This impressive piece in Sunday's New York Times Magazine offers a harrowing look inside one of New Orleans' hospitals as the waters of Hurricane Katrina rose and trapped patients and staff without power, sufficient supplies and any promises of imminent rescue. (The photo above shows patients and staff being evacuated in 2005.)

The story is one of doctors forced to make life or death decisions at Memorial Medical Center as the hours became days. In many cases, the doctors hastened the deaths of critically ill patients they believed would not survive evacuation. They also injected high doses of morphine and another drug into patients who had do-not-resuscitate orders but were not close to death. In an unusual move, the staff had decided to evacuate the healthiest patients first and leave the sickest to last.

Authorities later arrested a doctor and two nurses for second-degree murder, but a grand jury refused to indict.

Many stories were shocking. One stood out, mostly because of what the doctor involved would go on to tell Sheri Fink, the reporter who wrote the NYT piece. It is the case of Jannie Burgess, a 79-year-old woman with advanced uterine cancer and kidney failure.

Before the storm hit, Burgess was already sedated by morphine to keep her comfortable and, because of all the fluids she was getiing, weighed 350 pounds.

It would have been difficult for the exhausted staff to remove her from the building, a trip that would include many flights of stairs and tight spaces to get her to the helicopter pad atop a parking garage. At some point, Fink wrote, "Ewing Cook, one of the hospital’s most senior physicians, told me he decided that in order to lessen the burden on nurses, all but the most critical treatments and care should be discontinued. ...

Being comatose and on painkillers, she wasn’t uncomfortable. But the worst thing Cook could imagine would be for the drugs to wear off and for Burgess to wake up and find herself in her ravaged condition as she was being moved. “Do you mind just increasing the morphine and giving her enough until she goes?” Cook told me he asked Burgess’s nurse.

Cook scribbled “pronounced dead at” in Burgess’s chart, left the time blank and signed the note with a large squiggle. Then he walked back downstairs, believing that he had done the right thing for Burgess. “To me, it was a no-brainer, and to this day I don’t feel bad about what I did,” he told me. “I gave her medicine so I could get rid of her faster, get the nurses off the floor.” He added, “There’s no question I hastened her demise.”

Posted by Stephanie Desmon at 12:21 PM | Permalink | Comments (1)
Categories: General Health
        

Jurisdictions around the globe have tried to squash secondhand smoke by banning smoking in public places. But only a few have tried to prevent people from lighting up in their cars -- typically only when children are present. 

A new study from Johns Hopkins' school of public health takes on the question car smoking -- just how bad is it?

Pretty bad. The amount of secondhand smoke was significantly higher in cars than in bars and restaurants, the paper found. 

Makes sense. Anyone who has driven with a smoker knows it can be impossible to escape the air in a smoky car -- forget about it if the windows are rolled up. But researchers also found that exposure to secondhand smoke lingers long after the smoker has put out the butt.

It's important to note the small study size: researchers monitored and tested the air in the cars of just 17 smokers and 5 non-smokers. Still, the researchers say their study, published in the journal Tobacco Control, supports the "urgent need" for banning smoking in cars.

"Involuntary exposure to secondhand smoke accounts for thousands of cases of respiratory, cardiovascular and cancer deaths in the U.S. every year," said Ana Navas-Acien, the study's author. "The high air nicotine concentration measured in this study support the urgent need for smoke-free education campaigns and legislative measures banning smoking in motor vehicles, especially children, are present."

Researchers also asked participants about their views on smoking and laws designed to prevent it. A little over half of the smokers said being unable to smoke in their car would help them quit. That doesn't mean they support laws to prevent them from lighting up -- only 7 percent said they would. Still, smokers and non smokers agreed that smoking in cars can harm passengers.

So what's your take? Ban smoking in cars or no? 

photo: AFP/Getty images

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (14)
Categories: General Health
        

Happy Friday. Here's your weekly health news roundup. Enjoy.

+   As the fond tributes continue to roll in for the late Sen. Edward Kennedy, the NYT takes an in-depth look at Kennedy's battle with an aggressive and incurable brain tumor, glioblastoma, and how his fight mirrors the nation's 40-year war on cancer. In the wake of his death, could Congress could put aside the recent ugly debates on health care reform and actually pass legislation?

+   In other health care overhaul news, seniors are particularly skittish about proposed reforms, hospitals might actually profit from health care changes and a profile in the latest issue of Harvard Magazine goes deep on Dr. Atul Gawande, surgeon and writer who has unearthed a fascinating tale about excessive health care spending.

+   Maryland's budget woes are hitting health programs hard. In slashing $454 million from the state's $13 billion budget, officials will close an Eastern Shore psychiatric unit and cut millions in  funding to cancer research at the University of Maryland and Johns Hopkins.

+   Lots of swine flu updates as schools nationwide reopen, preparing for an onslaught of the virus this fall. New government data show children are 14 times more likely to get the H1N1 virus than adults, while others study whether the virus is more likely to affect blacks and Latinos . Got questions about swine flu? Have your say with public health officials on Monday and Tuesday through an online chat at www.WebDialogues.net/H1N1.

+   OK. This is just too much for me. Triathlons. For kids. As young as 3. Really?

And with that, have a great weekend!

Posted by Kelly Brewington at 5:31 PM | Permalink | Comments (0)
Categories: News roundup
        

The CDC is considering promoting circumcision of all infant boys as a way to reduce HIV transmission. (Warning: this, ahem, delicate, issue always seems to inspire sharp remarks from both sides.)

So far, data from Africa about whether circumcision reduces the spread of HIV is somewhat promising. Several large clinical trials in Uganda showed circumcision reduces a man's risk of getting HIV by more than half. Still, another trial was stopped recently when it showed circumcision does little to reduce the virus' transmission to a female partner. And circumcision doesn't appear to protect men who have sex with men from contracting the disease, a separate study found. It’s unclear how those studies might translate to reducing the HIV risk here.

The CDC isn't close to deciding whether or not to recommend the practice yet debate is already raging about it all over the web.

In a story I wrote last year, I learned that what was once standard practice is now a contentious and emotional issue pitting ardent supporters against "intactivstis," the name for some who are vehemently opposed to circumcision.

In the pro-circumcision camp are those who insist upon the procedure for religious, cultural and hygiene reasons. And then, there are those who highlight the "look like Dad" argument, which even The Economist wades into here:

"For men, for deep-seated psychic and cultural reasons, ensuring that your son's equipment looks like your own, and does not renounce his membership in a tribe you belong to, can be a very big deal."

Meanwhile, opponents include people who find circumcision simply unnecessary, those who insist it's cruel and painful to a baby and that removal of foreskin leads to diminished sexual sensitivity. Others say it's clearly a violation of human rights akin to female genital mutilation.

Georganne Chapin, executive director of Intact America, tells the Chicago Tribune:"There's no ethical justification for differentiating male genital alteration from female genital alteration," Chapin said.

So what's your view of circumcision? And further, is this a decision to be made privately by parents or a matter of public health?

AP photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (31)
Categories: Pediatrics
        

Caught this testy exchange this morning on NPR as I drove into the parking lot: Morning Edition host Steve Inskeep taking on RNC Chairman Michael S. Steele, Maryland's former lt. governor.

The topic: Health care reform, what else? Inskeep took Steele to task for an op-ed piece he wrote for Monday's Washington Post. In it, Steele wrote a clever line I'm sure he has used more than once: "President Obama's plan for a government-run health-care system is the wrong prescription." Later, he lays out his call for a "Seniors' Health Care Bill of Rights." The First Amendment: Don't cut Medicare, a program he acknowledges is going to run out of money.

