Well, it was only a matter of time. Last month, we told you about an iPhone application called Outbreaks Near Me, designed by researchers from the Children's Hospital of Boston, promising to help you track every move of the H1N1 virus.

There's also an application called Swine Flu Tracker from IntuApps which maps suspected cases and even informs you of the "threat level" of the virus. OK, this is just too Sci-Fi for me.

Well, of course, there's a new application designed to inform health geeks, iPhone addicts and hypochondriacs alike about all things H1N1. This one, however, carries the cache of Harvard Medical School and aims to educate more than entertain.

For $1.99 -- you didn't think it was free, did you? -- you get tools to help diagnose yourself, news feed from Harvard Medical School on the latest H1N1 updates from the CDC and local public health officials, and advice from Harvard Business School experts on how employers can best prepare their workers for a pandemic and even business guides for traveling employees.

It also offers phone hotlines for more flu information and guides for preparing for a pandemic emergency.

It's part of Harvard's overall strategy to promote public health through technology with its new venture called HMSMobile, where you can also check out a trailer of the new iPhone app.

What do you think? Any takers?

photo: AFP/Getty

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (3)
Categories: Swine flu/H1N1
        

We talk about it all the time here at Picture of Health -- diet and exercise can help ward off a host of diseases. Bear with me if you're tired of hearing it, but it's true. A new study based on 10 years worth of data drives home the point when it comes to a disease that affects some 24 million people nationwide: diabetes.

People who stuck to a healthy diet and consistent exercise over a decade cut their risk of diabetes by 34 percent, according to new research sponsored by the National Institutes of Health and published in the latest issue of The Lancet. Diet and exercised lowered the diabetes risk even better than the diabetes drug metformin, which reduced the rate of developing the disease by 18 percent, according to the study.

About 11 percent of the nation's adult population has diabetes, the vast majority of them the type 2 variety, the kind that can be prevented. Being overweight, inactive and having a family history all contribute as risk factors. Another 57 million overweight have glucose levels higher than normal, but not yet in the diabetic range. Still, those levels keep them at high risk of developing diabetes down the road or having a heart attack or stroke.

The study followed a racially-diverse group of 3,234 overweight and obese adults, aged 25-85, with high blood glucose levels. Over a decade, some changed their lifestyles, eating lower fat, lower calorie diets and exercising up to 150 minutes per week. Another group took metformin and a third was the placebo group.

After 10 years, the group that ate better and exercised delayed diabetes by about four years, while the metformin group delayed it by two years, researchers found. Older people had the best results -- those 60 and older lowered their risk of diabetes over the decade by about half.

Posted by Kelly Brewington at 12:31 PM | Permalink | Comments (2)
Categories: General Health
        

Children without insurance are 60 percent more likely to die than their insured peers, according to a new study from Johns Hopkins researchers that argues that health care reform must protect the nation's most vulnerable.  

The findings, published in the Oct. 30 issue of the Journal of Public Health, offer another sobering statistic: lack of insurance might have contributed nearly 17,000 deaths among children in the United States over the last two decades.

Researchers analyzed more than 23 million hospital records from 37 states between 1988 and 2005, comparing the risk of death in children with and without health coverage. When comparing death rates taking into account underlying disease, uninsured kids had a higher risk of dying regardless of their medical problems, researchers found.

The uninsured rate for children has been rising steadily for two decades causing some lawmakers to fight for expansion of the public insurance to low-income kids through the Children Health Insurance Program, which President Obama signed into law earlier this year. Last year, the rate and the number of uninsured children dipped to their lowest since 1987. Still, advocates are quick to point out, some 7.3 million children lack insurance nationwide.

Confronting the issue is a moral imperative, said researchers.

"Thousands of children die needlessly each year because we lack a health system that provides health insurance. This should not be," said Dr. Peter Provonost, director of Critical Care Medicine at Hopkins, in a statement. "In a country as wealthy as ours, the need to provide health insurance to the millions of children who lack it is a moral, not an economic issue."

The authors cautioned that the study has some big limitations, for instance: researchers examined hospital records after a child died, so they can't say for certain if there a direct cause and effect between lack of coverage and deaths. Still, they say, because of the large number of records studied, they can show a close link between children without coverage and their heightened risk of death.

"Can we say with absolute certainly that 17,000 children would have been saved if they had health insurance? Of course not," said Dr. David Chang. "The point here is that a substantial number of children may be saved by health coverage."

The study comes a month after Harvard researchers found that some 45,000 Americans die each year because of lack of health insurance.

Posted by Kelly Brewington at 7:13 AM | Permalink | Comments (3)
Categories: Pediatrics
        

Seems nearly everyone who wants a swine flu vaccine these days can't find one. Hospitals don't have enough to inoculate their at risk patients, pregnant women can't find the vaccine at their doctors offices and pediatricians have told parents of young children that they may only be able to get one dose of the vaccine, not the recommended two courses.

Manufacturing delays have caused unexpected shortages of the vaccine and huge lines like this one (right) are forming outside clinics nationwide.

While the government assures us that more vaccine is on the way, other public health experts think we may have the formula all wrong. The government would have more supply to go around if it took into account the immune response differences between men and women, argues a new op-ed in today's NYT by Sabra L. Klein, assistant professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health and Phyllis Greenberger, president and chief executive of the nonprofit Society for Women’s Health Research.

Right now, men and women get the same doses of the vaccine. Yet, research shows that women tend to generate a stronger immune response than men, so they would likely need less vaccine to be protected, according to the piece. Accounting for such differences would allow health officials to stretch vaccine supply further.

The research is quite interesting, and I have yet to hear any other public health official make mention of it. The authors quote a recent study showing that women produce as many antibodies to half a vaccine dose as men did to a full dose. While more study on such differences is needed, the evidence could have been used to help dole out more vaccine to more people, the authors say.

Taking into account such differences, could mean vaccinating more people faster -- not only in this country, but in poor nations across the globe who will undoubtedly struggle to vaccinate their populations, the authors conclude.

Baltimore Sun photo

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (0)
Categories: Swine flu/H1N1
        

Telecommuting is a way of life for most businesses, as the internet keeps us connected to the office, from near and far.

With the swine flu in full swing, businesses have adopted contingency plans to allow their employees to work from home if they are sick, or at least until they get well enough not to infect their colleagues upon their return.

But in the event of a severe pandemic flu emergency, sending millions of workers home, the sheer magnitude of people logging on from their home computers could create so much internet congestion, the entire system could be crippled, a new report from the Government Accountability Office warns. 

This is not merely a question of how would we all survive without Google for a few days. (Although that is a frightening prospect) Such an onslaught could imperil the financial markets and even threaten national security, the report states.

If schools and workplaces were to close because of a severe H1N1 outbreak, an increase in internet traffic could overwhelm local providers' capacity. Such clogged communications could threaten essential activity to keep the nation's economic engine churning.

