Did you throw your back out this weekend while getting the holiday decorations from the attic or basement? Or do you have lower back pain in general? Back pain is the second only to headaches as the most common neurological ailment in the United States, according to the National Institute of Neurological Disorders and Stroke.

Wednesday at noon, The Baltimore Sun will be hosting a live chat on lower back pain with Dr. Paul Christo, director, Pain Training Program, Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine. You can email questions in advance to healthcalendar@baltsun.com or just post them on Wednesday here. Can't make it? We'll send you a link to the transcript.

(Los Angeles Times file photo)

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Categories: General Health
        

Baltimore's health commissioner has decided to ban caffeine-infused alcohol drinks such as Four Loko on the heels of the U.S. Food and Drug Administration's determination that the drinks are unsafe. (read the baltimoresun.com story here.)

The ban, which takes effect Thursday at 5 p.m., gives the city the ability to fine retailers and bars that still sell the drinks.

Those merchants already needed to take the stuff off the shelves because of the FDA ban and because of an agreement with Maryland Comptroller Peter Franchot made with retailers.

Four Loko's maker Phusion Projects said it should have all its drinks off shelves by Dec. 13.

These drinks are specifically listed in the ban: Four Loko, Core High Gravity HG Green, Core High Gravity HG Orange, Lemon Lime Core Spiked, Moonshot, FourLoko, Joose and Max.

The ban does NOT impact on other drinks where caffeine is naturally occuring such espresso vodka. It also doesn't impact craft beers or mixed drinks.

Is this fair? Do you drink Four Loko and how does it impact you?

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Categories: Consumer health
        

In response to the shooting of one of its doctors, Johns Hopkins Hospital will file a report on its security measures to the panel that accredits U.S. hospitals on Tuesday.

The report was required by the Joint Commission, the independent, nonprofit panel that offers accreditation for more than 18,000 health care organization and programs around the country. It requires hospitals involved in “sentinel events” such as postoperative complications or medical errors to review what happened and say what, if anything, should be done to improve safety and quality of care.

The doctor, David B. Cohen, was shot by the distraught son of a patient Sept. 16 and continues to recover from his wounds. The shooter killed himself and his mother.

The commission reported that there have been almost 7,000 sentinel events since 1995. A category called “assault/rape/homicide” was the eighth most common type of problem.

A spokesman for the commission has said the confidential report will be reviewed and the hospital will be followed for a few months to ensure implementation of the plan.

There may be no changes to security necessary, and Hopkins officials have already said that metal detectors at all entrances and screening would be logistically difficult and unwelcoming. Some 80,000 workers and visitors come and go a week.

The officials still said security would be reassessed. And sometimes, magnetometer “wands” are used to check visitors during high-risk situations in the emergency rooms.

Have you been to Hopkins or another hospital recently? Think security is sufficient?

Photo of David B. Cohen courtesy of Hopkins

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Categories: Health care professionals
        

The public may demand information about their doctors be made public, but new research questions whether consumers actually use it to choose their care.

A paper published on the online version of the British Medical Journal, BMJ.com, two experts say it may not be realistic to assume the public will use performance data to choose health care providers, and so, drive improvements in quality.

The researcher, Martin Marshall and Vin McLoughlin from the Health Foundation, suggest ways to improve the information to optimize its effect.

They conducted their research during the last two decades in several countries. They said it’s clear consumers want information but rarely search for it and often don’t understand or trust it.

They suggested making clear the sources are trusted, the information is of interest to specific users and presented in a visually attractive way. The data needs to be simple enough to understand, and perhaps,  balanced with personal stories.

“In this paper, we present a significant challenge to those who believe that providing information to patients to enable them to make choices between providers will be a major driver for improvement in the near or medium term,” the researcher wrote. “We suggest that, for the foreseeable future, presenting high quality information to patients should be seen as having the softer and longer term benefit of creating a new dynamic between patients and providers, rather than one with the concrete and more immediate outcome of directly driving improvements in quality of care.”

So, do you seek out information about your health care providers?

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Categories: Consumer health
        

The pressure is on makers of those energy-alcohol drinks. The Food and Drug Administration has issued warning letters to manufacturers. And Maryland officials have been trying to get them off the shelves.

The officials consider being “wide-awake drunk” a public health threat.

Have you been wondering what’s so bad about Four Loco and other drinks so popular with teens and college students? St. Joseph Medical Center’s Powered by ME! Program has put together a fact sheet.

