Do you  have questions about mammograms?

Get them ready because Tuesday we're having a live chat on the blog at noon with Dr. Jean Warner from Mercy Medical Center.

Dr. Warner is the director of the Tyanna O'Brien Center for Women's Imaging. According to her bio, she has extensive experience in women's imaging, including digital mammography, ultrasound and MRI, as well as all imaging-guided interventional procedures including MRI-guided biopsy with a multidisciplinary approach to the diagnosis and treatment of breast disease.

She earned her medical degree from the Ohio State University College of Medicine and completed residencies in Internal Medicine and in Diagnostic Radiology at the University of Maryland Medical System. At Maryland, she also served as co-director of the Breast Center and as a consultant for breast imaging on "Ask the Expert," a Web site feature.

Photo of Dr. Warner courtesy of Mercy Medical Center

Posted by Meredith Cohn at 10:04 AM | Permalink | Comments (1)
Categories: News roundup
        

The chattering class is all abuzz about yesterday's unprecedented live TV showdown between Republicans and Democrats at President Obama's health care summit. In case you missed it, here's a general recap and some good resources for understanding what went down.

In a nutshell: Dems and Republicans appear no closer to any compromise on the legislation.

Along the way, there was some tense bickering, mundane discussion of the minutia of reform (check out this glossary by the folks at Slate for a translation of the jargon) and a personal plea by the president to pass reform as he recounted stories of his mother's death of ovarian cancer and his children's past illnesses.

Nearly everyone, it seems, was Tweeting or Facebooking about the day-long debate. Were you?

Politico offers this meaty (and at times hilarious) play-by-play of the entire summit. 

And Politifact combed through the truth from the hyperbole in this lengthy list of fact checks. 

Did you watch? What did you think? Don't let all the journos and talking heads have all the say. Sound off here.

AP photo

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

Hospitals around the country have begun cleaning and reusing medical equipment labeled for one-time use.

The goals are to help cut soaring health costs and waste in an industry that is among the largest contributors to landfills.

Many hospital workers, who routinely have to throw away what seems like perfectly durable devices, given a boost to the trend.

At least 25 percent of hospitals,and probably a lot more, are reprocessing equipment, according to a study lead by Dr. Martin A. Makary, a surgeon and associate professor of public health at the Johns Hopkins University School of Medicine. I wrote about the trend in today's Sun.

Some manufacturers and patient advocates do not think this is a good idea because items labeled for single use may not be able to withstand harsh cleaning techniques and may fail or cleaning may not rid the devices of all debris.

The Food and Drug Administration increased oversight after a 2002 bill was passed and now inspects reprocessing facilities and regulates which items can be reprocessed and how many times. A GAO study on reprocessing in 2008 found no elevated risk, though officials acknowledged there wasn't much research. 

So, would it bother you to know your blood pressure cuff, pulse oximeter or lapascopic port was being cleaned and reused? Or would it bother you to know they threw it away after it was used on only you?

Baltimore Sun photo of Dr. Martin Makary/Ken Lam

Posted by Meredith Cohn at 1:08 PM | Permalink | Comments (2)
Categories: News roundup
        

Folks are still gabbing about Tiger Woods' public apology for his infidelity, not to mention his admission of spending 45-days in a treatment facility. And everyone's entered the fray: were his philandering ways evidence of a sex addiction? Does such a thing even exist?

Technically, no. But possibly, yes. Confused? Well, even the psychologists can't agree on the topic. 

"Sex addiction" is not listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. But "hypersexuality disorder" is being considered for the next addition, explains this Reuters piece.

"There's been a lot of hype about it and I think it's unproven at present," Peter Nathan, a professor emeritus of psychology at the University of Iowa told the Sacramento Bee. "It's bad behavior, it's troublesome behavior, it gets people in a lot of trouble, but I can't say it forms to usual addictions."

But the story quotes another psychologist who insists the condition is not only real, it's becoming more of a problem in our hyper-sexual society. 

The idea that one can be addicted to sex is laughable to some (I'll admit, I chuckled). Meanwhile others insist the condition can be disastrous and needs better study to understand its roots.

Therapies are scarce, but the NYT reports that it's often treated with antidepressants, traditional talk therapy and the 12-step program used in Alcoholics Anonymous. Sex-addiction counselors familiar with one program told the Times that Wood's daily schedule at his treatment center likely began with morning meditation and exercise "including obstacle courses to build trust with other patients and eye movement exercises to 'get through his defenses'.”

So what do you think? Sex addiction: real or excuse? 

AP photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (9)
Categories: General Health
        

As if the devastation of Haiti's earthquake wasn't enough. Now comes the painstaking, morbid work of identifying the dead.

While the Haitian government struggles with this task, the U.S. has deployed a team of professionals from forensic dentists to fingerprint specialists to identify the at least 100 Americans who perished in the rubble.

Identifying the dead is a matter of dignity and respect and offers their families and sense of closure, said Towson University professor and forensic anthropologist Dana Kollmann, who I featured in this story today.

The American teams, called DMORTs -- Disaster Mortuary Operational Response Teams -- operate out of a portable morgue at the Port-au-Prince airport. Kollmann's task will be studying the bones excavated from the ruins.

The deployment is the culmination of her two decades of expertise from a crime scenes investigator in Baltimore County,  a grave excavator in the former Yugoslavia and a Smithsonian researcher who studies prehistoric bones on the weekends. 

All the while, she and her archeologist husband juggle raising four kids under 6(!) who explain "Mama studies bones." 

When I met with her earlier this week at her Catonsville home, the kids were running around, two dogs were barking up as storm. And yet, Kollmann was unfazed, and calmly explained why anthropology and forensics have been her passion ever since she was a little girl digging in her parents backyard. She's motivated by an insatiable curiosity and a need to answer questions that link the past to the present. Cool stuff.  

Baltimore Sun photo

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

Nationwide, about 17 million low-income children go without dental care each year, according to a new report by the Pew Center on the States. But Maryland is among the states recognized for its efforts to improve that problem.

Maryland was one of just six states that received an "A" grade on the report.

The study discusses how Maryland went from receiving national attention for a 2007 case in which a 12-year-old boy died after an abscessed tooth infection spread to his brain, to becoming a leader in dental care access for poor children.

States like Maryland which scored well made changes to their Medicaid structure to encourage more dentists to provide care to low-income kids and worked to increase the number of dental providers overall. In 2008, Maryland made a $7 million investment in reimbursement rates and added 200 new providers the same year, according to the study.

Elsewhere, poor children are suffering because of a lack of basic dental checkups. Often they are covered by Medicaid or eligible for it, but few dentists accept the government insurance because its reimbursement rates are lower than private coverage. In some places, there simply aren't enough dental providers to begin with. 

The consequences are more than just a nagging cavity, the report insists. Oral infections can be serious and lasting and impact a child's overall health, resulting in days lost at school and poor academic performance, the report states.

And the study's authors make this interesting observation: Twice as many Americans lack dental coverage than health care insurance. And yet, dental care has been largely absent from the health reform debate.

