Using ECMO, a highly advanced form of breathing support, does not appear to complicate treatment for obese adults in intensive care. ECMO, which is short for extracorporeal membrane oxygenation, may even help these patients when they experience respiratory failure, despite the fact that its use has been questioned for those with obesity. Obese patients who received ECMO for acute respiratory distress syndrome (ARDS) had lower death rates compared to patients with ARDS who received ECMO and were not obese, according to the study funded by the U.S. National Institutes of Health (NIH). To come to that conclusion, the researchers reviewed data from 790 patients from more than 20 medical centers across 10 countries who received ECMO for ARDS. In all, 320 of these patients were obese. The study found 24% of patients with obesity died in the intensive care unit, compared to 35% of patients who weren’t obese. Although the authors couldn’t control for all variables, including disease severity, they concluded the findings support the concept that obesity shouldn’t factor into treatment decisions for ECMO. “We hope that clinicians will consider the data from this study when making bedside decisions for ARDS patients with obesity, instead of preemptively withholding this lifesaving therapy,” study author Dr. Darya Rudym, a pulmonologist and assistant professor of medicine at NYU Langone Health in New York City, said in an…  read on >  read on >

When the pandemic began, spending on mental health services skyrocketed and it continues to rise even as use of telehealth services leveled off. That’s the key takeaway from a new study published Aug. 25 in JAMA Health Forum. Some rules for expanded payment for telehealth services have now expired, so it’s not known whether this level of spending will continue, according to researchers at the RAND Corporation and Castlight Health. “If greater utilization of health services drives higher health care spending, insurers may begin pushing back on the new status quo,” said lead author Jonathan Cantor, a policy researcher at RAND, a nonprofit research organization. “Insurers may look for ways to curb costs and that could mean less flexibility about using telehealth for mental health services,” he said in a RAND news release. Cantor and his colleagues found that spending on mental health services rose 53.7% between March 2020 and August 2022 in a large group of people with employer-provided insurance. Use of mental health services increased by nearly 39%, according to the research, which used claims data from about 7 million commercially insured adults. The analysis included anxiety disorders, major depressive disorder, bipolar disorder, schizophrenia and PTSD. The claims information was from Castlight Health, a health benefit manager for employer-sponsored health insurance plans for about 200 employers nationwide. From March 2020 to December 2020,…  read on >  read on >

Paper straws, meant to be an eco-friendly alternative to plastic, may not be better for the environment, a new study concludes, warning that they also contain “forever chemicals” that can harm human health. “Straws made from plant-based materials, such as paper and bamboo, are often advertised as being more sustainable and eco-friendly than those made from plastic,” said researcher Thimo Groffen, an environmental scientist at the University of Antwerp in Belgium. “However, the presence of PFAS in these straws means that’s not necessarily true.” For this study, published Aug. 24 in the journal Food Additives and Contaminants, Groffen and colleagues tested 39 straw brands in a variety of materials for poly- and perfluoroalkyl substances (PFAS). Straws were paper, bamboo, glass, stainless steel and plastic. Each straw went through two rounds of testing for PFAS. PFAS were found in 69% of the straws. Testing detected 18 different PFAS. These chemicals were found in 90% of paper straws; about 80% of bamboo straws; 75% of plastic straws, and 40% of glass straw brands. PFAS were not detected in any of the five types of steel straws tested. The most commonly found PFAS was perfluorooctanoic acid (PFOA), which has been banned worldwide since 2020. Testing also detected trifluoroacetic acid (TFA) and trifluoromethanesulfonic acid (TFMS). These “ultra-short-chain” PFAS are highly water soluble and so might leach out of straws…  read on >  read on >

Smoke from Canadian wildfires sent high numbers of people suffering from asthma attacks to America’s emergency rooms this spring and summer, according to two new reports. From April 30 to August 4, 2023, smoke from out-of-control wildfires in Canada increased emergency room visits for asthma by 17% over average, according to data from the U.S. Centers for Disease Control and Prevention. East Coast states, from New York down to Virginia, were especially affected, as were a swath of Midwest states including Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin. “These results highlight the need to reduce smoke exposure during wildfires and can help guide emergency response planning,” said CDC epidemiologist Cristin McArdle, who led the study. A second report focused on asthma-linked ER visits in New York state during the first two weeks of June when Canadian wildfire smoke blanketed the state. On the worst day, June 7, levels of tiny airborne particles called PM2.5 rose to levels that were six times higher than average for western New York and 13-fold higher for people living in New York City. That study was led by CDC epidemiologist Haillie Meek. PM2.5 are products of combustion and are a hazard for people with asthma and other respiratory and cardiovascular health conditions (including chronic obstructive pulmonary disease [COPD]), because they can lodge deep in the respiratory tract and even enter…  read on >  read on >