“Information is our best weapon to combat this dangerous new trend,” said Mike Gimbel, director of the program, in a statement. “Alcohol-caffeine drinks produce a false sense of alertness so kids don’t realize how drunk they are. They feel alert enough to drive. It’s a wide-awake drunk. There’s a need for education to prevent health emergencies. Even if these drinks are banned, we know that kids have been mixing energy drinks with alcohol on their own. There are even recipes on the Internet.”

To see the fact sheet, go to Poweredbymemd.com. Or, ask for a copy to be mailed by calling 410-337-1477. Gimbel is available to speak at community group meeting as well.

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

Waiting to get care for HIV is costly – in terms of health and dollars, according to a new Johns Hopkins University study.

Infected patients becomes sicker and require tens of thousands of dollars more in care during the first few years of treatment, and study authors say the findings means much more has to be done to get at-risk people tested and to the clinic for care.

 “We know that it's important clinically to get people into care early because they will stay healthier and do better over the long run,” says Dr. Kelly Gebo, an associate professor of medicine in the Division of Infectious Diseases at Hopkins’ School of Medicine and the study's senior author, in a statement. “But now we know it's also more costly to the health care system for potentially decades and a serious drain on our limited health care dollars.”

With antiretroviral therapy, patients are living a lot longer. But they have to actually get the care. Study authors say some people wait too long for care because they don’t know they’re infected, don’t know how to access care or have other problems such as mental health issue or an addiction.

For the study, researchers looked at 8,348 medical records at nine HIV clinics across the country between 2000 and 2007. More than 43 percent got care late and head weakened immune systems. Their CD4 counts, a measure of those systems, were below 200. A healthy person has a count between 800 and 1,000. Low counts mean the patient can more easily become infected or develop cancer.

It’s harder to recover to normal levels, even with the therapy. And the costs go way up when patients are sicker because of the high cost of hospitalization and medications for other diseases made worse by a weakened immune system. The researchers found in the first seven to eight years of treatment that the average difference in cost for treatment between early and late presenters were $27,275 to $61,615 higher.

The study findings were published in the December issue of the journal Medical Care.

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Categories: HIV/AIDS
        

It’s been 25 years, but there’s still Trouble in Toyland. The annual report about dangerous and toxic toys was released today -- in time for the holidays.

The consumer group Maryland PIRG took toys to the lab for testing. Officials said many are choking hazards or contain toxic chemicals.

“Choking on small parts is a leading cause of toy-related injury, causing fifteen deaths in the last three years,” said Jenny Levin, Maryland PIRG public health associate, in a statement. “We are concerned that the 30-year-old small parts standard is not protective enough. Children can and have choked on parts that are larger than the standard.”

She said there has been progress in the past two year on toy safety, as changes have been made at the Consumer Product Safety Commission. But she said the government agency needs more authority over chemicals. The group says there is no requirement that toys be tested or labeled.

PIRG pointed to agency data that found toy-related injuries caused more than 250,000 trips to the emergency room for children and 12 deaths last year.

The report, as well as toy buying tips, can be found at www.toysafety.mobi.

Findings from the report include:

+In 2009, many toys and other children’s products containing more than 0.1 percent of phthalates were banned in 2009. But the group found children’s products containing concentrations of phthalates up 30 percent.

+Small parts in toys for children under three were banned, but there are still toys available that pose choking hazards.

+Lead and other metals have been severely restricted in toys in the past two years, but the group found toys with metals for sale.

Reuters photo of toy included in PIRG report

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Categories: Consumer health
        

The end of the year is fast approaching, and many people still have money in their flexible spending accounts, those pots of tax-free money workers set aside for health expenses. They are use-it-or-lose-it, so get spending.

Here are some ideas on how from Save Smart, Spend Healthy, a national campaign to educate consumers on the value and proper use of FSAs:

+Review the list of eligible expenses. Many items may be eligible that you haven’t thought about.

+Check to see you have medications and supplies you need. This can include (for now) over-the-counter medications and prescriptions. It also can include medical supplies such as contact lenses and solution, glasses and bandages. Make sure you consider the expiration dates when you buy them.

+Schedule routine appointments. This includes routine check-ups at the doctor, dentist and optometrist. It also can include specialists such as a chiropractor or acupuncturist.

+Get a flu shot and vaccinations. Are you up to date?

+Invest in your wellness. Wellness programs such as smoking cessation expenses are eligible, and so is weight-loss counseling with a letter of medical necessity.

+Log your miles. You can be reimbursed 16.5 cents for mileage to and from eligible medical, dental and vision appointments.

And if you plan to sign up again, which you typically have to do each year during open enrollment, make sure you’re aware of changes. Top of the list: Over-the-counter drugs will require a prescription.