"Within a couple of paragraphs of writing we need to protect Medicare, you write that you oppose President Obama's plan for a 'government-run health-care system,'" Inskeep said. "Now you're a veteran public policy official. You're aware that Medicare is a government-run health care program?"

"Yeah," Steele snapped back, "and look how it's run."

Inskeep then accused Steele of backing Medicare only because it is "politically popular."

The two went back and forth like that for much of the nearly 8-minute chat. For more, check it out here.

One listener's take, posted on the NPR website: "I'm shocked by Steele's ill preparedness and equally shocked by Inskeep's rudeness."

So everyone is happy.

Photo/Associated Press

Posted by Stephanie Desmon at 11:15 AM | Permalink | Comments (21)
Categories: Health care reform
        

A study published today says that a lot of people are getting advanced medical scans -- half of patients ages 18 to 34 (!) had one in the last year. The scans can be costly to the health care system. They expose people to radiation, in some case levels that could increase their cancer risk. And very few of the tests have been scientifically proven to improve health or help people live longer.

And yet, when the doctor says you need a CT of your abdomen to check out the pain you've been having, you get one. The doctor ordered it, so it must have value, right? It won't cost you much money if you have decent insurance. And who thinks of cancer risk when sent for one little test?

Some doctors I spoke to yesterday just hope we will think about these questions next time our physician orders a radiologic test -- a nuclear stress test, a CT of your heart, an X-ray of your spine. It's a no-brainer when you break your arm or you have pneumonia or it's time for your annual mammogram. Those tests are needed. Others may not be.

And a word on price. Georgetown health economist Jean Mitchell pointed out something I had never considered. "This is the only industry where nobody knows the price" for services, she said of the medical field. "There's no price list. They only ask you what health insurance you have. People have no idea (of the cost) and they get the bill later.

"If patients had to pay more out of pocket, you'd see them saying ... 'Well I don't need them.'"

Posted by Stephanie Desmon at 7:34 AM | Permalink | Comments (1)
Categories: General Health
        

As friends, colleagues and even political adversaries offer praise and remembrances for Sen. Edward Kennedy, who died last night after a battle with brain cancer, everyone underscores his huge influence on efforts to overhaul the nation's health care system.

He called health reform the "cause of my life" during last year's Democratic National Convention, said it was a "defining issue for our society" years earlier, and throughout his recent illness continued to champion universal coverage while pushing Congress to act now on legislation.

"He pursued that cause vigorously, even as his health declined; when members of Obama’s administration questioned the president’s decision to spend so much political capital on the seemingly intractable issue, Obama reportedly replied, “I promised Teddy.’’ noted The Boston Globe adding that Kennedy's long committment to health care issues began in 1969.

Yet, he died with "one of his lifelong goals, universal health care, tantalizingly within reach yet struggling on Capitol Hill."

Beyond reform, Kennedy was instrumental in other legislative issues concerning health including helping create state health coverage for poor children known as S-CHIP, building federal support for community health centers and pushing successfully for increases in cancer reasearch funding.

The Wall Street Journal notes that his death has already become a rallying cry for passing reform legislation this year while others ponder, who will fill the shoes of the man called the lion of the Senate?

photo: AFP/Getty imags

Posted by Kelly Brewington at 1:20 PM | Permalink | Comments (2)
Categories: Health care reform
        

Men who embrace traditional beliefs on masculinity are 50 percent less likely than other men to go to the doctor, says a new study. And the attitudes of these "macho men" might just be what leaves them sicker than women, researchers conclude.

The study, led by a Rutgers sociologist and shared at a recent meeting of the American Sociological Association, touches on some stereotypes, for sure. But they appear to be grounded in facts, the researchers found. Based on responses from 1,000 men in the 2004 wave of the Wisconsin Longitudinal Study, researchers found education made no difference in the responses. Highly-educated men with the strong masculinity beliefs were just as unlikely to obtain preventative care as men with less education.

The study has some limitations -- mainly the participants were all white, middle-aged and had at least a high school degree.

But I think the authors make a good point. And I'd argue it has nothing to do with being "macho." Most men I know, regardless of their beliefs, are afraid to go to the doctor. I understand I may be generalizing, so please feel free to call me out on it. But in a very small unscientific sample of my girlfriends and women family members, all admit to being the ones who nag their husbands and boyfriends to go to the doctor, be it for a routine checkup or for a serious issue.

Are we alone?

Apparently, I'm onto something. The American Academy of Family Physicians found in a 2007 survey that more than half of men studied had not seen a primary care doctor for a physical exam within the past year and 36 percent put off appointments until they are really sick. 

And guess who they call on for advice and support? More than 78 percent of the men surveyed who had a spouse said the person has an influence over their decision to go to the doctor.

Posted by Kelly Brewington at 12:09 PM | Permalink | Comments (4)
Categories: General Health
        

The University of Maryland is still looking for some itty bitty volunteers to take part in its swine flu vaccine trial: babies 6 to 35 months.

Investigators have had no problem recruiting adults and older children in the trails, which started in adults earlier this month and in children last week. In fact, they had so many 18-64 year olds try to volunteer, they had to use a lottery to make the final cut. Even older children, many of whom were signed up by their doctor parents, have been an easy find.

But the smallest of all test subjects have proved a challenge for researchers. Officials say it isn't because parents are reluctant to test the experimental inoculation on their wee ones. They've had great response from all age groups. Rather, it seems babies' recommended -- and rigorous -- vaccine schedule might be getting in the way. From 12 to 18 months alone, children can receive various vaccines from shots against measles, mumps and rubella to hepatitus A. But the swine flu study requires that babies have not had recent inoculations and will not be vaccinated soon after they receive the H1N1 shot.

If you are interested in volunteering your tot and want to know if your child qualifies, call the University of Maryland's Center for Vaccine Development for details: 410-706-6156. Vaccinations are taking place now at the University of Maryland's Ambulatory Pediatric Center in Baltimore and at clinics in Annapolis and Frederick. The university, one of a handful of vaccination sites across the nation, hopes to test 40 children in the 6 to 35 month old range.   

Still, vaccination schedule alone might not be the only hindrance. Volunteers must keep a journal of how they are reacting to the shot, including daily temperature recordings. I met a mom who said she wasn't wild about the idea of taking the temperature of her squirmy 2-year-old every day for more than a week -- even in the name of scientific research and flu protection. Since I have no children, I wondered well, how hard can it be to take a toddler's temp? Then she began to describe the um, procedure, and I could see her point.

AP photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Pediatrics, Swine flu/H1N1
        

So just how bad will the swine flu be this fall? No one really knows for sure, but top researchers announced yesterday it is possible that up to 50 percent of Americans could be infected by this new H1N1 influenza virus.

As many as 1.8 million people could be hospitalized in the U.S. with up to 300,000 needing spots in Intensive Care Units. These very ill patients could take up from 50 to 100 percent of the beds in already crowded ICUs. And as many as 90,000 people could die (vs. 36,000 who die in the U.S. from seasonal flu in any given year).

Meanwhile, if the swine flu hits hard in September and early October before a vaccine is ready, "the timing could significantly diminish the usefulness of vaccination for mitigating the epidemic and could place many at risk of serious disease," write the well-respected authors of the report from the President's Council of Advisors on Science and Technology.

Freaked out? Well, don't be. Not yet.

These are "planning scenarios" based on previous pandemics and how the pandemic has behaved so far, not predictions, according to the report. The predictions could be high. Or, if the virus mutates or sickens more elderly people than anticipated, they could even be low. Sor far, the pandemic H1N1 is killing middle-aged adults and adolescents, whereas seasonal flu kills primarily the elderly.

Dr. Harold E. Varmus of Memorial Sloan-Kettering Cancer Center in New York, co-chair of the 21-member council, told The Washington Post: "This is going to be fairly serious. It's going to stress every aspect of our health system."

