Local governments have banned minors from using them and even the FDA is considering taking that step, but tanning beds remain popular. New research, however, suggests that indoor tanning might be riskier than previously thought.

In a study of about 2,200 people, those who used indoor tanning beds had a 74 percent higher risk of getting melanoma, the most dangerous form of skin cancer, than those who did not, according to new research published this week in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

The study asked about lifetime sun exposure and found the risks increased the most for those who tanned for 10 years or longer.

The study provides some of the strongest evidence yet of the link between tanning beds and melanoma, which strikes nearly 69,000 Americans every year, killing nearly 9,000, this USA Today story explains. Although the folks at the Tanning Association disagree with the findings, the story states.

Last year, the World Health Organization put tanning beds on its list of known carcinogens. Local governments including Howard County's have banned people under 18 from using tanning beds and FDA is considering doing the same. Health care reform legislation even includes a 10 percent tax on tanning. And we told you about a study earlier this year that likened tanning to an addiction. Yet, many remain devoted to the tanning bed. Are you?

AP photo

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Categories: Cancer
        

But today, with better testing and safety protocols, gay rights advocates and some medical experts alike think the policy is outdated. A federal panel will take up the issue next month.

This CNN story breaks down the arguments, from gay advocacy groups who say the policy is discriminatory, to medical experts who say it's not a matter of gay-rights, but epidemiology: the rate of HIV is higher in gay men then heterosexuals, so allowing them to donate means higher risks for the blood supply. Meanwhile other physicians assert that today's blood screening is so effective the ban makes little sense. 

This Scientific American piece explains how the blood screening process works. It discusses a report published in the Canadian Medical Association Journal in which AIDS researchers call for an end to the ban saying it puts an unnecessary burden on blood agencies and without it, the nation's blood supply would rapidly increase. The American Red Cross and America's Blood Centers support lifting the ban. Sen. John Kerry of Mass. and other lawmakers have also called on the FDA to end the ban.

More than 38,000 blood donations are needed daily in the U.S., but only 38 percent of Americans are eligible to donate blood, and of those, only 8 percent actually do, the story states. (There are other reasons people can be ineligible to donate, including having a history of blood cancers and travel within the last 12 months to a country where malaria is typically found -- see the Red Cross' eligibility criteria here).

The story continues:

"Today's technology makes it almost impossible for HIV to slip through, and the total ban puts a huge burden on blood agencies and the blood supply," said lead author Mark Wainberg, in a prepared statement. He helped in the discovery of 3TC, one of the first drugs to control HIV. "We constantly have blood shortages that would not occur, perhaps, if we had a more reasonable policy."

What do you think?

AP photo

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Categories: General Health
        

High blood pressure is so common, it affects nearly a third of the nation's adult population. A new study offers a good news-bad news picture of the disease: About half of the 65 million Americans with high blood pressure are controlling it, reaching a nationwide goal set nearly a decade ago to combat the illness. But the prevalence of high blood pressure has remained unchanged in recent years, according to research published in this week's Journal of the American Medical Association.

Back in 1988, about 27 percent of adults controlled their high blood pressure, according to the study's analysis of government data of nearly 43,000 people. The increase in those who got the illness under control is notable, say researchers, but more must be done to prevent high blood pressure, which can lead to damaged arteries, heart attack and stroke.

The research suggests more people are controlling their hypertension with medicine, not lifestyle changes. But if prevention is going to take hold, people need to change their diets and exercise, says an accompanying editorial by Dr. Aram V. Chobanian of Boston University Medical Center:

Although lifestyle changes can reduce [blood pressure] and the risk of developing hypertension, successful behavioral approaches to modify lifestyles on a population basis have lagged far behind the advances in the drug treatment of hypertension. Societal changes such as the rapid growth of the fast food industry, increased availability of prepared foods, and decreases in physical activity have had major adverse effects on cardiovascular risk factors.  Programs to incorporate healthier lifestyles into daily life need to be intensified on a national basis to deal with not only hypertension but also obesity, diabetes, dyslipidemias, and cardiovascular diseases.

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

And it's not pretty. The Center for Science in the Public Interest has come out with its "Xtreme Eating Awards" essentially calling out popular chain restaurants for their fatty, calorie-loaded meals. Brace yourselves.

Top on the list is Five Guys, the popular burger chain that got it's start here in the Mid-Atlantic and confession: my truly favorite of favorite comfort foods. Yes, this health writer indulges every once in a while. I'm human after all. Still, it hurts me to write this: A bacon cheeseburger and large fries tallies up to a whopping 2,380 calories.

But wait, doesn't it help that I don't put bacon on my burger and I always share the fries -- a small order at that?! No matter. A plain hamburger is 700 calories without any toppings -- way more than the 410-calorie Quarter Pounder at McDonalds. Why am I surprised?

Others on the list -- (you can take a look at all the offenders here): 

Tostada Pizza at California Pizza Kitchen: It sounds healthy enough with black beans, cheddar cheese, lettuce, salsa and -- uh oh -- ranch dressing. You're looking at 1,440 calories and more than a day’s saturated fat (27 grams) and sodium (2,630 mg). The crust alone supplies some 400 calories’ worth of flour, CSPI explains.

