As the wars continue in Iraq and Afghanistan, the Department of Veterans Affairs can be sure of something: more people will leave the military in need of long-term medical care – and long-term mental health care.

Robert A. Petzel, undersecretary for health at the VA, was in Baltimore for a meeting of mental health professionals trying to get up to speed on the latest treatments and services, and I was able to quiz him on the latest efforts to care for former service members. Joining in the discussion was Sonja V. Batten, Assistant Deputy Chief Patient Care Services Officer for Mental Health.

They told me that the agency has been working to bolster its staff of mental health professionals – adding 6,000 staffers from the field in the last four years, bringing the total to 20,673.

The VA has also added a suicide prevention hotline, which has taken 293,000 calls in the last two years, referred 35,000 callers to a suicide prevention coordinator and rescued 9,700 of those in immediate crisis.

But the number of those on active duty taking their own lives is, not surprisingly, rising. And many more are coming home from combat distressed. 

For post traumatic stress disorders, almost 366,000 vets were treated in fiscal 2009. That number is also rising. There were almost 255,000 treated in fiscal 2006. Of course, during conflicts, there will be more PTSD – as estimated 30 percent of those who served in Vietnam, for example, experienced PTSD and 10 percent of those in the Gulf War did. (About 6.8 percent of Americans will experience PTSD at some time in their lives.)

Officials say a main reason the numbers are going up now is because screening has gotten better. But certainly more vets need care.

In fiscal 2009, more than 1.4 million vets received care from the VA for a mental health problem, up from close to 1.2 million in fiscal 2006.

Petzel and Batten say that the VA is screening vets when they come in to a center during their reintegration period for PTSD, alcoholism and other mental health issues. Officials are also screening vets who come in for any health issue.

They also try to reach family members who can help steer vets into care and they have been heading out into the field to find vets who may need help. That includes going to military outings, National Guard stations, reunions and even rodeos to find vets where they live.

Batten said the VA has put together a handbook that clarifies all the services offered at clinics.

Still, Petzel said, “Assessing how effective the programs are is incredibly difficult.” In other words, he doesn’t know who the VA is missing – and surely it’s missing many. Once members of the military leave active duty, and coverage by the Defense Department, it’s  up to the VA to find them and treat them.

He doesn’t even have accurate data on how many vets commit suicide because states don’t list military status when they report the deaths.

And reaching vets once they leave urban areas with easy access to clinics is another problem. Petzel said there is an increased use of private providers and telemedicine.

“We’re still not getting everyone we need to and want to,” Petzel said. “There are a lot of young people who want to get back to their jobs and lives and think they are immortal and don’t avail themselves to services.”

But, if they do find the VA – or the VA finds them – officials say they are ready.

“The sooner you can begin to treat a person, the more likely they are to avoid social consequences, such as a disrupted marriage, loss of a job, drug use disorders,” said Batten.

Think the VA is doing enough to help those who served their country? Know anyone who needs help?

The suicide prevention hotline is 1-800-273-TALK. The number to call to enroll for VA health care services in Maryland is 800-463-6295 ext 7324 or go to www.maryland.va.gov. Enrolled vets who need advice can contact the care line in Maryland 24-hours a day at 800-865-2441.

Associated Press photo of a U.S. Marine taking cover behind a Humvee in Iraq

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Categories: Mental health
        

Wouldn't we all like to pop a smart pill from time to time?

Dr. Robert Schwarcz at the University of Maryland is working on it. See today's Sun for the full story on the smart pill. But basically, he made a connection between cognition and kynurenic acid, which is made in the brain after eating certain foods.

It may be possible to make a drug that blocks development of the acid, which interferes with brain receptors that stimulate memory and learning. The problem is, tryptophan, which triggers the acid production, also triggers production of serotonin, which we need to regulate mood and sleep.

So, the drug companies who are using Dr. Schwarcz' research to develop a drug have to ensure they didn't cause us to be smart but unhappy.

If they discover this drug, and it's approved by the government down the road -- a big maybe -- it could also be used to treat people with memory disorders such as Alzheimer's and schizophrenia. But Dr. Schwarcz' research so far has been in health people.

So, would you take such a drug, if there weren't significant side effects? How often do you think you'd want to take it? For projects, for trivia night, to go win big on a game show? Would that be ethical? Would there be sports-style doping, as one doctor suggested was a posibility? Should it be reserved for people with medical problems? 

Baltimore Sun photo of Dr. Schwarcz

Posted by Meredith Cohn at 10:30 AM | Permalink | Comments (2)
Categories: Mental health
        

Head lice may seem icky, but the little critters that end up in children's hair aren't medically harmful, doctors say.

They are so benign the American Academy of Pediatrics has issued a clinical report saying parents can even send their children to school with lice. The group goes as far as to say schools should get rid of policies that forbid kids from coming to school with lice.

The lice should still be treated of course.

Head lice are not a sign of uncleanliness and don't spread disease, the group said. Lice are transmitted from head-to-head contact, such as when children sleep near each other at camp or a slumber party.

The AAP's findings were published in the August print edition of Pediatrics and published online July 26.

So what do you guys think? Would you send your kids to school with lice? Take our poll.

Posted by Andrea Walker at 7:00 AM | Permalink | Comments (12)
Categories: Pediatrics
        

Two new studies support previous findings that mouth-to-mouth breathing when administering CPR shouldn't be used in many cases.

The studies say that using just chest compressions alone saves more lives when CPR is administered by bystanders. Many bystanders are not adequately trained to perform mouth-to-mouth or may feel uncomfortable administering it.

Myron "Mike" Weisfeldt, a cardiologist and physician in chief at The Johns Hopkins Hospital, has written an editorial in support of the studies, which will be published in the New England Journal of Medicine online July 29.

The two studies were conducted on more than 3,000 men and women who needed CPR from 2004 to 2009. The survival rates were similar for people who received CPR with just chest compressions as those who also had mouth-to-mouth rescue breathing. Random bystanders were instructed by 911 dispatchers on which method to use on the victims.

Weisfeldt said in a release that "less may be better" in CPR. However, he pointed out that the study was done on adults and that mouth-to-mouth must still be done on children who suffer cardiac arrest. He also said adults with breathing-related accidents that need CPR should also get mouth-to-mouth. For instance, patients with acute asthma or severe chronic lung disease.

Weisfeltd believes the studies' results could lead to stronger national guidelines on how bystanders should perform CPR.

New guidelines will probably be recommended at the American Heart Association meeting in November, Weisfeldt said. He said the guidelines will likely recommend 100 chest compressions per minute with less emphasis on mouth-to-mouth.

In 2008, the AHA recommended dropping mouth-to-mouth for CPR for bystanders not trained properly. Weisfeldt was president of the AHA from 1989 to 1990.

CPR has been in use since 1960 when Hopkins researchers published the first data on what was then "cardiac massage."

(photo courtesy of Getty Images)

Posted by Andrea Walker at 5:12 PM | Permalink | Comments (2)
        

When Dick Cheney got a new piece of equipment to keep his heart going, we wrote about how it works.

The device spins rather than pumps, so when we talked to Hopkins transplant doc Stuart D. Russell, he noted that means Cheney now officially has no pulse.

Of course, Picture of Health didn't joke about the former vice president's life-saving surgery. But that didn't stop Comedy Central. See this Stephen Colbert clip (item on Cheney is in the third segment):

Posted by Meredith Cohn at 1:17 PM | Permalink | Comments (2)
Categories: Cardiovascular Health
        

Ever wonder where all those stats on the health of Americans comes from?

The U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics regularly takes snapshots of public health by visiting different towns and collecting information that is representative of the country. And this year, the CDC is coming to Baltimore.