Health and Human Services Secretary Kathleen Sebelius says she fears people are not concerned enough about the possibility of a serious swine flu outbreak. According to the NPR Health Blog, she pointed to a recent Washington Post/ABC News poll that shows most Americans are not worried about the swine flu. Only one in eight thinks his or her family will be affected.

"We know right now there's a lot of complacency," Sebelius told reporters.

Others say we need to take a wait-and-see approach, that despite the best estimates no one really knows what will happen come fall.

"These speculations have no firm scientific basis, only a historical precedent from almost a 100 years ago and epidemiologic data from recent circulating virus patterns," UCLA's Peter Katona told ABC News. "Viruses have a mind of their own, and we will have to just see what happens."

Posted by Stephanie Desmon at 12:00 PM | Permalink | Comments (5)
Categories: Swine flu/H1N1
        

This is how most of my conversations about exercise used to go. Someone would ask if I ran. I would reply, laughing at my own stupid joke, "only when chased."

When I was in high school, they made us jog around Delaware Park in Buffalo -- a 2 mile loop -- to get in shape for lacrosse season. I couldn't do it. After a week, I quit and joined the softball team. No running there.

I'm thin, have always been thin, but was feeling awfully tired last October when my doctor told me I had to exercise. I told her I couldn't, no time -- full-time job, two kids, blah blah blah. She told me which DVD to borrow from the library. Anything by best-selling fitness guru Leslie Sansone, she said.

Six months later I was running 2 miles around my neighborhood. Now, I do it as often as five days a week (am I sounding like a cheesy infomercial?).

But Sansone doesn't sell running. She has made her fortune advocating walking. The first time I watched one of her 130 (!) DVDs, my editor at the time, a marathoner, couldn't hide her disdain. "You walk in front of the television?" she asked. "This is exercise?"

But it is exercise and I hear Sansone's voice in my head urging me on when I take to the outdoors. "From this tree to that tree, I'm gonna jog," she says, explaining how to build endurance if jogging is your goal. Yesterday, I got to hear Sansone's voice for real, on the telephone, pitching a new program and telling me about her latest video, "Walk Your Belly Flat."

"Don't watch it. Don't try to describe it. Just try it," is what she tells people who turn their nose up at walking videos as exercise. "If you try it, you're a believer," she said. "When you start talking about walking in front of your television, you sound a little kooky."

Trust me, her videos -- which come in bite-sized 1, 2, 3, 4 or 5 mile increments -- are a full body workout, something even the uncoordinated can follow. They are brisk walks and core training exercises, hardly marching in place in front of the TV, which is probably what my editor was envisioning.

"It's not a joke of a program -- it is low-impact aerobics," she said. "We've stripped away everything that's complex. If you can walk, you can follow every aspect of our program."

For someone who has interviewed governors and senators, I was oddly starstruck by this 48-year-old fitness instructor from the suburbs of Pittsburgh. When I told her how I can now run because of her, she seemed genuinely excited to be talking to a real-live success story. "This is years of this and I still don't believe it," she told me. "I'm thankful for being the ambassador of walking."

Sansone started out teaching walk aerobics at a local fitness center and the classes were always full. One day, in the mid-80s, a class member asked if she could film the session so she wouldn't miss her walking while on vacation. Then everyone in the class wanted a copy of the tape. Fast-forward more than 20 years and this woman is the undisputed queen of walking.

Now that she has conquered the home market, Sansone is trying to return to her roots. She wanted to talk to me about the "walk leader" certification program she has started to train people across the country to teach her walk workouts in their communities. Sansone will be holding workshops later this year and into 2010. There are details at her website, www.walkathome.com. Getting the Leslie Sansone seal of approval will run you more than $1,000.

Sansone still does some teaching herself. She's on hiatus right now, but come October, she'll be back at the front of the room every Monday night at her Walk Productions studio in New Castle, Pa.

Posted by Stephanie Desmon at 7:15 AM | Permalink | Comments (7)
Categories: Diet and exercise
        

Poison control centers have seen a sharp increase in the number of calls about teen misuse of attention-deficit drugs, suggesting "a rising problem with abuse of these medications," according to a new study out today.

The calls came from emergency room doctors, parents and school officials asking for advice for how to deal with apparent abuse of the increasingly common medications. The severity of the calls has increased over time and four deaths were reported in the study.

Teens, who many times use the drugs to get high, may not realize that there can be serious consequences to using what are, after all, prescription medications. Sales data of attention-deficit drugs suggest that abuse of the medications reflects an increased availability of the prescriptions, which have also been rising. The calls about ADHD medication rose 76 percent over an eight-year period, a pace outstripping calls for victims of substance abuse generally and teen substance abuse.

The study, in the journal Pediatrics, was done by Cincinnati Children's Hospital Medical Center researchers using data from 1998 to 2005.

Mark Stein, a psychiatry professor and ADHD expert at University of Illinois at Chicago, told the Associated Press that abuse typically involves crushing and snorting the pills, which speeds up the effects and can produce a buzz or sense of euphoria — along with dangerous side effects.

The study lacks information on whether abusers were teens with ADHD, but anecdotal evidence suggests many are not.

Posted by Stephanie Desmon at 12:00 PM | Permalink | Comments (1)
Categories: Pediatrics
        

There is no question that properly installed infant car seats save lives.

But a study today in the journal Pediatrics finds that even healthy newborns may not be getting enough oxygen when they spend too much time in those cozy and convenient carriers.

The study, done with 200 two-day-old babies in Slovenia, showed that infants placed in cribs got more oxygen than those who spent prolonged periods of time in either car seats or in car beds, which are designed for tiny or premature babies.

Among the findings: The percentage of time the babies spent with oxygen saturation levels below 95 percent was, on average, significantly higher for those in car seats (23.9 percent) compared to those in cribs (6.5 percent).

The moral here is not to dump your car seat. Instead, the authors note, parents should limit the their babies spend in those carriers to when they are on the road.

But the researchers say a baby's breathing can be compromised, as airways can become occluded and chest walls compressed in the angled position of an infant car seat.

Say the authors: "The use of these devices should ... be restricted to protection from injury and death in traffic accidents and they should never serve as a replacement for a crib. In addition, further modifications of car safety devices are clearly needed to minimize the respiratory compromise that has been consistently documented in current models."

Posted by Stephanie Desmon at 7:55 AM | Permalink | Comments (2)
Categories: Pediatrics
        

The tale of Caster Semenya and whether the world champion sprinter is a man or a woman has been a fascinating topic in sports circles over the last few days. After the masculine-looking 18-year-old girl's first major victory this week at the championships in Berlin, track and field officials said she would be undergoing tests to verify her eligibility as a woman.

Easy as pie, right? The whole Biology 101 thing -- two X chromosomes and you're female and if you have a Y chrosome, you're male, no?

But this piece in the New York Times is the best so far explaining why it just isn't as simple as a blood test to determine whether someone is male or female.

Photo by AFP/Getty Images

Posted by Stephanie Desmon at 3:39 PM | Permalink | Comments (1)
Categories: General Health
        

Now this might sound counterintuitive: Giving children small quantities of milk over time may ease their allergic reaction to it.

Allergy experts at Johns Hopkins started following a small group of children in 2008, giving them higher doses of milk over time in an attempt to train their immune systems to tolerate it. It worked. In a recent follow-up, all 18 children with a history of severe milk allergy saw their allergy eased or disappear within 17 months, researchers report in the Journal of Allergy and Clinical Immunology.  

Given the extremely small sample size, there are a number of caveats. Researchers are still learning about milk allergy and ways to possibly overcome it. What works for one child may not work for another. And these patients were given milk under the close supervision of a doctor. So a word of caution to parents -- don't try this at home.