Bob Evans’ Cinnamon Cream Stacked & Stuffed Hotcakes: This one is just too much. Two pancakes stuffed with fruit or cinnamon chips with a layer of vanilla cream cheese topped with whipped topping will cost you 1,380 calories, 27 grams of saturated fat plus 7 grams of trans fat, and 27 teaspoons of sugar. Calorie wise alone, you're looking at the equivalent to two breakfast orders of country-fried steaks and eggs. 

Are any of us surprised by this? Of course not. Still, with calorie counts soon to be required on chain restaurant meals, it's about time we get used to seeing these numbers, CSPI urges. 

Posted by Kelly Brewington at 7:05 AM | Permalink | Comments (6)
Categories: Diet and exercise
        

Parents worried that their babies are getting too many vaccines too soon often opt to space out vaccinations in an alternative schedule. But new research finds that doing so offers no benefit to a child's development.

In fact, delaying vaccines can cause health risks, this WSJ article explains, exposing children to the very illnesses the vaccines are designed to protect against.

The study, appearing online in this week's Pediatrics, analyzed data on more than 1,000 children born between 1993 and 1997. Researchers compared vaccination schedules up to the time they reached a year old, and studied their performance 7 to 10 years later on dozens of neuropsychological tests. Those who got vaccinated at the recommended schedule actually performed better on many of the tests, the researchers found.

While it's true that babies are given more vaccines in their first two years than they were a generation ago, the amount of antigen -- elements of the vaccine that spark the immune response -- have actually decreased, this NPR piece discusses.

Nevertheless, parents are opting for alternative vaccination schedules, or skipping the routine shots entirely. Some 39 percent of parents refused or delayed at least one routine childhood vaccine in 2008, up from 22 percent five years earlier, the CDC found.

The study comes out the same day that the doctor whose research first linked autism to the measles, mumps and rubella vaccine was stripped of his license. Dr. Andrew Wakefield's controversial paper from a dozen years ago was retracted by the journal the Lancet earlier this year, after igniting a global panic over claims of a link that has been proven not to exist.

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Categories: Pediatrics
        

Here we go again. Another healthy food is the subject of a major recall. Raw alfalfa sprouts linked to a salmonella outbreak have sickened 22 people in ten states, the Food and Drug Administration announced this morning.

People became ill after eating the sprouts in restaurants as well as from packages they bought at the grocery store. Salmonella infections typically cause diarrhea, fever and cramps. While most people get over the illness on their own, it can cause serious -- sometimes fatal -- infections in the elderly and children.

Sprouts are superhealthy-- low in calories and rich in nutrients -- but they grow in humid, warm conditions, the same environment that bacteria like salmonella love. Since 1996, there have been 30 outbreaks of foodborne illnesses associated with the sprouts, mostly linked to E.coli and salmonella, according to the FDA. Here are some tips from the agency on how to avoid the getting sick from eating sprouts.

Posted by Kelly Brewington at 12:20 PM | Permalink | Comments (1)
Categories: General Health
        

If you haven't already, take a look at the fascinating profile of Hopkins kidney transplant surgeon Dr. Robert A. Montgomery that ran in Sunday's Baltimore Sun. Written by our colleague Arthur Hirsch, it's a great tale that mixes vivid description of Montgomery's nonconformist ways with the science behind the multi-way kidney transplants that he's become known for.

Known as kidney-paired donations, the transplants go beyond a mere two-way organ swap. These transplants create a chain of donors and recipients often in multiple hospitals in various locations around the country. Hopkins has been doing the swaps since 2001, and today they're duplicated at other big medical institutions as a way to make more kidneys available to more recipients. With more than 89,000 people waiting for kidneys in the U.S., it's a life-saving strategy. The story explains:

Simply put, kidney paired donation is a way to get around the problem that arises when a donor is not a good match for the intended recipient. What then? Then the names of donors and recipients, along with their blood and tissue types, are fed into a computer database in hopes of finding better matches. Sometimes those matches are with strangers thousands of miles away. In a simple two-way swap, for instance, the donor in pair A gives to the recipient in pair B and vice-versa. The more pairs in the database, the more possible matches.

A donation "chain" is a bit different. This would start with one donor giving a kidney to no one in particular, setting in motion a succession of donor-recipient couplings. At the end, a kidney would be left that could start another chain or go to a patient on the list for a kidney from a deceased donor.

And that's just the medical stuff. The piece is chock-full of Montgomery fun facts: He's married to internationally renowned opera star Denyce Graves, with whom he appears to share a love for the dramatic. He drives a white Shelby Cobra with a blue stripe down the middle. And as early as forth grade his teacher noted: "Bobby doesn't think the rules apply to him." Oh yeah, and there's that mustache!

Baltimore Sun photo

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Categories: Surgery
        

It's hard to think of any occupation, any person for that matter, that doesn't rely on email these days. But medicine remains one of those areas where email is still a new phenomenon. Take parents and pediatricians. Parents want the convenience of emailing their pediatricians, but doctors tend to shy away from doing so because of privacy and safety concerns, says this piece that ran in yesterday's Health & Style section.

The story takes a look at a recent Johns Hopkins study that found even though parents want to communicate with their child's doctor through email, some physicians fear that parents will use e-mail in emergency situations, that it will lead to misunderstandings, or even that a message sent to a nonsecure computer constitutes a violation of privacy, the article explains.

Then there are worries about when a doctor's day starts and ends. If a doctor exchanges emails with a patient, does it imply they're on call around the clock? Will an insurance carrier reimburse a doc for sending an email? What about people who don't have email access? Are they forced to suffer with inferior care?

