Medicare officials this week announced a policy that may pay for some people to receive treatment longer. The policy says payments for physical therapy and other services will continue if they help a person not get worse. Improvement is not required. An outbreak of fungal meningitis linked to steroid shots continued to grow this week. Doctors said treatment of the previously rare infection has been a challenge. Massachusetts officials found problems this week during a surprise inspection of the pharmacy that made the shots. New details also emerged about past complaints. A study released this week found that puberty for boys is starting earlier than it did in past decades. Another study found that most people with advanced cancer expect too much from chemotherapy treatments. An expert panel said this week that pregnant women should get vaccinated against pertussis (whooping cough). The panel advises U.S. health officials.
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Medicare to Cover Skilled Care for More People
Medicare in the future will cover skilled care for some people with long-lasting illnesses, even if the services won't make them better. The policy also will cover services that just help to keep someone's condition from getting worse. The Obama administration announced the decision this week. It is the result of a settlement in a national class action suit. The suit said Medicare was paying for skilled care only if the person was showing improvement. The government denied that ever was the policy. It called the settlement a clarification. The policy covers physical and occupational therapy and other skilled services. Care can be given at home or in a nursing home. People affected could include those with Alzheimer's, Parkinson's and chronic lung diseases, among others. Officials could not say what impact the policy will have on the Medicare budget. Providing more services could increase payouts. But costs could go down if the services help to keep people out of hospitals. The Associated Press wrote about the policy.

Study: Puberty Starting Earlier for Boys
American boys, like girls, may be entering puberty earlier than they did 30 to 40 years ago, a new study finds. Based on prior research, doctors have considered 11½ to be the average age of puberty for boys. In the new study, the average was about 10 for whites and Hispanics. The average was 9 for blacks, about 2 years earlier than prior studies showed. The new study was based on exams of more than 4,000 boys. Their ages ranged from 6 to 16. Doctors in 41 states recorded information during well-child visits. They took note of pubic hair, genital and testicle size. Growth of testicles is considered the first sign of puberty for boys. Other research has shown that puberty in girls is starting sooner. This may lead to a higher risk of breast cancer. It's unclear why early puberty may be happening in boys, researchers said. It's also uncertain whether there's any health risk for them. The study was presented October 20 at a conference of the American Academy of Pediatrics. The journal Pediatrics published it online this week. The Associated Press wrote about it.

Outbreak Tests Doctors Treating Fungal Meningitis
Health officials and doctors are plowing new ground in treating people stricken by fungal meningitis. The outbreak is believed to be linked to tainted steroid shots. The outbreak has killed at least 24 people and sickened more than 300. Exserohilum rostratum, the fungus that caused most of these infections, is common. But infections are rare. Only 33 cases had ever been reported before this outbreak. Most involved people with compromised immune systems. New research published this week in the New England Journal of Medicine outlines what doctors know so far about treating the new cases. People received injections of a steroid near the spine. The steroid would have limited the ability of the immune system to fight the infection. Doctors think the fungus burrows into the spine just enough to make a hole in the spinal column and get into spinal fluid. From there it can reach the brain as meningitis. The journal article said early treatment is essential. The drug voriconazole can kill the fungus. But treatment may last up to 3 months and cause serious side effects. The Associated Press wrote about the new research.

Panel Backs Whooping Cough Shots in Pregnancy
An expert panel this week urged all pregnant women to get vaccinated against whooping cough. If possible, they should get the shot in the last 3 months of pregnancy, the panel said. More than 32,000 U.S. cases of whooping cough (pertussis) have been reported this year. Most cases have occurred in newborns. About 30% to 40% caught the infection from their mothers. Babies don't get their first shots against pertussis bacteria until age 2 months. The expert panel advises the U.S. Centers for Disease Control and Prevention (CDC). Last year, the panel said pregnant women should get a one-time dose of vaccine, before or during pregnancy. But new evidence suggests the vaccine wears off quickly. The CDC panel said getting the shot in the last 3 months of pregnancy is likely to provide the best protection. Some panel members said not enough is known about how safe and effective the vaccine is when given during pregnancy. But others said there's no evidence of serious harm to mothers or babies. And they said the shots could reduce whooping cough cases by 33% and deaths by 49%. The Associated Press wrote about the new advice.

Study: Most Think Chemo Can Cure Advanced Cancer
People with advanced cancers may have unrealistic ideas about what chemotherapy can do for them, a new study suggests. Generally, in these cases chemotherapy can extend life by a few weeks or months, or ease symptoms. But in the study, most people were expecting a cure. The study included 1,200 people. All had been diagnosed 4 months before the study began with lung or colon cancers that had spread widely in their bodies. They had received chemo treatments. Surveys showed that 69% of those with colon cancer and 81% of those with colon cancer thought chemo could cure them. This belief applied to people at all education levels. Hispanics and blacks were 3 times more likely than whites to believe they could be cured. The New England Journal of Medicine published the study this week. The Associated Press wrote about it.

State Cites Problems in Pharmacy Inspection
Massachusetts officials said this week that they had found unsanitary conditions and other problems at a compounding pharmacy. Injection vials from the New England Compounding Center are suspected in an outbreak of meningitis. New details also emerged regarding past complaints about the center. A surprise inspection this week found water from a leaking boiler on the floor outside a "sterile" room. Drugs were not tested well enough to ensure they were sterile, inspectors said. Steroid vials returned in a recall showed visible flakes of black mold. The recent meningitis outbreak is caused by a fungus. State officials said they also found drugs ready to ship that were not labeled with patients' names. They said this shows the center was going beyond its license and doing wide-scale manufacturing. A company lawyer said the state knew the scale of the pharmacy's operations. Documents released this week also described past complaints about the pharmacy. In 2004, state officials proposed, but did not issue, a formal reprimand. Complaints were settled with a consent decree in 2006. A state inspection in May 2011 found no problems. The Associated Press wrote about enforcement actions at the pharmacy.

Used with the permission of the copyright owner. All rights reserved. The above summaries are not intended to provide advice on personal medical matters, nor are they intended to be a substitute for consultation with a physician.