Still, researchers are encouraged by the findings: regular dairy use could help children become more tolerant and remain so.

Some children remained allergy free even without daily exposure. For others, the allergies returned after they stop drinking milk, said Dr. Robert Wood, a lead investigator on the studies.

"This may mean that some patients are truly cured of their allergy, while in others the immune system adapts to regular daily exposure to milk, and may, in fact, need the exposure to continue to tolerate it," he said.

Baltimore Sun photo

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (4)
Categories: Pediatrics
        

Yes! It's Friday. Hope everyone had a wonderful week. Here's your roundup of health news.

The big news in the health care reform front was the preisdent's shifting stance on the so-called public option. On Monday, it seemed Obama was ready to cave to critics and drop the idea of a public insurance option. Then, the White House backtracked, saying it wasn't shying away. We admit it; we're confused. Also confusing is what might replace the public option -- nonprofit co-ops. What are those, you ask? Folks here , here and here offer a few explanations.

In other health care news, the Brits are defending their system against U.S. attacks. Others ask if it's even fair to compare the American system with Canada's and countries in Europe.

Remember the craziness over "death panels" last week? Well put that silliness aside and read this very well-done piece about how doctors -- specifically palliative care specialists -- navigate end-of-life issues.

Stephanie wrote earlier this week about swine flu, er, H1N1 vaccine trials in kids, who are among the five priority groups who would get the shot. But maybe those priority groups are all wrong, says a new analysis by Yale and Clemson researchers. Instead of health care workers and pregnant women, the vaccine should be given first to children 5-19 and their parents to be most effective, the study says.

Cake that's good for you? Sign me up. The American Cancer Society asked the baking society to come up with a more nutrious birthday cake. Recipes included.

You know what's not good for you? Zombies. But how does one prepare for say, a zombie invasion and a subsequent assault on public health? I know, this has been keeping me up at night too. Well, someone actually did the math. The folks at the WSJ's health blog explain.

And with that, have a healthy and happy weekend!

Wired magazine photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: News roundup
        

Life expectancy has hit an all-time high, the CDC tells us, reaching nearly 78 years in the United States.

The most recent data, from 2007, shows an increase from a life expectancy of 77.7 years in 2006 to 77.9 in 2007. Over a decade, life expectancy increased 1.4 years. Meanwhile, the CDC says, the death rate is down.

Life expectancy may go down this year because death rates are up already and because there are more elderly in the U.S.

The United States lags behind about 30 other countries in estimated life span, the Associated Press reports. Japan has the longest life expectancy — 83 years for children born in 2007, according to the World Health Organization.

Some more tidbits from this week's report:

* Life expectancy was a record for both males and females (75.3 years and 80.4 years, respectively). The gender gap has narrowed from a peak of 7.8 years in 1979.

* For the first time, life expectancy for black males reached 70 years.

* Between 2006 and 2007, mortality rates declined significantly for eight of the 15 leading causes of death. The largest declines were observed for influenza and pneumonia (8.4 percent), homicide (6.5 percent), accidents (5 percent) and heart disease (4.7 percent).

Photo/Baltimore Sun

Posted by Stephanie Desmon at 12:00 PM | Permalink | Comments (0)
Categories: General Health
        

It appears I have peeved the folks at the American Meat Institute, whose website tells me is a national trade organization that represents most meat processors.

"Dear Stephanie," a spokesman for the group wrote in an e-mail I received yesterday, "I am writing to you about the critical role you play in providing balanced, accurate information to your viewers or readers about the Novel H1N1 2009 influenza virus."

To make a long letter short, I -- along with the rest of the media (Kelly got the same form e-mail) -- should cease and desist my "alarmist" behavior of referring to the H1N1 virus as the "swine flu." This, they tell me, reflects poorly on the pork industry and is "disruptive to farmers."

We here at Picture of Health use the terms H1N1 and swine flu interchangeably, a decision we made because so many people in the public do in fact refer to the new virus as the swine flu. The virus got its porcine name because the strain has some genetic markings derived from swine, though it also parts human and avian. The name, unfortunately for pork producers, stuck.

You cannot get the swine flu, er, H1N1, from eating pork. It is a human disease. Pigs do not have the disease and even if one got it, it would not pose a food safety risk, Riley tells me.

Pig photo/Associated Press

Posted by Stephanie Desmon at 7:30 AM | Permalink | Comments (9)
Categories: Swine flu/H1N1
        

Two new studies shed light on the safety of the vaccine to protect women from cervical cancer and call into question the ethics behind the marketing of the shot.

Gardasil, the blockbuster vaccine to combat the human papillomavirus (HPV), which can cause cervical cancer, is linked to complications, including 32 deaths, according to an analysis in today's Journal of the American Medical Association. But researchers note that the rate of side effects is low and the safety record is not out of line from other similar vaccines. The most common side effects are fainting, nausea and dizziness at a rate of about 40 to 80 cases per 1 million girls vaccinated.

Raising more eyebrows, however, is an accompanying JAMA article revealing that the makers of Gardasil, Merck & Co, provided grants to professional medical associations to help promote the vaccine.

"However, much of the material did not address the full complexity of the issues surrounding the vaccine and did not provide balanced recommendations on risks and benefits," the authors note.

With some 23 million doses nationwide since its FDA approval in 2006, Gardasil has been marketed heavily with commercials depicting young girls chanting they would become "one less." Approved for girls and women ages 9 to 26, worldwide sales reached $1.4 billion in 2008. Still, the vaccine has been controversial from the start.

By marketing it as an anti-cancer vaccine, the company tried to avoid unease from parents and the public about how HPV is spread -- through sexual contact, increasing the threat of cancer to all adolescents, while ignoring the subgroups that are most at risk, said authors Sheila M Rothman and David J Rothman of Columbia University's school of public health.

Merck told the Washington Post that it gave professional groups funding for educational programs on the vaccine, but didn't tell the groups what to say.

Still, the Rothmans don't mince words when taking on the big drug maker and the professional medical organizations (PMAs):

That these arguments were delivered by PMAs is a cause for concern. Professional medical associations are obligated to provide members with evidence-based data so they can present relevant risks and benefits to their patients. To this end, PMAs must become more transparent about their relationship with the industry, disclosing both the precise funding and technical assistance they have received to develop and disseminate the promotional products.

AFP/Getty photo

Posted by Kelly Brewington at 12:22 PM | Permalink | Comments (6)
Categories: Medical studies, Pediatrics
        

And you thought the uproar over "death panels" had reached a fever pitch. Well, here's another topic making the heated rounds in the health care reform brawls: Should illegal immigrants be eligible for coverage?

First off, none of the plans currently in Congress include illegal immigrants. President Obama and Nancy Pelosi have made a point of underscoring this lately. In fact, up until the town halls got ugly in recent weeks, no one in Congress was even talking about health insurance for illegal immigrants. That hasn't stopped angry opponents from asserting all sorts of false claims -- free insurance to non-citizens, among them. (PolitiFact debunks a that claim, for the record.)

It also hasn't stopped immigrant advocates from asking -- wait a second, what about us?

There's a moral obligation to provide access to health coverage to all Americans, regardless of their immigration status, they say. Any plan that excludes illegal immigrants will fall short, says the advocacy group the National Council of La Raza, considering that illegal immigrants account for 15 percent -- nearly 7 million -- of the nation's 47 million uninsured. But proponents of strict immigration enforcement counter that providing insurance would only encourage more immigrants to flock here illegally.

Thing is, just how much illegal immigrants cost the health care system is unknown and therefore, up for debate. Nearly half the country's estimated 12 million illegal immigrants don't have health insurance, according to the Pew Hispanic Center, a non-partisan think tank.