I wonder, too, do docs even have the time to email patients? Most of us find ourselves hurried through doctors appointments, as it is. And getting a doctor on the phone is no easy feat.

Still, I wonder if this becomes a place where medicine evolves. If enough parents, especially first-timers, who are known for calling pediatricians offices early and often, ask to email their doctors, will practices begin to do so?

The story quotes one doctor who thinks email has helped avoid phone tag with parents, some of whom have even sent him photos of their kids' rashes. 

What do you think? Does your doctor use email? If not, would you prefer if the doc did?

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

There's no doubt that having a child with autism can put stress on a marriage. The same can be said for any number of puzzling childhood diseases. But a common perception that parents of autistic kids have high divorce rates -- as much as 80 percent -- is a myth, according to a new study from Kennedy Krieger researchers.

Using data from nearly 78,000 children ages 3 through 17 recorded by the 2007 National Survey of Children's Health, researchers found that the parents of autistic children are just as likely to be married as the parents of their peers.

Some 64 percent of children with an autism spectrum disorder have two married biological or adoptive parents, compared with 65 percent of children without autism, researchers found.

Brian Freedman, the lead researcher at the Baltimore-based Kennedy Krieger Institute, said that parents of children recently diagnosed with the disorder often quote the 80 percent divorce rate figure and feel an instant sense of hopelessness. But there's no reason to believe that their marriage is likely doomed, he said. (In fact, no one knows for sure where the 80 percent figure first came from. But it's been perpetuated for years.)

At the same time, however, researchers know that parents of autistic children report more stress than parents of non-autistic kids, even more than parents of children with other disorders like Down syndrome. Mothers of autistic children, for instance report more depression than other moms, while dads are known to distance themselves from the family to cope with their stress, the study explains. 

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Medical studies, Pediatrics
        

Improving minority health and advancing research on frustrating health gaps between whites and minorities are the focus of two new initiatives at the University of Maryland.

The School of Public Health has recruited Stephen B. Thomas from the University of Pittsburgh to lead the new Maryland Center for Health Equity. Thomas and a team of new recruits will focus on community-level research and outreach to minority populations in Maryland. Thomas, who launched a program that brought prostate cancer screenings to barbershops -- you read that correctly --  plans to start similar projects here.

Key to the effort will be breaking down barriers of distrust. 

"You'd think that communities lacking the most basic health care would welcome outside help," said Thomas in a statement. "However, the burdens of race and history cannot be ignored. The reality is that we have to build trust and overcome cultural barriers first."

Meanwhile, a project at the School of Medicine will offer free community seminars aimed at improving health in Baltimore neighborhoods and tackling minorities' historic distrust about participating in clinical trails.

The Mini-Med School, free classes on specific health topics presented by faculty researchers, is the first effort of the new Bioethics Research Center, whose goal is to get more minorities, particularly African Americans and other underserved groups, into clinical trials. The legacy of the Tuskegee experiment and other research that exploited blacks without providing medical benefits remain a barrier to getting African Americans into clinical trials. Diversity in clinical trials is key to getting a more complete picture of medical research, experts say.

Mini-Med School sessions started last week. There's one tonight on irritable bowel syndrome/Celiac disease from 6 p.m. to 8 p.m. at the Medical School Teaching Facility Auditorium, 685 W. Baltimore Street in Baltimore. Two more sessions are planned the following Wednesdays -- one on diabetes research and another called Clinical Trials 101. Check out the website for a full list and details.

Posted by Kelly Brewington at 12:46 PM | Permalink | Comments (0)
Categories: General Health
        

About one in 10 fathers experience prenatal or postpartum depression, with those at greatest risk if their partner also is depressed, new research has found.

Dads had the highest rates of depression in the three to six months after a baby was born -- 26 percent. Consider that in the general population, just 5 percent of men are considered depressed at any given time. Dads had the lowest rate -- about 8 percent -- in the immediate postpartum period, just before three months, according to the study  appearing today in the Journal of the American Medical Association.

While clinicians and researchers talk a lot about the very serious effects depression can have on women and their families while they're carrying a baby and in the postpartum period, there's little understanding on the impact of fathers who struggle with depression, the report explains.

Even less is understood about why fathers struggle with depression after the birth of a child. Researchers think the reasons are similar to why mothers get depressed -- financial stress and sleep deprivation among others, this NPR piece explains. But there may be other issues particular to dads, just as mothers have their own concerns, including hormonal changes.

Researchers did an analysis of some 43 studies involving 28,000 participants to take a closer look at the phenomenon. The findings indicate a "significant public health concern" that a lot of doctors may be overlooking, researchers said.

Further, depression can affect the entire family and the fact that fathers were likely to be depressed when mothers were, points to the need for screening both moms and dads for the blues, the study states.

The authors write:

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Categories: Men's health
        

Rules requiring doctors to get approvals from insurance companies to do procedures or prescribe certain drugs hinder doctors' ability to provide good care, says a new survey of doctors from MedChi, the state's medical society.

In the small survey, the group asked 135 doctors statewide about insurance protocols, a long-standing issue that Med-Chi leaders said they hope to address as health care reform is implemented in Maryland. Today, the group sent a letter to Maryland's insurance commissioner detailing the concerns.