Associated Press photo

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Categories: Consumer health
        

The homeless faces all sorts of health problems. And doctors at Mercy Medical Center have seen just about all of them.

On Tuesday, as part of a national event, doctors from the Institute for Foot and Ankle Reconstruction plan to head to the Helping Up Mission in Baltimore to look at some feet.

They will provide foot screenings, as well as footwear, to residents. While the doctors have been to the mission before, this effort is sponsored by Our Hearts to Your Soles, a nonprofit founded by a Pittsburgh teen in 2005.

Dr. Clifford Jeng, Dr. Rebecca Cerrato and Dr. John T. Campbell, as well as medical fellows from the Institute, will offer their services to the mission, at 1029 E. Baltimore St. from 1 p.m.-3 p.m.

“With people more health conscious these days, we're walking more, running, hiking--always on our feet,” said Jeng in a statement. “We take healthy feet for granted. But for those who can't afford proper footwear or don't have access to good medical care for their feet, it's a different story. This program helps by providing shoes and foot screenings and by raising awareness, encouraging people to help those less fortunate.”

For more information about Our Hearts to Your Soles, visit www.heartstosoles.com.

Baltimore Sun file photo of a homeless man wearing two different shoes/Chiaki Kawajiri

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Categories: Health care professionals
        

Social networks may not be for the broken hearted.

An 18-year-old man, depressed after his girlfriend broke up with him, appears to have had asthma attacks brought on by logging into the social media site, five Italian doctors wrote in the journal Lancet.

She had deleted him from her page and “friended” other men. The former boyfriend used a new name to become friends with her again so he could see this.

The site seemed to induce shortness of breath each time he looked, wrote the doctors.

“The [man's] mother was advised to ask him to measure the peak expiratory flow before and after internet login and, indeed, ‘post-Facebook’ values were reduced, with a variability of more than 20 percent,” wrote Dr. Gennaro D'Amato of the High Speciality Hospital A Cardarelli in Naples, Italy.

“In collaboration with a psychiatrist, the patient resigned not to login to Facebook any longer and the asthma attacks stopped.”

Once the doctors took a full history and physical exam, they concluded it was seeing the girlfriend on Facebook that triggered the attacks. They concluded that social networks could be a new source of psychological stress and should be considered by doctors assessing others with asthma.

Has Facebook or another social network caused you stress?

Posted by Meredith Cohn at 3:35 PM | Permalink | Comments (2)
Categories: Mental health
        

Say what you will about airplane food – or the complete lack of it – but don’t complain about greasy, unhealthy fare in the airport.

Apparantly, they are changing their french fried ways. During the last decade there has been a dramatic increase in low-fat vegetarian options at airport restaurants, according to the Physicians Committee for Responsible Medicine.

Some 82 percent of restaurants in the busiest airport now offer at least one low-fat, cholesterol-free option. Ten years ago, just 57 percent offered such a healthful choice.

Of course, some airport still favored cheeseburgers and other less nutritious food, especially Hartsfield-Jackson Atlanta International, Chicago O’Hare International, and Ronald Reagan Washington National.

The committee looked at 18 major restaurants in more than a dozen states. Tops were Detroit’s Wayne County Airport (96 percent with at least one healthy option), San Francisco International Airport (95 percent) and Houston’s George Bush Intercontinental Airport tied for third with Newark Liberty International.

Baltimore-Washington International Thurgood Marshall Airport, which underwent a major overhaul of concessions a few years ago, had a score of 79 percent, to rank No. 10.

Have you eaten in an airport lately? Pleasantly surprised?

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Categories: Consumer health
        

Today is the Great American Smokeout. That’s the day when smokers are supposed to quit for at least one day.

State officials believe there will be a flood of calls to its free Quitline, 1-800-QUIT-NOW, which is manned from 8 a.m. to 3 a.m. seven days a week by professionals who can help smokers with their addiction.

Last year, more than 12,000 Marylanders called – a number that officials say helped the state achieve the 6th lowest prevalence of cigarette smoking in the nation, based on data from the U.S. Centers for Disease Control and Prevention. That’s despite cuts to the state’s smoking cessation funding, which comes from the Cigarette Restitution Fund created by a legal settlement with tobacco companies.

The day is sponsored by the American Cancer Society. Tips for quitting can be found on the group’s website. So can benefits, which include lower blood pressure, better lung function and circulation, and lower chance of heart disease and stroke. That annoying cough will also diminish.

Think you can quit, even for a day?

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Categories: Cancer
        

School vending machines may be teaching your kids bad eating habits, according to recent research.