Unlike so many of America’s other health care problems, the challenge of ensuring disadvantaged children’s dental health and access to care is one that can be overcome. There are a variety of solutions, they can be achieved at relatively little cost, and the return on investment for children and taxpayers will be significant.

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Pediatrics
        

When it comes to health care reform, President Obama and the Democrats seeming to be going all-in. Obama has proposed a plan that largely follows the Senate proposal, though it merges some of the points of the House plan.

This comes just ahead of Thursday's reform summit, where Dems will make the case for this comprehensive approach. Republicans plan to show up, but have already slammed the proposal as more of the same that Americans don't want and can't now afford.  

See a side-by-side comparison by the Kaiser Family Foundation.

Dems argue that health care reform can't be done piecemeal, with only the most popular element, because the changes are all linked -- to offer insurance to those with potentially costly pre-existing conditions, for example, healthy people not currently insured would have to enter the system a pay premiums to offset the cost. Many can't enter the system without subsidies. Etc.

The Dems appear to be cautiously embracing the push, saying it's their last, best chance for reform, according to the Associated Press.

What do you think about Obama's new push? Not the right time? Have the lawmakers come too far to turn back? Your premiums going up?

Associated Press file photo of Obama talking to Congress about health care in 2009 

Posted by Meredith Cohn at 2:00 PM | Permalink | Comments (0)
Categories: News roundup
        

Maryland lawmakers are joining 20 other states in considering a ban on BPA in baby bottles and sippy cups. The House has already passed the legislation and the Senate plans to take up the measure any day. See a story I wrote in today's Sun.

Bisphenol-A, or BPA, is a chemical that mimmicks estrogen and has been linked to developmental problems in babies and reproductive problems in women, among other problems.

And it's in a lot of our food packaging beyong baby bottles. It's in the lining of most of the metal cans on grocery shelves. It's in soda can and a lot of plastic water bottles. It's also on retail receipts.

The U.S. Centers for Disease Control and Prevention say it's found in more than 90 percent of Americans. Officials at the Food and Drug Administration, in a reversal, recently said they had "concern" about BPA and have helped form a task force to study the chemical. Results are due in 18 months to two years.

The delay is why states are moving ahead on their own, though they are only addressing the baby bottles and sippy cups because babies are considered the most vulnerable population.

In the meantime, the government and comsumer groups say people should not use scratched bottles or use glass. Avoid cans by buying frozen vegetables and boxed soups. Tomatoes are especially acidic and may leach more BPA out of cans. Wash your hands after touching the receipts. Consumers can also buy containers marked BPA-free, though consumer groups have found trace amounts in some of these products.

The Washington Post said in a story today that the industry is working on alternatives, and have found them for plastic. They are having a harder time finding a replacement for metal can liners. BPA adds to container durability and improves the shelf life and safety of food, manufacturers say.

Getty Images Photo

Posted by Meredith Cohn at 11:07 AM | Permalink | Comments (0)
Categories: News roundup
        

Choking is one of the leading causes of injuries and death in kids, particularly those under 3. Toys, coins and food are the biggest hazard. Choking on food alone sends more than 10,000 children under 14 go to the emergency room each year.

The American Academy of Pediatrics thinks the government needs better regulations to curb this public health problem, according to a policy statement released today in the journal Pediatrics. 

To that end, the AAP is calling for a few foods to be redesigned so that they're less likely to get caught in a child's throat.

Enter the choke-proof hot dog, USA today reports. But really, is that even possible?

Well, sure the APP states: 

The characteristics of these foods are engineered and, therefore, amenable to change, unlike naturally occurring food products such as certain fruits and vegetables. Manufacturers of foods that are frequently consumed by children should, to the extent possible, design these products to minimize choking risk to those in that age group.

Hot dogs alone accounted for 17 percent of food-related choking deaths children younger than 10, according to a 41-state study, the report states. But don't stop there, the APP advises. Grapes, carrots, popcorn, marshmallows, chewing gum and sausage all have the same choke-prone characteristics as franks.

In summary, the APP recommends the Food and Drug Administration adopt the following steps to limit food-related child choking hazards: Use warning labels on foods that pose a choking hazards and create a surveillance and reporting system to alert the public of food-choking risks.

In addition, pediatricians, dentists and other health care providers should offer better choke-related counseling to parents. Meanwhile, the US Consumer Product Safety Commission needs better choke-hazard warnings on toys sold in vending machines, the APP advises.

Baltimore Sun photo

Posted by Kelly Brewington at 12:04 PM | Permalink | Comments (8)
Categories: Pediatrics
        

African-Americans have the highest incidence and death rates for lung cancer. As with many puzzling racial disparities in health, researchers don't know for sure why blacks are more likely than other racial groups to suffer from the disease. But a new study suggests blacks may hold mistaken and fatalistic perceptions toward lung cancer treatment which, coupled with a reluctance to visit the doctor, could attribute to the disparity.

Researchers at the Dana-Farber Cancer Institute in Boston wondered if perception of lung cancer among different races could explain some of the disparity. The study, appearing today CANCER, the journal of the American Cancer Society, surveyed 1,530 people from a National Cancer Institute 2005 study.

Both blacks and whites underestimated how lethal lung cancer is, with many saying that the percentage of people who survive lung cancer past 5 years is 50 percent, when the actual figure is 15 percent. Lung cancer is the leading cause of cancer deaths in the U.S., killing 162,000 people each year.

But on other issues, blacks and whites had very different views. African-Americans were more likely than whites (53 percent vs. 37 percent) to say they were confused by too many recommendations on how to prevent lung cancer. Blacks were also less likely than whites to say the disease caused by lifestyle (i.e. smoking) --73 percent of blacks vs. 85 percent of whites.

And here's where it gets interesting: 22 percent of blacks said they would be reluctant to be checked for lung cancer symptoms because they're scared of getting a bad prognosis. That figure was just 9 percent for whites.

Now, a few caveats: The study is based on just a small survey of people -- so how representative can it be of a race of people you might ask? Good question. We have the same reservations.

Researchers acknowledge that this is just one study of the issue and cannot alone explain the complexities of racial disparities. There are, of course, a host of other factors likely at play in racial health disparities, from patients lacking insurance to possible genetic differences to doctors' attitudes in treating patients.

Still, the take home message of better outreach to minority communities is needed, researchers said. 

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (3)
Categories: Cancer
        

I'm getting a kick out of this blog, in which a teacher sounds the alarm on less-than-nutritious school lunches by deciding to eat them every day through 2010 and write about the experience. (Photos included!)

We confess, we don't know much about this effort. The teacher is remaining anonymous and she quiet on the details of her school. But the little blog is already getting some notice out on the internets.  

With everyone from Michelle Obama to the U.S. Preventive Services Task Force sounding the alarm on childhood obesity, I'm intrigued if this blog will gain any traction. The first lady's campaign aims to improve school lunches by cutting out the fat and the sugar. And the Institute of Medicine called for the same last year.

Any parents out there monitor their kids school lunches? What's on the lunch trays in your child's school?

Baltimore Sun photo

Posted by Kelly Brewington at 12:16 PM | Permalink | Comments (6)
Categories: Diet and exercise
        

Let's say that you didn't sign a form and your appendix goes on to help a researcher discover an amazing medical advancement. Are you due any credit? Any of the profits?