The agency will arrive August 6 and stay for several weeks to gather information for the National Health and Nutrition Examination Survey (NHANES). 

The information gathered from health interviews and measurements is used to develop health policies and programs. Those who participate also get information about themselves, though the data is confidential and no individual’s health status is revealed to outsiders.

About 7,000 people of all ages are randomly selected in 15 counties across the country for the survey. Surveys are done in people’s houses and then a physical exam is done by a doctor in one of three mobile exam centers. Some people will have hearing tests, skeletal scans, breathing tests and blood pressure tests.

 “NHANES is very much like a ‘health exam center on wheels,’ that goes out into actual communities to get data on real Americans,” said Edward Sondik, director of the health stats office. “It truly is a unique resource for health information in this country, and without it we wouldn’t have data on a number of important health conditions.”

The study has been conducted for almost 50 years. It tells officials how many people have heart disease, diabetes, osteoporosis, hypertension, respiratory disease and other illnesses. It establishes height and weight standards. And it has helped government officials make recommendations such as reducing cholesterol and laws such as lead-free gasoline.

Anyone been asked to participate yet?

Posted by Meredith Cohn at 5:00 AM | Permalink | Comments (0)
Categories: General Health
        

The damage from the oil spill in the Gulf of Mexico isn't just financial and environmental. It's emotional.

A researcher from the University of Maryland was surprised by the depth of the psychological damage done to communities – even before the oil reached their shores.

Lynn Grattan, a neuro-psychologist, joined a colleague from Florida in studying a fishing community called Apalachicola for about a week. The slick had not yet made it there, but the levels of stress and anxiety were obvious, she said.

“You could see and feel it in every restaurant and shop, at every town meeting,” said Grattan, an associate professor of neurology, psychiatry, epidemiology and public health. “Where ever people gathered, it’s discussed. It’s a community in crisis.”

She said some fisherman had already lost their jobs because of the impacts to the industry as a whole. And some were working for BP on prevention measures, such as laying booms to capture oil before it reached the shores. But the oil wasn't yet there.

And while Grattan was expecting some increase in stress levels, she was struck by the level it had already reached. They were worried about their financial future, the safety of consuming shrimp and oysters and also the environment and wildlife, including the population of turtles that lived there.

She plans to analyze her data this week to see the actual level of distress. The information will be compared with that from a community that has been exposed to oil. The researchers plan to visit that community next week.

Then, all of the data will be used to help care for the affected areas – and it will be used to help people who suffer in future disasters.

There has only been limited data collected on the mental well-being of communities after oil spills. But Grattan said public health officials did discover that those in Alaska impacted by the Exxon Valdez spill suffered effects for up to four years after the spill.

“We hope to develop effective communications and outreach to minimize the impacts,” she said. “Based upon what we find, we’ll use the best available knowledge to plan outreach and intervention for the current communities. And what we learn hopefully will help future communities coping with disaster.”

Grattan said she’d report back in a week or so when she has actual data to share.

NASA photo via the Associated Press of Kemp's ridley sea turtle hatchlings from eggs saved from the Gulf Coast and release into the Atlantic Ocean

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Categories: Mental health
        

A Johns Hopkins pharmacologist who specializes in finding new uses for often-forgotten drugs has won a grant to develop a series of novel drugs.

Jun O. Liu, a professor of pharmacology and molecular sciences and oncology in the Hopkins School of Medicine, won the $2.5 million, five-year award from the National Institutes of Health.

Liu is the director of the Hopkins Drug Library, which houses, which houses 3,000 of the estimated 10,000 drugs used in medical practice. And there, he discovered that an antifungal antibiotic, itraconazole, is an inhibitor of the new blood vessel formation indicative of cancer, macular degeneration and other diseases. The drug is now in clinical studies for treating cancer.

Liu also found that an antibiotic once used to treat leprosy, clofazimine, may effectively fight autoimmune disorders like multiple sclerosis and psoriasis.

With his new grant, Liu will design and synthesize “cyclic combinatorial libraries,” which are collections of cyclic-shaped molecules. Liu will screen the libraries to identify compounds that can bind and affect the activity of proteins in humans. If the target is a disease process that could lead to the new drugs.

Getty Images file photo

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Categories: Drugs
        

The Americans with Disabilities Act is 20 years old today, and the state is celebrating with a reception to mark the advances made in areas such as accessibility and rights – leaving employment as the major challenge.

Gov. Martin O’Malley is expected to attend the event at Camden Yards, which is slated to run from 3 p.m. to 6 p.m. Hundreds of people with disabilities and their families and caregivers will be on hand and some will offer testimonials on how their lives have changed or become more meaningful.

“The Americans with Disabilities Act was a major milestone in ensuring that each individual has equal opportunity to make a positive difference in this world,” O'Malley said in a statement. “On this, the 20th anniversary of the ADA, we are deeply committed to the principles of the ADA and ensuring that Marylanders with disabilities receive the same basic freedoms – independence, equal access, freedom of choice and inclusion – afforded to every citizen in our State and in our country.”

Baltimore Mayor Stephanie Rawlings-Blake is also expected to attend the event, which is open to the public.

O’Malley is expected to present citations to nine Maryland citizens, organizations and businesses that have made contributions to the employment, education, independence, advocacy and quality of life of Marylanders with disabilities, according to event organizers at the Maryland Department of Disabilities.

The ADA covers all public and private employers with 15 or more employees. It requires reasonable accommodation for and bans discrimination against those with physical or mental impairments, according to the Department of Justice. More information on the rules for businesses can be found at ada.gov.

The U.S. Department of Labor estimates that there are 49.7 million Americans with disabilities. More information can be found at disability.gov.

Associated Press photo of people in wheelchairs spell out ADA at Dodger Stadium in commemoration of the 20th anniversary of the act's passing

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Sometimes drugs approved by the Food and Drug Administration are later linked to serious health risks – as was the case with GlaxoSmithKline PLC’s diabetes drug Avandia.

And the agency decided it needed help in determining when officials need to take action, such as ordering new “post-market” trials and label warnings.

Two Johns Hopkins University professors lead an independent committee at the Institute of Medicine in developing a framework to guide the agency.

The panel has met, and in a letter earlier this month to the agency, they determined the FDA should:

Determine if the questions about the drug’s risks are serious enough to justify action such as revising the drug label; conduct new studies on side effects only when scientific evidence or observational studies do not offer enough data to make policy decisions; and use principals that emphasize public accountability and transparency when deciding on the need for a new policy decision.

The agency should also ensure post-market trials should minimize the risk to patients and monitor ongoing risks, and the FDA should have a meaningful informed-consent process in place so participants understand the risks.

“The letter report was designed to provide general, broad guidance about some of the ethical issues that need to be taken into account by the FDA in requiring post-market safety studies,” says Ruth Faden, the committee's co-chair and the director of the Johns Hopkins Berman Institute of Bioethics.

The other co-chair is Dr. Steven Goodman, a professor of oncology in the Division of Biostatistics at the Johns Hopkins Kimmel Cancer Center and a core member of the Berman Institute faculty.

There’s more to come from the panel, which plans to detail recommendations in a full report in the spring of 2011.

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You can eat right and exercise to stay healthy, but you can't do much about the genes you were born with.

Family history plays a big part in whether you are prone to diseases such as high blood pressure, diabetes and even breast cancer.

But many of us don't know what kind of ailments our parents suffer from, let alone relatives three generations away. How many of us have been diagosed by a disease just to find out that a slew of uncles and aunts you've never met also had the disease?