The survey goes after insurers big time, saying they shouldn't be in the business of making health care decisions. Insurers often require doctors to get approvals before they can authorize certain types of care in an attempt to save costs and prevent unnecessary procedures, but those decisions should be made by medical professionals, said Gene Ransom, MedChi's executive director.

Among the findings: 

• 95 percent of docs surveyed said such protocols had a "somewhat" or "very negative" effect on the doctor's ability to treat patients effectively. 
• 89 percent of doctors called the protocols "burdensome", "very burdensome" or a "major hassle."
• Nearly 77 percent of physicians asked said they considered moving their practices out of Maryland, leaving the profession to avoid such protocols

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Categories: Health care professionals
        

The results of the world's biggest study on whether cell phones are linked to brain cancer turned up inconclusive, researchers reported yesterday. But the bigger story might just be the controversy behind the report.

This Reuters article explains major flaws in how the study was conducted. Instead of finally putting to rest the question of a possible link between cancer and cell phones, the long-awaited Interphone study has only left everyone -- scientists included -- frustrated, the story explains. 

While studies structured this way can help explain whether a disease is associated with a lifestyle, they're voluntary and, well, that can make the results unreliable, the story explains. Some people may have participated because they believe that cell phones caused their brain cancer, skewing results, the story states.

In the 10-year study of 13,000 people, cell phone use didn't increase the risk of developing two types of brain cancer.

The researchers themselves acknowledged the report's limitations.

So now what, you ask? Back to the drawing board. Researchers said more study is needed, particularly when it comes to how cell phones affect teens, who are the fastest growing group of cell users.

"This was a very complex study, and results were very difficult to interpret because of a number of methodological issues," said Elisabeth Cardis at the Centre for Research in Environmental Epidemiology in Barcelona, who led the group of 21 international scientists conducting the study, told the Washington Post.

Baltimore Sun photo

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Categories: Cancer
        

As if we needed more evidence that common pesticides in produce could be bad for us. Now a new study suggests that they could be linked to ADHD in children.

The research, published today in the journal Pediatrics, found that children with higher levels of pesticides measured in their urine were more likely to have attention-deficit hyperactivity disorder.

Researchers at the University of Montreal and Harvard measured pesticide levels in the urine of more than 1,100 children ages 8 to 15 and found that those with the highest levels of markers for a common class of pesticide known as organophosphates, had the highest incidence of ADHD. In one measure, children with higher than average levels of the marker, had twice the incidence of ADHD. The compound itself was found in nearly all -- 94 percent -- of children.

Of course the study couldn't prove that the insecticides caused ADHD. Researchers note that a limitation of the study is that childrens' urine was only tested once. Measuring any link to ADHD likely would require evidence of long-term exposure and require ongoing testing, the investigators said.

Still, the findings are consistent with previous research that shows links between organophosphates and behavior problems and lower cognitive function, the paper notes. Researchers have been warning for some time about too much exposure to the pesticides, but mostly with farm workers, not the general public.

Posted by Kelly Brewington at 1:18 PM | Permalink | Comments (6)
Categories: Pediatrics
        

Quality child care can make a difference in a child's readiness for school and overall socialization. It can also have an impact well into adolescence, according to a new government study.

Teens who attended high-quality child care programs scored better on cognitive and academic tests -- particularly reading and math -- and had fewer behavior problems than teens who did not, researchers from the National Institute of Child Health and Human Development found.

The study, published in the May/June issue of the journal Child Development, followed 1,364 children in 10 cities across the country from birth until they turned 15. In addition to examining the type and quality of child care they were enrolled in using a 1-4 rating system, researchers examined their grades and reports from parents, teachers and the kids themselves when they became teenagers.

While the link between academic performance and child care quality was small, the researchers are quick to note, it does underscore the importance of quality child care on the life of a child -- beyond those early elementary school days.

Researchers discovered another interesting finding: The amount of time spent in child care seemed to have an impact on behavior. Teens who spent the most hours in child care by age 4 1/2 were more likely to be impulsive and risk taking at 15 than those who spent less time at daycare.

Experts aren't sure exactly why this is. But they have a few theories: 

"High quality child care appears to provide a small boost to academic performance, perhaps by fostering the early acquisition of school readiness skills," said James A. Griffin, deputy chief of the NICHD Child Development & Behavior Branch, in a statement. "Likewise, more time spent in child care may provide a different socialization experience, resulting in slightly more impulsive and risk-taking behaviors in adolescence. These findings underscore the importance of studying the linkages between early care and later development."

Baltimore Sun photo

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Categories: Pediatrics
        

Barbara Walters' heart surgery to replace her aortic valve is serious surgery, but it's not an uncommon procedure. About 18,000 such surgeries took place in the U.S. 2007, according to  the American Heart Association.

But what exactly is the surgery and why is it needed? We caught up with Dr. John Conte, associate director in the division of cardiac surgery at Johns Hopkins, to answer some basic questions. 

What is aortic valve surgery?
The aortic valve is the main valve leading out of the heart. Surgery is performed to repair or replace it.

What is the aortic valve replaced with?
There are many different types of valves. Bioprosthetic valves are made from living tissue. Specifically pig heart valves and cow pericardium (the sac around the heart of all mammals). Mechanical valves are made of a carbon-based metal. In simplest terms, bioprosthetic valves can wear out in 10 to 20 years but don't need blood thinners. Mechanical valves last forever but demand blood thinners your entire life.