Researchers with the National Institutes of Health found that the types of food in vending machines affect the overall dietary intake and health of what kids are eating. Most school vending machines sell foods with little nutritional value.

Researchers looked at the foods sold in vending machines at 152 schools and the dietary behaviors of 5,930 students. In elementary schools where vending machines sold fruits and vegetables kids consumed more of these foods. The same relationship was true in schools where the vending machines sold less healthy options.

About 83 percent of the schools sold mostly junk food like sodas, sweets and chips. The study was published online in the Journal of Adolescent Health.

"We are supposed to be teaching proper nutrition in the schools and having a vending machine in the school doesn't make sense," Joel Fuhrman, told Health Behavior News Service in commenting about the study.  

Sarah Palin recently entered the debate over schools' role in teaching our kids good eating habits. She said that it is parent's job. Tell us what you think.

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

The new body scanners at U.S. airports are getting a lot of attention for how much they show of the human body, but doctors are saying there’s another problem: The radiation ticks up the chance of developing skin cancer.

In an interview with Agence France Presse, Dr. Michael Love, who runs an X-ray lab at the department of biophysics and biophysical chemistry at Johns Hopkins University School of Medicine, said, “They say the risk is minimal, but statistically someone is going to get skin cancer from these X-rays."

Travelers have the option of going through the scanner or getting a full-body pat down. But given the time constraints it’s not clear how many people will opt for that.

A Sun Sentinel story that rounds up Love’s and others’ comments, quotes scientists and doctors concerned about the screening because so many people use the nation’s airports. That story quotes scientists with the University of California at San Francisco who wrote a letter to the White House Office of Science and Technology in April raising concerns.

“While the dose would be safe if it were distributed throughout the volume of the entire body, the dose to the skin may be dangerously high,” said the letter, adding that “independent safety data do not exist” and raising the potential for further harm if a high dosage was accidentally emitted."

The government said the doses were small and met safety standards.

So, which is more concerning, radiation or exposure?
 
Chicago Tribune photo of scanners

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Categories: Cancer
        

Want to learn about staying or getting healthy?

Johns Hopkins Medicine’s is holding its annual day-long conference at the Hilton Baltimore Hotel aimed a female consumers called A Woman’s Journey this Saturday. It’s 32 seminars lead by Hopkins doctors and professionals that focused on preventing disease and maintaining good health.

Some topics: Fit at 50 and Beyond, Use and Abuse of Supplements, A Menu for Skeletal Health, A Pain in the Neck, Predictors of Heart Disease in Women, Night Noise and Saving Your Voice.

The keynote speaker is Laurie Singer Sievers. She’s a network television news producer and widow of journalist and ABC News “Nightline” executive producer Leroy Sievers, and she’ll talk about being his caregiver while he battled cancer. She continues to write for her husband's “My Cancer” blog, now called “Our Cancer.”

The registration fee is $105, or $85 for students. Participants get to choose four seminar and meals are included, as is a 50-page program. For more information or to register, go to http://www.hopkinsmedicine.org/awomansjourney/baltimore/.

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

According to an account from a Capitol Hill staffer in Politico, newly elected Maryland congressman Andy Harris -- who ran on an anti-health care reform platform -- wanted to know why it was taking so long for him to get his government-subsidized health care.

He demanded to know during freshman orientation why his government health care wouldn't kick in for a month, according to the account. It starts in February, a month after he's sworn in, something he says is unusual and, according to one of his staffers, inefficient.

He ousted the Eastern Shore Democrat Frank Kratovil even though he voted against the health care reform package. Harris wants to repeal the law. 

The staffer said Harris asked if he could buy insurance from the government to cover the month-long gap, and Politico said the aide "was struck by the similarity to Harris’s request and the public option he denounced as a gateway to socialized medicine."

So, is this a non-issue for a congressman intitled to insurance coverage from the government because he'll be working for the government? Or is Harris demanding generous health care benefits that he doesn't think other American's (employed or not) should enjoy?

Associated Press photo

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Categories: Health care reform
        

Kennedy Krieger Institute said today that it has opened a 5,000-square-foot clinic in Columbia, it's first clinical care facility outside of Baltimore.

The center will provide pediatric behavioral psychology services. The company said the location was selected to better serve families in Howard, Anne Arundel, Montgomery, and Prince George’s Counties, as well as the military families at Fort Meade.

The new outpatient clinic opens today and will provide assessment and treatment of children ages 2-18 with a variety of behavior problems, including sleep difficulties, tantrums, toileting issues, aggression, parent-child interaction issues, poor social skills and conduct-related problems in school-age youth.