 The National Institutes of Health, just in time for family reunion season, has recently released tips for people to share their family health history. They advise families to set it up much like a family tree. They even have an online tool on their NIHSeniorHealth website, developed by the National Human Genome Research Institute and the Surgeon General's Office, to help get people started.

They say older family members often know the most about family health histories.

Knowing what diseases run in the family can help doctors with preventive care strategies for patients, and perhaps help you live a longer life.

Photo courtesy of Getty Images

Posted by Andrea Walker at 6:42 PM | Permalink | Comments (1)
Categories: General Health
        

Michael Phelps’ Olympic success may come down to biology.

Some academics took a look at the record books from the past 100 years and the bodies of the athletes and made this determination. It wasn’t about race, but body type – though the fastest sprinters tended to be of West African ancestry and the fastest swimmers tended to be white.

A Duke engineer and a couple of fellow researchers say it’s about an athlete’s center of gravity. The center tends to be slightly higher in the bodies of blacks (longer limbs and smaller circumferences) than whites (longer torsos) – giving an advantage to blacks in running and an advantage to whites in swimming.

“Locomotion is essentially a continual process of falling forward,” said Adrian Bejan, professor of engineering at Duke's Pratt School of Engineering and a study author. “Body mass falls forward, then rises again. Mass that falls from a higher altitude falls faster. In running, the altitude is set by the location of the center of gravity. For the fastest swimmers, longer torsos allow the body to fall forward farther, riding the larger and faster wave.”

This is not to say there aren’t cultural factors, such as lack of access to swimming pools and lower socioeconomic status, said Edward Jones, a Ph.D. candidate at Cornell University who is teaching at Howard University and was another study author.

And, he said, encouragement can make the difference. “Just look at the Williams sisters in tennis or Tiger Woods in golf.”

Associated Press photo of Michael Phelps

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Categories: Medical studies
        

For people self-conscious about varicose veins, summer can be torture. They affect one out of two people above age 50, according to the National Institutes of Health.

Later this week, I'll be talking to Robert Weiss, a dermatologic surgeon at the Maryland Laser, Skin and Vein Institute, about varicose veins and the latest treatments for our Ask the Expert feature. If you have any questions, leave them in the comments here, and I'll work them into the interview.

Posted by Kim Walker at 7:00 AM | Permalink | Comments (1)
Categories: Women's health
        

A group of brainiac Johns Hopkins graduate students have developed a device to detect a woman's likelihood of delivering a premature baby.

The CervoCheck is a small ring embedded with sensors that picks up electrical signals associated with uterine contractions. The ring is designed to be embedded in a woman's vaginal canal at a physician's office or hospital.

The device has only been tested on animals at this point. But the students have obtained a provisional patent on the device.

There are about 500,000 premature births in the United States each year, according to The National Center for Health Statistics. A normal pregnancy lasts 40 weeks, while a preterm baby is delivered before 37 weeks.

Preterm babies may experience complications and health problems. The births can also result in more costly medical bills.

The students, who studied biomedical engineering, said that current technology doesn't detect preterm labor until it's too far along. By that time medications can only delay the birth by a few days.

They believe their device can detect the likelihood of early labor sooner and prolong the pregnancy by as much as six weeks. Cost savings could be as much as $44,000 per patient, the students believe.

The students who invented the CervoCheck system were, from left, Karin Hwang, Chris Courville, Deepika Sagaram and Rose Huang. They have all recently received their graduate degrees from Hopkins. Photo courtesy of the University of Louisville Brown-Forman Cardinal Challenge Business Plan Competition.

Posted by Andrea Walker at 11:27 AM | Permalink | Comments (3)
        

Can we trick our minds into thinking we’re not hungry?

After a set of experiments, a British researcher has concluded that portion control is a matter of perception. If we believe a meal will be filling or remember it was the last time, it will be – and that belief might inform those who label food.

“Light” and “diet” foods could be relabeled as “satisfying” or “hunger relieving,” said Dr. Jeff Brunstrom, a University of Bristol researcher, who presented his findings at the annual meeting of the Society for the Study of Ingestive Behavior.

He showed some study participants the ingedients of a fruit smoothie. Those who were shown a larger portion of fruit reported significantly greater fullness, even though they ate the same amount as the other participants.

In another experiment, researchers increased and decreased the amount of soup in participants bowls as they ate. Three hours later, participants “remembered” the amount of soup in the bowl and not how much they actually ate when they rated their fullness.

Think these experiments would work on you? Would a different label?

Associated Press photo

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Categories: Diet and exercise
        

Dr. Peter Pronovost, the Johns Hopkins patient safety guru, is keeping the problem of hospital-acquired infection in the news. He’s blaming his own kind for the problem of hospital-acquired infections.

Some doctors are arrogant, he said, which is probably not news to all patients.

In commentary published in the July 14 issues of the Journal of the American Medical Association, Pronovost, a professor of anesthesiology and critical care medicine at the Hopkins School of Medicine, argues that the healthcare industry doesn’t’ have measurable, achievable and routine ways to prevent patient harm.

And in many cases the problem is arrogance of doctors who are either overconfident in the quality of care they offer or unprepared for when things go wrong because they don’t expect them to go wrong. He also says hospital administrations don’t aggressively seek to solve infection problems.

 “It's unconscionable that so many people are dying because of these arrogance barriers,” Pronovost said. “You can't have arrogance in a model for accountability.”

About 100,000 people die from healthcare-associated infections a year and some 44,000 to 98,000 die of other preventable mistakes. More die from diagnostic errors or because they didn’t get recommended therapy, he said. Arrogance plays a role in many of them.

He called for “valid and transparent” measures to improve performance.

He cited an example of where such a measure worked. Central line-associated bloodstream infections kill 31,000 patient a year. But a Pronovost checklist used in the ICU at Hopkins and the entire state of Michigan showed that the infections could be reduced to almost zero.

Pronovost credited the list and the change in the medical culture – it became okay to question doctors who violated safety protocols. 

There is a federal mandate to reduce bloodstream infections by 75 percent of three years, which Pronovost called the “first quantifiable patient safety goal in the U.S.” Everyone from doctors to hospital administrators to insurers needs to get on board if that goal is to be reached.

Baltimore Sun file photo/Kenneth K Lam

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Categories: Health care professionals
        

A task force charged with overseeing sweeping federal health care reform in Maryland approved Monday an interim plan that outlines steps to prepare for the changes it will bring.

The plan sets goals such as containing costs while improving quality, expanding the health care work force to meet demands of new patients and making sure reform actually leads to the better health of Maryland residents.

The 12-member Maryland Health Care Reform Coordinating Council voted unanimously to approve the plan. Three members were absent.

Most facets of reform will not take place until 2004, although some other parts will take place a little earlier.

For instance, the state was awarded $85 million in federal funds earlier this month to help immediately insure people with pre-existing conditions. The state is using the money to increase its high-risk pool, which now insures about 20,000 people. The state will start accepting applications for the high-risk pool in August, and people will be able to enroll in September.

Lt. Gov. Anthony Brown said the interim plan helps to set the frame work of what the state will need to do to implement more sweeping elements of reform.

“Because of the enormity of this, we think it is important to spend time on the up-front work to set up a foundation,” Brown said.

Brown co-chairs the coordinating council with John M. Colmers, secretary of state of the Department of Health and Mental Hygiene. The committee also announced chairs of working groups that will come up with concrete ways to implement reform.

For example, one group will look at how to create health care exchanges where people can shop for coverage with subsidies. The state is also looking at creating pilot programs to test out new ways of caring for patients.