Some groups claim this means they are more likely to jam hospital emergency rooms -- which by law can't turn anyone away -- ratcheting up health care costs even higher. But others insist illegal immigrants are actually less likely to clog emergency rooms and have lower health care costs than U.S. citizens.

What is clear is no elected official is likely to touch the incendiary issue, if they can help it. Before coming to the health beat, I covered immigration for eight years. I can think of no other issue that's sure to spark a backlash for politicians already under heavy scrutiny by voters. Couple that with health care reform and oh man, go grab yourself some popcorn and get ready for the drama.

photo from stock.xchng

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (40)
Categories: Health care reform
        

Laid-off workers have been flocking in recent months to COBRA, the federal program that has long allowed them to keep their employers' health insurance for 18 months -- but for a hefty price.

Lots of people have become eligible for the program -- with unemployment at a 25-year high -- but few are able to afford it when they lose their income. COBRA allows involuntarily terminated to pay 100 percent of the premium plus 2 percent for administrative costs. The cost: roughly $8,800 a year for the average worker.

The doubling of COBRA enrollment has been since February, when the government began paying a subsidy to make the coverage actually affordable to some unemployed people, according to an analysis by Hewitt Associates, a human resources consulting firm.

According to Hewitt's data, eligible workers receive a nine-month subsidy that leaves them responsible for paying only 35 percent of their COBRA premium -- about $3,300 a year. The firm says that, on average, workers with employer-sponsored health coverage pay 22 percent of the premium cost, about $1,900 a year. The company's data was culled from enrollment activity for 200 large U.S. companies representing eight million employees.

In the six months before the subsidy, Hewitt says, only 19 percent of those eligible for COBRA signed up for it; that was up to 38 percent from March to June. Some of those who lose their health insurance when they lose their jobs end up covered by a spouse's employer or by a new employer. But many are likely foregoing health insurance altogether.

COBRA usage varies by industry and those hardest hit by layoffs -- manufacturing, construction, leisure and retail -- have seen their rates spike the most since the temporary subsidy was introduced.

Posted by Stephanie Desmon at 10:47 AM | Permalink | Comments (0)
Categories: General Health, Health care reform
        

Researchers say that one in four men suffer from sleep apnea and nearly one in 10 women do. Even moderate episodes of interrupted breathing at night can increase the risk of death significantly, according to a new study led by Johns Hopkins researchers.

The causes of death are many, and they appear to be linked to repeated stretches of time when the body is deprived of oxygen over the course of a night, every night, for a long period of time.

The main symptom of apnea is snoring, loud snoring that often awakens the snorer. Still, many people with apnea don't even know they have the disorder.

Sleep apnea is believed to be on the rise because it is linked to the growing obesity epidemic in theh United States.

"These two disorders go in tandem," said Dr. Naresh M. Punjabi, a Hopkins pulmonologist and one of the authors of the study published online today in Public Library of Science, Medicine. "With weight gain, the likeliness of sleep apnea increases."

One of the first things a doctor recommends to an overweight person diagnosed with sleep apnea: Lose some weight.

Photo: Amy Davis/Baltimore Sun

Posted by Stephanie Desmon at 8:25 AM | Permalink | Comments (5)
Categories: General Health
        

A quick swine flu roundup this afternoon.

Ever wonder why we have to get seasonal flu shots every year? Why they doesn't provide long-term protection like most vaccines do? My story in the Baltimore Sun this morning tells the tale.  In a nutshell, the flu is this slippery, rapidly mutating viruses that changes so quickly that one year's vaccine just won't work against the next year's circulating strain.

Researchers for years have been trying to develop a universal flu vaccine, one that would guard against all strains of the flu -- even those like the pandemic H1N1 virus we're seeing this year. It would remove the need for the scramble underway now to develop, test and administer a vaccine to counter a brand-new virus. It would already work against all flus, even a strain never seen before. Development, however, could be a decade away.

A short science lesson on how it might work: Current flu vaccines target two parts of the virus — hemagglutinin, the protein spikes covering most of its surface that when inhaled help it stick to the cells lining the nose and lungs, and neuraminidase, the enzyme that releases the viral particles into cells to infect them. These are also the parts of the virus prone to rapid mutation, the main reason why no one has yet been able to stop all influenza. Researchers are looking to target (much smaller) parts of the virus that don't appear to change.

Also in the Sun today, an excellent op-ed piece by two Johns Hopkins researchers, Dr. Ruth A. Karron and Dr. Ruth R. Faden. They question whether the United States has the responsibility to produce not only enough H1N1 vaccine for its residents but whether the country should make enough doses for nations that can't afford to do it themselves.

"Careful research established that in the 1918 pandemic the death rate in poor countries was as much as thirty-fold higher than the death rate in wealthy countries; it is predicted that up to 96 percent of deaths from a new pandemic may occur in developing countries," they write.

One more thought on swine flu for today. I caught a bit of this morning's "Today" show on NBC. The segment that was airing: How to protect your kids from swine flu as they return to school.

It was the same-old advice we've heard for months. Wash their hands regularly (and long enough for them to sing "Happy Birthday"). Don't let them share things like cups with each other. And if they're sick, keep them home. This is news? My question is this: Is it just an example of needing to say something, anything, about the swine flu epidemic? Or do they think people just haven't been listening? I'm not really sure which is the answer.

Posted by Stephanie Desmon at 12:00 PM | Permalink | Comments (2)
Categories: Swine flu/H1N1
        

Twice as many kids are overdosing on what's in the medicine cabinet as what's underneath the sink, according to a new study.

More than 70,000 kids each year in the U.S. are treated in emergency room for unintentional medication overdoses -- 80 percent of them from unsupervised ingestion of drugs. Many are getting sick after they get their hands on commonly available over-the-counter medications. The four most frequent culprits: acetaminophen (Tylenol), cough and cold medicine, antidepressants and non-steroidal anti-inflammatory drugs (Ibuprofen).

The rate of hospitalizations for medication overdoses, according to the study in this month's American Journal of Preventive Medicine, was four times that for poisonings from non-pharmaceutical products like cleaning sprays, pesticides and shampoos.

"The high frequency of medication usage and the rising number of medications stored in American homes increases the potential for medication overdoses ... especially among children," write the study's authors, who are from the Centers for Disease Control and Prevention. 

The number of pediatric medication poisonings in the U.S. could be even higher because the data only included those who were taken to the hospital, not those who called poison control centers or went to the pediatrician.

The numbers, to me, are pretty shocking, so let me throw in one more: One out of every 180 2-year-olds is treated in an ER for medication overdose. This is despite education campaigns and allegedly child-resistant packaging available on most medication.

As I write this, I keep thinking about the leftover vitamins and pain relievers from my recent vacation just sitting out on my dresser while the cleaning products are guarded behind child safety locks or are on shelves so high I can barely reach them.

The authors call the whole thing a "substantial public health burden" and think prevention efforts need to be redoubled.

Posted by Stephanie Desmon at 7:07 AM | Permalink | Comments (0)
Categories: Pediatrics
        

It's been a frenetic week on the health care reform front. Couple that with some interesting studies and other health tidbits and here you have it -- your weekly installment of health news:

+   Health care overhaul goes over-the-top: Stephanie summed up above the latest drama with the Senate's end-of-life provision and the ugliness of town halls meanwhile, I blogged earlier about the misinformation over euthanasia claims in the health care bills. With that in mind, here's a roundup of fact-check links to help you sort the real from the absurd. This is great, too: Seven lies about health care reform.

+   Sleep out for medical care: Town halls aside, some folks are actually trying to get health care to people who need it. In Los Angeles, hundreds slept outside to a basketball arena to get free medical care. The effort was founded by a man who spent years in the Amazon rain forest helping folks in need.

