the needles and moved them up and down several times during the session.

The other participants had the needles inserted and left alone.

All of the patients also received prednisone.

Neurologists, who didn't know which treatment each participant had received, determined the patients' facial function score on a scale of 200, with higher numbers corresponding to better movement.

In both groups, patients had started with facial function scores around 130 to 135. After six months of treatment, participants in the de qi group had somewhat greater facial function, such as in raising the eyebrows, blinking and baring teeth.

The de qi group scored an average of 195, while the other acupuncture group scored 186.

Wang said it's difficult to interpret just what these numbers mean in terms of muscle performance - say, whether a person can smile fully or not - but that a difference of nine points would be noticeable to the patients.

In addition, the team found that 94 percent of participants who received de qi acupuncture completely recovered their facial function by the end of six months, while 77 percent did in the other acupuncture group.

It's not clear how acupuncture - and de qi in particular - might improve the recovery from Bell's palsy.

Dr. Jian Kong, an assistant professor at Harvard Medical School and Massachusetts General Hospital, said one explanation could be that needles in the face increase blood flow to the area "so we can provide more nutrition to the nerves and help the inflammation to diminish quickly so people can recover."

Kong, who was not part of this study, agreed with the researchers that de qi is important to consider in acupuncture research, and that it is often overlooked.

One reason it's not always included in studies is that "there are many schools of acupuncture," with some placing greater emphasis on de qi than others, Kong told Reuters Health.

De qi is also complex, subjective and difficult to quantify. He said some people even consider the sensations of the acupuncturist to be more important in eliciting de qi than the sensations of the patient.

"Most clinical trials don't measure de qi sensation so we don't know how this sensation is associated with clinical outcomes," Kong said.

Wang said that this lack of standardization in acupuncture research might be why studies have yielded a mixed bag of results - sometimes showing a benefit and other times not.

"The effect of acupuncture may be seriously compromised" by not stimulating de qi, he said.

Kong said he and others have been developing standard de qi scales to offer some uniformity across studies.

"Hopefully we can figure out how this sensation is connected with the clinical outcome," Kong said. (Reuters Health)

1st Photos from New Discovery Channel Telescope Unveiled

1st Photos from New Discovery Channel Telescope Unveiled - A privately funded telescope has taken its first images, capping off a two decades-long quest to construct the facility for research and public engagement.

The Discovery Channel Telescope is an observatory with a 14-foot (4.3-meter) mirror built near Happy Jack, Ariz., by the Lowell Observatory and Discovery Communications, the parent company of television's Discovery Channel. The telescope's opening was marked with a gala on Saturday (July 21) at Lowell Observatory in Flagstaff and featured a keynote speech from Neil Armstrong, the first person ever on the moon.

"The First Light Gala is a historic event in the annals of Lowell Observatory," Jeffrey Hall, director of Lowell Observatory, said in a statement. "It marks completion of our spectacular new research facility, initiation of superb projects that will bring our research to millions through our partnership with Discovery Communications. We are honored to be part of it and grateful to all who have helped make it a reality."

The $53 million Discovery Channel Telescope is the fifth largest telescope in the continental United States, and was paid for without any federal or state funding. The observatory snapped its inaugural pictures — including views of the famous Whirlpool and Sombrero galaxies, as well as the M109 barred spiral galaxy — in May using its 16-million-pixel camera.

"The Discovery Channel Telescope is emblematic of our mission to ignite curiosity and stir the imagination of audiences here and around the globe," said John Hendricks, founder and chairman of Discovery Communications, who, with his wife Maureen, was a major donor to the project. "The telescope represents 'discovery' in both word and deed and we are thrilled to see the amazing places it will take us with breathtaking images and vital new research."

Though the telescope's eyes are now open to the universe, it will undergo a testing phase for about 18 months, with its first scientific data gathering expected to begin in 2013 or 2014. Its location, in the Coconino National Forest about 45 miles (72 kilometers) south-southeast of Flagstaff, is in a dark-sky site, one of the darkest, best places from which to view the night sky in the United States.

The process of planning and building the telescope is due to be featured in a one-hour Discovery Channel documentary set to air in September 2012. ( SPACE.com )

Boy dies after sand tunnel collapse in New Jersey

Boy dies after sand tunnel collapse in New Jersey - A 12-year-old boy who was rushed to the hospital after a sand tunnel collapsed on him at a New Jersey beach has died.

The boy and his brother were digging a tunnel at the Long Branch, N.J., beach late Tuesday when it collapsed on him, trapping him under the sand, police and witnesses said. Lifeguards pulled the boy out of the sand and began administering CPR. He was unconscious "with blood trickling from his nose," a witness told the Asbury Park Press.

(Thomas P. Costello/APP.com)

The boy was rushed to Monmouth Medical Center, where he was placed in the pediatric intensive care unit. He was pronounced dead on Wednesday afternoon, hospital officials told the paper.

According to NBCNewYork.com, a fire truck responding to the tunnel collapse struck a man holding his infant son, "knocking them both to the ground." Both were taken to Jersey Shore Medical Center, NBC said. The father suffered broken limbs; the baby was "injured but not severely."

Sadly, deaths from sand tunnel collapses are not terribly uncommon. According to CBS News, there were at least 16 beach-hole-related deaths between 1990 and 2010. According to a 2007 report in the New England Journal of Medicine—"Sudden Death from Collapsing Sand Holes"—there were 31 over a 20-year span.

"At least once a day, lifeguards have to stop someone from digging a hole too deep," a lifeguard told the North County (Calif.) Times after an 18-year-old man nearly suffocated in a sand tunnel collapse. "Holes are a hazard for everyone who uses the beach." ( The Lookout )

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