The council’s interim report will be officially released Monday. The report will include a cost analysis outlining how much money Maryland taxpayers will save under health care reform. The report will also include an overview of the federal legislation, key points the state needs to address and potential grants and funding opportunities. Some of the suggestions in the report were taken from more than 160 ideas from the public submitted on a state website and during past hearings.

A final report is due to Gov. Martin O’Malley Jan. 1.

State officials have said that they are in better shape than other steps because they already have initiatives for the uninsured, such as its high-risk pool.

Posted by Andrea Walker at 6:40 PM | Permalink | Comments (5)
Categories: Health care reform
        

Johns Hopkins University researchers are part of a team that will study how the BP oil spill will affect aquatic life off the coast of Florida.

The university said today that it is part of a group of many institutions that will join in the research led by the National Aquarium and Mote Marine Laboratory in Sarasota.

The Johns Hopkins University Center for Contaminant Transport, Fate and Remediation is also a major player in the research. The center will use mathematical models to show how contaminants in oil move through the food chain and accumulate in marine plant and animal tissues. The models could then potentially help study how humans could be affected by contaminated seafood.

Researchers have begun collecting samples of water, sediment, marine animals and plant life in the Sarasota Bay region. The region hasn't been impacted by the oil spill, but as it spreads could enter the Sarasota Bay ecosystem. Samples are being taken now so researchers will have something to compare when oil does move into the region.

Posted by Andrea Walker at 2:25 PM | Permalink | Comments (0)
Categories: General Health
        

The medicine cabinet is getting more threatening.

There has been a 400 percent increase in substance abuse treatment admissions for people abusing prescription drugs, according to new government data.

The study was conducted by the Substance Abuse and Mental Health Services Administration from 1998 to 2008 for those 12 and older. The increase spanned every age, gender, race, ethnicity, education and employment level and region.

Among the findings: There was a tripling of pain relieve abuse among those patient who needed treatment for opiate dependence.

The data “highlights how serious a threat to public health we face from the abuse of prescription drugs”, said Gil Kerlikowske, national drug policy director, in a statement. “The spikes in prescription drug abuse rates captured by this study are dramatic, pervasive, and deeply disturbing.”

The non-medical use of prescription drugs is now the nation’s second-most prevalent form of illegal drug use, said Pamela S. Hyde, administrator of the substance abuse agency.

A recently released national drug control strategy outline steps to curtail this fast-growing drug problem.

They include increasing prescription drug take-back and disposal programs, educating doctors about opiate painkiller prescribing, expanding prescription drug monitoring programs, addressing doctor shopping and pill mills, cracking down on illegal internet pharmacies and rouge pain clinics that ignore appropriate prescription practices. 

What do you have leftover in your bathroom cabinet?

AFP/Getty photo

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Categories: Consumer health
        

In the wake of the H1N1 flu pandemic, you would think everyone had learned to cover their mouths when they sneezed or coughed.

But researchers in New Zealand found that one in four people observed in a public setting did not. And of those who did, only 5percent covered their mouth in a way recommended by public health officials.

Those officials had been telling people they could avoid spreading infection if they would cough or sneeze into a tissue or their elbows. This way, they wouldn’t get germs on their hands and spread them around.

Researchers did their study in three public areas in the New Zealand capital city of Wellington – a train station, a hospital and a shopping mall. This was after a bunch of public service advertisements in the newspaper and on radio telling people about proper infection control, much like public health officials did in the United States.

The most common response to a sneeze or cough was covering the mouth with the hands.
“This study showed a low prevalence of recommended respiratory hygiene behaviors suggesting that hygiene messages promoted in mass media campaigns have not been seen and/or have not been readily adopted by the public in this city,” said Nick Wilson of Otago University Wellington in New Zealand, an author on the study.

They presented the finding to the International Conference on Emerging Infectious Diseases, which was organized by the U.S. Centers for Disease Control and Prevention, the American Society for Microbiology, the Council of State and Territorial Epidemiologists, the Association of Public Health Laboratories and the World Health Organization.

So, how do you cover your mouth? Or do you?

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

After five heart attacks, former Vice President Dick Cheney’s ticker has taken a beating. Last week, he said that he underwent surgery to install a new heart pump.

What he got was a LVAD, or left ventricular assist device, which is made for people like Cheney who need a little help pumping blood because their hearts aren’t keeping up.

The pump runs something like a drill bit, continuously rotating at 9,000 rotations per minute rather than squeezing and releasing, so Cheney now officially has no pulse, according to Dr. Stuart D. Russell, chief of heart failure and transplantation at Johns Hopkins’ Comprehensive Transplant Center.

But what he’s likely getting in return, says Russell, who is not involved in Cheney’s care, is a better quality and quantity of life.

Cheney said in a statement that he had “increasing congestive heart failure,” which afflicts about 5 million Americans whose hearts have weakened over time. In most candidates for the device, the amount of have blood squeezed out with each beat is significantly reduced – normal is 55 percent or greater and Cheney was likely more in the 10-15 percent range. That makes the people grow tired quickly after doing minor chores such as dressing.

Pumps have been around for about three decades, but this version by Thoratech Corp., at about five years old, gives people a 60 percent survival rates after 2 years. There’s not a lot of data on this pump after that. Drug therapy, in contrast, gives patients about a 10 percent survival rate.

“That’s a lot better than 10 percent on the pills,” Russell said. “Some would say going from 10 percent to 60 percent is phenomenal.”

Some patients use the device, Russell said, as a bridge to a transplant. But Cheney, at 69, might not be a candidate. In that case it’s a “destination therapy,” meaning this is his treatment destination.

But Russell says that he could live 4,5 or 6 years with this pump and new ones already are in development. And “6 years for a 69-year-old who has had 5 heart attacks is significant,” he said.

Russell said those who get this pump are generally in the hospital 14 to 21 days and start to feel normal after two to three months. The device requires an energy source, so the people have a line coming out of their skin near their belly that need to be hooked up to a battery pack during the day -- it can be worn holster-style if Cheney prefers. It also needs to be plugged into an energy source at night.

It can’t get submerged, so wearers can’t swim but they can shower. They also need to take anti-coagulation drugs. They are also at increased risk of infection and gastrointestinal tract infections.

“People generally can get back to a fairly normal lifestyle,” Russell said. “The vast majority do well.”

Graphic reprinted permission from Thoratec Corp.

Posted by Meredith Cohn at 4:17 PM | Permalink | Comments (1)
Categories: Cardiovascular Health
        

The widely regarded U.S. News and World Report is out with its annual hospital rankings and several Maryland hospitals, led by Johns Hopkins Hospital, made the list.

Hopkins placed first in five specialties (Ear, Nose and Throat; Gynecology, Neurology and Neurosurgery, Urology and Rheumatology) and ranked in 11 more categories (Cancer, Diabetes & Endocrinology, Gastroenterology, Geriatrics, Heart & Heart Surgery, Kidney Disorders, Ophthalmology, Orthopedics, Psychiatry, Pulmonology and Rehabilitation).

That gave the hospital top ranking for the 20th year in a row.

The University of Maryland Medical Center ranked in nine categories (Cancer, Diabetes & Endocrinology, Ear, Nose & Throat, Geriatrics, Heart & Heart Surgery, Kidney Disorders, Orthopedics, Pulmonology and Urology).

Ranking in three were Good Samaritan Hospital (Gastroenterology, Geriatrics and Orthopedics) and Union Memorial Hospital (Orthopedics, Heart & Heart Surgery and Neurology & Neurosurgery).

And ranking in one were Franklin Square Hospital Center (Gastroenterology), Johns Hopkins Bayview (Geriatrics), Mercy Medical Center (Neurology & Neurosurgery) and Sheppard Pratt Hospital (Psychiatry).