+   Swine flu and you: I reported this week on the start of trials for a swine flu vaccine at the University of Maryland, which aims to have initial results about whether the shot is safe and effective within weeks. Meanwhile, H1N1 infection is on the rise among soldiers in Iraq. Add the President of Costa Rica to the people sickened by the pandemic. Look out for Stephanie's story this weekend about the efforts to make a universal flu vaccine.

+   Stealing not uncommon among children: A doctor tells us stealing in childhood does not mean your kid will grow up to be a criminal. Young kids are still figuring out what the rules are and child development experts call a minor shoplifting incident a "teachable moment." 

+   Sleep genes: My husband can survive on four hours sleep. Me? I need eight or I'm a cranky mess. A new study says a genetic mutation could be why some people can function on less sleep than others.

+   Surviving allergy season: I know I've been sneezing up a storm. You too? Here are some tips for getting through it.

And with that, have a happy and healthy weekend.

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (0)
Categories: News roundup
        

Apparently cowed by protestors and talking heads who called plans to pay doctors to assist with end-of-life decisions "death panels," a Senate committee has dropped the provision from its health care reform bill.

The idea was to let Medicare pay for these voluntary counseling sessions, where items such as living wills and hospice care would be discussed. What rankled many seemed to be that these sessions were billed as cost-saving measures. The last year of life is the most expensive and one recent study concluded that much of end-of-life spending isn't sought by patients and goes against their families' wishes, according to yesterday's Wall Street Journal.

But many saw a more sinister motive. They equated these end-of-life sessions with rationing care for the elderly and even euthanasia, calling them death panels which would play God and decide who would live and who would die. And the concerns didn't only come from sign-waving protestors and an angry Sarah Palin, the failed 2008 vice presidential candidate. Sen. Charles Grassley, the top Republican on the Senate Finance Committee, said yesterday that the provision was dropped because it wasn't just about providing information at the end of life, but was "likely to lead to the rationing of care for everyone."

The brouhaha even forced President Obama to tell folks at a town meeting this week that no one wanted to "pull the plug on Grandma because we've decided that it's too expensive to let her live anymore."

In an op-ed in the WSJ yesterday, Dr. Peter Pronovost, a professor of anesthesiology and critical care medicine at Johns Hopkins School of Medicine, said "we spend half of our health care dollars during the last six months of a patient's life."

What really got me thinking were the thorny issues raised by this anecdote from the Pronovost piece:

"A patient in the intensive care unit where I work is dying from an infection that is resistant to all known antibiotics. None of the intensive care physicians on the unit think the man has any chance of being discharged alive. But the patient's surgeon, who is in charge of his care, has hope.

"The man has been in the ICU for six months now. His care has cost more than $1.5 million. He has insurance but his family is so strapped that they have difficulty affording gas to drive to the hospital. ...

"If we are ever to control rising health costs, we will have to do a better job confronting realities for patients like this man."

Photo via AFP/Getty Images

Posted by Stephanie Desmon at 7:17 AM | Permalink | Comments (10)
Categories: Health care reform
        

Breast is best. That's what the breastfeeding advocates always say. Public health proponents, too, have long promoted the benefits of nursing, from boosting infants' immunity to encouraging critical bonding time between mother and baby.

With that in mind, the CDC, the Surgeon General and the Department of Health and Human Services have announced a "Call to Action on Breastfeeding" seeking public comment on ways to encourage the practice. While the site is no longer accepting new comments (you can read the old ones here), the organizers are still holding public hearings, including one happening today in Atlanta. The goal is to update the government's Blueprint for Action on Breastfeeding, a 10-year- old document that spearheaded the push to get moms to nurse.

Now, that's not the only way to extol the virtues of nursing. How about something a little more, how shall we say, interactive? A doll. That makes sucking sounds. Who breastfeeds. You can't make this stuff up.

The Spanish doll -- known as Bebe Gloton (roughly, Gluttonous Baby in English) -- comes with a halter top with flowers placed where nipples should be. Bebe latches on and voila, sucks. There's even a video demonstration.

The doll, not yet available in the U.S., has sparked all sorts of controversy with opponents calling it "sucky", creepy and that it could encourage teen sex.  Meanwhile, defenders argue there's nothing wrong with a doll promoting this very natural, very healthy practice.

So, what say you?

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (11)
Categories: General Health
        

With summer football practice in full-swing, we thought we'd get on the bandwagon and bring a little sports to our health blog.

Maryland Terrapins football coach Ralph Friedgen -- a bear of a prescence on the sidelines -- is missing something as he heads into the season. It may not look like much from these photos, but Friedgen this week is 105 pounds lighter than he was in October, when he weighed 401 pounds (see photo, far left). Of course, the question always is, how did he do it?

The 62-year-old Friedgen decided against weight-loss surgery. He lost it the old-fashioned way, by eating less. But after years of losing and then gaining back weight, he had to find something he could stick to.

He has been using Medifast, a plan from an Owings Mills company that has participants eat small prepared meals or snacks every few hours. He's down to about 1,000 calories a day, swearing off the high-calorie offerings of the training table. His cholesterol has improved, the university reports, as has his blood sugar, which was in the pre-diabetic range. He wasn't even supposed to exercise until he had dropped 50 pounds, but now walks 45 minutes, three or four times a week.

Still tipping the scales near 300 pounds, the coach hopes to lose another 45 pounds. He'll need a whole new wardrobe of white collared shirts.

"I'd like to lose 150, but I don't know if I can do it," Friedgen told The Washington Post in May. "It gets harder now, but I'm going to keep on this thing. My age right now, I'm 62. I want to try to get this thing down so I can have a good life."

Photos/Associated Press

Posted by Stephanie Desmon at 7:45 AM | Permalink | Comments (7)
Categories: Diet and exercise
        

Hospitals have been sending me e-mails lately, telling me that "Prostate Cancer Awareness Month" is coming and touting free cancer screenings. We've all been told that early detection  saves lives.

A study published online late yesterday in the Journal of the National Cancer Institute suggests that these messages are getting through -- probably a bit too loud and a bit too clear. In fact, in the study of more than 10,000 Europeans, researchers found that 92 percent of women either overestimated the mortality reduction associated with breast cancer or didn't know what it was. They also found that 89 percent of men overestimated or didn't know the mortality reduction associated with prostate cancer screening.

The truth is that studies have shown that approximately 1 life is saved for every 1,000 mammograms given. The recommendation in the United States is to screen women with mammograms every year or two from the age of 40.

As for prostate-specific antigen (or PSA) screening, there is insufficient evidence that it saves lives and could instead lead to unnecessary treatment of cancers that might never develop into anything.

Most other forms of cancer screening have not proven to be helpful and may be more harmful than doing nothing.

Why people are so off-base is unclear. The study found that people who get their information from doctors are no better informed about screening than people who do not.

"A big challenge is conveying the counterintuitive idea that screening does not always help -- and can even be harmful," wrote Steve Woloshin of the Darthmouth Institute for Health Policy & Clinical Practice and Lisa M. Schwartz of the VA Outcomes Group in White River Junction, Vt., in an accompanying editorial in the journal. "Surveys have shown that most people believe that cancer screening is almost always a good idea and few believe harm possible. ...

"The harms can be serious. False-positive results cause anxiety and can lead to invasive and sometimes dangerous testing. Most importantly, screening leads to the overdiagnosis of some cancers never destined to harm."

The authors conclude this way: "Screening can lead to important benefits, but it can also lead to important harms, And the net effect may be a very close call. Screening messages should reflect this complexity. We should not be selling screening. We should be giving people  the numbers they need to decide for themselves."

photo/National Cancer Institute

Posted by Stephanie Desmon at 12:00 PM | Permalink | Comments (0)
Categories: Cancer
        

The White House launched full court press against what it says is misinformation being spread about health care reform by protesters at raucous town halls nationwide.