The clinic will specialize in serving both typically-developing children, as well as those with developmental delays and disabilities, such as autism spectrum disorders and intellectual disability.

“This is an important expansion for Kennedy Krieger because it allows us to respond directly to the needs of the community,” Gary Goldstein, president and CEO of Kennedy Krieger Institute, said in a statement. “Although the clinic will serve children from all backgrounds, I’m pleased that we’re able to improve our ability to help children of military personnel, whose families make tremendous sacrifices for this country.”

Kennedy Krieger has ten sites in Baltimore City and a special education school in Montgomery County. The new clinic is located at 9810 Patuxent Woods Drive, Suite C, in Columbia. Referrals and appointments can be made by calling 443-923-7508.

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Categories: General Health
        

Johns Hopkins Medicine is hosting a community forum to commemorate the 100-year anniversary of the discovery of the Sickle Cell Disease.

The painful blood disease is the most common genetic condition affecting African-Americans in the United States. The forum, scheduled for Wednesday, will address the challenges facing those living with sickle cell.

Participants will learn how to advocate for resources, address barriers to care and promote participation in research. Sickle Cell Disease researcher Michael DeBaun, M.D., a professor of pediatrics and medicine and vice chair of clinical research in pediatrics at Vanderbilt University School of Medicine, and Baltimore County delegate Shirley Nathan-Pulliam will be among the featured speakers.

The event begins with a reception at 6:15 p.m. with forum to follow at 7 p.m. It is being held at the Johns Hopkins Cancer Research Building, Albert Owens Auditorium, 1551 E. Jefferson St. Baltimore, MD 21231

FOR MORE INFORMATION AND TO REGISTER: ODCC@jhmi.edu or 410.502.6568

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Categories: General Health
        

Researchers at the University of Maryland School of Medicine have found that a new highly sensitive blood test may help doctors predict a person’s risk of heart failure much earlier than tests allow now.

The study is being presented today at the Scientific Sessions of the American Heart Association and published in the Journal of the American Medical Association.

Unlike existing tests, this new one measures troponin T, a marker for the biological process of cell death that leads to heart failure, at such low levels they can be detected in people who have no symptoms.

The new test found the market in two-thirds of seniors without symptoms. The blood samples were stored and subjects were followed to see if they developed heart disease. 

“We found that the higher the level of troponin, the greater the individual was at risk for symptoms of heart failure or death from cardiovascular disease over the next 10-15 years. The meaning of these elevated levels was unknown until this point,” said Dr. Christopher deFilippi, the principal investigator and a cardiologist at the University of Maryland Medical Center and a professor of medicine, in a statement.

People 65 and older are most likely to suffer heart failure, but without symptoms it’s tough to determine if they are at risk for heart disease – the top killer in the United States.
If doctors know a person is at risk, they could intervene. And the people could change their habits.

Researchers also say more study is needed to confirm the findings before a test could become available. But if you knew, would you change your ways?

Posted by Meredith Cohn at 9:00 AM | Permalink | Comments (1)
Categories: Cardiovascular Health
        

Residents in Harford, Washington and several Eastern Shore counties will be able to properly dispose of old and unwanted medications Saturday during the American Medicine Chest Challenge.

The B'More Green blog has written before about the damage flushing drugs down the toilet causes to waterways. The folks behind the Medicine Chest Challenge are also concerned about prescription drug misuse and overdoses. Unsupervised medicine ingestions result in almost 60,000 children under age 5 going to the emergency room a year, according to otcsafety.org.Reducing the amount of drugs you keep in the house can help safeguard against such incidents.

Challenge hours are 10 a.m.-2 p.m. Go to americanmedicinechest.com to search for drop-off locations.

Photo by PAUL J. RICHARDS/AFP/Getty Images

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Categories: Drugs
        

Teens, caught up in sports and friends, probably aren't giving too much thought to their heart disease risks.

But doctors and officials at Johns Hopkins and in the city school system want them to learn about their risk factors -- and hopefully, change their bad habits are engrained.

They plan to screen some 2,000 kids this weekend at Baltimore Polytechnic Institute from 9 a.m.-2 p.m. The free screening will look at obesity, high blood pressure and family history of disease, among other things.

The program expands on one Hopkins started with school athlete. The doctors screen the kids for heart problems that could prove fatal on the field.

Wish someone took at look your heart health at 13?

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Categories: Cardiovascular Health
        

Companies that provide access to flu shots for their employees may be helping their bottom line too.

Researchers from the University of Pittsburgh said the earlier companies get their employees vaccinated the better.