It's unclear. Even experts in bioethics haven't sorted out these thorny issues. These big questions of consent and compensation are laid out by science writer Rebecca Skloot in the new book "The Immortal Life of Henrietta Lacks." (Here's a link to a review in The Sun)

I wrote about these issues and spoke to Skloot about the modern day ethical dilemma that Lacks' story presents. 

Lacks was an African-American woman from Baltimore County who died of cervical cancer in 1951. But her cells live on in laboratories around the globe and helped spur medical advances from cancer treatments to the polio vaccine. During her treatment, Johns Hopkins researchers collected her cells without her permission. Even her family didn't know about the research and the success of the HeLa cells, as they are known, until decades later.

It's a fascinating story about race, class and medical ethics. And it sheds light on modern-day ethics of tissue research -- a complex, intriguing topic, but one that few people know anything about (I, for one, was in the dark about it until writing this story).

Lack's tale has lessons for us to learn from today, says Skloot, who is speaking at Hopkins tonight. "There are human beings behind every sample we rely on in science," she said.

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: General Health
        

The use of imaging technology such as MRI and CT scans tripled between 1996 and 2007, according to a new report by the Centers for Disease Control and Prevention's National Center for Health Statistics.

In emergency rooms alone, the use of such technology quadrupled since the mid 1990s, the AP reports.

The news comes on the heels of growing concerns that the tests are ordered too often, exposing people to potentially dangerous amounts of cancer-causing radiation and swelling the cost of health care. Earlier this month, the Food and Drug Administration said it would begin trying to reduce unnecessary exposure to such tests, NPR reports. 

The data come from an exhaustive report on the nation's health, including statistics on everything from the increased use of anti-diabetic drugs to the rise in kidney transplants.

A few highlights:

• In 2007, 20 percent of adults had visited the emergency room at least once in the past year. Seven percent had two or more visits.
  
• The racial gap in life expectancy is narrowing. Life expectancy for blacks increased more than for whites from 1990 through 2007. In 1990, whites' life expectancy was 7 years longer than for blacks. By 2007, it was 4.6 years longer. Overall life expectancy for the nation was 77.9 years.
• In 2007, about 20 percent of adults smoked cigarettes, a slight decrease from 21 percent in the previous 3 years. Men were more likely to smoke than women -- 22 percent vs. 17 percent
  

True health geeks can take a gander at the more 150 tables of data meant to provide a snapshot of the nation's health.

Baltimore Sun photo

Posted by Kelly Brewington at 12:23 PM | Permalink | Comments (1)
Categories: General Health
        

Hospitals can reduce medical errors and cut unnecessary hospital-related infections with the use of a checklist. Dr. Peter Pronovost, a professor of critical care medicine at Johns Hopkins School of Medicine, showed this years ago in a 2003 study of Michigan hospitals.

Since then, Pronovost, who won a "genius award" from the MacArthur Foundation two years ago for the innovative checklist borrowed from the aviation industry, has been on a mission to have the program rolled out around the country and the globe.

This month, a new study in BMJ, shows how three years after instituting the five-step checklist for doctors to follow when placing a central-line catheter, Michigan hospitals virtually eliminated ICU infections. And this week, Pronovost is out with a new book, called "Safe Patients, Smart Hospitals" with stories of real Hopkins medical errors and explanations how he thinks the checklist can improve health care.

I caught up with Pronovost who explained the concept as more than a simple checklist. It's a three-pronged strategy that requires hospitals to measure results and change their cultures. 

"Could a new nurse go up to a senior doctor who doesn't wash his hands and the doctor respond in positive way?" he said. "Just having a senior executive saying 'I’m using a checklist,' is good, but if that nurse doesn’t feel comfortable speaking up to the doctor, it’s not really going to be used."

Doctors aren't perfect and no one wants to put patients at risk. But sometimes egos get in the way, Pronovost said.

The checklist has been met with praise (notably from Boston surgeon and New Yorker writer Dr. Atul Gawande, who also has a new book out extolling the virtues of checklists). But there's also been some resistance from hospitals who say they are following the checklist, but they don't bother measuring their infection rates.

To be effective, Pronovost stresses, hospitals must embrace the entire strategy.

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

Howard County was the healthiest county in the state and Baltimore City was the least healthy, according to a story in The Sun today.

The information is based on a study by the Robert Wood Johnson Foundation and the Univeristy of Wisconsin Population Health Institute.

The study ranked all the counties in Maryland and used data on health outcomes and the length and quality of people's lives. Researchers looked at behaviors such as smoking, clinical care, social and economic circumstances and environmental factors.  

In the Baltimore area, Howard was first, Frederick County third, Carroll was fifth, Harford ninth, Anne Arundel 11th, Baltimore County 15th and Baltimore City was 24th.

Howard health officer Dr. Peter L. Beilenson, formerly Baltimore's health officer, said that general wealth and high educational levels helped the county in the survey, but so did public policies like the smoking ban and efforts at getting the uninsured health care.

So, is it any surprise wealthier counties ranked higher than lower-income ones?

Associated Press photo of a smoker

Posted by Meredith Cohn at 11:05 AM | Permalink | Comments (0)
Categories: Medical studies
        

We've talked a lot about the three-decade rise in childhood obesity. But it's not the only chronic health problem children struggle with.

In fact, the prevalence of child chronic health conditions, from asthma to behavioral problems, increased  from nearly 13 percent in 1994 to nearly 27 percent in 2006, according to a new study appearing in the latest Journal of the American Medical Association.

Harvard researchers examined three groups of children ages two to eight and followed them for six years.

Despite the overall increase, most children got better over the course of the study period. Only about 7 percent of children who reported a chronic health problem in the beginning of the study had one six years later, researchers found.

(This begs for a definition of the word "chronic." The study defined a chronic condition as one lasting at least 12 months). Among the illnesses they found: diabetes, heart problems, ADHD and ear infections.

While the increase in obesity has been well-documented, the rise in other conditions is less understood, the study states. 

One explanation is that children have better access to specialized care for chronic problems and are able to survive diseases today that would have killed them decades ago, the study explains.

The National Children's Study, a massive government effort to study children from their mother's pregnancies through their 21st birthday, could help explain the trends, an accompanying editorial states. For now though, the issue needs to be addressed, say Dr. Neal Halfon of UCLA and Paul W. Newacheck, of the University of California at San Francisco.

The data presented by Van Cleave et al suggest that the prevalence of other chronic health conditions is also increasing among US children and that obesity is not the only clinical time bomb ticking away in children. There is an urgent need to better understand why this is the case and what can be done about it.

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

A government panel's recommendation last fall that women start routine mammograms at age 50, not 40 and that doctors shouldn't bother teaching breast self-exams, set of a firestorm of controversy and much confusion.

Well, the uproar isn't over.

Doctors and patients disagree about the guidelines, with doctors more likely to adopt the new recommendations and patients more apt to reject them, a new editorial in today's Annals of Internal Medicine reveals.