On Monday, the administration released a new website aimed at countering the attacks and at a town hall Tuesday, President Obama said flat out: his health care plan won't "pull the plug on grandma."

He was referring to euthanasia claims made by fierce opponents to reform proposals, including none other than Sarah Palin, who said on her Facebook page that the "downright evil" plan will lead to health care rationing:

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care."

Now, let's get this straight. Palin was referring to a provision that would allow Medicare to reimburse doctors for consulting seniors about living wills, advanced directives and end-of-life care. Sound like a death panel to you? The Associated Press says there's nothing in the bill about "death panels". Pulitzer-prize winning PolitiFact.com also debunks the claim. And if you're interested, here's the actual bill with the information -- see pg. 425,.

As politicians, interest groups and lobbyists of all stripes try to put their spin on the debate, it can be tough to figure out who is telling the truth. Not to mention, the major health care bills are more than 1,000 pages long and very complex. 

Here's a look at how folks are trying to sorting out fact and fiction in this debate. Let us know if you have any others to share.

image from iStockphoto

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

My Sunday story focused on a key question in health care reform -- will there be enough doctors to go around? With plans to extend insurance to some 47 million people, the current primary care doctor shortage will only get worse, many say. One solution could be to increase the role of nurse practitioners. 

The piece generated positive feedback and lots of interesting responses from readers across the spectrum about primary care, nursing and the reform debate. I also heard from a group of providers who felt overlooked: physician assistants.

I hope folks don't see this as an intentional slight, as the story was a narrowly-focused piece looking at one slice of the health care debate. But it is true that using more physician assistants is among the solutions being tossed around to help fill the primary care gaps. And some observers think they could play an important role.

Physician assistants work under the supervision of a doctor and diagnose illness, order and interpret tests and, in most states, can prescribe medication. Training includes graduation from an accredited physician assistant program and passage of a certification exam.

Locally, more than 1,800 physician assistants are practicing in Maryland -- about 90 percent of those in the Baltimore and Washington suburbs, according to the Maryland Academy of Physician Assistants. Like nurse practitioners, physician assistants work in a variety of disciplines, from primary care to specialty fields.

Baltimore Sun photo

Posted by Kelly Brewington at 11:11 AM | Permalink | Comments (9)
Categories: Health care reform, Physician shortage
        

Studies have found many benefits to babies who are breastfed. But what about to their mothers? New research finds that women with a family history of breast cancer had a lower risk of developing the disease themselves if they breastfed.

The paper, published in the latest Archives of Internal Medicine, was based on questionnaires of 60,000 women who had given birth and took part in the long-running Nurses Health Study out of Harvard. Researchers followed them from 1997 to 2005 and found 608 cases of breast cancer from the group.

Women who had a mother or a sister with breast cancer and had breastfed were 59 percent less likely to develop breast cancer compared to women who had never breastfed. The study did not find a difference in risk for women without a family history of breast cancer.

The authors found that it didn't matter how long a woman breastfed -- the reduced risk was similar if a woman did it for three months or three years.

But the study leaves some unanswered questions. Experts don't know why breastfeeding could reduce the risk of cancer. And since the study was observational, there are reasons other than breastfeeding that could explain participants' decreased breast cancer risk. And in a study limited to nurses, are the results applicable to the general public?

Researchers think when women don't breastfeed, their breast tissue changes and that could increase the risk for cancer. But more study is needed in this area, they said.

For now, the study's authorhers say women with a family history of breast cancer should be encouraged to breastfeed, especially since the practice is associated with other health benefits.

Baltimore Sun photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Cancer
        

It's going to be a hot one today. It's already 91 degrees in Baltimore and some places may even reach 100. The city has declared it a Code Red day, opening cooling centers to ensure people get enough cool air and water. One of the city's many tips: Stay inside during the hottest time of the day.

Unless, it turns out, you have to attend the groundbreaking being held for a new homeless shelter downtown. Reporters and advocates are being called to an empty lot on the Fallsway at 2 p.m. (the hottest time of the day) for a dog-and-pony show where city officials -- including Mayor Sheila Dixon -- are likely to don hard hats and carry shovels to commemorate the occasion.

Here's hoping they have enough water on hand. And maybe even a paramedic or two. Heat exhaustion is a real issue on days like today (a healthy member of our softball team had to be rushed to the hospital yesterday when she fell ill in the heat).

Perhaps there is an upside. At least city officials will have an incentive to keep the proceedings short.

Illustration from stock.xchng

Posted by Stephanie Desmon at 10:54 AM | Permalink | Comments (1)
Categories: General Health
        

The University of Maryland kicked off its tests of the H1N1 vaccine this morning with 67 adult volunteers. It's one nine centers nationwide testing whether the shot is safe and effective. The trial is the first step in what could be a mass vaccination campaign to start in mid-October, as infectious disease experts anticipate a resurgence of the new flu.

I'm spending the morning with volunteers and researchers over at the university and will be certain to keep you all updated as things get going. For now, here's the nuts and bolts:

Volunteers started arriving at 7 a.m. for an orientation session, briefing on consent forms and a medical assessment. (Volunteers must be healthy to take part). Those who make the cut will get stuck and will remain on site for about 20-30 minutes in case of any allergic reactions, before they may go home.

Researchers will follow up with them in eight days for blood tests. Then, volunteers will return after two weeks later for another injection. If all goes well in adults, the vaccine will be tested in children as soon as the end of next week, said Dr. Karen Kotloff, the study's lead investigator.

Kotloff told me last week that she's been impressed by the response from volunteers. While researchers are still seeking people 65 and over to take part, they have had an easy time getting adults and even children -- especially those with doctors for parents.

"To me, that is very comforting," she said. "These are people who have a very good understanding of influenza and influenza vaccine, they have weighed, in a very personal way, what the risk and benefits are and have decided to volunteer their children. That says a lot."

AFP/Getty photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Swine flu/H1N1
        

Happy Friday. Here's your dog-days-of-summer weekly installment of health news. Enjoy.

+   Lawmakers may be on summer vacation, but there has been no end to the political maneuvering on health care reform. Yesterday, the pharmaceutical industry made a deal with the Obama administration to save the nation $80 billion over the next decade.  Meanwhile, town halls on reform have become a free for all on both sides. And some say that the some of the reform rhetoric is trying to scare seniors by asking "will reform promote euthanasia?"

+   The American Psychological Association said that mental health professionals shouldn't tell gay clients they can change their sexual orientation through therapy. There's no evidence that such therapy works, the organization said.

+   Who is to blame when a diagnosis is missed? Some say doctors and patients both share responsibility.

+   The NYT takes an interesting look at another barrier at finding a cure to cancer: not enough people participating in clinical trials. Forty years since the government declared a "war on cancer," death rates have barely budged.

+   Stephanie blogged earlier about the phenomenon of donating a kidney to a stranger. Well, with a money-laundering scheme in the news involving kidneys, some are asking why not buy a kidney?

+   With an eye toward pandemic preparedness, Stanford's hospital and clinics are experimenting with a drive-thru emergency room. Being able to treat patients without having them leave their cars could help triage patients in the event of a pandemic emergency. Can we get fries with that? Doubtful.

And with that, have a happy and healthy weekend!

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: News roundup
        

Earlier, I blogged about a report on children as young as 3 being diagnosed with depression. Well, another mental health study this week is sparking lots of discussion: the number of Americans taking antidepressants increased from about 6 percent in 1996 to 10 percent in 2005, or from 13 million to about 27 million people.