Workers who get vaccinated are less likely to call out sick.

The researchers found that getting an employee immunized in November instead of December can save an employer between $63 and $95 per person. Vaccinating an entire firm of 150 employees earlier could save a business between $9,450 and $14,250.

Data to support the findings came from the Centers for Disease Control and Prevention and the U.S. Department of Labor. The findings were presented at the American Public Health Association's 138th meeting in Denver this week.

"Employers have huge incentives to solve this widespread public health problem with timely vaccination," Rachel Bailey, the study's lead researcher said in a statement. "Even though workplace vaccination may appear expensive, the cost savings provided by preventing influenza-associated absenteeism with vaccination programs early in the influenza season more than compensates."

Posted by Andrea Walker at 11:04 AM | Permalink | Comments (0)
Categories: General Health
        

A diet of Twinkies and other snack foods helped a college professor lose so much weight over a couple of months that he went from being overweight to being normal.

Many media outlets have reported about this. Here's CNN's take.

But nutritionists say while he lost weight by lowering his caloric intake, they say there are tradeoffs. Nutritionists have long said that the amount of calories matters more than the kind of diet. 

While the professor lost weight, and even improved other numbers such as cholesterol -- atttributed to the weight loss and not the diet -- he may have put his health at risk for other problems such as cancer and other problems. No one was recommending the diet.

But could this really be a strong message that there is no one diet right for everyone. The right one is the one that helps you cut calories. What works for you?  

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

Sarah Palin shook things up this week during a speech to Pennyslvania students as she entered the debate about how involved schools should be in kids food choices.

The former Alaska governor thinks not at all. And she brought cookies to prove her point.

The Pennsylvania school system is looking at whether to ban sweets in public schools in an effort to help kids eat better and fight the problem of childhood obesity. Palin denounced the idea during her speech describing it as unwarranted government intervention.

She brought the students she was speaking to cookies and said she wanted to "shake things up," according to a CNN story.

"I wanted these kids to bring home the idea to their parents for discussion," she said. "Who should be deciding what I eat? Should it be government or should it be parents? It should be the parents." 

She also took the issue up on Twitter.  Before meeting with the students, Palin tweeted, "2 PA school speech; I'll intro kids 2 beauty of laissez-faire via serving them cookies amidst school cookie ban debate;Nanny state run amok!"

So is Palin right? Does the job of deciding kids' food choices fall in the hands of parents? Or should schools play a part as well. Take our poll and tell us what you think.

Posted by Andrea Walker at 11:49 AM | Permalink | Comments (8)
Categories: Diet and exercise
        

Since news broke that CT scans are better than X-rays in finding early lung cancer tumors, and thus increasing the chances of survival, the questions from patients have begun.

So, the University of Maryland has set up a web chat with Dr. Martin Edelman, a lung cancer expert.  It will be held today at 1:30 p.m.

The link at Maryland is here: http://www.umm.edu/webchat/. You can post a question there, or just read more about lung cancer.
 
You also can read my story in The Sun on the trial that produced the data.

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

Doctors and others in the medical field will have instant access to information about diabetes with the use of a new guide Johns Hopkins Medicine is making available on smart phones.

The guide was written by Hopkins physicians to help providers make the best clinical decisions, particularly when a patient is sitting in one of their examining rooms.

The guide provides advice on issues such as diabetes management and complications to medications.

It offers almost instant, at-a-glance access to the latest consensus guidelines and expert opinions on a broad spectrum of topics in diabetes care," said Rita Rastogi Kalyani, the guide's mangaging editor and an assistant professor of medicine in the Division of Endocrinology.

Nearly 24 million people have diabetes in the United States and 5.7 million people don't know how to manage it, Kalyani said. Complications of the disease can be managed or avoided through proper care, she said.

The diabetes guide is available on smart phones and the web. A print version will be released in the spring.

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

Sometimes we appreciate things we work harder for. And a Johns Hopkins researcher believes that this may also true when it comes to food.

The researcher, Alexander Johnson, wasn’t exactly sure why but when he tested the theory on some mice, he found that the theory held. And he believes that conditioning could someday help those trying to help those needing to lose weight – and perhaps, other disadvantageous behavior.
The findings are being published in the Proceedings of the Royal Society B.

“Basically, what we have shown is that if you have to expend more effort to get a certain food, not only will you value that food more, but it might even taste better to you,” said Johnson, an associate research scientist in the Department of Psychological and Brain Sciences at the Krieger School of Arts and Sciences at Johns Hopkins. “At present, we don't know why effort seems to boost the taste of food, but we know that it does, and this effect lasts for at least 24 hours after the act of working hard to get the food.”