Posted by Meredith Cohn at 12:05 PM | Permalink | Comments (16)
Categories: Health care professionals
        

Getting ready to schedule a surgical procedure and not sure which hospital to choose?

The state has added some new ratings to its web-based hospital guide.

It includes a patient survey that asks people about their recent stay at a hospital. About 64 percent of the patients said they would recommend a Maryland hospital.

The survey asked 41,000 discharged patients 27 questions about their hospital stay that included topics such as pain management, hospital cleanliness and communication about medication. The survey covered all of 2009 and included patient ratings for specific areas, such as maternity.

The hospitals were also rated on specific illnesses, such as heart attacks and pneumonia.

Consumers will also find new data on the number of hospital healthcare workers that have received seasonal flu vaccinations.

The hospital guide is managed by The Maryland Healthcare Commission.

Posted by Andrea Walker at 10:45 AM | Permalink | Comments (2)
Categories: General Health
        

Military drills and crack of dawn runs haven't been enough to keep our men and women in the armed forces fit and trim. 

The country's obesity problem is just as rampant in the military as it is the general population. The Department of Defense spends $1 billion a year on weight-related healthcare. About 27 percent of today's youth are too fat to serve in the military.

The Naval Academy, aware of the problem, is about to have healthy vending machines installed at its campus as one way to tackle the fat problem.

It has contracted with Vend Natural, a company with dual headquarters in Annapolis and Venutura, Cal., that specializes in vending machines with healthy snacks. The machines will offer packaged fruits and vegetables, juices and organic and all-natural foods.

"We want our students to have the healthiest choices available to them in their on-campus environment," Linda Rodrock, of the Naval Academy's Business Services division, said in a statement. "Our midshipmen have physically and academically demanding schedules and healthy eating is important to them."

Vend Natural also said that its vending machines are energy efficient. The company specializes in providing machines to schools and hospitals and has 400 machines installed in 25 states.

Posted by Andrea Walker at 11:03 AM | Permalink | Comments (0)
Categories: Diet and exercise
        

A bit of good news for those with pancreatic tumors: Johns Hopkins doctors did their first laparoscopic Whipple operation.

Generally, these six or seven-hour operations are highly invasive. The patients are cut all the way up the abdomen and parts of several organs are removed: the head of the pancreas, gallbladder, common bile duct and part of the duodenum, stomach and small intestine.

The surgery leaves a big scar that can become infected.

But the surgeons, Martin Makary and Barish Edil, were able to avoid the big incision. The had been doing parts of the Whipple operation laparoscopically – through tiny incisions – but never the whole thing. They gave it a try when a 43-year-old North Carolina woman asked them to. They had warned her that it might not be possible.

When she awoke, she had three small bandages on her belly. And the fist-sized tumor turned out not to be malignant. She didn’t have cancer.

Other doctors have performed such a surgery, but this is a first at Hopkins, where the procedure is considered one of the signature surgeries. Perhaps more could be done this way?

It would cut down on hospital stays and reduce the risk of infection. 

Graphic courtesy of Johns Hopkins

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (5)
Categories: Cancer
        

Later today, President Obama will unveil his national strategy for fighting AIDS.

According to the Associated Press, the strategy calls for reducing the rate of new HIV infections by 25 percent over the next five years, and for getting treatment to 85 percent of patients within three months of their diagnosis.

This should benefit Baltimore, which ranks among the metropolitan areas with the highest rates of infection. Only the Miami, New Orleans, Baton Rough and Washington metro areas have higher rates.

The rate has been dropping in Baltimore in recent years, but the city still far outpaces the state and nation. In 2007, the latest year for which data is available, there were 145 new cases for every 100,000 people. That compares to the state as a whole, which had about 46 cases, and the nation, which has 12.5 cases.

About 86 percent of those with HIV are African American. About one in nine black men in Baltimore between 40 and 49 years old has a confirmed HIV diagnosis. Many more don't know they have the disease.

But there have been advances, said Richard W. Matens, assistant commissioner for chronic disease prevention at the Baltimore City Health Department.

A needle program now exchanges 400,000 needles annually, and the percentage of people exposed to the disease through infected needles has dropped from almost 53 percent of cases in 2000 to about 31 percent in 2008. An outreach program has identified more people with HIV diagnoses and gotten them into primary care.

The city receives about $22 million annually from the federal government for use on treatment and other services for those with HIV and AIDS, and gets another $4 or $5 million from the state. The city spends about $800,000 in city and state money for the needle exchange and other programs and gets more state money for medications and prevention.

City officials are optimistic that the announcement from President Obama will bring renewed attention to the problem.

"President Obama is demonstrating this is a priority focus for him by coming out with a report and that will help," Matens said. "Getting together and developing a plan that sets a clear agenda will help focus efforts locally as well as federal funding."

If you need assistance, or want a free HIV (or other STD) test, go to the Health Department website. Also, on July 19, additional sites around the city will offer rapid testing and referral for services. Go to www.togetherbaltimore.com for information.

Posted by Meredith Cohn at 3:44 PM | Permalink | Comments (2)
Categories: HIV/AIDS
        

If you can resist ordering the salsa and guacamole at your favorite restaurant, here's a new report from the Centers for Disease Control and Prevention that may get your attention.

Nearly 1 out of every 25 restaurant-associated foodborne outbreaks with identified food sources between 1998 and 2008 is traced back to these contaminated foods.

That's more than double the rate during the previous decade, according to the CDC, which presented the finding at the 2010 conference of the International Conference on Emerging Infectious Diseases.

"Fresh salsa and guacamole, especially those served in retail food establishments, may be important vehicles of foodborne infection," Magdalena Kendall, an Oak Ridge Institute for Science and Education researcher who collaborated on the CDC study, said in a statement.

"Salsa and guacamole often contain diced raw produce including hot peppers, tomatoes and cilantro, each of which has been implicated in past outbreaks."

The CDC has been collecting foodborne disease outbreaks information since 1973. Salsa and guacamole didn't register as a problem until 1984.

The outbreaks accounted for 1.5 percent of all food establishment outbreaks from 1984 to 1997. The number more than doubled to 3.9 percent from 1998 to 2008.

To blame may be inappropriate storage times or temperatures. They were reported in 30 percent of the cases. For another 20 percent, food workers were the source of contamination.

Kendall said anyone preparing these items, at a restauarant or at home, needs to be make sure the raw ingredients are fresh, clean and refrigerated.

Baltimore Sun file photo/Algerina Perna

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Diet and exercise
        

If you’re a patient at Greater Baltimore Medical Center on a really hot day, you might notice that some parts of the hospital are dimly lit.

That’s because when the temperatures start soaring as they have in the record-breaking 100-degree days last week, the GBMC Green Team goes into elevated energy conservation mode.

An e-mail is distributed to hospital executives who get their staff in motion. They turn off lights in vacant rooms and pull down the shades on windows to keep out the sunlight. It might feel a little warmer in non-critical areas, such as hallways, because the hospital turns the air conditioner up a little.

Hospitals, 24-hour operations that rely on electrical equipment and are big energy users, have joined a growing number of private companies and government offices to institute measures to conserve and cut costs.

“It is similar to what you do at home but on a larger scale to make sure we’re doing what we can for energy savings,” said GBMC spokesman Michael Schwartzberg.

University of Maryland Medical Center also takes extra steps to conserve energy when a heat wave hits, although none of the changes are probably visible to patients.

The hospital uses steam rather than electricity to heat water during peak heat days or other times when electricity consumption may be high. They melt stored ice to cool buildings. And although this rarely happens, the hospital also can switch to emergency generators that operate from diesel fuel rather than electricity.

