Stroke

• As dentistry scholars, we believe Koop also deserves credit for something else.
• Americans who rely on the traditional Medicare program for their health insurance get no help from that program with paying their dental bills aside from some narrow exceptions.
• This group includes some 24 million people over 65 – about half of all the people who rely on Medicare for their health insurance.

‘Medically necessary’ exceptions

• The list of circumstances that would lead patients to be eligible is short.
• Some examples include patients scheduled for organ transplants or who have cancer treatment requiring radiation of their jaws.
• But we believe that dental care is necessary for everyone, especially for older people.

Chew, speak, breathe

• While many working Americans get limited dental coverage through their employers, those benefits are usually limited to as little as $1,000 per year.
• And once they retire, Americans almost always lose even that basic coverage.
• Rich Americans with Medicare coverage are almost three times more likely to receive dental care compared to those with low incomes.

Connected to many serious conditions

• Having diabetes makes you three times as likely to develop gum disease because diabetes compromises the body’s response to inflammation and infection.
• At the same time, treating diabetes patients for gum disease can help control their blood sugar levels.

Chemo can damage your teeth

Many cancer treatments can damage teeth, especially for older adults. As a result, Medicare has started to reimburse for dental bills tied to tooth decay or other oral conditions after they get chemotherapy or radiation treatment.

More than nice to have

• Doctors and dentists are educated separately, and doctors learn very little about dental conditions and treatments when they’re in medical school.
• Most dental electronic health records aren’t linked to medical systems, hindering comprehensive care and delivery of dental care to those in need.
• Medical insurance was designed specifically to cover large, unpredictable expenses, while dental insurance was intended to mainly fund predictable and lower-cost preventive care.

Medicare Advantage plans

• Until Medicare expands coverage to include preventive dental services for everyone, alternative plans such as Medicare Advantage, through which the federal government contracts with private insurers to provide Medicare benefits, serve as a stopgap.
• In 2016, only 21% of beneficiaries in traditional Medicare had purchased a stand-alone dental plan, whereas roughly two-thirds of Medicare Advantage enrollees had at least some dental benefits through their coverage.

Frank Scannapieco is affiliated with The Task Force on Design and Analysis in Oral Health Research, and consults for the Colgate-Palmolive Company. Ira Lamster is a member of the Santa Fe Group. He currently receives consulting fees from Colgate, and research support from the CareQuest Institute.

• Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight.
• As demand for semaglutide increases, so are claims that taking it is “cheating” at weight loss or the “easy way out”.
• We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.

How does it work?

• GLP-1 gets secreted by cells in your gut when it detects increased nutrient levels after eating.
• GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.
• Read more:
  The rise of Ozempic: how surprise discoveries and lizard venom led to a new class of weight-loss drugs

What can users expect? What does the research say?

• Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).
• A large group of randomised controlled trials, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.
• Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections led to 6–12% greater weight loss compared to placebo or alternative interventions.

• Weight reduction due to semaglutide also leads to a reduction in systolic and diastolic blood pressure of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in triglyceride levels (a type of blood fat) and improved physical function.
• Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a 20% lower risk of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.

Who is eligible for semaglutide?

• Australia’s regulator, the Therapeutic Goods Administration (TGA), has approved semaglutide, sold as Ozempic, for treating type 2 diabetes.
• The TGA has approved Wegovy to treat obesity but it’s not currently available in Australia.

What else do you need to do during Ozempic treatment?

• In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.
• The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.

A review of obesity medication trials found people reported they needed less cognitive behaviour training to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and avoiding things that trigger eating.

But what are the side effects?

• In on study these led to discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.
• More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.
• Here are some potential risks and benefits

  To reduce risk or severity of side-effects, medication doses are increased very slowly over months.

• Health, Meat and Livestock Australia, and Greater Charitable Foundation.
• She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute, Dietitians Australia and the ABC.

• SUNNYVALE, Calif., April 09, 2024 (GLOBE NEWSWIRE) -- Silk Road Medical, Inc. (Nasdaq: SILK), a company focused on reducing the risk of stroke and its devastating impact, today announced it will report financial results for the first quarter 2024 after market close on Tuesday, April 30th, 2024.
• Company management will host a corresponding audio webcast beginning at 1:30 p.m. Pacific Time / 4:30 p.m. Eastern Time.
• Those interested in listening to the conference call should register online using this link .
• Participants are encouraged to register more than 15 minutes before the start of the call.

• Driven by strong patient and physician interest globally, NewAmsterdam will extend enrollment to the end of April where we expect to randomize over 9,000 patients.
• “PREVAIL, our pivotal CVOT, will potentially demonstrate that obicetrapib’s lowering of LDL-C will reduce major adverse cardiac events (“MACE”).
• The primary objective of the study is to evaluate the effect of obicetrapib compared to placebo on MACE, including cardiovascular death, myocardial infarction, stroke and non-elective coronary revascularization.
• “Despite widespread availability of statin therapies, CVD-related deaths are on the rise, and many patients are not at their risk-based LDL-C goals.