Johnson did two experiments with another researcher, Michela Gallagher, the Krieger-Eisenhower Professor of Psychological and Brain Sciences and Neuroscience and vice provost for academic affairs at Johns Hopkins.

In the first, mice had two leavers, one that instantly gave them a sugary treat and one that had to be pushed 15 times for a similar snack. Later, given access to either option, the mice preferred the food they worked for. Later they used low-calorie food with easy and high-effort levers, and those who had to work ate more and seemed to enjoy it more.

The researchers said they didn’t study manipulating mice, or people, into wanting low-calorie food more, but said the implications are there. So, you like things you work harder for? You think people who work for low-cal food would come to prefer it?

Baltimore Sun file photo

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Categories: Diet and exercise
        

CareFirst BlueCross BlueShield is expanding the role of nurse practitioners in its network.

The state's largest insurer said this week it will allow nurses to participate in its healthcare provider network as primary care physicians. Until now, CareFirst has only permitted nurses to practice independently of physicians in underserved areas with limited access to doctors.

The insurer is making the change as health care reform is expected to add hundreds of thousands of people to the rolls and put tremendous pressure on primary physicians when it is fully implemented in 2014. Many believe nurses will take on many of the roles of these doctors.

The Associaton of Medical Colleges projects that by 2015, there will be a shortage of nearly 63,000 doctors across all specialties.

Nurses will need to meet CareFirst credentialing standards and become nationally certified to enroll in the CareFirst network as primary care providers. The nurse must also form a collaboration with a physician within the health insurer's network.

Posted by Andrea Walker at 10:26 AM | Permalink | Comments (0)
Categories: Health care professionals
        

A years-long study that compared methods of detecting lung cancer is ending early because the researchers believe they have identified a method that can reduce deaths by 20 percent.

Lung cancer is the leading cause of cancer-related deaths. It killed 159,390 people in 2009, according to the National Cancer Institute – more people than breast, prostate, colon and pancreatic cancer combined.

Not all lung cancer is a result of smoking. But with 90 million current and former smokers around the nation at higher risk of developing lung cancer, finding a way to diagnose and treat them has been a priority at the National Cancer Institute, which initiated the study.

The randomized clinical trial, which began in 2002 with 53,000 current and former heavy smokers, found that spiral computed tomography (CT) scans are better than standard X-rays. Thirty sites were used to test the patients for lung cancer, including Johns Hopkins in Maryland. A University of Maryland oncologist also helped verify the study results.

Now, most lung cancers are detected when there are symptoms, often after it has spread outside the lung in up to 30 percent of cases, according to the National Cancer Institute. The CT scan, first used in the 1990s, is better at finding small cancers before they have spread.

While the CT scans were found to be more effective in finding cancer earlier, there were drawbacks. It’s more costly and not covered by most insurance or Medicare. It can have a higher rate of false positives, which could lead to more unnecessary procedures. And there’s more radiation to the patients, itself a cancer causer.

The study was supposed to last 10 years, but a body examining the study said there was enough evidence to stop and issue findings and publish the data in a peer-reviewed journal.

According to Dr. Harold Varmus, NCI Director, during a press conference today, “Lung cancer is the leading cause of cancer mortality in the U.S. and throughout the world, so a validated approach that can reduce lung cancer mortality by even 20 percent has the potential to spare very significant numbers of people from the ravages of this disease. 

He added, "But these findings should in no way distract us from continued efforts to curtail the use of tobacco, which will remain the major causative factor for lung cancer and several other diseases.”

Posted by Meredith Cohn at 12:45 PM | Permalink | Comments (0)
Categories: Cancer
        

Many conservatives running for Congress, including many who won, say they want to revisit health care reform – repeal or tweak or defund or something.

Americans do remain split on the legislation overall – CNN said exit polls showed half want it repealed and the other half want it expanded or maintained.

Though, advocates point out that many of the individual elements remain popular, such as keeping kids up to 26 on their parent’s health insurance, closing the Medicare prescription benefit “donut hole,” banning insurers from bumping those who get sick out of coverage and not covering kids with pre-existing conditions.

It seems the part many have a problem with is the mandatory coverage for everyone, mainly because of the costs. Though, the advocates say putting so many more people in the system spreads the risk and makes the other provisions possible.

Those advocates, including Health Care for America Now, said they believe the election hinged more on the economy than health care. The group points to a CNN poll that found only 19 percent of voters named health care as their top concern, second, and well behind, the 61 percent who said it was the economy that was most important.