Meanwhile, the number of people being treated with antidepressants who also sought help from a therapist declined. Researchers think high out-of-pocket costs and insurance barriers could be to blame. The paper's lead researcher said he worries that patients who only receive medication may be not be getting enough help.

The study, of nearly 50,000 people, which appears in the latest issue of the Archives of General Psychiatry, found the use increased in adults and children alike. Racial and ethnic minorities, however, were less likely to take antidepressants, an example of broader disparities in mental health treatment, researchers said. 

The authors think the rise is likely due to a number of factors including: an increase in the incidence of major depression and more drugs flooding the market to treat it, campaigns promoting better mental health care and a lessening stigma attached to mental illness and antidepressants. 

It's interesting that the increase took place even after the FDA issued a "black box" warning in 2004 on the use of antidepressants in children after some studies showed an increase in suicidal thoughts. 

photo courtesy of the Associated Press.

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (5)
Categories: Mental health
        

We've written about kidney donation here a few times lately, most of it stemming from the 16-person, domino transplant completed at Johns Hopkins this month. That transplant began when a man from Virginia offered to donate his kidney to a stranger. A fascinating piece in the most recent issue of The New Yorker, written by Larissa MacFarquhar, asks a terrific question: "What sort of person gives a kidney to a stranger?"

She tells the tale of one man who donated his kidney to a woman he found online, on a site designed to link donors to those in need. When a story about his deed hit the local news, someone called him on the phone in the hospital and "told him that she hoped his remaining kidney would fail quickly and kill him because her husband had been next in line to receive a kidney and (the donor) had given his to someone else." When a story appeared in the local paper, it asked "whether it was fair for him to pick his recipient, choosing who lived and who died."

Another story is of a young woman who donated her kidney to someone she didn't know, enamored with the idea that she could save someone's life. But after the surgery she seemed to regret it in ways, feeling that the recipient wasn't grateful enough to her. Was she really doing it as an altruistic act or was it really about her?

The piece also explores the concept of paying people for their organs, which is illegal.

Dr. Robert Montgomery of Johns Hopkins, who led the record-setting domino transplant, is featured in the New Yorker story. MacFarquhar observes the mustachioed surgeon in the operating room as he removes the kidney from an Essex pastor who donates to someone she will never meet. For Kimberly Brown-Whale, the pastor wiho has spent years doing missionary work overseas, "part of what appealed to her about donating a kidney was the concreteness of it: she knew that she was helping someone and she knew exactly how.

"She thought of herself as being in the helping business, but so much of her work was just talk, talk, talk -- her Sunday sermons, funerals, visting parishioners in the hospital -- that she wondered whether anything she did made any difference."

Posted by Stephanie Desmon at 7:00 AM | Permalink | Comments (2)
Categories: General Health
        

Consumer Reports is now in the hospital rating business. The site rates more than 3,400 hospitals nationwide based on surveys of some 1 million patients.

The surveys come from the government's Hospital Consumer Assessments of Healthcare Providers and Systems.

The ratings take into account patient satisfaction in a variety of ways such as, communication with doctors, pain control, cleanliness and quietness of rooms, information about discharge and new medicines and whether a patient would recommend the hospital.

Locally, Anne Arundel Medical Center and Johns Hopkins Hospital were ranked highest in Maryland, both with overall scores of 78 out of 100.

Survey respondents' biggest complaints were about discharge planning and communication about their medications.

Consumer Reports partnered with Dartmouth Institute for Health Policy and Clinical Practice to analyze the data. They found that patients who live in regions with more intense care such as longer hospitalizations and more doctor visits, were more likely to rate the care lower, an indication that patients preferred conservative and less expensive care.

For more information: ConsumerReportsHealth.org.

Baltimore Sun photo

Posted by Kelly Brewington at 2:12 PM | Permalink | Comments (3)
Categories: General Health
        

In recent years, childhood depression has received a lot of attention as researchers have tried to unravel how the disorder affects kids. But little is known about if, and how, depression strikes very young children. A new study suggests that children as young as 3 can be diagnosed with depression and that the disorder is often a chronic condition.

The study, which appears in the August issue of the Archives of General Psychiatry, is sure to raise eyebrows among people who question if children that young are emotionally mature enough to be depressed. The study's authors say that despite skepticism, a growing body of research suggests that depression does exist among preschoolers and they launched the study to better understand it.

The authors studied 306 children 3 to 6 years old, including 75 of them diagnosed with depression, and evaluated them for up to two years. Preschoolers with depression at the beginning of the study were four times more likely to have depression 12 or 24 months later  than children who were not depressed at the study's start. 

Researchers found depression was more common in children whose mothers were depressed and those who had experienced a traumatic event.  The study underscores the importance of diagnosing depression as early as preschool, the authors say. But the study didn't research treating children so young with medication, for instance, which has been controversial. The authors say more study is needed in this area.

I wonder what parents make of this research. Is it possible to diagnose depression in children so young? And, if so, what is an appropriate treatment for a preschooler? 

photo from stock.xchng

Posted by Kelly Brewington at 7:08 AM | Permalink | Comments (3)
Categories: Mental health, Pediatrics
        

As long as marriage has been around, people have been extolling the benefits of it. And every so often a study comes along to tell us a new perk of being wed, from sheer happiness to financial stability to, of course, health. Well, here's the latest: Not only is marriage good for you, the inverse is also true -- divorce or the death of a spouse can harm one's health even if the person remarries, according to a study by researchers from Johns Hopkins and the University of Chicago.

(Is it just me, or do these studies always seem to come out when some high profile split is in the news? Jon and Kate plus 8 anyone? With all their drama, I wonder how their health is doing?)

Anyhow, the marriage study, appearing in next month's Journal of Health and Social Behavior, found that people who were divorced or widowed were 20 percent more likely to have a chronic health condition such as heart disease, diabetes or cancer than married people. They were also 23 percent more likely to have mobility problems than couples who stayed together. Even people who remarried were 12 percent more likely to have chronic health problems and 19 percent more likely to have mobility troubles than their married peers.

The data come from interviews done in 1992 of some 8,600 people aged 51-61 years old. Researchers said stress is a likely factor for poor health of those who divorced, findings they say back up years of research on the benefits of marriage. I should point out that one of the investigators is University of Chicago sociologist Linda Waite, author of the book: The Case for Marriage: Why Married People are Healthier, Happier and Better off Financially.

One could argue being in a couple has the simple advantage of having someone there to look out for your health when you aren't. I know many men who say they wouldn't go to the doctor for a checkup if their wives didn't make the appointment for them. I know that's true in my household. What do you think?

photo from stock.xchng

Posted by Kelly Brewington at 12:58 PM | Permalink | Comments (1)
Categories: General Health
        

A new study out today suggests that 7 out of 10 children in the U.S. have low levels of vitamin D, raising their risk for bone and heart disease.

The findings, in what appears to be largest study to date of children and vitamin D, seemed to surprise even the researchers. In sheer numbers, the study published online in the journal Pediatrics suggests that 7.6 million children have a vitamin D deficiency while 50.8 million more have levels considered insufficient.

The American Academy of Pediatrics recently recommended that children take vitamin D supplements of 400 IU a day.

Vitamin D is called the "sunshine vitamin," because much of our intake comes from the sun's rays. But with children spending less time outside and usually being slathered with sunscreen when they are there, vitamin D levels have been dropping for years.

Those who are more likely to have lower levels of vitamin D were older children, non-Hispanic blacks, Mexican Americans, those born outside the United States, obese children and those who spent more time watching television, playing video games or using the computer. In contrast, those who drank milk daily and those who took supplements were more likely to have adequate vitamin D levels.

Baltimore Sun photo

Posted by Stephanie Desmon at 7:00 AM | Permalink | Comments (0)
Categories: Pediatrics