While many of the securities markets have contingency plans in place to be certain they can stay up and running during an emergency, not all were prepared, the GAO said. The Securities and Exchange Commission needs a better review of the policies, the report stated.

Meanwhile, the Department of Homeland Security, responsible for making sure critical communications continue in an emergency, needs to develop a plan for confronting such a scenario, the GAO said.

In addition, according to the report, the agency hasn't discussed the issue with the public, recommending such things as limiting internet usage to vital matters only during an emergency and other guidelines. And it hasn't sorted out with other agencies who has the authority to do what needs to be done to lessen internet congestion.

Baltimore Sun photo

Posted by Kelly Brewington at 7:10 AM | Permalink | Comments (3)
Categories: Swine flu/H1N1
        

Last week, we discussed the American Cancer Society's guidelines on breast and prostate cancer and the notion that some cancer screenings may do more harm than good. It all comes from the idea that people can have certain cancers that may never hurt or kill them.

Some of you responded, well, how is that? We agree, it's a puzzling idea. Most of us have been taught that modern medicine exists to find our health problems and cure what ails us, fast and before it gets any worse. Shouldn't that be the same with cancer?

Well, a NYT story yesterday takes a look at how cancers detected early when they are very small can actually vanish and not cause a patient any harm in the future. Instead of growing worse, some of these cancers get smaller and cause the patient no problems.

Not all cancer experts are sold on this viewpoint. Others have come around slowly:

“At the end of the day, I’m not sure how certain I am about this, but I do believe it,” said Dr. Robert M. Kaplan, the chairman of the department of health services at the School of Public Health at the University of California, Los Angeles, adding, “The weight of the evidence suggests that there is reason to believe.”

The piece is a good explainer for a complex topic. Take a look and let us know what you think.

Baltimore Sun photo

Posted by Kelly Brewington at 12:20 PM | Permalink | Comments (2)
Categories: Cancer
        

The University of Maryland Medical Center has joined other area hospitals in instituting a new visitor policy today in an effort to protect visitors, staff and patients from H1N1 influenza, or swine flu now widespread in the Baltimore region.

The new policy says:

+No one under 18 is allowed in inpatient units, unless they are parents of hospitalized children.

+There is a 2-person limit on visitors per patient.

+All visitors must check in at either the Greene Street or Gudelsky Reception Desk.

+Visits are not permitted by anyone with flu symptoms, including fever, cough or sore throat.

Officials say children and teenagers have been restricted because they are  among those most affected by the swine flu outbreaks and are at highest risk of complications and death.

Officials also say patient care leaders may alter the policy on an individual basis if it's in the best interests of patients. That could mean excluding visitors altogether or allowing additional visitors for compassionate care reasons.

The hospitals plan to put up posters announcing the new policy.

Associated Press photo

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

You can get just about anything online these days. Problem is, some of it isn't what it seems.

As the swine flu continues to sicken people, it has also created a market for treatments. The U.S. Food and Drug Administration is warning everyone to take care because some of the stuff isn't real.

The FDA has rooted out all kinds of bogus treatments, including shampoos, dietary supplements and air purifiers that claim to prevent the flu. Officials have also tested samples of "Tamiflu," the drug treatment for the flu, and found them to be talk and aspirin or something else.

Don't be fooled. Search for fraudulent products here:

Posted by Meredith Cohn at 3:18 PM | Permalink | Comments (1)
Categories: News roundup
        

Anyone who has struggled with their weight knows what it's like to be on the receiving end of fat jokes. Despite a national obesity epidemic, our society isn't particularly sensitive to overweight people. Doctors included.

A new study from Johns Hopkins researchers found that physicans actually have less respect for their obese patients. In fact, in a study of 238 Baltimore patients, researchers found the higher their body mass index, or BMI, the less respect they received from their doctors. Ouch.

For 40 years, studies have documented health care providers' negative bias toward overweight people, the new study states. Some past research has found that obesity was a characteristic that elicited "negative feelings" among doctors. Others found that health care professionals associate obesity with negative terms such as lazy, incompetent and ignorant. Wow. And still other studies have found doctors are ambivalent about treating obesity.

But Hopkins researchers say this new study, appearing in the November issue of the Journal of General Internal Medicine, is among the first to examine doctors' direct attitudes toward their obese patients.  

Beyond the obvious reasons, here's why respect from one's doctor is important: when physicians respect the people they care for, patients get more information out of their doctors, and one would hope, make better health decisions. 

I'd bet that patients can likely sense that lack of respect and I would expect it would have bad health consequences. I mean, if you get the feeling your doctor thinks you're a lazy fat slug, what's the likelihood that you would go back to him or her for your care?

Researchers say more study is needed about how these negative attitudes affect the quality of patient care.

"If a doctor has a patient with obesity and has low respect for that person, is the doctor less likely to recommend certain types of weight loss programs or to send her for cancer screening?" said Dr. Mary Margaret Huizinga, an author of the study. "We need to understand these things better."

And beyond, doctors need to be taught about obesity bias and how to avoid discrimination. For now, in med school, there's little discussion about these negative attitudes, Huizinga said.

photo: AFP/Getty images

Posted by Kelly Brewington at 7:11 AM | Permalink | Comments (7)
Categories: General Health
        

Around the country 60 percent of the best-selling health care plans will charge a 40-year-old nonsmoking woman more for her health insurance  than a nonsmoking man of the same age, according to a recent report by the National Women's Law Center.

The discrepancy has sparked the center's new campaign web: "Being a woman is not a pre-existing condition," complete with T-shirts and direct to congress form letters to urge legislators to make sure women are not forgotten in the health care reform debate.

The report also found that in some states, it's legal for an insurer to reject a woman who has been a victim of domestic violence, or reject a woman simply because she's pregnant or has had a c-section in the past. This Newsweek article also breaks down some other inequities.

Insurance companies can charge women more for similar coverage through gender rating, which is allowed in 40 states and the District of Columbia, the report states. This happens in the individual insurance market, not typically among large employers, who are prohibited from discriminating on the basis of gender and other factors. Still, those higher costs affect millions of women every day.

Gender, it turns out is just another characteristic that insurance companies use to determine costs, just like age or whether someone smokes. Maternity care is a not the only cause for the discrepancy. Studies find that women are more likely to go to the doctor than men.

Some women lawmakers are joining groups like the law center to demand health insurance reforms that will put an end to some of these little known provisions.

"When it comes to health insurance, women are discriminated against," said Sen. Barbara Mikulski, a Maryland Democrat, who wants the any bill that's passed to require policies that cover mammograms and pap tests. "We pay more and we get less, and often we are denied care."