The group also pointed to Politico's assessment that 22 of the 34 Democrats who voted against the health care legislation still lost, as well as three of five senators. Certainly, few even mentioned the legislation on the campaign trail, and many of those who did were running away from it.

For sure, not all lawmakers are anti-health care reform. Senate Majority Leader Harry Reid, who won reelection to his post, says he doesn't want the legislation dismantled. And Maryland officials, led by Gov. Martin O'Malley and Lt. Gov. Anthony Brown, have embraced health care reform.

So, what do you want the new Congress to do with health care?

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (63)
Categories: Health care reform
        

Greater Baltimore Medical Center has received $1 million from an anonymous donor to support a program that serves victims of sexual assault.

It is the largest gift ever for the GBMC Sexual Assault Forensic Examination program. There are 21 of the programs across the state.

Under the program, forensic nurse examiners complete a full assessment of victims of sexual assault age 13 and over. They collect forensic evidence and provide antibiotic therapy and emergency contraception. They also provide resources for crisis counseling.

Young women between the ages of 13 and 24 account for more than 60 percent of victims that use the program. 

The grant will be used to train nurses among other things.

Posted by Andrea Walker at 12:45 PM | Permalink | Comments (1)
Categories: Women's health
        

A Johns Hopkins doctor took a look at primary care programs that treat older patients with chronic conditions and found three models that seem to be the best for providing care while reducing, or not increasing, costs.

The study by Dr. Chad Boult, of the Bloomberg School of Public Health, appears today in a issue of the Journal of the American Medical Association that focuses on aging.

“Older patients with multiple chronic health conditions and complex health care needs often receive care that is fragmented, incomplete, inefficient, and ineffective,” wrote Boult and co-author G. Darryl Wieland, of Palmetto Health Richland Hospital in Columbia, S.C.

The authors looked at other studies on comprehensive primary care for seniors with chronic conditions and found there are good ways to substantially improve care. They include comprehensive assessment, evidence-based care planning and monitoring, promotion of patients’ and (family caregivers’) active engagement in care, and coordination of professionals in care of the patient.

With this criteria, the three models were identified:
+the Geriatric Resources for Assessment and Care of Elders (GRACE) model
+Guided Care
+the Program of All-inclusive Care for the Elderly (PACE)

All there incorporate teams of health care professionals such as primary care doctors, registered nurses and other professionals. They offered comprehensive assessment, development of a plan, implementation of the plan over time, proactive monitoring and coordination of care and facilitation of the patients transition out of hospitals and to support programs that include meals and exercise.

The plans operate differently, with nurses and social works in charge for one and primary care doctors coordinating another and managed care for the third. The authors said more research is needed to determine who benefits most from each type. They also said more education is needed for providers on the effective models.

Anyone participate in one of the programs?

Posted by Meredith Cohn at 10:19 AM | Permalink | Comments (2)
Categories: geriatrics
        

It's Election Day and maybe you just can't help yourself when you go into the booth.

Researchers at the University of California, San Diego and Harvard say that your surroundings and upbringing certainly do shape your ideology. But a person can also be predisposed to a certain way of thinking.

The researchers matched the genetic makeup of 2,000 people with maps of their social networks and found that those with a varient in a dopamine receptor gene were more likely to be liberals as adults -- but only if they had a lot of friends as kids.

The research builds on past research done on dopamine, a neurotransmitter repsonsible for feeling pleasure and pain. It was published in the Journal of Politics.

The theory is that those with this "novelty seeking" gene variant who had a lot of friends would seek out a lot of their opinions. Being exposed to so many points of view would make them more liberal if they were already predisposed that way. But more study is needed, researchers say.

What do you make of this?

Posted by Meredith Cohn at 2:24 PM | Permalink | Comments (0)
Categories: Medical studies
        

Most offices will have bowls of leftover Halloween candy lingering around today.

We're all trying to get the temptation out of our houses, only to have it thrown in our faces at work.

A dietician from Loyola University Health System has some tips on how to fight the urge. Dietician Brooke Schantz said that eating all that candy can lead to fatigue after the initial sugar rush wears off.

Here are her tips:

1. This probably won't happen, but make pacts with your co-workers to leave the candy at home.

2. Eat breakfast so you don't come to work hungry

3. Bring in healthy snacks - low-fat cheese, carrot sticks, cucumber slices

4. Can't resist? Limit yourself to a small, bite-sized piece.

5. Put candy out of site so you're not tempted by it all day. The more visible it is, the more you'll eat.

Posted by Andrea Walker at 11:21 AM | Permalink | Comments (0)
Categories: Diet and exercise