The editorial includes the results of a survey of 651 people, about 60 percent were physicians or other medical professionals and nearly 40 percent were members of the general public. 

Some 67 percent of medical professionals said they would stop offering routine mammograms to patients in their 40s. Another 41 percent say they would stop advising patients to do breast self-exams.

Women thought otherwise. About 71 percent said they were very or somewhat unlikely to forgo routine screening in their 40s, no matter what their doctor recommended.

The findings underscore the complexity of the debate, the editorial goes on to say. Breast cancer on its own is emotional. Everyone knows someone touched by the disease. Add the new guidelines, and you've got the makings of a confusing, politically-charged discussion that has yet to be resolved.  (Indeed, some feared insurance companies would no longer cover the screening, others predicted it was the beginning of rationing, and politicians moved to get legislation passed to guarantee women get mammograms starting at 40.)

So, now what?

The editors at the Annals of Internal Medicine come to the defense of the task force saying that even though people claim mammograms save lives, "only a fraction of abnormalities initially detected on mammography and subsequently treated truly represents a life saved rather than unnecessary or premature treatment."

The editorial stresses that the task force's goal was to issue guidelines, not a "one-size-fits-all" recommendation for screening. It intended to spark a rational discussion about the harms, risks and benefits of screening, not a political uproar about rationing care, the editorial states.

It's a fascinating debate. Few other recommendations by the U.S. Preventive Services Task Force have sparked such a reaction. No one flinched when the USPSTF advised against routine depression screening, even though depression is more common than breast cancer, the editorial explains.

But breast cancer is not depression. Just a glimpse at the letters the journal received in response to the guidelines -- from "I am furious!" to "What a relief"-- reveal how on this issue, medicine, politics and emotions collide.

Chicago Tribune photo

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

Minimally invasive surgery that has become popular for everything from gallbladder to weight loss surgery seems to be good for everyone but the surgeons, according to a story in the today's Sun.

The surgery requires the doctors to use small instruments through small incisions in the patient and follow the procedures on a video monitor usually above their heads. All that repetitive movement, leaning over patients in awkward positions and standing still has taken a toll.

Doctors' hands, necks, backs and other parts are getting sore -- some 87 percents reported some discomfort in a new survey from the University of Maryland Medical Center. Dr. Adrian Park, chief of general surgery and the report's chief author, said that the careers of the doctors are at stake if nothing is done. And that could mean fewer surgeons trained, experienced and available to do the laparoscopic surgery.

Park is planning more research into the area, and wants other to join him, so new guidelines and equipment can be developed that may help reduce pain for surgeons.

So, have you had laparoscopic surgery and did you have a good outcome? Are you now concerned about the health of your doctor?

Baltimore Sun photo of Dr. Park/Gene Sweeney Jr.

Posted by Meredith Cohn at 11:54 AM | Permalink | Comments (1)
Categories: News roundup
        

Baltimore medical staff have flocked to Haiti since the devastating earthquake struck last month. Now, under an agreement between Johns Hopkins and the Navy, several teams of Hopkins doctors and nurses will spend the next 12 weeks caring for victims aboard the USNS Comfort. It's the only medical institution to have such an agreement, according to Hopkins. The first team deployed yesterday.

That group will stay for two weeks, then another group will replace them. They have a difficult task ahead of them. As our colleague Robert Little reported from  the floating hospital last month, the ship was near it's breaking point , overwhelmed with urgent injuries forcing doctors to make tough decisions about who could be treated and how.

We've been updating you with reports about how teams are managing amid horrific conditions in Haiti, as well as the work being done on the Comfort. But many medical professionals have been blogging about their experiences in their own words. Here's a link to the Hopkins blog if you'd like to follow their mission.   

Baltimore Sun photo by Kim Hairston

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: General Health
        

About 57 million people in the United States have come down with swine flu infections, resulting in 257,000 hospitalizations and 11,690 deaths, according to new data out today from the CDC.

The estimates are from last April, when the outbreak first began, through Jan. 16 of this year and are an increase from the 47 million figure reported through mid-November.

The new numbers are actually the mid-level of a wide range of estimates. The range of infections goes from 41 million to 84 million, and the number of deaths from 8,330 to 17,160.  

As we've reported before, children have been disproportionately affected by the H1N1 virus, with the latest estimates totaling nearly 20 million infections among people less than 18 years old.

While infections have certainly slowed since last fall, the virus is still spreading and will continue for months, public health officials continue to warn. It's not too late to get your swine flu shot.

Posted by Kelly Brewington at 3:06 PM | Permalink | Comments (0)
Categories: Swine flu/H1N1
        

We told you in a story yesterday about what an ordeal the storm has been for dialysis patients who must often adhere to a strict three-day-a-week schedule to receive the life-sustaining treatment.

Now, dialysis patients who have missed treatments because of the storm, are showing up in large numbers at area emergency rooms and calling hospitals seeking care.

Missing treatments, which are usually scheduled three times a week, can cause fluid build up in the body, making a person short of breath and lightheaded.

In serious cases, patients are at risk for hyperkalemia, a condition in which too much potassium can cause abnormal heart rhythm and sudden death, said Dr. Benjamin Vanlandingham, an emergency room physician at St. Joseph Medical Center.

"We've admitted quite a few patients for dialysis in the last 48 hours," he told me yesterday. One patient missed a treatment Tuesday drove himself to a local dialysis center Wednesday morning only to find out it was closed, he said. 

The same is happening at other hospitals I've talked to including Greater Baltimore Medical Center and Baltimore's Sinai and Union Memorial hospitals.

Posted by Kelly Brewington at 11:57 AM | Permalink | Comments (0)
Categories: General Health
        

Former President Bill Clinton had two stents placed in his arteries yesterday after being hospitalized with chest pain.

What's a stent, you ask?

The mesh metal tubes work as a scaffolding to keep clogged arteries propped open. The procedure is so common, about 1 million are done each year in the United States.

We gave you the scoop on stents, about cardiologists' debates over when they are necessary and a local controversy about hundreds of patients who may have received stents when they didn't need them.

And last month in this live chat with Dr. Claudia Hochberg, an interventional cardiologist at Boston Medical Center, to answer your questions on the ABC's of stents.

Here were a couple of the most common question and answers: (Or replay the entire chat with this link.)

Q: Are there different kinds of stents? What's the best kind to get?

A: Claudia Hochberg:
There are different kids of stents and the type of stent that is best for a particular patient depends on multiple factors. Your doctor will decide what type of stent to use based on your clinical history, the lesion type and location and the your ability to take blood thinning medicines after the procedure. Stents basics are that there are two types, drug coated stents and bare metal stents (just metal with no medicine)

Q: What percent blockage in an artery is considered the cutoff for intervention (need for stent)?
 
A: Claudia Hochberg:
Generally speaking, a blockage of less than 70% is not thought to be hemodynamically significant and therefore is not treated with stents. The exception to this is a blockage in the left main coronary artery which is a big vessel that branches into the two arteries that feed the left side of the heart. There a blockage of 50% or greater demands treatment (and that treatment has historically been surgical)

Got more questions? Ask away and we'll get them answered.

AP photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Cardiovascular Health
        

Thanks to our colleague Liz Kay who trudged through the snow to find us this:

Some runners don't give up even when the U.S Postal Service cries uncle. But even some of Baltimore's most diehard runners thought it was best to wait until the flakes stopped falling before lacing up their shoes for a run.

"You get to a certain point where you simply can’t perform the mechanics of running,” said Bart Rein, a board member of the Baltimore Road Runners Club.

“If it’s like mid-calf, you can still get out there and do it,” he said.

But given the accumulations that had arrived by Wednesday afternoon, even devoted joggers shouldn’t venture out, he said. Most members of the running groups he monitors via Facebook and other sites were canceling their runs.

“You kind of get used to running in just about anything,” Rein said, including rain and snow. However, runners would be putting themselves at risk of getting hit by vehicles that lose control, he said.

“When you have 4- and 5-foot mounds of snow on a corner, it becomes a blind corner. Trying to use the same space a car is trying to use ... it’s just ridiculous,” he said.

Instead, Rein will maintain his training schedule — he’s aiming for a 50-kilometer race in March — by picking up miles on his treadmill.

Once the snow stops falling, Rein and running coach Jeff Gaudette had some tips for those who can’t wait to lace up their shoes.

Gaudette, who has been running for nearly 15 years and coaching for seven, said he ran outside every day since Friday — but wasn’t sure he would go out yesterday. The Maine native attended school in Providence and ran professionally in Michigan, so he’s experienced plenty of winter weather. But this has been a challenge, even for him.

“I hate the treadmill, I’m not going to lie,” Gaudette said. “For me, I would rather be outside and enjoying it, even when it’s crazy like this.”

On Saturday, the Charles Village resident headed to Johns Hopkins University. “I’ve always found that running on college campuses is usually the best way to go,” he said. “Those tend to clear up the fastest.”

He also recommends that people just take things easy rather than try for speed or to do any sort of workout. “It’s too easy to slip and mess yourself up,” Gaudette said.

Both Rein and Gaudette put short screws in the soles of sneakers to enhance grip on the snow or ice. Runners are advised to run against the flow of traffic, so they can see cars, even if drivers can’t see them.

Rein dresses in layers and puts duct tape over the mesh of his running shoes to avoid losing heat. Gaudette layers tight clothes that won’t get heavy and saggy when wet. He also lines his gloves with latex gloves, which are waterproof, and uses Vaseline to create a waterproof barrier on any exposed skin.

“I think all athletes, no matter what level you’re at, there’s an inherent level of competitiveness there,” Gaudette said. “It’s kind of fun to think to yourself, ‘I’m kind of crazy for doing this.’”

Baltimore Sun photo

Posted by Kelly Brewington at 9:00 AM | Permalink | Comments (1)
Categories: Diet and exercise
        

Teens who went under a type of bariatric surgery called gastric banding lost 50 percent more weight than those who made lifestyle changes, according to a new study appearing in the Journal of the American Medical Association.

The small study of 50 14-18 year olds with a body mass index (BMI) of more than 35, compared teens in two groups. One received banding, a laparoscopic procedure in which a silicone band is placed around the upper part of the stomach. The other made lifestyle changes such as lowering their calories and increasing their exercise.

After two years, the gastric banding group lost an average of 76 pounds, while the lifestyle group lost just 6.6. pounds on average, the Australian researchers found.

The jury is still out whether weight loss surgery is recommended for adolescents and most programs that provide it do so as part of clinical trials -- like this one -- to study their effectiveness and safety.

Critics say any weight loss surgery for teens should only be done as a therapy of last resort, and some fear the impact of surgery on a child's growth and development. Others say another type of weight loss surgery -- bypass surgery -- is better than banding.

Meanwhile, the obesity epidemic among children and adolescents remains a huge national problem.

Nationwide, more than 17.4 percent, or more than 5 million adolescents were obese in 2004, a jump from 14.8 percent in 2000. Obesity leaves teens at risk for type 2 diabetes and health problems once thought strictly the domain of adults: sleep apnea, hypertension and pyschosocial problems, the report explains.

AP photo

Posted by Kelly Brewington at 11:36 AM | Permalink | Comments (7)
Categories: Pediatrics
        

With the blizzard warning in effect, lots of closures to keep mind of. Among the latest, the University of Maryland Greenebaum Cancer Center is closing it's outpatient clinic at the Stoler Pavilion today and tomorrow. It plans to reopen Friday and Saturday for chemotherapy and urgent visits only. For more info: call 410-328-7609.

Meanwhile, Baltimore's Sinai Hospital is looking for volunteers with four-wheel-drive vehicles to transport essential staff. Call 410-601-9791 if you can help.

The one-two punch of snowstorms has depleted area blood supplies, so the Red Cross is urging people to donate, particularly platelets. Not today, of course, but once the snow stops. You can get a $5 gift card to Starbucks for your troubles. Call 1-800-272-2123 to schedule an appointment.

Posted by Kelly Brewington at 9:30 AM | Permalink | Comments (0)
Categories: General Health
        

No, you're not imagining things. MORE snow is expected to pound the region, with estimates of about a foot or more.

The prospect of a double whammy has made hospitals shift their disaster teams into high gear for the second time in a week, making sleeping arrangements for clinical staff and in some cases canceling elective surgeries. 

Howard Gwon, administrator for Johns Hopkins emergency management, said the needs are unprecedented.

"We’ve never had to activate our command center a second time in one winter -- this is record history for not only the state but Hopkins," said Gwon, Hopkins' incident commander for the last 20 years.

The hospital had some 2,000 staffers sleep at the hospital over last weekend's storm and is preparing for more tonight arranging empty hospital beds and air mattresses around the campus, he said. About 70 staffers are prepared to shuttle people to and from the hospital if the snow makes it impossible for them to travel on their own.

At Greater Baltimore Medical Center in Towson, the majority of physician practices affiliated with the hospital plan to close Wednesday, but patients should check first with their doctors, said Michael Schwartzberg, a GBMC spokesman.

The hospital, where some 4,500 births take place each year, has rescheduled some c-sections planned for tomorrow as well as some elective procedures, he said.

With this snowfall coming during a weekday -- typically busier for hospitals than weekends -- among the most important preparations is having enough staff and keeping roadways clear, he said.

Some clinicians have already put in marathon hours. Schwartzberg told me the story of a nurse who stayed in the emergency room last Friday through Sunday, catching a few hours of sleep here and there on a stretcher. She's back today, with an overnight bag, and expected to stay until Friday.

"People are really coming together, doing jobs that aren’t normally their jobs," he said. "People are going above and beyond."

Posted by Kelly Brewington at 5:09 PM | Permalink | Comments (0)
Categories: General Health
        

President Obama signed a memorandum this morning officially launching a federal task force to battle the  childhood obesity epidemic. It's part of a government campaign to tackle the problem, led by first lady Michelle Obama, who declared fighting childhood obesity would be her signature issue this year. 

Known as Let's Move, the campaign focuses on better informing parents of the importance of nutrition and exercise, decreasing fat and sugar in school lunches, making healthy food more accessible to families and more emphasis on physical education.

The administration plans to get the FDA and the American Beverage Association to use better labeling of nutritional information, according to the Politico. The American Academy of Pediatrics will also work to educate their members on better obesity monitoring.

This falls in line with news we reported a few weeks ago that a government task force now recommends screening children as young as 6 for obesity and referring them to a weight loss program.

While government statistics released last month suggest the stunning three-decade rise in child obesity rates is leveling off, the rate is still too high, say public health officials. A third of U.S. children are obese or overweight, putting them at risk for diabetes, high blood pressure, sleep problems and depression.

Michelle Obama has spoken candidly about why this is a priority for her -- and the nation. Her own children had troubles with fluctuating weight, leading to Obama to make changes in their eating habits and exercise. Obama told NPR:

I thought my kids were perfect," Mrs. Obama said. "They are and always will be." She hadn't realized that her daughters were in danger of becoming obese. She wasn't sure what to do, but she knew she had to do something she said.

Over the course of a few months, the Obama family started making what seemed like minor changes. "We did things like limit TV time," she said.

(Of course, the first lady's gotten a heap of criticism for being so forthcoming about the issue. Who knew trying to get kids to eat right and exercise could be controversial?)

The announcement comes on the heels of a Pediatrics article out this week about three key ways to curb childhood obesity: eating meals as a family, limiting TV time and getting kids enough sleep. Children in families who do this have a 40 percent less prevalence of obesity, the study found.

AP photo Michelle Obama and helpers tend to the white house garden.

Posted by Kelly Brewington at 12:30 PM | Permalink | Comments (2)
Categories: Pediatrics
        

Mothers over 40 are more likely to have a child with autism, but the age of fathers often has little to do the chances of a child having the developmental disorder, new research has found.

For years, researchers have known that the age of the parents affects a child's risk for having autism. But experts couldn't say for sure whether the risk was higher for older mothers, older fathers or both. 

In fact, some studies suggested that it was the father's age that increased the autism risk. The new study, published in the journal Autism Research, found the father's age increased the chance of a child having autism only when the dad is over 40 and the mother is under 30. 

The risk of having a child with autism increased by 18 percent for every five-year increase in the mother's age, according to the study which examined nearly 5 million births in California in the 1990s. A 40-year-old woman's risk of having a child diagnosed with autism was 50 percent greater than that of a woman between 25 and 29 years old.

Researchers at UC Davis Health System compared the 4.9 million electronic birth records, noting the parents ages, with cases of autism diagnosed before age 6 as classified by the California's department of developmental services.

Other experts warned that the increased risks are small, even for older mothers. The overal low risk for autism "may be the most important take-away message," Maureen Durkin, a University of Wisconsin researcher told the AP.

While interesting, the new study tells us nothing why the risk of autism may be linked to a mother's age. The authors say more study is needed to explain the connection, although they have a few theories.

For now, though, add this to the multitude of incremental findings as researchers work to unlock the mysteries of the puzzling disorder, affecting as many as 1 in 100 children.

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

Seniors are especially susceptible to pneumonia and yet, just 30 percent of adults 65 and older get the vaccine to protect against it, a new study has found.

We wrote a story recently about how the vaccine has been successful with kids, but adults have been underusing it. And that's been a problem because pneumonia is a common complication of the flu. This new study of 2008 figures by the Trust for America’s Health, the Infectious Diseases Society of America and the Robert Wood Johnson Foundation, offers the latest numbers on vaccine use among adults in states across the country.

The District of Columbia had the highest percentage of adults who had not been immunized -- nearly half, while Maryland was slightly higher than the national average with nearly 40 percent of seniors not getting the vaccination. Just about a quarter of seniors in Oregon hadn't been vaccinated.

It's not just low rates of pneumonia vaccinations. Just 2 percent of adults had tetanus, diphtheria and whooping cough vaccine in the previous two years and a little over a third had received the seasonal flu vaccine. Overall, the report found that the millions of adults who go without routine vaccines leads to an estimated 40,000 to 50,000 preventable deaths, thousands of preventable illnesses and $10 billion in preventable health care costs each year. 

So why don't we get vaccinations?

The uninsured are unlikely to get vaccinated and even for those with insurance, many plans don't cover routine shots. There's also a lot of misunderstanding about vaccine safety, the report states. The study recommends health insurance reform that closes coverage gaps and more public awareness campaigns.

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

Still shoveling? We are too. As you tackle the remains of the weekend's snowpocalypse, which dumped at least 2 feet in the Baltimore area, be safe.

Here are a few good tips from the American Physical Therapy Association that could spare your back and shoulders.

· Lift smaller loads of snow, bend your knees and lift with your legs rather than with your back.

·         Use a shovel with a handle that lets you keep your back straight while lifting. A short handle will cause you to bend more to lift the load. A long one makes the load heavier.

·         Avoid twisting as much as possible. The spine can't tolerate twisting as well as it can other movements.

·         Step in the direction that you're throwing snow to prevent low back twisting. This will help avoid the “next-day back fatigue."

·         Take breaks. Stand up straight and walk around every so often. Standing backbends help reverse all that forward bending that occurs while shoveling. To do this, stand straight and tall, place your hands toward the back of your hips and bend backward slightly for a few seconds.

Also, the American Academy of Orthopaedic Surgeons has more tips on preventing shoveling injuries.

And for all you with fancy snow removing equipment, remember that snowblowers can be dangerous too. Sunday, the folks at Union Memorial Hospital's Curtis National Hand Center  treated 8 patients in just 3 hours for snowblower injuries. Here are some tips on how to use that equipment safely.

Baltimore Sun photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: General Health
        

For patients who need life-sustaining treatment such as dialysis, the snow storm threatens to get between them and their care.

The Baltimore health department was fine-tuning emergency plans Friday to shuttle dialysis patients between their homes and treatment centers over the weekend. The department covers transportation for patients on medical assistance, as required by federal law. The safety-net program also offers transportation to patients who need chemotherapy and radiation. But among the most challenging logistically for the department are those patients who need three-times-a-week dialysis, said Pamela Somers, program director of field health services for the health department.

The program ferries 446 dialysis patients to and from their treatments, some of whom have a strict Tuesday, Thursday, Saturday schedule to adhere to. The threat of a blizzard means trying to reschedule some patients, a challenge in itself, while arranging a fleet of vans to go out on snow-covered roads to transport patients who cannot change their schedule.

“It’s also a huge challenge for patients, said Somers. “For folks whose times are being shifted, they need to change their diet a bit and watch their fluids,” she said. “There are medications that we can give them to have them hold out an extra day.”

Somers' team has been working on contingency plans since Tuesday.

“This is not something you do at 5 p.m. when the snow is starting,” she said. “This is something you that you have to plan for several days, and that the patients themselves need to think about.”

For her staff, the storm will mean working extra hours Saturday and Sunday, when they plan to transport about five dozen patients.

Meanwhile, Somers will be carefully monitoring the safety of van drivers. During December’s record-setting blizzard, several drivers got into accidents skidding down slick roads, although there were no serious injuries, Somers said.

“I don’t think enough of us gave enough weight to how bad conditions deteriorated throughout the day,” she said. “This time, we’re ready.”

Posted by Kelly Brewington at 4:25 PM | Permalink | Comments (0)
Categories: General Health
        

While H1N1 infections appear to have leveled off, the virus is still circulating, causing hospitalizations and deaths, the Centers for Disease Control and Prevention said this afternoon.

In fact, even though infections are below baseline for this time of year, deaths due to influenza and pneumonia rose sharply nationwide and have been up over the last three weeks, said the CDC's Anne Schuchat in an update to reporters. 

At the same time, seasonal flu appears nearly nonexistent, with the swine flu remaining the dominant strain circulating.

So, what does it all mean? It's not too late to get vaccinated, the CDC urges. Supply is plentiful and a shot can still protect you through the season. "We are remaining vigilant here," said Schuchat. "Many people believe the outbreak is over. It’s too soon for us to have that kind of complacency."

Still, public health officials can't say whether we are in for a third wave of the virus, which infected 55 million people in the United States from April through December, resulting in 246,000 hospitalizations and 11,160 deaths, the CDC said last month. It's more likely, however, that transmission will continue and so, hospitalizations and more deaths are possible, Schuchat said.

Nevertheless, nearly half of Americans think the whole swine flu deal is over, according to a new survey by Harvard researchers. And just 18 percent think it's "very likely" that we're in for a third outbreak of infections in the next year, the study of about 1,400 adults conducted between Jan. 20 and Jan. 24.

The survey also revealed ongoing skepticism about the vaccine. About 35 percent said they had concerns about the vaccine's safety and another 30 percent don't think they are at risk of serious illness.

Schuchat reiterated that the vaccine is safe. "If safety is the reason you have been waiting, then you can be reassured on that front." 

Meanwhile, about 23 percent of Americans -- 70 million people -- have been vaccinated against the H1N1 virus, according to a new CDC survey of about 4,100 adults conducted between Jan. 24 and Jan. 30.

Schuchat said she was encouraged that it seems more parents want to get their children vaccinated. About half of parents either got the vaccine for their children or intend to get it before the end of February, the Harvard survey found. She said CDC data show about 37 percent of children had been vaccinated, but not all of them had received the booster shot recommended for children under 10.

"I encourage parents to get that second dose," she said. 

Posted by Kelly Brewington at 2:30 PM | Permalink | Comments (0)
Categories: Swine flu/H1N1
        

We'll admit it. The prospect of a mega snowstorm, makes us freak out a bit. We Marylanders love to make panicked last-minute trips to the grocery store for toilet paper and milkat the sight of a flurry. But the storm on its way this afternoon could be huge -- smacking the area with as much as 2 feet.

Hospitals are bracing for it too by fine-tuning contingency plans, jump-starting emergency command centers and making sleeping arrangements for critical staff, from hotel reservations to outfitting hospital units with free beds.

Greater Baltimore Medical Center, Anne Arundel Medical Center and the University of Maryland Medical Center have volunteers with four-wheel-drive vehicles on hand to drive people to work if they can't make it on their own. During December's blizzard, GBMC used its emergency command unit to notify the National Guard to order a Humvee to pick up nurses who lived in rural Harford County and take them to the Towson hospital, said Michael Schwartzberg, a GBMC spokesman.

Hospital administrators said they made improvements after December's record-setting blizzard. "We are reaching out more broadly to the medical staff earlier," said Herbert C. Buchanan Jr., chief operating officer for the University of Maryland Medical Center. "We have tightened up the processes.

Meanwhile, I learned this cool tidbit from the folks at the state's emergency medical systems: most of the state's firetrucks and ambulances are outfitted with technology that with a click, enables chains to be switched onto tires so the vehicles can drive safely through the snow and ice. How very Transformers of them. I so need those on my car.

So, how are you prepping for the big snow? 

Baltimore Sun photo

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

Some patients diagnosed as being in a vegetative state showed signs of brain activity during brain scans, according to a new study that researchers said could change the way science views patients thought to have lost all awareness.

It was a small study -- of just 54 patients with severe brain injury, 23 in a vegetative state and the rest in a less severe "minimally conscious state." But the British and Belgian researchers think the findings could be quite significant, offering clues for better diagnosis of people with brain injuries and development of a technique to communicate with them.

Patients were placed in an MRI scanner and asked to imagine hitting a tennis ball and walking from room to room in their homes. Four of the 23 vegetative patients responded to the commands by showing brain activity on the scanners.

And one man was even able to detailed yes and no questions about his life before his injury.

The research, appearing in the latest New England Journal of Medicine, also raises ethical dilemmas about how modern medicine should treat such patients, this NYT story explains. 

It also comes with plenty of caveats: Only a small number of patients responded. The scanning technology needs work and isn't ready to be a diagnostic tool just yet. And as an accompanying editorial by Dr. Allan H. Ropper of Brigham and Women's Hospital in Boston states, brain activity as seen on the scanner is not indicative of a "stream of thought," i.e. memory, self-awareness and reflection. 

AFP/Getty images

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Medical studies
        

A new study by Consumer Reports finds traces of bacteria in bagged salad -- even those labeled "pre-washed."

The lab tests of 208 containers of 16 brands of greens found several types of bacteria, including coliforms and Enterococcus, a type of organism found in the human digestive tract and the environment, which could be a signal of inadequate sanitation, the report states. 

These bacteria don't generally make healthy people sick (nor did the tests find E. coli or salmonella, pathogens that can be deadly). Still, the report calls them "indicator" bacteria, a sign that "not enough is being done to assure the safety or cleanliness of leafy greens," said Michael Hansen, a senior scientists at Consumer Union, the non profit that publishes Consumer Reports, in a statement.

Consumer Union also issued a report urging the FDA to set safety standards for greens.  

We've talked before about how veggies pose some of the biggest food poisoning risks. Your best bet to avoid any problems, rinse those greens, even the ones whose packages claim they have already been washed.

Baltimore Sun photo

Posted by Kelly Brewington at 11:30 AM | Permalink | Comments (1)
Categories: Diet and exercise
        

We have a story today about the Lancet retracting Dr. Andrew Wakefield's controversial article from a dozen years ago that first linked a childhood vaccine to autism and spurred a global panic over vaccines and an emotional debate over the causes of the disorder.

This comes after years of mounting evidence, including two review papers from the Institute of Medicine showing no link between the measles, mumps and rubella vaccine and autism. Last week, a British medical panel said Wakefield's work was full of false information and he risks losing his medical practice.

It's highly uncommon for a prestigious medical journal to retract a paper, usually done only in examples of "fraud or misrepresentation," and as Dr. Paul A. Offit, author of "Autism's False Profits" told me yesterday. Offit, chief of infectious diseases at the Children's Hospital of Philadelphia is a huge critic of Wakefield and other vaccine skeptics.

So is this the end of the vaccine-autism debate?

Don't be so sure, said medical experts I spoke to. Despite the evidence, groups such as Jenny McCarthy's Generation Rescue are calling Wakefield a hero and vastly misunderstood. What do you think?

Posted by Kelly Brewington at 8:30 AM | Permalink | Comments (8)
Categories: Pediatrics
        

B'More Green posted today about efforts in Annapolis to ban products containing two chemicals that have raised concerns about their toxicity:

At 2 p.m. today (Tuesday), the House Health and Government Operations Committee is scheduled to air HB33, which would ban the sale, manufacture or distribution of children's toys or child-care articles such as baby bottles made with bisphenol-A, or BPA. The bill, sponsored by Del. Jim Hubbard, a Prince George's County Democrat, would prohibit it by Jan. 10, 2011.

The plastic has been widely used as a lining in canned foods and some plastic water and baby bottles. For years, the Food and Drug Administration maintained it was safe, but amid growing scientific evidence of potential harm, the agency last month reversed course and declared concern about the effects of BPA on the brain, behavior, and prostate gland in fetuses, infants, and young children.   The agency now is pushing to end the use of BPA in baby bottles and infant feeding cups and is pressing for safer alternatives to line canned formula and other foods.

Connecticut and Minnesota already have banned BPA in certain children's products, according to legislative analysts, and 18 states last year weighed legislation to curtail the plastic. Several manufacturers already have begun phasing out use of BPA, including Wal-Mart, Toys “R” Us, and Babies “R” Us. For more on the bill, go here.

On Feb. 10, the House Environmental Matters Committee will hear another Hubbard bill, HB35, which would ban the sale of products containing brominated flame retardants.   Decabromodiphenyl ether, or decaBDE, is used in a wide variety of plastic products, including television cabinets and other electronics, in wire insulation and in draperies and upholstered furniture.

Hubbard pressed for a ban before, but his bill failed to pass.  Last year, though the Environmental Protection Agency, citing concerns that exposure to decaBDE may cause cancer and impair brain function, announced an agreement with chemical manufacturers to phase out its use by 2013.   Hubbard reintroduced the bill this year, seeking to ban it in Maryland by January 2011.

Maryland PIRG is backing both measures.

Baltimore Sun file photo of Nalgene travel bottles made without BPA/Jerry Jackson

Posted by Meredith Cohn at 12:36 PM | Permalink | Comments (3)
Categories: News roundup
        

Finding that you need fewer ZZZs?

Most healthy older adults need less sleep and tend to be less sleepy during the day than healthy younger people, according to a new study in the February issue of the journal SLEEP.

Results of the study showed that older adults slept about 20 minutes less than middle-aged adults, who slept 23 minutes less than young adults. The number of times older people woke up in the night increased and the amount of deep sleep decreased significantly, the report said.

Yet, this didn't seem to be a problem for the older folks without sleep disorders.

When all ages were disrupted multiple times during the night, everyone had the same reaction -- daytime napping. 

"Our findings reaffirm the theory that it is not normal for older people to be sleepy during the daytime," said principal investigator Derk-Jan Dijk, professor of sleep and physiology at the University of Surrey in the United Kingdom, in a statement. "Whether you are young or old, if you are sleepy during the day you either don't get enough sleep or you may suffer from a sleep disorder."

The study was conducted at the Clinical Research Centre of the University of Surrey and involved 110 healthy adults without sleep disorders or sleep complaints.

So, are you a daytime napper? do you feel you need a little less sleep as you have aged?

Associated Press file photo of woman sleeping at an airport

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

Sixth and seventh graders who took part in an abstinence-only education program were more likely to delay sex, according to a new study that could reignite the debate over what's the best method to reverse the teen pregnancy rate and prevent sexually transmitted diseases. 

The study, appearing in today's Archives of Pediatrics & Adolescent Medicine suggests that abstinence-only programs that don't preach about morals may be effective in preventing young teens from engaging in sex, according to the authors of the NIH-funded study. 

The research is billed as the first of its kind to measure the effectiveness of abstinence-only programs and comes on the heels of last week's news about a rise in the teen pregnancy rate , which set off yet another round of the contentious contraception vs. abstinence-only debate.

Researchers from the University of Pennsylvania enrolled 622 African-American students in either an 8-hour abstinence-only class, or one of three other classes that focused on condom use, other interventions and general health issues. Black teens are at especially high risk for unintended pregnancies, sexually transmitted diseases and HIV/AIDS.

By the three-year follow up mark, about a third of kids in the abstinence only course had had sex, while nearly half of the kids in the other courses had.

Critics of abstinence-only programs say they actually lead to less condom use if teens do end up having sex. But this study found that wasn't the case.  

The findings don't settle the contraception vs. abstinence only debate, the authors are clear to note. Nor should this study signify that all abstinence only programs work.

"Tackling the problem of STIs among young people requires an array of approaches implemented in a variety of venues," they conclude. "What the present results suggest is that theory-based abstinence-only interventions can be part of this mix. Using theory-based abstinence-only interventions selectively might contribute to the overall goal of curbing the spread of STIs in both the United States and other countries."

Perhaps in anticipation of a heated policy debate, an accompanying editorial written by Dr. Frederick Rivara of the University of Washington and Dr. Alain Joffe of Johns Hopkins, offer a warning to those looking to use the findings to drive home a particular agenda. (We're not holding our breath.) The results of the study should be combined with other research to probe what kind of interventions work best, they said. 

"No public policy should be based on the results of one study, nor should policy makers selectively use scientific literature to formulate a policy that meets preconceived ideologies," they write. 

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (3)
Categories: Pediatrics
        

According to a story in today's Sun, Congressional leaders are still trying to figure out a way to pass health care reform -- albiet quietly.

Democrats may try and persuade House members to vote for the Senate package and then go back and fix some things later under a budget procedure that is filibuster proof. Or they may seek a scaled down package that can pass both chambers.

But after the loss of former Sen. Ted Kennedy's seat in Massachusetts to a Republican, possibly due in part to voter anger over the economy, Dems are trying to keep the negotiations low key. They'd like to appear to be working full-time on job creation.

Indeed, President Obama barely touched on the subject of health care reform in his State of the Union message. But you can read more about the President's plan and watch a video at whitehouse.gov.

Meanwhile, some medical groups, including the American College of Physicians, are urging lawmakers not to give up on reform this year.

So, what do you think? Did the Dems overreach? Or, should they keep pushing for coverage for the millions who don't have it and protections for those who do?

Associated Press file photo of the State of the Union speech

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

In this Sunday story Meredith Cohn and I explained how a backlash against medical marijuana elsewhere could influence an expected proposal to legalize the drug for medical purposes here in Maryland.

Those behind the effort say they hope to craft a bill that imposes several restrictions on the drug's use, such as specifying that people have a long standing relationship with their doctor's before they get permission to use the drug. That means no showing up at a dispensary asking to see the doc on call for some pot. The Maryland effort may also prevent people from growing their own drugs. Supporters say the proposal could be among most stringent in the nation.

Our recent poll here at Picture of Health showed overwhelming support for medical marijuana. If you're for it, how do you think such a law should work in Maryland? What restrictions would you impose? What caveats would you implement? Or would you follow the models of other states like California? And of course, feel free to sound off if you think it's one giant bad idea. Let's hear it.

AP photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (16)
Categories: General Health