During last week’s heat wave, when temperatures elevated to triple digits, the hospital cut its average electric use by 5 megawatts, according to UMMC spokeswoman Ellen Beth Levitt.

 “All of these strategies were carefully timed to reduce our demand on the area power grid,” Levitt said in an e-mailed response.

GBMC, which began its energy conservation efforts last year, reduced its energy usage by 700 kilowatts on 11 hot days in 2009, saving $30,000. It hopes to save 1,500 kilowatts, or $50,000, this year.

The Baltimore County hospital, most known for maternity and women’s health, assigns hot days color codes depending on what the temperature hits. Code red days are the worst and code green is a typical day. It has had five code red days so far this summer.

Codes are assigned based on factors such as temperature and humidity level. GBMC works with the South River Consulting and Energy Network Operations Center, an energy consulting firm, to help identify high-use days.

Both hospitals have conservation efforts throughout the year.

GBMC also has employees turn off computers at the end of the day and makes sure hot water taps do not leak. In other cost-saving moves, UMMC made more local and organic foods available in the cafeteria and began using environmentally friendly plastic IV tubing, a change that saved $8,000 a year. Patient slippers are now made out of recycled cotton, a $6,000 savings.

The hospital has also started using single-stream recycling. Overall, the hospital has reduced energy consumption by 5 percent.

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

Mercy Medical Center in Baltimore has agreed to let cameras into its NICU to let the viewing public see what' it's like.

Z on TV writer David Zurawik wrote about the first couple of episodes of the documentary, which will premier this Thursday at 10 p.m. on the Discovery Health cable channel.

It doesn't sound like Zurawik thinks this is in the same league as the Hopkins documentary "Hopkins 24/7." But he thought that was one of the finest documentaries he'd ever seen.

But he does say the Mercy show is compelling, and a bit emotional. Some of the babies are so sick that the mothers can't hold them for weeks.

Watching babies fighting for their lives might be hard to watch for many people. But the hospital wanted to participate so people get an idea of what they do in this unit.

If anyone watches, we'd be interested in your impressions.

Dr. Susan J. Dulkerian, director of newborn services at Mercy Medical Center

Posted by Meredith Cohn at 10:50 AM | Permalink | Comments (0)
Categories: Health care professionals
        

The bad economy may have pushed more of the nation's children into poverty, according to a report released today by the Federal Interagency Forum on Child and Family Statistics.

During the onset of the recession, as parents began to lose their jobs, the poverty level began to climb, according to the report.

In 2008, 1 in 5 children lived in poverty, the highest rate in a decade, according to the report. About 8 percent of children lived in extreme poverty, which means their families had an income less than one-half of the poverty threshold.

The federal interagency forum is a group of 22 agencies that collect, analyze and report data on issues dealing with families and children.

The poverty numbers are important because a child's economic conditions affect their health and development, according to the report. For instance, families of children living in poverty are also having problems providing healthy foods, putting their children's nutritional needs at risk. About 52 percent of children living in poverty lived in "food-insecure households."

Despite the findings, the lives of the nation's children did improve in some ways. More children had health insurance and adolescent births declined. Eighth-grade math and reading scores also improved.

Posted by Andrea Walker at 11:51 AM | Permalink | Comments (1)
Categories: General Health
        

After years of efforts to reduce youth smoking, little progress has been made, according to the U.S. Centers for Disease Conrtol and Prevention.

One in five high schooler is still smoking.

Smoking among high school student began to decline across the country in the late 1990s, the CDC said. But the rate of decline slowed from 2003 to 2009, according to the CDC's Morbidity and Mortality Weekly Report.

The rate slowed for all racial/ethnic groups.

This means the country has not met its 2010 goal of reducing cigarette use among high school students to 16 percent or less.

"Although 4 of 5 don't smoke, it's discouraging to see that current smoking did not continue to decline more rapidly among youth," said CDC Director Thomas R. Frieden in a statement. "Smoking is the leading preventable cause of death in this country and 9 out of 10 adults started smoking in their teens or earlier. The slow progress since 2003 tells us that much more needs to be done to reduce youth smoking."

The CDC called for a renewed push to curb teen smoking. Officials said effective strategies include expanded mass media campaigns, less tobacco advertising, promotions, reduced availability of tobacco products, tobacco-free environments, programs that promote changes in school norms and higher tobacco taxes.

Specific findings from the CDC:
+The percentage of students who currently smoke increased from 27.5 percent in 1991 to 36.4 percent in 1997, declined to 21.9 percent in 2003, and declined more gradually to 19.5 percent in 2009.
+The percentage of students who ever smoked did not change from 1991-1999, declined from 70.4 percent in 1999 to 58.4 percent in 2003, and then declined more gradually to 46.3 percent in 2009.
+The percentage of students who reported smoking frequently increased from 12.7 percent in 1991 to 16.8 percent in 1999, declined to 9.7 percent in 2003, and then declined more gradually to 7.3 percent in 2009.

For help quittting, call 1-800-QUIT-NOW or go to www.smokefree.gov.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (2)
Categories: Healthy Living
        

A group of scientists has made a breakthrough in what they say could lead to the creation of an HIV vaccine.

The team led by scientists from the National Institutes of Health have discovered two antibodies that can stop more than 90 percent of HIV strains from infecting human cells.

Articles about the findings appeared today in the online edition of Science.

The scientists found that antibodies called VRCO1 and VRCO2 neutralize more HIV strains with more strength than any other known antibodies to the virus. HIV is the virus that leads to the deadly AIDS disease.

The scientists have also discovered the atomic-level structure of the VRC01 antibody when it attaches to HIV. Knowing the structure has enabled the scientists to know exactly where the antibody attaches to the HIV virus. They are using this information to begin designing a candidate vaccine.

Scientists have in the past had trouble finding antibodies that neutralize HIV because the virus frequently changes its surface proteines making it hard to be recognized by the immune system.

Posted by Andrea Walker at 5:17 PM | Permalink | Comments (0)
Categories: HIV/AIDS
        

Johns Hopkins University was chosen as one of 10 International Centers of Excellence for Malaria Research by the National Institutes of Health, the agency reported today.

NIH’s National Insitute of Allergy and Infectious Diseases is trying to accelerate the control of malaria and eventually eradicate it. So, officials put up $14 million in the first year of funding. The grants will continue for seven years.

There are about 240 million cases of infection from malaria-causing parasites every year and more than 850,000 deaths. The new funding will go directly to some of  the regions where malaria is the greatest problem, including parts of Africa, Asia, the Pacific Islands and Latin America.

Teams will conduct research in more than 20 countries.

 “One of our primary goals with these centers is to fund cutting-edge research in malaria-endemic areas that will keep up with the rapidly changing epidemiology of the disease,” said the agency director, Dr.  Anthony S. Fauci.

About 40 percent of the world’s population lives in an area where they are at risk for malaria, though it has been eliminated from many parts of the world.

The new centers will aim to produce intervention and control measures, officials said.

Here is the list of centers, their focus and their principal investigators:

• Malaria Transmission and the Impact of Control Efforts in Southern Africa
Principal Investigator: Peter Agre, M.D.
Lead Institution: Johns Hopkins University, Baltimore

• Center for the Study of Complex Malaria in India
Principal Investigator: Jane Carlton, Ph. D.
Lead Institution: New York University School of Medicine, New York City

• Southeast Asia Malaria Research Center
Principal Investigator: Liwang Cui, Ph.D.
Lead Institution: Pennsylvania State University, University Park

• Program for Resistance, Immunology, Surveillance & Modeling of Malaria in Uganda
Principal Investigator: Matthew Dorsey, M.D.
Lead Institution: University of California, San Francisco

• Latin American Center for Malaria Research and Control
Principal Investigator: Socrates Herrera-Valencia, M.D.
Lead Institution: Caucaseo Scientific Research Center, Cali, Colombia

• Research to Control and Eliminate Malaria in SE Asia and SW Pacific
Principal Investigator: James Kazura, M.D.
Lead Institution: Case Western Reserve University, Cleveland

• Population-based Approach to Malaria Research and Control in West Africa
Principal Investigator: Donald Krogstad, M.D.