What are the reasons for replacing it?
They are replaced because they become stenotic, meaning the openings are too tight, and blood has a hard time getting out of the heart. Or the valves leak and blood goes back into the heart.

How are such valve problems detected?
Usually they are detected when the patient becomes short of breath, becomes tired easily or develops chest pain.

Are the causes of aortic valve problems genetic or due to lifestyle, or both?
The cause is usually wear and tear which causes the valve to calcify. It can also be caused by inherited traits and congenital anomalies.

What's the recovery time and how safe is the procedure?
The recovery time is usually measured in weeks, following a hospital stay of a few days to a week. It is a very safe and good procedure that is easy to reproduce.

AP photo

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Categories: Cardiovascular Health
        

If you've suffered serious trauma in an accident in the greater Baltimore area, there's a strong likelihood you'll be taken to Maryland Shock Trauma. About 8,000 people a year go to Maryland, and officials say it's time to expand.

The University of Maryland Medical Center plans a groundbreaking ceremony today at 10 a.m. for its new $160 million building. 

The nine-story tower, at Penn and Lombard streets, will significantly expand the R Adams Cowley Shock Trauma Center. It will add capacity to the adult and pediatric emergency departments and to intensive care.

To pay for the growth, Maryland will also launch a major fundraising campaign with Cal Ripken, Jr. serving as honorary chairman.

The current Shock Trauma building is 20 years old. The new tower, scheduled to be completed in 2013, will be 140,000 square feet and house 10 high-tech operating rooms and 64 new and replacement critical care beds. It will connect to the existing building.

Artist's rendering courtesy of the University of Maryland Medical Center

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

How common are food allergies? What's the best way to make a diagnosis? And how best should people manage the illness? In short, doctors don't know.

A review of 72 food allergy studies between 1988 and 2009 found that research is lacking on all of these questions, confusing doctors and the patients they treat.

For example, there's no agreed-upon definition for food allergies and no clear best way to diagnose them according to the research, published in today in the Journal of the American Medical Association.

Of course, all that makes it tremendously difficult to pin point who has a legitimate food allergy and who doesn't. Researchers think food allergies affect more than 1 or 2 percent -- but less than 10 percent -- of the U.S. population. Whether the prevalence of food allergies are increasing, well that's not clear either.

In terms of specific treatment, researchers found there is not enough study on the effectiveness of elimination diets and immunotherapy. With infants at high risk of developing milk allergies, it's unclear what treatment is most effective. Giving infants hydrolyzed formula may work to prevent allergy, but more research is needed. The same is true of giving infants probiotics in addition to breast milk or hypoallergenic formula -- results remain unclear, the study states.

The paper is part of a project organized by the National Institute of Allergy and Infectious Diseases in an attempt to sort out the confusion surrounding food allergy testing, the NYT reports. An expert panel is expected to have a draft report by the end of June that will offer guidelines about defining food allergies and how to diagnose and treat patients, the story states.

AP photo

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Categories: General Health
        

Baltimore City has had food problems for years. There isn't enough healthy food in all parts of town and that means more obesity and more heart disease and diabetes, particularly in poorer neighborhoods.

But Tuesday, a task force formed in 2007 to look at the problem came out with a report that had 10 recommendations. Some the city has already started on: expanding and promoting farmers' markets, improving school lunches and increasing home delivery of groceries.

But others will take longer: Expanding community assisted agriculture, where people pay upfront for produce from a local farmer all season. Only, the task force wants residents to be able to pay in installments.

Another suggestion is researching ways to deal with food deserts, those vast expanses where there are no major groceries, just corner stores and that may not sell fresh fruit and other good foods.

Other ideas include encouraging vendors to carry healthy food, turning vacant lots into community gardens and further expanding home delivery. On that front, the city got $60,000 in federal money to launch a program at a couple of libraries. Residents can order online and pick up their food there.

A new food czar also was introduced yesterday. Hollu Freishtat's pay comes from private sources, but she'll work with city agencies, businesses and nonprofits to help figure out some of these intractable problems. She wants to start by involving city kids in an ad campaign to promote good eating and getting more farmers' markets to accept food stamps.

So, how's your city neighborhood? You have access to healthy food? You have ideas to get it to others?

Read my full story in The Sun. And find the whole report at www.baltimorecity.gov, keyword "food policy."

Baltimore Sun file photo of a city farmers' market 

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Categories: Healthy Living
        

Our live chat with Dr. Lawrence Cheskin, director of the Johns Hopkins Weight Management Center, kicks off in a couple hours, but you can ask questions now via the comments or the widget below. Cheskin will be live on the blog at noon with answers to weight-loss, diet and nutrition questions, and he'll address other concerns you may have.

Posted by Carla Correa at 10:31 AM | Permalink | Comments (1)
Categories: Diet and exercise
        

Millions of people pop a pill to reduce heartburn and stomach acid making the class of drugs one of the highest sellers in the nation. But the remedies could actually pose more risks than benefits for most people, according to a package of new studies published in the Archives of Internal Medicine.

Known as proton pump inhibitors (PPIs), drugs such as Prilosec and Prevacid -- available over-the-counter -- and by-prescription Nexium were associated with a type of bacteria infection and bone fractures, the studies found.

In one study, people who took the PPIs daily had a 74 percent increase in a bacteria infection called Clostridium difficile. In another, postmenopausal women who took the drug were more likely to have spine, wrist and forearm fractures.

This is not the first research to raise concerns about the risks of the drugs. We reported on this a few years ago when a study first suggested that the medications were associated with weakened bones among older people. 

While the risks of developing complications were relatively small overall, the bigger problem is that the drugs are overused, says Dr. Mitchell H. Katz, of the San Francisco Department of Public Health, in an accompanying editorial.

The market for the drugs is huge with 113.4 million prescriptions for PPI's are filled each year, accounting for $13.9 billion in sales -- the third highest seller nationwide, he writes.

The reason? Many people take the drugs to relieve the symptoms of dyspepsia, a fancy word for persistent indigestion and a condition that affects some 25 percent of adults. The next step -- medicine designs a pill to treat the common condition and overuse ensues, he writes.

"The problem with this paradigm is that for most patients the adverse effects of PPIs outweigh the benefits. Reducing the unnecessary use of these medications will require action by both physicians and patients."

"Harm will result if these commonly used medications are prescribed for conditions for which there is no benefit, such as non-ulcer dyspepsia," write Dr. Deborah Grady, of the University of California, San Francisco and Dr. Rita F. Redberg, in another editorial.

The research and the opinion pieces are part of the journal's "Less is More" series, highlighting the need for the medical community, and the public at large, to question when certain medical interventions are appropriate. 

photo: stock.xchng

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Categories: General Health
        

We're less than 24 hours away from our live chat with Dr. Lawrence Cheskin, director of the Johns Hopkins Weight Management Center.

Dr. Cheskin will take all your weight loss questions. Need advice about diets? Have a nutrition question? Considering bariatric surgery? Feel free to start asking your questions now in the comments section below and we'll see you here at noon tomorrow with answers. 

Posted by Kelly Brewington at 3:00 PM | Permalink | Comments (0)
Categories: Diet and exercise
        

We hear a lot about pricey new cancer drugs driving up the cost of treating the disease, but a new study suggests meds aren't the sole reason for soaring treatment costs.

The research, published today in the journal Cancer, finds the cost of treating cancer doubled over the last two decades with  more people getting treated for the disease helping to drive that cost.

The total cost of treating cancer in the U.S. in 1987 was $24.7 billion (in 2007 dollars), compared with $48.1 billion a year during 2001-2005, according to the research compiled by experts at the Centers for Disease Control and Prevention. But that cost kept in line with the rapid rise in health care spending. Cancer treatment as a percentage of overall medical treatment has stayed steady at about 5 percent for the past two decades.

That's not to discount the exorbitant cost of new cancer drugs. Consider this story from the NYT about prohibitively expensive cancer treatments that leads with a new chemo medication that costs $30,000. You read that right -- 30K.

And heard of Provenge? The prostate cancer vaccine that recently won FDA approval? That's expected to cost a mere $93,000.

Posted by Kelly Brewington at 12:40 PM | Permalink | Comments (0)
Categories: Cancer
        

The use of weight-loss surgery has surged in recent years. But it's not just adults who are getting it. Increasingly, adolescents are receiving invasive surgery to treat obesity and it's been a heated topic of debate among experts.

Two recent studies express caution about recommending the procedure in children.

In a survey of pediatricians and family practitioners, half said they would not recommend the surgery to people under 18.  The findings, published last week in the journal Obesity Surgery, stressed that the surgery is still new and no one knows the long-term effects on children.

Meanwhile, a review article in The Lancet takes a tougher stance. It urges against weight loss surgery for teens, saying it should be used only as a last resort after diet, exercise and lifestyle changes have been exhausted. The authors write:

But then there's this research from just a couple months ago, indicating a type of bariatric surgery called gastric banding showed promise in teens.

The NYT took a fascinating look at the question recently. Those who endorse the procedure say simply that it works and children shed weight dramatically in the first year. More hospitals are offering obesity surgery for teens and specialized centers which once served only adults have expanded to adolescents.

After all, the health risks for obese teens are great. 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, studies have found.

But many experts caution that the surgery could cause adverse affects on a child's growth and development. Consider that children are coming to the operating table both emotionally and physically immature, the NYT article points out.

Of course the overarching problem, say some experts, is that there hasn't been enough research to conclude whether such surgery is effective long term -- or safe. 

AP photo

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

Restaurants and wholesalers are pulling romaine lettuce from their supplies in Maryland and 22 other states after an outbreak of what appears to be E.coli sickened at least 19 people, three of them critically.

The Food and Drug Administration is investigating a farm in Arizona as the source of the tainted lettuce, the AP reports. The illnesses took place in Michigan, Ohio and New York.

The romaine lettuce comes from Freshway Foods, in Sydney Ohio, sold under the Freshway and Imperial Sysco brands in Maryland and other states. Here's a full list of the places affected and an explanation from Freshway.

The company points out the recall affects lettuce in grocery store salad bars, restaurants, wholesalers and delis. It doesn't make the pre-packaged kind you can buy at the grocery store.

Here's the Centers for Disease Control and Prevention take on investigations of the outbreak in New York, Michigan and Ohio. And here are some more details from the FDA.

The recall is just the latest example of the need for greater oversight and safety controls when it comes to food, according to a pair of reports to Congress, this San Francisco Chronicle story explains.

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

Trying to lose weight for the summer? Struggling to shed a few pounds and adopt a healthy lifestyle? Well, who isn't?

We've got advice coming your way at noon Tuesday when we'll host a live chat with weight loss expert Dr. Lawrence Cheskin, director of the Johns Hopkins Weight Management Center. Dr. Cheskin founded the center in 1990 and is a noted researcher on such topics as obesity, weight loss and overall health and nutrition.

You can start asking questions now by emailing me at kelly.brewington@baltsun.com, or leave them in the comments section below. See you there!

Posted by Kelly Brewington at 11:18 AM | Permalink | Comments (0)
Categories: Diet and exercise
        

Mothers these days are older and better educated than they were a decade ago, according to a new report from the Pew Research Center.

The study analyzes the shifting demographics of motherhood between 1990 and 2008 with the help of some Census figures. Consider that in 1990, 13 percent of all births were to teen mothers, while 9 percent were to women 35 and older. In 2008, it was the reverse: 10 percent of births were to teens, while the share of births to women  35 and older was 14 percent.

In 2006, a little more than half of all moms of newborns (54 percent) had at least some college education, up from 41 percent in 1990. Of older moms of newborns, 71 percent had at least some college education.

Couples are waiting to have children after they've achieved certain goals such as completing an advanced degree, starting a career and marrying later -- and in many cases not at all -- the authors said. Meanwhile, breakthroughs in fertility treatments mean women can have children later in life.

Attitudes of motherhood are also evolving, the study points out.  The stigma of fertility treatments and unwed births is waning. Most people say they know at least one unmarried woman who has had a child, and at least one unmarried man who has fathered one, according to the Pew survey.

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Women's health
        

A New York state proposal aims to enroll everyone as an organ donor, unless they opt out. Instead of giving permission to donate organs by checking a box on a driver's license, people would have to indicate that they don't want to be organ donors.

In addition, next of kin would no longer be able to challenge the decision of their dead relatives to donate their organs.

The notion of such a "presumed consent" measure is sparking a contentious debate among lawmakers, advocates and folks all over the web.

Those opposed to the measure say it could force people to become donors against their will or lead to concerns that  doctors aren't doing enough to save patients, the Associated Press reports.

The lawmaker who proposed the measure says the only reason his daughter is alive is because she was able to get two kidney transplants. But too often, people suffer and die because waiting lists far exceed available organs. In New York, just 13 percent of residents are organ donors.

Roughly 150,000 New Yorkers die each year, but less than 1 percent, or only 1,500 people, are likely to possess organs healthy enough for transplantation, says Sally Satal, a scholar at the American Enterprise Institute in this debate with other scholars and advocates in the NYT.

What do you think? Are proposals like this one a good way to push people to be organ donors? Or does it go too far?

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

Interested in supermodel-grade eyelashes? Be wary of the prescription lash-lengthener Latisse, which promises fuller, darker, longer lashes but has been noted for some ugly side effects.

This NYT story reports that the drug is easily available without prescription. While many people have used the product without problems, others have reported redness, itchiness and swelling after using the topical solution. One woman quoted in the story had "dark purply" eyelids after using the stuff.

Taking on those risks -- for about $100 a month -- is one thing, but many people seem to be doing so without consulting a doctor, the story states. 

Consumer Reports, which has been warning about the product for months, advises: stick to mascara. Last year, the Food and Drug Administration warned the maker of Latisse that its ads downplay serious risks. Recently, the FDA has been cracking down on other manufacturers for the same reasons.

Baltimore Sun photo

Posted by Kelly Brewington at 12:15 PM | Permalink | Comments (0)
Categories: General Health
        

The more than 40 over-the-counter infant and children's medications recalled last Friday were contaminated with bacteria, according to a report released this afternoon from the Food and Drug Administration.

The report finds more than 20 manufacturing problems found by FDA investigators at the McNeil Consumer Healthcare plant in Fort Washington, Pa. The problems had to do with quality control, such as the company didn't have a lab to test the drug ingredients and did not follow up on customer complaints.

McNeil issued a statement Tuesday saying it suspended operations at the plant today until it "can assure the quality of products made there," according to the Washington Post.

The FDA is considering possible criminal action against the company.

The recalled products include children's Tylenol, Motrin and Benadryl -- see the full list here. 

Concerned parents should check out this good Q&A about the recall. For more information on the recall and to get a refund see the McNeil website. 

Posted by Kelly Brewington at 6:56 PM | Permalink | Comments (0)
Categories: Pediatrics
        

The D.C. city council just approved a measure legalizing marijuana for medical use, The Washington Post reports

It's a step that Maryland lawmakers considered this legislative session but couldn't gather enough support to pass. A measure passed in the Senate that would allow people suffering from certain illnesses to get marijuana to relieve their symptoms, but it went nowhere in the House of Delegates.

The District could join 14 states with similar laws, according to the Marijuana Policy Project, while more than a dozen other state legislatures are considering them. While polls show support for such laws, they haven't been without their controversies, as we reported in this story earlier this year.

In DC, not only is there vast support for the measure, the button-downed District is apparently a city of pot enthusiasts, according to this Post story that ran today. Who knew? Hmmm, so how does Maryland compare?

Posted by Kelly Brewington at 4:25 PM | Permalink | Comments (1)
Categories: General Health
        

To anyone who was ever taunted for being even a little pudgy as a kid, this is not surprising. But the study, appearing in the latest issue of Pediatrics, sheds light on yet another negative impact of the nation's childhood obesity epidemic.

The study of 821 third, fifth and sixth graders based on reports from parents and teachers, found that children who were obese were 63 percent more likely to be the target of bullies. Consider that impact on the 17 percent of 6- to 11-year-olds estimated to be are obese.

The study implies that it's obesity that attracts the merciless teasing. But could being bullied actually lead to being obese instead of the other way around?

The researchers say likely not. They address that concern and other questions about child bullying in this Q&A with the Chicago Tribune.

AP photo

Posted by Kelly Brewington at 12:40 PM | Permalink | Comments (0)
Categories: Pediatrics
        

The rate of childhood obesity in the U.S. rose by 10 percent between 2003 and 2007, but in Maryland that rate of increase was just two percent, according to new study that shows wide variations in obesity rates by states.

About 13 percent of Maryland children ages 10 to 17 were obese in 2007, a slight increase from four years earlier, the study found. But it was still below the national average of a little more than 16 percent.

The percentage of overweight children in Maryland was 29 percent, a decrease by nearly four percent, according to the statistics published online in the Archives of Pediatric and Adolescent Medicine.

We've known for years that children across the country are getting fatter. But this study zooms in on the huge disparities that exist by state and region and suggests that if the country is going to fight the obesity epidemic as everyone from local schools to Michelle Obama would like to do, zeroing in on these variations will be key. 

Nationwide, more than 16 percent of American children are obese and 32 percent are overweight, with rates highest for states in the Southeast. The highest was Mississippi, where more than a fifth of children are obese. Oregon had the smallest percentage -- just under 10 percent of children were obese. It was the only state that had a significant decrease over the four-year period.

African-Americans and Latinos were twice as likely as whites to be overweight and obese, even when researchers adjusted for issues such as poverty and inactivity. And the increases for girls in some states were dramatic. For instance, in Arizona and Kansas the obesity rate for girls doubled, the study found.

The findings, gleaned from statistics of more than 44,000 children, mirrored geographic differences among adults. For both adults and kids, the Southeast had the highest obesity rates and the Western states had the lowest. 

Prevention programs should focus on reducing these disparities and should include behavior interventions -- getting kids more active and cutting out the TV time -- as well as policy measures that get at the broader societal factors for the obesity epidemic, the authors write. 

AP photo

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

This weekend's huge recall of 40 over the counter infant and children's liquid medicines from a division of Johnsons & Johnsons has caused a flurry of panic among parents.

The company announced the recall, which affects Children's Tylenol, Motrin, Benadryl and other products -- see the full list here -- because the products didn't meet quality standards.

For instance, some of the medicines have higher than normal quantities of the active ingredient, while others didn't meet testing standards. The company and the FDA say that the possibility for serious medical problems is "remote," but if you bought the recalled products, don't use them just in case, they warn. 

It's the second Tylenol recall in recent months. Back in December, the maker of Tylenol Arthritis Pain medicine recalled that product because a moldy smell triggered nausea, dizziness and stomach pain.

With all the concern over the popular name brand, are people switching to generics? That's the question this NYT story asks, quoting wary parents and industry watchers who say the company's going to have to go the extra mile to regain consumers' trust.

Of course, generics are also cheaper, and for penny-pinchers, they've always been a good option. Besides, when it comes to the formulations, the active ingredients in generic drugs and name brands are the same, says the FDA.

What do you think? Would you rather buy generics?

For more info on the recall, and to get refund see McNeil's product recall site for contacts and instructions.

Posted by Kelly Brewington at 11:18 AM | Permalink | Comments (3)
Categories: Pediatrics
        

Even though blood pressure readings are standard at any check up, doctors and nurses often miss abnormal readings in children -- and in some cases don't bother to check blood pressure at all, according to a new study from Johns Hopkins researchers.

The findings, published in the latest issue of Pediatrics, underscore the need for better monitoring in children of a condition that most of us erroneously associate with adults, the authors say.

In an analysis of 2,500 child medical records, medical staff failed to check a child's blood pressure in about 500 of them -- about a fifth of the total. And while higher than normal blood pressure scores were recorded in 726 of the 2,000 cases, the implications of the problem weren't recognized in 87 percent of them, the research found. The American Academy of Pediatrics recommends routine blood pressure checks for all children ages 3 and over. Three consecutive high readings could indicate hypertension, according to the AAP.

Taking a child's blood pressure isn't as straightforward as you might think. For adults, high blood pressure is a pretty standard benchmark. But for children, each reading needs to be checked on a chart of a child's age, weight, height and gender, writes Dr. Tammy Brady, the study's lead author.

I spoke with Dr. Brady last year on this story about doctors not only missing hypertension in children, but missing the clues of a serious heart problem associated with it. The condition, left ventricular hypertrophy, or LVH, can lead to heart failure, rhythm abnormalities and death. Black children are at a higher risk of developing it.

Doctors know to look for high blood pressure in obese children or those with family members with the disease. But too often, they overlook children without symptoms or risk factors, the authors warn.

"Nurses and doctors may be so falsely reassured by a child’s lack of symptoms and risk factors that they either miss milder elevations or may chalk them up to measurement error and never follow up on them,” Brady said in a statement.

Tribune photo

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Categories: Pediatrics