Baltimore Sun photo

Posted by Kelly Brewington at 11:58 AM | Permalink | Comments (1)
Categories: General Health
        

A CDC advisory panel has said the HPV-vaccine Gardasil should not be used routinely in men and boys. The panel's advice, which the CDC usually follows, comes on the heels of the vaccine winning approval for boys by the Food and Drug Administration.

The panel said it's OK to give the vaccine to males who want it, but stopped short of adding it to the list of routine recommended vaccines for boys.

Supporters of the vaccine's use in boys had hoped recommending the vaccine to them would lead to greater protection for girls and women from the sexually transmitted virus (HPV) that can cause cervical cancer. But members of the panel questioned whether this was cost effective. The vaccine isn't cheap -- a series of three injections runs upwards of $300.

Others hoped that the approval would signal gender parity in the war against sexually transmitted diseases. After all, it takes two doesn't it? If girls can contract HPV from sex, shouldn't their partners help protect them from the virus?

The vaccine would also protect boys from genital warts. While genital warts may not be as severe as cervical cancer, the costs associated with its treatment could be reason enough to vaccinate boys, some experts say.

"It’s embarrassing, but it does not cause cancer," Dr. Maura Gillison, an oncologist at Ohio State University told me recently. "But it does cause a heck of a lot of money for the American health care system. For that, there is no question."

Gillison, who made the connection between HPV and head and neck cancers in men, thinks perhaps with more study, the vaccine could be shown to protect against these painful, disfiguring and difficult to treat cancers.

For now, though, the CDC news begs an interesting question: will teenage boys end up getting the vaccine anyway? Will parents think it's necessary and worth it? And how will they navigate yet another uncomfortable conversation of adolescence?

As far as girls are concerned, pediatricians tell me the conversation is tough and many parents are reluctant to have their daughters vaccinated. About one in four girls gets the vaccine, which is expensive and remains controversial because of some side effects.

"Girls' parents are really hesitant about it," Dr. Terry Nguyen, a pediatrician told me recently, adding that about half of her teenage girl patients get the vaccine. "For boys, I think it’s probably going to be different. For girls, it's a conversation about cancer and their futures. For boys, it's genital warts. It’s not as concrete for them."

Posted by Kelly Brewington at 7:39 AM | Permalink | Comments (4)
Categories: Pediatrics
        

We've had this conversation a lot here at Picture of Health when it comes to breast and prostate cancer: to screen or not to screen?

We've explored studies that expressed some doubts about the benefits of mammography, that some women overestimate the mortality reduction of breast cancer screening and that studies have shown that approximately 1 life is saved for every 1,000 mammograms given.

And we've discussed the debate over prostate cancer screening and whether the disease is being overdiagnosed, exposing men to potentially harmful treatment for cancers that may pose no harm to them in the long run. Another recent study showed that some men may not be getting the counseling from their doctors that they need to understand the risks.

So it didn't surprise us when an NYT story reported yesterday that the American Cancer Society is reconsidering its screening guidelines for breast and prostate cancer. And a new editorial in the Journal of the American Medical Association raises similar doubts, finding that such screenings are turning up more cancers that may never hurt people.

We wondered, though, is this really a shift in philosophy?

The idea that screening saves lives is not as simple as it sounds, and the advantages of screening have been "exaggerated,"  Dr. Otis Brawley, chief medical officer at the American Cancer Society told the Times. 

The NYT story created quite the buzz yesterday, so much so that the cancer society clarified its stance on breast and prostate cancer screening, saying that while the benefits of some screening have been overstated, mammograms for women 40 and over are still encouraged.

I've talked to Brawley about this concept before -- that people can have cancers that may never kill them and never pose them harm. And sometimes, treating those cancers exposes the patient to harmful and unnecessary treatment. His major point, I believe, was that clinicians should exercise caution and that patients should be aware of the benefits AND the potential risks.

Brawley underscored those points on NPR this morning, specifically regarding prostate cancer screening: "I and the American Cancer Society are not against screening, but we're for men knowing that there are some questions here as to whether screening is effective and then making a decision that they are comfortable with."

Associated Press photo

Posted by Kelly Brewington at 11:09 AM | Permalink | Comments (2)
Categories: Cancer
        

Medical professionals are often left in the dark about the benefits and harms of prescription drugs because the details often fail to make their way to the label, according to a new editorial in the New England Journal of Medicine.

The whole process of which harms and benefits end up on drug labels -- package inserts that come with medications -- is complex. And sometimes, harmful information is excluded, according to the article by Dr. Lisa M. Schwartz and Dr. Steven Woloshin of the Darthmouth Institute for Health Policy and Clinical Practice.   

The labels, it turns out, are written by the manufacturers of the medication. Those labels are later approved by the Food and Drug Administration. Drug companies provide documents to support their case for the benefits and harms of a drug, but too often, doctors who want to prescribe a drug don't have all the critical information they need because its missing from the approved label, the authors contend.

Take the drug Lunesta, whose sales reached $800 million last year. The label says only that it is superior to placebo, but it doesn't explain how much, the authors state. In fact, the FDA review of studies on Lunesta found that while it did perform better than placebo in one test, on average, patients still had trouble falling asleep and didn't report being more alert in the morning.  

While the FDA has made improvements recently, the bottom line, the authors say, is the agency needs more thorough in communicating drug information to doctors.

Baltimore Sun photo

Posted by Kelly Brewington at 7:03 AM | Permalink | Comments (0)
Categories: General Health
        

The level of mercury in the blood of autistic children is no different than that of their typically developing peers, according to new research that takes aim at the theory held by some parents that one trigger -- mercury in vaccines -- causes autism.

Several studies have ruled out that vaccines cause autism. Nevertheless, the issue sparks controversy in some circles at just the mention of a possible link.

The new study by researchers at the University of California Davis' MIND Institute, looks directly at blood-mercury levels and finds they are virtually no different a group of 452 children 2 to 5-year olds, 249 of whom were diagnosed with autism. The study examined a wide range of sources of mercury in the children's environments, from dental fillings to fish consumption. The research, published in the journal Environmental Health Perspectives, comes from a long-range study to identify causes of autism, a wide spectrum of disabilities marked by impaired communication and social interaction.

It's important to note that while the study is among the first to examine the blood mercury levels of children with autism, researchers cautioned that they did not probe whether mercury is a factor in the cause of autism.

Still, researchers point to it as evidence that a host of research is necessary to identify what is likely a complex web of causes for a very complicated set of neurobiological disorders.

 "Just as autism is complex, with great variation in severity and presentation, it is highly likely that its causes will be found to be equally complex, " said Irva Hertz-Picciotto, the study's lead author. "It's time to abandon the idea that a single 'smoking gun' will emerge to explain why so many children are developing autism. The evidence to date suggests that, without taking account of both genetic susceptibility and environmental factors, the story will remain incomplete."

Baltimore Sun photo

Posted by Kelly Brewington at 7:03 AM | Permalink | Comments (1)
Categories: Pediatrics
        

Back when I was in school -- no need to specify when -- lunches consisted of a rectangular block of pizza and milk (chocolate if it was Friday!). On some days I don't recall a single vegetable on my plate.

School lunches have improved since then, but they have a ways to go as far as nutrition is concerned, according to a new study by the Institute of Medicine, that urges new dietary standards. The current guidelines -- which set the standard for school lunches for some 30.5 million children and breakfasts for another 10.5 million -- haven't been changed since 1995, the report states. 

The report recommends that lunches have more fruit, vegetables and whole grains and less saturated fat and sodium. Right now, there are no requirements for whole grains and fruit and veggies are counted in the same category. While the current guidelines set minimum calories needed, there is no maximum set.

The current guidelines don't specify limits for sodium, either. Right now, a typical high school lunch contains about 1,600 milligrams of sodium. The new recommendations say the limit should be more than half that amount at 740 milligrams.  

Making these changes will mean an increase in the cost of providing these meals --  but the changes are necessary, the report states. Considering the growing child obesity levels, teaching children to eat right early is important.

"The programs that nourish so many American schoolchildren need to reflect the latest child health and nutrition science given the extent to which dietary habits shape lifelong health, said Virginia A. Stallings, of Children's Hospital of Philadelphia and chairwoman of the committee that wrote the report.

Baltimore Sun photo

Posted by Kelly Brewington at 3:00 PM | Permalink | Comments (3)
Categories: Pediatrics
        

We're less than a few short hours from our live chat about all things H1N1. Got a question about the vaccine? It's safety? The supply? Or just curious about the flu itself?

Flu expert Andrew Pekosz, a professor of immunology at Johns Hopkins Bloomberg School of Public Health, will be here at noon to answer all your swine flu questions.  

You can send questions in advance to me at kelly.brewington@baltsun.com or comment below. See you soon!

Posted by Kelly Brewington at 7:06 AM | Permalink | Comments (1)
Categories: Swine flu/H1N1
        

The Obama Administration said today that people who use and sell marijuana for medical purposes should not face federal prosecution. Instead, prosecutors should go after only high level traffickers.

The new Justice Department guidelines issued today to 14 states that allow medical marijuana effectively reverse long-existing stance on the drug. The Bush Administration raided medical distributors who violated federal laws.

While a handful of states allow marijuana for medical purposes, it's carefully restricted. California, however, is the only state where dispensaries can sell and advertise marijuana.

And the practice has taken off in recent years and attitudes toward the drug appear to be changing. Smoking pot is no longer taboo, but just well, normal, according to this piece in the LA Times. 

At fashion-insider parties, joints are passed nearly as freely as hors d'oeuvres. Traces of the acrid smoke waft from restaurant patios, car windows and passing pedestrians on the city streets -- in broad daylight. Even the art of name-dropping in casual conversation -- once limited to celebrity sightings and designer shoe purchases -- now includes the occasional boast of recently discovered weed strains such as "Strawberry Cough" and "Purple Kush."

As I heard Jon Stewart say on The Daily Show recently: did California just legalize marijuana without anybody noticing?

It's not just that the practice has gone mainstream, but so has the press about medical marijuana. Check out the interactive map  also from the LA Times, which notes Los Angeles-area dispensaries as well as the huge growth in applications to open new ones.

Medical marijuana patients, who say the drug eases chronic pain and helps with nausea often triggered by chemotherapy, call the new guidelines a huge victory. Meanwhile others say they will do nothing to clamp down on the big problem of marijuana trafficking. What do you think?

Associated Press photo

Posted by Kelly Brewington at 3:15 PM | Permalink | Comments (3)
Categories: General Health
        

Andrew Pekosz, an associate professor of molecular microbiology and immunology at Johns Hopkins Bloomberg School of Public Health, chats about H1N1 and the vaccine.

Posted by Kelly Brewington at 10:14 AM | Permalink | Comments (26)
Categories: Swine flu/H1N1
        

Health care workers have notoriously low rates of vaccination against the seasonal flu -- as low as 42 percent according to estimates by the Centers for Disease Control and Prevention, even though they are constantly encouraged to be among the first to get the vaccine.

Hospitals are trying to improve this, especially this year, as the swine flu pandemic is making everyone worried that a severe flu season could overburden hospitals and their staffs.

In this story, I explain how some Maryland hospitals are becoming more strict with their policies, making seasonal flu shots mandatory, with certain exceptions for people with medical or religious excuses. If they refuse, workers could be face disciplinary action, including termination. In New York, a statewide mandate has been greeted with loud protests and a lawsuit from hospital workers.

So, would you want your doctor to get a shot?

Associated Press photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (3)
Categories: Swine flu/H1N1
        

We know you have questions about all things H1N1 -- seems it's all we talk about these days. Is the vaccine safe? What's in it? Will it work? Is it even necessary?

Well, we are here to help. Andrew Pekosz, a professor of immunology at Johns Hopkins Bloomberg School of Public Health, will be here Tuesday to do a live chat with readers to answer all of their swine flu questions.  

Chat starts at noon. You can send questions in advance to me at kelly.brewington@baltsun.com

Posted by Kelly Brewington at 5:40 PM | Permalink | Comments (9)
Categories: Swine flu/H1N1
        

Smoking bans--love them or hate them--appear to reduce the risk of heart attack and heart disease of nonsmokers, a major government report concludes.

It's a finding that many researchers had expected. As smoking bans proliferate around the globe, health officials' major argument for implementing them is to prevent illness in non-smokers. 

The report, from the Institute of Medicine, part of the National Academies of Sciences, is based on a major review of numerous studies on smoking and long-term cardiovascular problems. 

Eleven key studies of smoking bans in the US, Italy, Canada Scotland showed repeatedly a reduction of heart attack rates in places after bans had been instituted. It was hard to say precisely how much the risk decreased, since the studies varied in their methods. But the range was between 6 percent and 47 percent decrease in the incidence of heart attack in places with smoke-free policies.

The bottom line, according to the report: smoking bans work.

"Bans reduce the risks of heart attack in nonsmokers as well as smokers," said Lynn Goldman, professor of environmental health sciences at Johns Hopkins Bloomberg School of Public health in a statement.

More research is needed to quantify exactly how great the effect of smoking bans is on one's health, said Goldman, who is also chair of the committee of medical experts who wrote the report. "However, there is no question that smoking bans have a positive health effect."

After covering smoking bans in the past -- and writing about secondhand smoke here -- I know this is a divisive issue. Some people love the bans; others say they infringe upon individual rights. What do you think?

photo: stock.xchnge

Posted by Kelly Brewington at 7:07 AM | Permalink | Comments (8)
Categories: Cardiovascular Health
        

It's been mantra of public health officials since the swine flu outbreak in the spring: wash your hands.

But you never hear folks instruct how. Seems pretty ridiculous doesn't it? Everyone knows how to wash their hands, don't they?

Well, apparently they do not. Lots of people are forgetting a crucial companion in the handwashing game: soap.

A new study appearing in the American Journal of Public Health takes an examination of British handwashing trends, specifically after people had exited the loo.

Researchers installed sensors in highway service station bathrooms to record soap use in about 200,000 people. Flashing signs reading such messages as "Don't be a dirty soap dodger" and "Don't be a dope, use soap" encouraged people to wash their hands the right way. Researchers alternated between more than two dozen  reminders, from the gentle to the heavy handed. They also tested what happened when people didn't get a reminder. 

Without reminders, only 32 percent of men washed their hands with soap. Seriously, guys! Women did twice as better -- 64 percent. Still, ewwwww. I'm disturbed.

People who got reminders did a little bit better. But what's really fascinating is the kind of reminders people responded to.

Women increased their soap use regardless of the kind of message reminding them to do so. But they increased their use the most --9.4 percent -- with simple messages such as "wash your hands with soap." Men, meanwhile, preferred messages that signaled disgust. They increased their soap use --9.8 percent -- after reading signs that said "soap it off or eat it later." Gross.

Overall among men and women, guilt was most effective, as in: "Is the person next to you using soap?" Maybe folks should ask themselves this more often.

photo: AFP/Getty

Posted by Kelly Brewington at 12:29 PM | Permalink | Comments (7)
Categories: General Health
        

We've written a good deal here at Picture of Health about racial and ethnic health disparities. But here's an issue of unequal access that's news to me: gaps in care among children with brain tumors.

Hispanic children who have been diagnosed with brain tumors are less likely to receive high-quality treatment in specialty hospitals than their peers of other ethnicities, according to a recent paper by Johns Hopkins researchers.

The findings, published in a recent issue of the journal Pediatrics, found that out of a study over 18 years of 4,421 children with brain cancer, Latino children had the worst access to quality care.

You might think this is a matter of access to good health insurance. But researchers found that coverage didn't play a role in where a patient was treated. Rather, even after adjusting for socioeconomic status, Latino children received top-notch care at one-third of the rate of other children, researchers found.

The gaps in care were shocking to researchers. Despite recent studies and industry efforts pushing to provide quality care for all, the gaps remain, they said. The reasons for the gaps are unclear. Perhaps Hispanic kids are less likely to live near to-notch institutions? Or maybe something else is at play? Researchers also found disparities were higher in communities with high numbers of immigrants and fewer neurosurgeons, which makes sense.

Researchers said the findings are yet another example of the major changes needed to improve access to care.

"Our findings are yet another reminder that we are at a unique corssroad in history as we try to  restructure our healthcare system," said Dr. Alfredo Quinones-Hinojosa, associate professor of neurosurgery and oncology at Hopkins (pictured above) in a statement. "we have been given a chance to reduce, perhaps even, eliminate, these inequities once and for all.

Baltimore Sun photo

Posted by Kelly Brewington at 7:21 AM | Permalink | Comments (0)
Categories: Pediatrics
        

The Sun has launched a new feature we hope will keep us better connected with readers and help us tell stories about the economy that are most important to them. 

By joining Light Source, you'll get a monthly email asking about your experience with various economic topics. This month: health care. We'll use the answers to help shape stories that you will eventually read in The Sun's news pages and on its website. You'll be our new network of real-life experts.

We know Picture of Health readers have lots to say about health care reform. Whether you're a provider, patient or insurer, we want to hear your issues and concerns. Check it out here and let us know what you think.

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (1)
Categories: Health care reform
        

When it comes to the H1N1 virus, falsehoods, half-truths and straight wackiness abound. So perhaps it's no surprise that even some of the nation's popular commentators are taking to the airwaves with their own brand of swine flu paranoia.

First, from the left: Talk show host Bill Maher, technically a Libertarian, but he's got a big lefty following, has said he doesn't think healthy people can come down with the flu (false) and discouraged pregnant women from getting vaccinated (even though they are at higher risk for complications and death from the virus).

He even told his Twitter followers that people who get the shot are "idiots." Now, that's just mean! Maher told Bill Frist, a doctor and former Republican Senate Majority Leader that the vaccine puts "a disease into your arm.” No. While the nasal spray version of the vaccine contains a form of the live virus -- though much weakened -- the flu shot is made of a killed virus.  The NYT Well blog breaks it down further.

The right's at it too: Rush Limbaugh and Glen Beck have both suggested that the vaccine may be unsafe and that it's the latest example of the government overreaching into Americans' private lives.

The liberal group Media Matters has even compiled the details of their concerns, including this quote by Limbaugh: "Screw you, Ms. Sebelius! I am not going to take it, precisely because you're now telling me I must." (In reference to Health and Human Services Secretary Kathleen Sebelius.)

Classy.

Folks here and here have already come out to blast these opinions, specifically Maher's. Here's some good commentary by the folks at Discover Magazine's Bad Astronomy blog, with a clip of the interview exchange between Maher and First.

What do you think?

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (9)
Categories: Swine flu/H1N1
        

After months of partisan debate and political wrangling, the Senate Finance Committee prepares its crucial vote today on legislation to overhaul the nation's health care system and expand insurance to many of the nation's 47 million people without coverage. 

We figure this is as good a time as any to take the pulse of our Picture of Health readers on what they think of the plan.

The bill would raise the number of Americans with insurance from 83 percent to 94 percent and cost some $829 billion over a decade and Sen. Max Baucus, the committee chairman, says he's got the votes to get it approved. It would also expand Medicaid, require most Americans to have health insurance and impose a fee on most employers who don't offer insurance to their employees.

If you're interested in further details on the bill, the Kaiser Family Foundation has a great web tool that allows you to get the highlights and compare it to other plans being batted around in Congress. Check it out here.

A recent poll by Consumer Reports found that just 64 percent of Americans are satisfied with their current health care plans. Another new study by the nonpartisan think thank the Brookings Institution sheds light on how the public feels about a host of health care reform issues.

For instance, a the Brookings poll found that three in five Americans think the government has the responsibility to ensure that citizens can meet their basic need for health care and two out of three think the government is doing a bad job at meeting those needs.  Among the other key findings:

• A majority favors a public insurance option -- which would compete with the private sector -- should be available to all, while three-quarters think it should be limited to people who cannot get insurance through their employers.
• Three in four Americans said they were concerned that the cost of health insurance may soon be too great for their families to afford.
• The public is split on individual mandates -- requiring most Americans to have insurance for themselves and their children, with subsidies for low-income people to help them pay for coverage. Those who don't get insurance risk a financial penalty. 52 percent agree with the mandate, while 44 percent did not.

So, what do you think? Like a public option? Hate individual mandates? Think there's not enough pressure on insurance companies to do right by patients? Sound off!

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (8)
Categories: Health care reform
        

As the swine flu virus spreads swiftly across the nation, hospitals are getting strict about their visitation policies, forbidding children and urging visitors to screen themselves for flu-like symptoms before they enter the hospital doors.

In a story in today's Sun, I talked to a Mom of a 3-year-old, who is due to have a c-section with her second baby next week. She's upset about the new policies because her 3-year-old will be banned from her hospital room. The intimate family moment where she hoped to introduce her older child to the newest addition to the family won't happen.

Hospitals say the new policies are vital to patient and staff health and safety. And depending how severe the virus becomes, they may not be the last restrictions that hospitals enact. Hospitals have told us they have lengthy pandemic preparedness plans. Still, in a worst-case scenario, they will encounter serious challenges if masses of sick people flood emergency rooms and intensive care units.

An interesting editorial in this week's Journal of the American Medical Association asks: How will hospitals respond to the needs of the sickest patients? The editorial examined several recent studies that show that people seriously sickened by the H1N1 virus deteriorate rapidly.  

Key to any hospital's strategy is a detailed plan for triaging the most sickest of, the editorial states. The guidelines must be specific, such as, who should and should not get life support in an emergency situation and other tough calls. The questionable calls made during Hurricane Katrina, during which some doctors hastened the death of sick patients they believed wouldn't survive an evacuation, highlights the need for explicit plans, the article states.

"Any deaths from 2009 influenza A(H1N1) will be regrettable, but those that result from insufficient planning and inadequate preparation will be especially tragic," the paper concludes.

Baltimore Sun photo

Posted by Kelly Brewington at 7:24 AM | Permalink | Comments (1)
Categories: Swine flu/H1N1
        

Two recent stories about the swine flu pandemic reflect persistent fears about the vaccine and reveal how work places are gearing up to protect their employees from the virus.

First off: the worries. For weeks, it's become a mantra of public health officials and infectious disease experts: the swine flu vaccine is safe. Make sure you get one. 

Nevertheless, parents are still very uneasy about the vaccine. A recent article by our colleague Meredith Cohn found parents who fear the inoculation hasn't been thoroughly tested and others who worry about giving their small children too many vaccines. Others are bewildered by the onslaught of information about the virus and the development of the vaccine. An Associated Press poll last week found that a third of parents oppose giving their children the vaccine.  At a dinner party I attended Saturday night, I heard the same fears repeated by moms.

And yet, public health officials are quick to note that children are more vulnerable to this new flu. In fact, a 14-yearold Baltimore girl with no underlying health problems died of the virus two weeks ago. I expect officials' get-the-shot urgings will not end any time soon.

Meanwhile, workplaces are making sick leave policies more lenient, developing contingency plans in the event of mass absenteeism and even offering cool incentives to their workers who get a swine flu shot. We told you about the former on the blog a few weeks ago -- Pinnacle Communications employees who get vaccinated against the H1N1 virus, get an hour of personal training and a free day off. Cool. 

Hoping to keep businesses productive this winter, workplaces everywhere are driving home one message: get vaccinated and you fall ill, stay home.

Posted by Kelly Brewington at 12:01 PM | Permalink | Comments (2)
Categories: Swine flu/H1N1
        

So, the big 5K race on Saturday turned out to be... well, a piece of cake! Ok, exaggeration. It wasn't easy, but it certainly wasn't as scary as we made it out to be.

It was, in fact, heaps of fun. So much so that we're already talking about taking part in the Baltimore Running Festival's relay team next year or --gasp-- maybe a 10K come spring. To think, a year ago, my idea of running was a quick scurry across the street to make the light. Yes, we have thoroughly lost our minds.

Stephanie, my former colleague here at Picture of Health, and I held a steady -- i.e. slow -- pace throughout the 3.1 miles. That was key for us first-timers. Our expert running colleagues Julie Scharper and Anica Butler, meanwhile, left us in the dust early on. But we didn't mind so much. Stephanie and I chatted the whole time, waved at the awesome spectators who were cheering us on and didn't once try to walk or roll up in the fetal position on the corner somewhere. We really couldn't have asked for a better day with the cool breeze, throngs of cheering onlookers and upbeat music blasting when we made it to the finish line.

Real runners talk about that endorphin rush that comes after any meaningful run. I'm not sure if I felt that, or rather, complete and utter relief that the race was over. Nevertheless, I spent the rest of the day smiling at my new accomplishment, eager to set the next challenge.

Anyone else take part in the Baltimore Running Festival this weekend? How'd it go?!

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (7)
Categories: Healthy Living
        

You heard that right. Your faithful Picture of Health bloggers will be running the 5K in tomorrow's Baltimore Running Festival.

Now, to all you seasoned runners, this may sound like a piece of cake, but for Stephanie and me, this is a true challenge.

We both started running -- well, slow jogging -- earlier this year. Stephanie described on the blog earlier how she got the running bug with the help of a cool fitness DVD.

I took a less structured approach by throwing on some sneakers, plugging in my iPod and just going for it. I tried to following a modified Couch to 5K plan, allowing my iPod to dictate my speed. At first, I'd run one song, walk the next song, eventually running more than I was walking. Then, about a few weeks ago, I realized I could run 2 miles without stopping. Who knew?

All summer, some of our colleagues at The Sun have been nagging us to run the 5K with them. Naturally, we were were terrified. But after months of hemming and hawing, we finally caved. 

And here we are, the day before race day, freaking out! 

Important note: neither Stephanie nor I have ever run an entire 3.1 miles in one shot. Clearly, we have no idea what we are doing. But we're hoping for a fun day out with friends and that the adrenaline of our first race will get us through. We'll update you on Monday about the experience. Until then, pray for us.

Anyone else running this weekend? See you there! 

Baltimore Sun photo

Posted by Kelly Brewington at 12:23 PM | Permalink | Comments (5)
Categories: Diet and exercise
        

Everyone is making their voice heard on health care reform it seems, but there's one group that has been noticeably absent from the fray and experts say they have the most to gain from reform: minorities.

Well, this week some of the nation's most influential minority advocacy groups have stepped up to demand a voice at the table as Congress continues to battle over how to overhaul the nation's health care system. The NAACP, the National Council of La Raza and the Leadership Council on Civil Rights and others have joined forces to advocate for reform.

Blacks and Latinos are more likely than whites to go without health care because they can't afford it, are less than half as likely as whites to have a regular doctor and minorities have among the highest rates of being uninsured.

Preaching that health care is a moral imperative, the groups are taking to the airwaves with an ad campaign, for which the details can be found here: http://www.healthequityforall.org. They're pushing for a comprehensive coverage and quality for all and a plan that includes what has been at the core of the health care fight lately: a public insurance option.

 "If we had enacted real health care reform in the past decade, then we would have saved the lives of 880,000 African-Americans," said Benjamin Todd Jealous, NAACP president and CEO, in a statement. "Real people are going bankrupt, losing their homes and even dying for real health care reform in this country."

Last night, the NAACP's Washington branch held a town hall meeting in an effort to debunk myths about the proposals in congress and provide members an opportunity to ask questions of congressional staffers and experts on reform. As the fight over health care reform heats up, we expect there will be more advocacy to come.

Photo: NAACP president Ben Jealous and members of Congressional Black Caucus urge for reform earlier this year.

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

Maryland ranks 17th in the nation for health care quality, access and affordability, according to a new study by the Commonwealth Fund, which reveals stark differences in care among the states.

The state didn't make it to the top tier of 13 states such as Vermont, Hawaii and Maine who continued to improve quality measures and decrease the ranks of the uninsured. But Maryland held steady for the second year (it was ranked 16 the year before) in the second tier of states doing a decent job amid a "health care system under stress, with deteriorating health insurance coverage for adults and rising health care costs." the report states.

Maryland, for instance, is among just three states with premiums averaging under 14 percent of median income -- far more affordable than the lower ranking states, the report found. Some 83 percent of adults have insurance, just a bit lower than the 86 percent of adults who are insured in top-ranking Vermont.

Last week, we brought you a look at the huge disparities in health care coverage by state, so it's no surprise that another study would find big differences in issues such as wellness and equity -- a measure of how minorities and low-income people fared in each state's medical system.

The report offers an interactive map, where you can click and compare states from #1 ranking Vermont, where 13 percent of adults said they put off seeing a doctor for a medical problem because they couldn't afford it, to #56 Texas, where that figure was more than 35 percent.

In underscoring the disparities, the report presents what it calls a need for real health care reform.

The scorecard highlights persistent wide variation in performance across states and continued evidence of poor care coordination. Increasing cost pressures and deterioration in access across the U.S., together with geographic disparities in performance, underscore the urgent need for comprehensive national reforms to ensure access, change the trajectory of costs, and enhance value.

Posted by Kelly Brewington at 12:19 PM | Permalink | Comments (0)
Categories: Health care reform
        

Got a bad cough, sore throat and an awful fever? Having pain in your chest and trouble breathing? Think it could be the swine flu? Well, like everything in this digital age, there's an app for that. Almost.

Microsoft, actually, not Apple (although, it's only a matter of time before the iPhone jumps on this bandwagon, I predict) has aligned forces with Emory University to launch an online H1N1 symptom checker.

Known as the H1N1 Flu Response Center, the tool asks a series of questions about how you're feeling. Based on the results, it tells you whether you are likely sick with something else or likely to have the swine flu, in which case you should call the doctor, stat.

The U.S. Department of Health and Human Services just launched a similar tool at its www.flu.gov website called H1N1 Flu Self-Evaluation.

The two sites are pretty similar and so are the caveats. The information is meant strictly for people 18 and over and is no substitute for advice from an actual medical professional. So if you're really worried, no matter what, call your doctor.

It's not surprising that the H1N1 scare has sparked these tools. Who among us doesn't plug symptoms into search engines when we're sick, curious to find out what might be afflicting us? But again, Dr. Google, as I like to call this approach, is no substitute for real life medical advice.

The idea behind these new web tools, however, has a real public health implication. The goal is to prevent throngs of people from overburdening emergency rooms, especially when they may not be sick enough to need such attention. If you have a mild illness you can likely stay home and get better on your own, but if you are really ill you may require immediate attention, the folks at HHS remind us.

Flickr photo from el_finco

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

A few days ago, we discussed the scary tale of E.coli contamination in hamburgers and some of you commented that you had gone vegetarian  to avoid the recent meat scares.

Well, turns out veggies can be bad for you too. Leafy greens, tomatoes, even sprouts are among the 10 foods that pose the biggest risks of food poisoning, according to a new report from the nonprofit Center for Science in the Public Interest. These 10 foods account for nearly 40 percent of all foodborne outbreaks linked to FDA-regulated food, the report found. Jeesh.

Leafy greens top the list, followed by eggs and tuna, foods with nutrients that doctors have told us for years are essential for good health. Cheese, a great source of calcium, came in at #6 and berries -- loaded with antioxidants -- round out the list at #10. Also on the list: oysters, ice cream and potatoes.

Together, the 10 foods resulted in more than 1,500 outbreaks, responsible for nearly 50,000 reported illnesses, according to the center. Many more illnesses may go untreated and unreported, so the figure may actually be much larger, the center said.

So, let's get this straight. We've been told that processed foods are bad and meat has its risks, but now that veggies are getting a bad rap, what exactly are we supposed to eat?

The folks at the center say don't abandon healthy options on the list. With so many healthy foods on the list, the watchdog group is urging congress to pass legislation to reform the nation's "fossilized food safety laws."

In fact, the news comes a day after the FDA and the USDA announced it was joining forces to enact new food safety rules for fresh produce.

OK, cool, but what shall we eat for lunch -- today?

Baltimore Sun photo

Posted by Kelly Brewington at 12:06 PM | Permalink | Comments (3)
Categories: Healthy Living
        

With the H1N1 flu virus going around, and the seasonal flu on surely on its heels, what can we do to keep from getting sick – or getting others around us sick?

Wash your hands frequently, is generally the answer. Cough into your sleeve or a tissue instead of into the air or your hands. Get a H1N1 and a season flu shot. And wear a face mask.

Wear a face mask? Yes, said Dr. Faheem Younus, medical director for healthcare epidemiology and infection prevention at Upper Chesapeake Health in Bel Air and a clinical assistant professor at the University of Maryland School of Medicine. He wrote about the subject in The Sun on Oct. 1.

He argued that the Centers for Disease Control and Prevention data showed the masks reduce the spread of the flu in household settings. He says we should wear them at work if we have symptoms but won’t or can’t stay home. (Many Americans have no sick leave.)

"While you may have seen coworkers standing beside you hacking away and spreading germs, when was the last time you saw a colleague wearing a face mask to work because he or she had a fever or cough?" he wrote. "Studies show that 76 percent of the population used face masks in Hong Kong during the SARS scare in 2003, which helped to reduce the number of respiratory infections."

He suggests the CDC tweet and use other methods to remove the stigma of wearing a mask, and authorities should distribute them.

The CDC doesn’t seem ready to recommend face masks, however. Authorities say face masks and N95 particulate respirators – the dense and tight fitting face masks that construction workers tend to wear – are appropriate for health care workers. They don’t seem sure about other work places. They say there hasn’t been enough research done on their effectiveness. Here's the CDC guidance.

So, would you wear a mask to protect yourself at work or home from others who are sick? Would you wear a mask if you had symptoms?

Photo courtesy of the CDC

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (4)
Categories: Swine flu/H1N1
        

We tend to think of vaccines as preventing traditional infectious diseases like measles or viruses like the flu. But what if one could get a shot to prevent drug users from getting high?

New research on an anti-cocaine vaccine shows that such a shot reduced cocaine use in 38 percent of people vaccinated with it. While that figure may not sound significant -- far from full abstinence -- it's an important finding in what will likely be a long road of research toward a vaccine.

The study done by Yale researchers and funded by the National Institutes of Health appears in the latest issue of the journal Archives of General Psychiatry . It examines cocaine addiction from a purely medical standpoint. Like vaccines that fight infectious diseases, an inoculation against cocaine stimulates the body to produce antibodies, the study states. The antibodies bind themselves to cocaine molecules in the blood and prevent them from allow the drug to enter into the brain. Fascinating.

The study randomly assigned 115 people to receive the cocaine vaccine or a placebo over 12 weeks. Since a minority of people developed antibodies, researchers think a booster shot might help increase the response.

An effective vaccine could make huge inroads in the fight against drug addiction. Some 2.5 million Americans are dependent on cocaine, but only about 800,000 of them receive treatment, according to the paper.

"The results of this study represent a promising step toward an effective medical treatment for cocaine addiction." said Dr. Nora Volkow, director of the National Institute on Drug Abuse, part of NIH. "Provided that larger follow-up studies confirm its safety and efficacy, this vaccine could offer a valuable new approach to treating cocaine addiction, for which no FDA-approved medication is currently available."

And that's just the medical side. Consider the impact on communities like Baltimore that have been ravaged by drug use if a vaccine could help people kick for good.

photo from stock.xchng

Posted by Kelly Brewington at 12:50 PM | Permalink | Comments (6)
Categories: Mental health
        

So much about autism is a mystery to scientists -- no one knows what causes it and there is no cure. But in recent years one aspect of the puzzling neurobiological disorder appears clear: more children are being diagnosed with autism.

New research suggests that previous estimates of the number of children with autism are too low. As many as 1 in 100 children may have autism -- higher than the 1 in 150 estimate widely cited.

The findings come from the journal Pediatrics and an unpublished paper from the Centers for Disease Control and Prevention.

The Pediatrics study was based on a phone survey of some 78,000 parents of children ages 3 to 17 and asked if they had been told by a health care provider that their child had autism, Asperger disorder or a related disorder. The results showed 1 in 91 children had received such a diagnosis. Parents who answered yes were asked about the severity of the disorder.

For years, researchers have been trying to understand the causes of autism and whether there is a true increase in its prevalence. Some specialists think genetics are its main cause while others see environmental factors. And other experts attribute some of the growth to better diagnosis and a broadening of autism's definition.

Now researchers think the figures might reflect a real rise in cases.

"The concern here is that buried in these numbers is a true increase," said Dr. Thomas Insel, director of the National Institute of Mental Health told the Associated Press. "We're going to have to think very hard about what we're going to do for the 1 in 100."

And here's an interesting finding. Many parents believe their children once diagnosed with autism had "lost" the disorder. About 38 percent of the children diagnosed with autism or a related disorder were reported by their parents to no longer have that diagnosis.

It's not really clear why. Autism is actually a wide range of disabilities known as autism spectrum disorders and is marked by impaired communication and social interaction. Researchers said it's difficult to diagnose young children and some may no longer fit the criteria for the disorders as they get old. Others may have different kids of developmental disabilities or mental health problems mistakenly thought to be autism.

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (6)
Categories: Pediatrics
        

A story in Sunday's New York Times takes a terrifying look at beef contamination and the industry's lack of testing and oversight to prevent it. Brace yourself, this could make you rethink that burger at lunchtime.

The fascinating piece tells the tale of a 22-year-old dance instructor, who after eating a grilled burger, came down with a food-borne illness so severe that it shut down her kidneys, caused seizures and ultimately left her paralyzed.

E.coli was the culprit. Ground beef, the article explains, is vulnerable to the bacteria since it rarely comes from a single cut of meat, but rather from multiple sources ground together in a process that makes contamination possible every step of the way. The Times tracked the source of the woman's burger to various slaughterhouses and packaging plants in the U.S. and Uruguay. (A journalistic feat in itself, since such details are shrouded in secrecy). Inadequate testing and lax safety mechanisms along the way led to the tainted burger.

"As the trimmings are going down the processing line into combos or boxes, no one is inspecting every single piece," said one federal inspector... who requested anonymity because he was not authorized to speak publically.

Yikes. Despite a rash of outbreaks, media attention and federal regulations that forbid companies from selling meat tainted with E.coli, eating ground beef is "still a gamble" the article contends. Every year, tens of thousands fall ill from the bacteria.

“Ground beef is not a completely safe product,” said Dr. Jeffrey Bender, a food safety expert at the University of Minnesota who helped develop systems for tracing E. coli contamination. He said that while outbreaks had been on the decline, “unfortunately it looks like we are going a bit in the opposite direction.”

The American Meat Institute acknowledged the industry isn't perfect, but a spokesman said it has made considerable improvements.

But will big processing plants stop making ground beef from multiple sources? Making burgers from trimmings from numerous sources cuts costs for producers. But what about the costs of selling contaminated meat? Cargill, the company that sold burgers that left the woman paralyzed had to recall more than 800,000 patties responsible for sickening some 900 people back in 2007.

It's important to note the vast majority of people infected with E.coli get better on their own, the article explains. But clearly, the minority of severe cases can be devastating.

photo courtesy of CDC

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (12)
Categories: General Health
        

Over at my blog Charm City Moms, I have posted about a dilemma many of you may be facing or soon to face: I'm a little bit sick. At work.

So far, it just seems to be a bad head cold. Lots of sniffles, and a runny nose. A headache, but no achy throat or cough. Yet.

Still, in these days of swine flu fear, I feel damned if I stay here at work sneezing into my sleeve, and damned if I go home, where I would undoubtedly be viewed from afar as a slacker. What if this is nothing and I get the H1N1 virus later, and people look at me like the lady who cried wolf? Or what if this is something bad, and I stay and infect my co-workers, despite my best attempts at hand-washing and sanitizing?

What would you do?

Posted by Kate Shatzkin at 2:22 PM | Permalink | Comments (3)
Categories: Swine flu/H1N1
        

It's that time of year, when you see pink ribbons and products everywhere, hear stories of women (and some men) living with breast cancer, celebrate the survivors, and remember those we've lost.

For Breast Cancer Awareness month, we've collected stories about breast cancer and information on upcoming events here. You can also share photos of your own triumphs and trials with breast cancer.

Posted by Kate Shatzkin at 9:25 AM | Permalink | Comments (5)