Lead Institution: Tulane University, New Orleans

• Malaria Evolution in South Asia
Principal Investigator: Pradipsinh Rathod, Ph. D.
Lead Institution: University of Washington, Seattle

• Determinants of Malaria Disease in Malawi
Principal Investigator: Terrie Taylor, D.O.
Lead Institution: Michigan State University, East Lansing

• Peruvian/Brazilian Amazon Center of Excellence in Malaria
Principal Investigator: Joseph Vinetz, M.D.
Lead Institution: University of California, San Diego

Posted by Meredith Cohn at 1:57 PM | Permalink | Comments (0)
Categories: Medical studies
        

Eating carrots won't improve your vision. That's a myth. But it will protect your vision, according to VSP Vision Care, a non-profit provider of vision services in a new video.

Carrots have vitamins and nutrients, such as vitamin A, C and E that can reduce the impacts of cataracts and age-related macular degeneration.

Some 30 percent of eye care providers are asked at least once a week about carrots improving vision, according to VSP.

But doctors say that carrots and other healthy foods are important. Lutein, zeaxanthin and minerals including zinc, copper and selenium can help protect the retina, which is the light- sensitive part of the back of the eye. Special fatty acids in fish protect the retina and can help the eyes maintain a layor of protective moisture.  
 
“One of the keys to keeping your vision healthy is an overall healthy diet. Developing good eating habits and a balanced diet to maintain proper levels of the important vitamins A, C, E as well as lutein and zinc such as are found in fruits and vegetables will help to lower the risk of some of these serious vision related problems in the future,” said Roger Phelps, an eye doctor in the VSP system, said in a statement.
 
The eye docs recommend eating these foods at least three times a week for good eye health:

+Carrots, kale, spinach, dairy products, egg yolks for vitamin A 
+Citrus fruits, especially kiwi, and juices, green peppers, broccoli, potatoes for vitamin C
+Eggs, whole grains, vegetable oils, sunflower seeds for vitamin E
+Spinach, corn, kale, broccoli, Brussels sprouts for lutein and zeaxanthin
+Coldwater fish, such as salmon, mackerel, and rainbow trout, and sunflower oil and corn oil for omega-3 fatty acids
+Meat, poultry, fish, whole grains, dairy products for zinc
 
See videos on this subject and others produced by VSP on Facebook or YouTube.   

Baltimore sun file photo/Andre F. Chung

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

What do you think about the state's response to the H1N1 flu epidemic last year?

Was the way officials passed out vaccinations fair? Did they drop the ball? Were you happy with how fast you could get a shot?

Officials at the Maryland Department of Health and Mental Hygiene want to know. They are asking for volunteers for focus groups being formed in the city and each county in the state.

You don't need to have had swine flu.

To be considered for a panel, you just need an opinion and maybe some advice -- you also need to be 18-64 years old, confortable speaking English and any race or ethnic group.

Discussions will last for two hours.

You can find an application and aditional information on the health department website. 

Baltimore Sun file photo/Jed Kirschbaum

Posted by Meredith Cohn at 4:26 PM | Permalink | Comments (1)
Categories: Swine flu/H1N1
        

With temperatures passing the 100 degree mark, everyone struggles a bit.

But seniors have an especially had time in the heat, and Dr. Alicia I. Arbaje, of Johns Hopkins' Division of Geriatric Medicine and Gerontology has some explanations of why -- and what the older people can do to stay healthy and safe.

She said seniors can feel the heat or cool down as easily and they are less likely to feel thirsty even when they are nearly dehydrated

They also have chronic medical problems such as heart disease and diabetes, and the medicines used to treat them, including water pills, allergy and sinus medications, medicines for depression and anxiety, can compound the problems of heat.

She said 90 degrees is already too hot for seniors. She has the same suggestions for many people who are sensitive to heat: They should stay in air conditioning and strenuous activity, stay hydrated, wear light clothing and hats and make sure their urine in light yellow.

Seniors need to look for signs of dehydration and heat stroke, which include dizziness and confusion, weakness and headache, muscle cramps, nausea and vomiting, a fast pulse, sweating and passing out.

If someone has these symtoms, they should get out of the heat and consume a sports drink that can replace sodium and potassium chloride. They should switch back to water once they are again in cool air. 

Seniors on water pills or blood pressure medications should call their doctors to see if they should lower and stop taking the drugs while they are in the heat. They should weigh themselves to see if they are replacing enough fluids by drinking -- urine flow shold be about 1 to 1.5 cups every 3 or 4 hours. 

The doctor also offers this recipe for making your own sweat replacement drink:
• 1 quart (32 oz) or 1 liter water
• 1/3 cup sugar
• ¼ teaspoon table salt
• use orange or lemon juice to flavor
• keep refrigerated

Baltimore Sun file photo/Jerry Jackson

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

Most Americans are getting screened for colon and breast cancer, two of the nation’s deadliest cancers. But millions still are not, and more than 30,000 people died last year because they weren’t screened, according to new data from the U.S. Centers for Disease Control and Prevention.

Colorectal screenings have increased to 63 percent in 2008 from 52 percent in 2002, the CDC said. And 81 percent of women 50-74 years old did get the recommended mammography screening for breast cancer in 2008.

That left more than 22 million people who did not have the colon screening and about 7 million women without a mammogram.

“It's encouraging to see more adults getting recommended cancer screenings,” said Dr. Thomas Frieden, CDC director, in a statement. “But we have more to do, especially when it comes to getting more people screened for colorectal cancer, which kills more American non-smokers than any other cancer.”

The data come from the state-level 2008 Behavioral Risk Factor Surveillance Survey.

Freiden said that the data show one in three people who should be screen for colon cancer have not been, with rates lower for Hispanics and Blacks. He said 32,000 lives could be saved is every adult 50 and older got tested regularly. Colon cancer is the second leading cause of death in the country, after lung cancer.

He estimated 12,000 women’s lives are saved by mammography every year. Breast cancer is the most commonly found cancer and the second leading cause of cancer deaths among American women.

The CDC found that doctor recommendations and health insurance coverage strongly influence screening rates. Officials also said the doctor recommendations were underused.

For more information, go to the CDC’s site for colon cancer  and the agency’s screening site.

AP photo of a mammogram

Posted by Meredith Cohn at 3:00 PM | Permalink | Comments (0)
Categories: Cancer
        

When the temperature hits 100 degrees, most of us can escape to our frigid, air-conditioned offices and cubicles to wait out the heat wave.

I even have co-workers with heaters under their desk because our office gets so cold.

But there are many occupations that don’t have the luxury of air-conditioning, in which workers must keep on toiling even when summer days reach their hottest.

Construction workers, landscapers and other outdoor workers are the most obvious. But indoor jobs, such as those at bakeries and Laundromats, can also pose health risks, according to the Maryland Occupational Safety and Health office.

The state agency, a unit of the Department of Labor, Licensing and Regulation, recently released tips on how companies can keep employees safe.

Working in sweltering conditions without the proper precautions can lead to fainting, rashes, cramps and, in the worst cases, heat exhaustion or stroke, according to the federal Occupational Safety and Health Administration.

Heat stroke can shut down bodily functions. Sweating stops, skin can turn red or mottled, and mental confusion and delirium can set in, the health authorities say. If not treated immediately it can lead to death.

There have already been at least 6 heat-related deaths in Maryland so far this year, according to the state Department of Health and Mental Hygiene. T

he risk is even greater in Maryland, where high humidity can make the temperatures seem even hotter. Humidity reduces sweat evaporation, making it harder for the body to cool off.

Equipment such as ovens and clothes dryers that give off heat can also make temperatures soar even more, putting some indoor workers at risk.

How each worker responds to heat can also vary depending on varying factors from age, physical health, weight and mental condition. For instance, the elderly and obese may be more prone to heat-related illnesses.

The state and federal occupational and safety offices offer these tips to companies to help prevent heat- related illnesses and accidents.

Have workers drink a cup of cool water or other fluid every 20 minutes.

Avoid alcohol and caffeinated drinks.

Allow workers to take frequent breaks in cooler areas.

Acclimatize workers to the level of heat they will be working, gradually exposing them to the conditions over a few weeks.

Encourage workers to live healthy lifestyles with a nutritional diet.

Provide cooling fans in hot areas. Schedule heavy work for cooler parts of the day.

Call the state with further questions about heat stress in the workplace, 1-888-257-MOSH.

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

This is the time of year when we get the call from doctors and safety experts cautioning the public about fireworks.

They have hurt a lot of people and even killed a few in recent years.

From 2000 to 2008, the number of fireworks set off by individuals and in major displays has risen from 152 million pounds to 213 million pounds, according to the American Pyrotechnics Association.

During the same time, the official count of injuries has declined from 11,000 to 7,000, according to the Consumer Products Safety Commission. But that doesn’t mean vigilance isn’t required.

The safety commission says the number of emergency department-treated injuries tends to fluctuate between 8,300 and 10,800 – the high number of injuries in 2000 may be related to millennium celebrations.

Children 15 and younger accounted for 40 percent of the estimated injuries.

Most often, injuries were to hand and fingers, eyes and legs. More than half were from burns. The eyes tended to be damaged by foreign objects.

In Maryland, residents are only legally allowed: sparklers containing no chlorates or percholorates, ground based sparkling devices that are non-aerial and non-explosive, and are labeled in accordance with the requirements from the safety commission. 

But, of course, that doesn’t stop residents from driving to Pennsylvania to buy all kinds of other fireworks.

If you fall in that category, the National Council of Fireworks Safety offers these tips:

+Use fireworks outdoors only.

+Always have water handy, as in a hose or a bucket.

+Only use fireworks as intended. Don't try to alter them or combine them.

+Never relight a “dud” firework. Wait 20 minutes and then soak it in a bucket of water.

+Use common sense. Spectators should keep a safe distance from the shooter and the shooter should wear safety glasses.

+Alcohol and fireworks do not mix. Have a “designated shooter.”

+Only persons over the age of 12 should be allowed to handle sparklers of any type.

+Do not ever use homemade fireworks of illegal explosives: They can kill you. Report illegal explosives to the fire or police department in your community.

Baltimore Sun fire photo/Gene Sweeney Jr.

Posted by Meredith Cohn at 11:23 AM | Permalink | Comments (1)
Categories: General Health
        

Wearing sunblock and drinking plenty of fluids are well known defenses against the harmful effects of the sun.

But Rebecca Myrowitz, a nutritionist, in the Greater Baltimore Medical Center's Comprehensive Obesity Management Program, says food is important too.

"It's getting nicer outside, and people are enjoying the weather," she said. "It's important to wear sunblock and drink fluids, but don't forget about food."

Fruits and vegetables have protective qualities for skin, as well as hair and nails, because they contain vitamins, minerals and anti-oxidants, she said.

But there are others high in biotin, omega 3s, manganese, copper, vitamin E, and protein.

Here are her five picks to mix things up:

+Sunflower seeds: They are an excellent source of vitamin E. which is an antioxidant that provides protecton from damage caused in cells by free radicals. UV radiation from the sun causes free radicals in the body that can mutate DNA and lead signs of aging and cancer.

+Almonds and Greek yogurt: They both have biotin, a B vitamin that is a natural skin protectant. Greek yogurt is higher in protein than regular yogurt, 18 grams of protein vs. 6 grams. Protein supports skin, hair and nails, which are most susceptible to damage when exposed to sunlight.

+Salmon: It's an excellent source of anti-inflammatory omega-3s. Low-grade inflammation increases a person's risk for cancer. It also helps lower cholesterol.

+Quinoa: This looks like a grain but is the seed of a plant, that is becoming more common in stores. It contains magnesium and copper, which make an enzyme that protects the skin from free radicals.

So if you are wondering about good-for-you-foods for summertime, Myrowitz hopes you think of these.

"Sunblock for the outside, these foods for the inside," she said.

Associated Press photo of almond-incrusted salmon

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (1)
Categories: Cancer, Diet and exercise
        

A realtor associate of mine tried to buy health insurance a few years ago, but was denied time after time because as he bluntly described it "i'm too fat."

He wasn't obese by any means, but would probably admit he could lose a few pounds. Those few pounds were enough of a "preexisting condition" for health insurers to consider him a risk.

He may have a better chance at getting some coverage soon.

The federal government announced today that as part of national healthcare reform it has a new "pre-existing insurance plan" for those with conditions that have prevented them from getting insured. The program is a transitional program that will exist through 2014 when full reform is implemented.

Health reform has provided $5 billion in federal funding to each state to support pre-existing health insurance. Some states will operate their own program, while other states will let the government run theirs.

Maryland is one of the few states that has long offered insurance for high-risk pools, but many complained it was too expensive. Some chose to go without instead.

Maryland will get $85 million in federal funding through 2013 to expand the pool and hopefuly get more people with pre-existing conditions on the health care rolls. It is unclear whether the plans will be cheaper than they are now or if it will just allow more people to get on the rolls.

The Maryland Health Insurance Plan will begin accepting applications in early August and begin enrolling people Sept. 1. The temporary pool will end in 2013 when it will be replaced by federal exchanges.

Look for a follow up blog soon on how people can apply and whether the additional funding will help lower the cost of the high risk plan.

Read more from my colleague Meredith Cohn about healthcare reform in Maryland.

Posted by Andrea Walker at 12:19 PM | Permalink | Comments (1)
Categories: Health care reform
        

In an effort to improve care for Marylanders, and also cut costs, state officials are launching a pilot program that aims to involves 200 primary care doctors and 200,000 patients.

Called the Patient Centered Medical Home program, it will give incentives to doctors to spend more time with patients, coordinate their care across the health care system and promote prevention and wellness, according to Lt. Gov. Anthony G. Brown, who co-chairs the panel inplementing health reform in Maryland and has been working on changes to the state's system of care.

The pilot is the result of legislation passed by the state legislature this year and is based on programs already running throughout the nation that report high patient and provider satisfaction.

The doctors will offer enhanced access, expanded hours and telephone and email communications. The goal of the prevention emphasis is improved quality of care and fewer emergency department visits and expensive hospitalizations.

The primary care providers will receive a fee from participating insurers for each patient to cover the extra care, in addition to their regular fee-for-service payments, and they will have a chance for additional compensation if there are savings from improved health.

Health and Mental Hygiene Secretary John M. Colmers said the three-year program will help change the way care is delivered.

It will launch in January 2011. Members of the Maryland Health Care Commission have begun talking to doctors about participating. Patients can talk to their doctors about signing up their practices.

For more information, go to the PCMH Pilot website  or send an email to:pcmhpractices@mhcc.state.md.us.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform