The international arm of Johns Hopkins Medicine has signed an agreement to help four public hospitals in Kuwait improve their standards and provide better treatment to patients.

The five-year agreement signed on Christmas Day with the Ministry of Health of Kuwait calls for Hopkins to provide the hospitals training and advice on patient safety, preventive medicine, nursing and health care policy. Focus areas will be trauma, orthopedics, rehabilitation, diabetes and obstetrics, pediatrics and telemedicine. 

The hospitals they will work with are Amiri, Farwaniya, Jahra and Adan. The hospitals account for more than 40 percent of the public-sector beds in the country.

 Kuwait officials said they hope to raise the standard of health care delivery and to increase the number and expertise of local doctors, hospital managers, administrators and nurses.

Posted by Andrea Walker at 11:30 AM | Permalink | Comments (0)
Categories: General Health
        

The cigar industry is preparing to fight a tobacco tax that health advocates hope to push through the General Assembly next year.

The International Premium Cigar & Pipe Retailers Association, which represents thousands of mostly mom-and-pop cigar stres, said it is organizing in hopes of preventing the proposed tax on cigars and others tobacco products other than cigarettes from passing.

“Maryland voters are sick of increased taxes disguised to obscure government over-spending and they are tired of being told what to do and how to behave," Bill Spann, CEO of the IPCPR said in a statement.

Maryland Citizens’ Health Initiative is pushing for the the new tax. They successfully pushed dime-a-drink tax on alcohol through the last General Assembly session.

The group published a recent telephone poll of more than 800 people that found that two-thirds of Maryland voters supported a cigar tax. The group said the poll by Opinion Works also found that about 72 percent of Maryland voters like the idea of taxing cigars and smokeless tobacco at the same rate as cigarettes.

The group believes increasing the tax will cut consumption and fund health care programs, especially among youth who have adopted the use of cigars, especially flavored ones.

As of 2010, 15.2 percent of adults and 14.1 percent of high school students in Maryland were smokers.

The cigar stores say the argument by health advocates is a misguided effort to prevent underage smoking. Youth can't afford cigars which cost $6 to $30 and they industry has strict policies against underage sales, Spann said.

He said a tax would hurt small businesses and kill jobs.

Posted by Andrea Walker at 12:01 PM | Permalink | Comments (3)
Categories: General Health
        

Johns Hopkins Medicine International has signed a contract to help improve standards at seven hospitals in Peru.

The international arm of Johns Hopkins Medicine entered into the agreement with Lima, Peru-based Pacifico Salud, a subsidiary of Credicorp Ltd., the leading financial services holding company in the country. The company operates several health care facilities.

Under the terms of the agreement signed Dec. 2, Hopkins will help improve patient safety, management and the quality of health care delivery at the hospitals. Beginning in January, Johns Hopkins will assess the hospitals’ strengths and provide a gap analysis of Pacifico Salud’s health care facilities.

Pacifico Salud belongs to Pacifico Peruano Suiza, one of the largest insurance companies in Latin America and the largest health insurer in Peru, earning about 46 percent of the segment in 2010.

The company said in a statement that the memorandum of understanding is the first step for Pacifico Salud to consolidate its leadership in the Peruvian health care industry. It will allow the company to help raise the standards of care throughout the country and introduce a new vision for patient safety and quality of care in Peru, the statement said.

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

Welcome guest blogger Hanah Cho, a business reporter at The Sun. She attended the Gerontological Society of America conference as a 2011-2012 Metlife Foundation Journalists in Aging Fellows Program, a project of GSA and New America Media.

As the country grows older, caregiving will become an even bigger issue for families. In Maryland alone, the 65-and-over population grew by more than 18 percent in the past decade, according to the U.S. Census.

While all families face difficult and a wide range of choices when it comes to caregiving options, the state’s growing immigrant and ethnic populations could encounter additional barriers in accessing available services.

To find such evidence, Banghwa Lee Casado, an assistant professor at the University of Maryland School of Social Work, conducted a study of 146 Korean American caregivers in Maryland and northern Virginia to examine access barriers to using home- and community-based programs, such as respite care, adult day care, home health and transportation services.

Casado’s research found a good majority of her subjects had never used these services. A lack of awareness was the most cited reason for not accessing these services. For instance, more than eight out of 10 reported having no knowledge of respite care and caregiving support group.

 “We know anecdotally they have limited resources,” said Casado, who presented her findings at The Gerontological Society of America conference last month in Boston. “But without the data, we can’t show evidence there is unmeet need.”

Casado said her findings – which also could be broadly applied to other limited English populations – could help social agencies improve their education outreach and work with community groups focused on ethnic populations. In fact, Casado recently presented her findings to the Howard County Office of Aging and the Fairfax Area Agency on Aging.

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

The U.S. Centers for Disease Control and Prevention says it’s National Influenza Vaccination Week, and federal and state health officials are pushing the flu shots to keep people from getting sick.

The CDC is again recommending everyone older than 6 months get vaccinated to prevent infection. It takes two weeks for the vaccination to kick in and provide protection from the virus, so the officials say to get the shots early in the season.

“Our priority is keeping all Marylanders healthy and safe,” Dr. Joshua M. Sharfstein, health and mental hygiene secretary, said in a statement. “I urge all Maryland residents to get their flu vaccines before it's too late.”

The state Department of Health and Mental Hygiene is also recommending preventive measures such as frequent hand washing, covering your mouth and nose when coughing and sneezing and staying home if you’re sick. Other tips can be found at the CDC's flu page.

Flu symptoms include fever, dry cough, sore throat, runny or stuffy nose, headache and muscle aches and extreme fatigue. Anti-viral medications can shorten the length of illness for some high-risk people.  But complications including death can occur, especially in seniors and those with underlying health conditions.

The CDC reports that just over 36 percent of adults and children have had vaccinations as of the first week of November, which is above the number of children and about the same number of adults who were vaccinated at the same time last year.

Among health care personnel, the number is up about 7 percent from last year to 63.4 percent.
And among pregnant women, about 43 percent were vaccinated, about the same as last year.

You have your flu shot yet?

Patuxent Publishing photo

Posted by Meredith Cohn at 3:00 PM | Permalink | Comments (0)
Categories: General Health, Swine flu/H1N1
        

Ray Lewis, the Raven’s linebacker, has already missed two games and hasn’t been coming to practice because of a hurt toe.

While it may be hard to believe a toe injury could sideline such a player, doctors say “turf toe” can end careers.

It’s called turf toe because it’s associated with American football players who get hurt on artificial turf. Often a player has his foot planted and another player lands on the back of his calf, driving the toe to hyper-extend.

Dr. Rebecca Cerrato, a surgeon in the Institute for Foot and Ankle Reconstruction at Mercy Medical Center, said the degree of injury matters. Turf toe is basically a sprain of the ligaments that line the bottom of the big toe joint and it’s graded like any other sprain.

Grade 1 is when the ligaments are partially stretched and it’s considered mild. Grade 2 is a partial tear but not fully ruptured. Grade 3 is usually a complete rupture and maybe some breaks in the little bones in the area.

“The grade has a lot to do with how quickly they can come back,” said Cerrato, adding the injury is typically diagnosed with an X-ray.

Players with a grade 1 sprain can often return by the end of the game if they have no pain. The vast majority with grade 2 sprains are out for weeks as the swelling and pain subside. The toes need to be without pain and have a range of motion. They are often protected with tape and shoes that don’t allow the toe to lift up, Cerrato said.

Grade 3 injuries often need surgery. They are season-ending and can affect a career, said Cerrato, who has not treated Lewis and does not know the extent of his injury. Though, she said, since he’s been out two weeks already, it’s not likely a mild injury.

“The reason it’s debilitating is because an athlete needs to accelerate and change directions quickly, which requires pushing off of the toe,” she said. “That is definitely extremely difficult and painful.”

Athletes who try and play through the pain can more severely injure themselves and develop chronic long-standing problems with the joint, she said.

Athletes that want to avoid turf toe should avoid hard, inflexible artificial turf – which isn’t always an option. Cleats with stiff soles may also help.

Baltimore Sun photo/Karl Merton Ferron

Posted by Meredith Cohn at 3:10 PM | Permalink | Comments (0)
Categories: General Health
        

Urgent care company Patient First is offering free X-ray imaging of Halloween candy.

Bags of candy corn and chocolate bars can be brought into any Patient first facility from 6 p.m. to 9 p.m. today.

The company said it parents should check candy for objects like glass, metal or plastic themselves. The X-ray will just provide another layer of precaution.   

Posted by Andrea Walker at 7:00 AM | Permalink | Comments (4)
Categories: General Health
        

International health organization Jhpiego will lead a $24.9 million effort to develop inexpensive medical equipment and other technology it hopes will help save lives and improve health across the world.

The non-profit associated with The Johns Hopkins University says it will take these technologies from the lab to the village.

“We believe that bringing together the community of biomedical innovators to focus on global health needs and engaging with commercialization partners very early in the process has the best chance to fast-track urgently needed, low-cost solutions to save more lives,” Dr. Harshad Sanghvi, Jhpiego’s medical director and vice president for innovations, said in a statement.

The five-year project, funded by the U.S. Agency for International Development, will involve creating, testing and bringing the technologies to market.

Jhpiego will partner with Johns Hopkins Engineering’s Center for Bioengineering Innovation and Design, the Center for Global Health and Population Services International on the project.

Posted by Andrea Walker at 11:30 AM | Permalink | Comments (0)
Categories: General Health
        

As people sign up for health insurance in the next few weeks during open enrollment, the state's doctor's group is offering some tips for what can seem like a complicated process.

MedChi, the state's medical society, said it is important that people are informed about their health benefits.

 “Understanding your insurance before you need it is a great way to prevent problems,” said MedChi CEO Gene Ransom.

For Medicare beneficiaries, open enrollment runs October 15 to December 7. People who work for private companies should ask their human resources department about open enrollment dates.

Here are five tips from MedChi:

1. Make sure that your doctors are still covered. Check to see if your family’s current physicians and area hospitals are in the plan’s network. Using providers that are in-network will save money. Mistakenly seeing an out-of-network provider can leave you stuck paying medical bills out of pocket.

2. Check that your medications are covered. If you take prescription medications, check them against the list of approved drugs in each plan booklet.

3. Watch out for medication management policies like prior authorization and step therapy. Prior authorization policies require that doctors get insurer approval before the carrier will agree to cover certain medications or treatment, while step therapy policies require that cheaper options fail before the insurer will cover the preferred treatment.

4. Check your co-pyments and deductibles. In order to estimate the full cost of each plan, determine what co-pays, deductibles, and other out-of-pocket expenses you will be responsible for paying.

5. Read the fine print. Make sure to read all of the plan materials thoroughly. Doing so will tell you what your rights and responsibilities are under each plan, and can prevent you from incurring unexpected medical costs later on. If any part of a plan is unclear to you, ask for help from your human resources department or the insurance carrier.

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

Join us Wednesday for another live health chat with Dr. Paul Christo of Johns Hopkins.

We've tackled many pain topics on our live chats since December. Some have resonated more than others, so we decided to have an open forum on Oct. 19 at noon. Ask Christo about any pain condition, including back pain, neck pain, headaches, carpal tunnel syndrome, neuropathy and more.

Christo is director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine. He also has a radio talk show Saturday nights on WBAL.

Can't make the chat? Send questions in advance to healthcalendar@baltsun.com and return here to read the transcript.

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

Readers seem to be interested in the stories about the Legionnaire’s outbreak at an Ocean City hotel, see stories here and here. But state health officials say there’s no need to panic – cases are about average for the year and far below many other diseases.

There have been 93 confirmed cases of the disease, a form of pneumonia, in Maryland. About 100-130 is typical.

But Dr. David Blythe, an epidemiologist at the state Department of Health and Mental Hygiene, said most cases are not investigated because they involve only one person and it’s difficult to determine where the individual came in contact with the Legionella bacteria.

The bacteria is found naturally in many water systems and affects only those with weakened immune systems, smokers and seniors. Investigators would need cultures from every water system the person came in contact with, as well as a culture from the diseased person, which are not generally produced. (It’s diagnosed through a urine test.)

Only when there is an outbreak, do officials step in. They try and notify others who might have been exposed because if the disease is caught early, antibiotics can be used for treatment. (If you have flu-like symptoms, fall in a high-risk group and believe you may have been exposed to the bacteria, call your doctor.)

A look at the state database shows that incidence of the disease is quite low when compared to other maladies related to pets, dinner and other extracurricular activities:

For example, Marylanders are much more likely to be bitten by an animal (9,733 cases in 2010) or come down with chlamydia (26,192 cases) gonorrhea (7,413 cases) Lyme disease (1,617 cases) or meningitis (650 cases), or get salmonella from their food (1,086 cases).

Posted by Meredith Cohn at 6:30 AM | Permalink | Comments (0)
Categories: General Health
        

Patient First will open an urgent and primary care facility in Catonsville next week.

The center, to open Oct. 19, will the be the 13th for the company in Maryland.

 Patient First physicians and other staff offer urgent care; work, school, camp, sports and travel physicals; occupational health; and primary care for patients who do not have a primary care physician.

 Patient First will also transmit a copy of the visit record to the patient’s primary care physician.

Posted by Andrea Walker at 11:52 AM | Permalink | Comments (0)
Categories: General Health
        

Your zip code might be making you sick.

A new study by the Johns Hopkins Bloomberg School of Public Health found that where people live plays more of a role in health disparities than was known before.

Researchers studied a racially mixed neighborhood in Baltimore and found that disparities commonly found among the races were less prevalant or didn't exist at all. Disparities in hypertension, diabetes, obesity among women and use of health services were less common.

The results of the study are published in this month's issue of Health Affairs.

“Most of the current health disparities literature fails to account for the fact that the nation is largely segregated, leaving racial groups exposed to different health risks and with variable access to health services based on where they live,” Thomas LaVeist, lead author of the study and director of the Johns Hopkins Center for Health Disparities Solutions, said in a statement. “By comparing black and white Americans who are exposed to the same set of socioeconomic, social and environmental conditions we were better equipped to discern the impact of race on health-related outcomes and have concluded social factors are essentially equalized when racial disparities are minimized.”

LaVeist and colleagues identified communities in the U.S. containing a population of at least 35 percent African American and 35 percent white residents, and where the African Americans and white residents have similar income and education.

Two communities in Baltimore were selected as study sites and in-person interviews were conducted with adult residents. Blood pressure was also measured among a number of study participants.

The researchers used various national health databases for comparison.

They found that racial differences in social environments explained a significant portion of disparities typically found in national data.

“When whites are exposed to the health risks of an urban environment their health status is compromised similarly to that of blacks, who more commonly live in such communities,” said Darrell Gaskin, co-author of the study and deputy director of the Hopkins Center for Health Disparities Solutions and an associate professor with the Bloomberg School’s Department of Health Policy and Management."

Posted by Andrea Walker at 11:20 AM | Permalink | Comments (1)
Categories: General Health
        

Hospital and medical providers who use electronic medical records could be eligible for federal money to help with implementation.

Providers who are eligible will receive $21,250 the first year to implement or upgrade medical record technology. An additional $8,500 is available each year after for those who meet certain "meaningful use" requirements.

The Maryland Department of Health and Mental Hygiene announced the incentive program Monday.

The money is being made available through the federal Medicaid Electronic Health Record Incentive Program. The program runs through 2021 and providers can participate for up to six years.

Physicians, nurse practitioners, certified nurse-midwives, dentists, or physician assistants who participate in Medicaid and meet specified Medicaid patient volume thresholds are eligible for the program. Hospitals that are acute-care facilities with at least 10 percent Medicaid patient volume, as well as children’s hospitals, are also eligible to receive funds under the program.

Eligible hospitals would receive a $2 million base incentive, plus additional money reflecting Medicaid inpatient bed-days and other factors.

For more information, visit http://www.dhmh.state.md.us/mma/ehr/index.html.

For questions, email MarylandEHR@dhmh.state.md.us.

Posted by Andrea Walker at 10:51 AM | Permalink | Comments (1)
Categories: General Health
        

At the 2011 Natural Products Expo in Baltimore this week, a large trade show for store and food service buyers and distributors, there were many pitches being made about what foods contained, or didn't contain.

Coconut, yogurts from Australia and Greece and all forms of grains. There were also gluten free, sugar free and non-genetically modified foods.

But around the room, one theme seemed to be honey -- in chocolate, shampoo, cough drops and jars. It came raw, flavored, and of course, organic.

Mom always pitched honey in tea as soothing for sore throats. But it may have other health benefits. There's not a lot of scientific papers, but a few do note the antibacterial benefits,  potential for wound and scar care, and therapy for coughing children.

Anyone have unique uses for honey?

(For more about the expo and Maryland companies offering their wares, click here.)

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

Free yoga, health screenings and a block party will be available to city residents later this month as Baltimore health officials promote healthy lifestyles.

The events are part of the second annual Healthy City Days - a week of free events designed to get Baltimore residents to exercise more, eat better and take control of their health.

Health officials announced the weeklong event, that runs Sept. 30 to October 7, at a press conference today with Ravens fullback Vonta Leach.

Officials acknowledge that the events won't solve all the health problems in a city with high rates of heart disease, infant mortality and colon cancer - just to name a few. But they hope to give residents the tools to begin living healthier lives.

Check here for the list of events.

 Ravens' fullback Vonta Leach and Molly Shattuck at Tuesday's kick-off event. Baltimore Sun photo by Lloyd Fox

Posted by Andrea Walker at 12:01 PM | Permalink | Comments (1)
Categories: General Health
        

The Baltimore City Health Department is getting a $1.75 million federal grant to help prevent teen dating violence.

The grant from the Centers for Disease Control and Prevention will be used to develop a program to stop teen dating violence before it happens.

It is part of CDC initiative called Dating Matters: Strategies to Promote Healthy Teen Relationships. Three other cities will also participate in the five-year initiative.

The CDC will use the results from the cities to look at the cost, feasibility, sustainability, and effectiveness of a comprehensive approach to teen dating violence.

The federal agency wants the health department to become the primary agent for dating violence prevention programming in Baltimore.

Posted by Andrea Walker at 3:44 PM | Permalink | Comments (0)
Categories: General Health
        

The cost of a hospital stay in Maryland is on the rise, but not as much as that nationally, according to a report released today by the Maryland Health Services Cost Review Commission.

The average cost to stay in a Maryland hospital was $10,983 in fiscal year 2010, compared to $10,767 the previous year, according to the report. The 2 percent increase was lower than that nationally where the cost of a hospital stay increased 3 percent.

The markup - or difference between hospital costs and what hospitals ultimately charge patients - is also the lowest in the nation, the report found. The average markup was 24.5 percent for Maryland hospitals compared to 198 percent nationwide, according to the state report.

Maryland's rate setting system is different from the rest of the nation in that the commission sets the same rates for everybody. It allows for everyone to share in the cost of uncompensated care and makes it harder for hospitals to shift costs to the employers that pay insurance premiums.

The report released today also found that the state's uncompensated care dropped to $926 million in fiscal 2010 to $999 million the previous year.

Posted by Andrea Walker at 1:33 PM | Permalink | Comments (0)
Categories: General Health
        

Insomnia is costing the country 252.7 days of work, or 11.3 days per worker, according to a new study in the September issue of the journal Sleep.

The cost is $63.2 billion in lost productivity, or $2,280 per worker.

The results, funded by pharmaceutical companies, come from a national sampling of 7,428 employees and provide a clearer picture that existing estimates, which were derived from smaller samples or estimates based on those being treated for insomnia.

“We were shocked by the enormous impact insomnia has on the average person's life,” said lead author Ronald C. Kessler, a psychiatric epidemiologist at Harvard Medical School’s department of health care policy, in a statement. “It's an underappreciated problem. Americans are not missing work because of insomnia. They are still going to their jobs but accomplishing less because they're tired. In an information-based economy, it's difficult to find a condition that has a greater effect on productivity.”

The costs, he said, may justify screening and treatment programs for workers. Now, employers mostly ignore insomnia because it’s not considered an illness.

Study authors said average cost of treating the condition ranges from $200 annually for a generic sleeping pill to $1,200 for behavior therapy.

They estimated just over 23 percent of workers have insomnia, and prevalence was lower among older workers and higher among women than men.

For more information, go to the American Academy of Sleep Medicine website’s sleep blog or the Associated Professional Sleep Society website.

Posted by Meredith Cohn at 5:26 PM | Permalink | Comments (1)
Categories: General Health
        

Doctors in America make more money than those in other countries, which raises the questions about whether it is driving up healthcare costs.

Doctors in the United States charge sometimes twice as much for procedures than their counterparts overseas, according to a study by scientists at the Mailman School of Public Health at Columbia.

The pay gap is biggest for speciality procedures, such as hip replacements.

The study compared the cost of care in the United States to that in Australia, Canada, France, Germany and the United Kingdom. The findings were published in the September issue of Health Affairs.

The higher fees in turn lead to higher incomes for US doctors and are the main driver of higher overall spending in the United States on physicians’ services, the researchers found.

The largest difference in fees paid to doctors was for hip replacements. U.S. physicians were paid 70 percent more for these procedures by public insurance such as Medicaid, and 120 percent more by private insurers, than the average fees paid to physicians in the other countries.

“For decades, policy makers and medical leaders in this country have debated financial incentives to spur more doctors to become primary care physicians," said lead author Miriam Laugesen. "Our work shows that continuing attention needs to be paid to the difference in payments across specialties, and how we can get better value for those expenditures.”

The study also further proved that the biggest disparities in U.S. pay to physicians are on the private side. Fees paid by large private national insurers in six markets in the United States were on average about one-third higher than Medicare rates for primary care and 50 percent higher than Medicare for hip replacements. Private insurers have been less successful in negotiating fees with orthopedic surgeons than with generalist physicians, the authors said.

Physicians in the United States also reported higher salaries in comparison to the other countries, despite the fact that there was little difference in the amount of services performed. The authors suggest that the differences may reflect the fact that US physicians are being paid more for their skill and time than are physicians in other countries.

The study did not look into whether the higher salaries were warranted.

US primary care physicians earned the highest average annual incomes at $186,582, while the French at $95,585 and Australian at $92,844 earned the lowest. US orthopedic surgeons earned the highest average annual incomes at $442,450, followed by $324,138 for orthopedic surgeons in the United Kingdom.

The finding that US health care fees and spending are higher than in other countries is nothing new. However, the study finds that the higher fees paid to physicians—rather than factors such as higher practice costs, volume of services, or medical school tuition expenses—are the main drivers of higher US spending on physicians, particularly in orthopedics.

The authors of the study said that as policy makers look for ways to restrain health care spending, findings from the new study could provide a reason to look at physician fees for savings.

So what do readers out there think. Are doctors paid too much in the United States?

Doctors, are you being paid your worth?

Chime in and let us know.

Posted by Andrea Walker at 12:01 PM | Permalink | Comments (21)
Categories: General Health
        

Venus Williams has withdrawn from the U.S. Open because she’s has Sjogren’s syndrome, a hard-to-diagnose autoimmune disorder that can cause dry eyes and mouth and painful joints.

It’s not exactly clear what causes the disorder, but it probably has a genetic link – though that doesn’t mean Williams’ sister Serena has a greater risk, said Dr. Julius Birnbaum, associate director of the Johns Hopkins Jerome L. Greene Sjögren's Syndrome Center.

He said viral infections and other factors could play a role.

“Sjogren’s syndrome is emerging as among the most common autoimmune diseases affecting adults,” said Birnbaum. “Two to four million adults may be affected.

He said the body’s strategy for combating infections and tumors “essentially turns into a traitor and starts targeting different organs.” It targets the glands that produce tears in people’s eyes and saliva in their mouths. It also can affect a host of different organs.

It’s hard to diagnose because the dryness isn’t always considered a factor by doctors who are looking for causes of fatigue and joint pain.

Birnbaum said the disease is chronic, but that it’s treatable. The first line of defense is a drug called Plaquenil, which originally was developed as an anti-malarial drug but is now used for Sjogren’s and Lupus. If that is ineffective, there are other drugs that can suppress the immune system.

Doctors will also have to look for hypothyroidism, vitamin D deficiency and other causes of fatigue that often surface in Sjogren’s patients.

“In the absence of other organ complications, Venus can hopefully return to tennis,” Birnbaum said, though he’s not treated the tennis star and is not familiar with the specifics of her case. “There will need to be a lifelong commitment to treatment.”

To read more, go to the Hopkins Sjogren's Syndrome Center website or this Los Angeles Times story.

AFP/Getty photo of Venus Williams

Posted by Meredith Cohn at 12:30 PM | Permalink | Comments (0)
Categories: General Health
        

Chronic obstructive pulmonary diseases, or COPD, including emphysema and chronic bronchitis, are the third leading cause of death in the United States, according to government data. It’s caused by smoking, secondhand smoke, chemicals and air pollutants. But many people don’t know they have it, according to Danica Patrick, the race car driver who has become a spokeswoman for DRIVE4COPD, a campaign aiming to raise awareness of the diseases. Ahead of her trip to Baltimore for the IndyCar Grand Prix races this weekend, she talked about her public health work.

Question: Why did you get involved with DRIVE4COPD?

Answer: My grandma had emphysema and she really suffered and died far too young at 61 years old. When the awareness campaign came along, it was a chance to turn a negative into a positive.

Q: Can you talk about COPD, how widespread it is and what people need to know?

A: Awareness is the goal. COPD kills more people than breast cancer and diabetes combined. Twenty four million people have it and only half know. There’s a definite need for awareness of the diseases and symptoms. At the DRIVE4COPD website, DRIVE4COPD.com, they make it pretty easy with five questions that give you an idea if you’re at risk.

Q: Air quality is important for people with these breathing problems, do you think about what we can do as a society to improve the situation?

A: Coming from a race car driver that’s tough. There are simple things, like not exercising or going out on busy streets, staying inside when there is smog. But many people don’t have this luxury. They can’t avoid going outside or moving from cities to less polluted areas.

Q: IndyCar has switched to 100 ethanol in its cars and taken other steps to be more green, right?

A: It’s what the world is doing — going green. We’re not only becoming more aware of our health, but we’re taking care of the world, trying to make it a little bit better too. Putting ethanol in the cars is one step.

Q: You’re switching from IndyCar to NASCAR. What’s NASCAR doing?

A: They’re taking steps too. They run on 85 percent ethanol now.

Q: What do we in Baltimore have to look forward to with the Grand Prix and urban car racing?

A: It’s something I’m very used to. We race on a lot of streets of a lot of cities. You don’t have to travel, you’re right there. It’s a great atmosphere. There’s a lot of energy. Any time IndyCar goes into a new venue, there tends to be a great turnout. There’s lots of entertainment. We do apologize for the road closings.

Continue reading "Danica Patrick raises awareness of COPD ahead of Baltimore Grand Prix race" »

Posted by Kim Walker at 4:38 PM | Permalink | Comments (0)
Categories: General Health
        

Health officials say they are seeing an uptick in people being treated for carbon monoxide poisoning after Hurricane Irene.

Massive power outages have caused people to use generators to provide electricity to their homes. But these generators aren't alway being used properly.

There were 13 reported cases of possible carbon monoxide poisoning from August 28 through 30, according to the Maryland Department of Health and Mental Hygiene. An Ellicott City man died this week from carbon monoxide poisoning after the use of a generator.

Health officials are reminding people to place generators outside and away from open windows, carports, garages, and other enclosed spaces. It is also important to have a working carbon monoxide detector.

Carbon monoxide gas is made when fuels burn improperly or the exhaust is not vented outdoors, according to state health officials.

Symptoms of carbon monoxide poisoning are similar to the flu and include:

• Headache

• Fatigue

• Shortness of breath

• Nausea

• Dizziness

Here are tips for using a generator:

• Never use a generator in garages, basements, crawl spaces and other enclosed or partially-enclosed areas.

• Follow the manufacturer’s instructions for your generator.

• Install battery-operated or plug-in CO alarms with battery backup in your home.

• For maximum effectiveness during sleeping hours, CO alarms should be placed close to sleeping areas. Additional alarms on every level and in every bedroom of a home can provide extra protection.

• If your CO alarm goes off or you begin to feel sick, dizzy or weak while using a generator immediately get outside and call 911.

Posted by Andrea Walker at 11:31 AM | Permalink | Comments (0)
Categories: General Health
        

Looks like marriage may be good for your lifespan.

Single people die a decade earlier than their married friends, according to a new study published in the American Journal of Epidemiology.

Yet another reason for singles to feel the pressure to tie the knot. Check out this story about the issue on MSNBC.com.

Here are excerpts from the article:

The researchers found the risk of death was 32 percent higher across a lifetime for single men compared to married men. Single women face a 23 percent higher mortality risk, compared to married women.

In real numbers, “under the worse-case scenario,” single men could die about eight to 17 years earlier than their married male friends, said the study's lead researcher David Roelfs, assistant professor of sociology at the University of Louisville, Ky., citing that nearly all of the data was gleaned from studies conducted in the last 60 years.

Women don't fare much better. They could die seven to 15 years earlier than their married female counterparts. The researchers speculate their longevity findings could be tied to poorer health benefits, meager public assistance and less income for singles. And some singles may not have the same social support that married couples have “by default,” Roelfs said.

Posted by Andrea Walker at 11:59 AM | Permalink | Comments (7)
Categories: General Health
        

State health officials said Thursday they have identified the first case of West Nile virus this year.

It was contracted by an adult in the Baltimore metropolitan area, according to the Department of Health and Mental Hygiene.

Most people who come in contact with the disease show no symptoms, but in rare instances it can cause death.

The number of humans with the disease in Maryland has varied widely over the past several years. Seventy-three human cases were reported in the peak year of 2003. Only one confirmed case was identified in 2009 and last year 23 people contracted the disease.

The disease has also recently been detected in mosquitoes and birds in Maryland. Three pools of mosquitoes collected in Montgomery County by the U.S. Department of Defense tested positive for West Nile. A mosquito pool is a group of mosquitoes collected at sites across the state.

Three sick birds from a Montgomery County wildlife center also recently tested positive for the disease.

Symptoms of West Nile include fever, headache, body aches, skin rash and swollen lymph glands. Symptoms generally appear three to 15 days after a mosquito bite.

Less than one percent of persons exposed to the virus will develop more severe infections with symptoms such as headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness and paralysis.

People over age 50 and those who are immunocompromised have the highest risk of developing more severe disease.

State officials said people can take precautions to prevent the disease including, avoiding areas of high mosquito infestation and limiting outdoor activities at dawn and dusk when mosquitoes are most active. Also, wear long pants, long-sleeved shirts and hats when concerned about mosquito exposure and use mosquito repellants according to directions.

Residents should also monitor their own yards and gardens for standing water that can serve as a breeding ground for mosquitoes. As little as one-half inch of water in a discarded can or container will support dozens of mosquitoes.

Sick or injured birds can be reported to local wildlife rehabilitators.

Posted by Andrea Walker at 11:08 AM | Permalink | Comments (1)
Categories: General Health
        

Today is the first official World Health Organization World Hepatitis Day.

It was created to increase awareness about the viral infections and the diseases they cause – and call for more prevention, screening and control, according to WHO.

The viruses – A, B, C, D and E – cause inflammation of the liver, and in some cases can lead to cirrhosis and liver cancer. Hundreds of millions of people are living with the viral infections around the world and about a million people a year die from them, according to the U.S. Centers for Disease Control and Prevention.

The A and E viruses are spread by water and food contaminated with feces, while B, D and C are spread by blood and body fluids, through childbirth, injecting drugs or transfusions.

The federal and international agencies say there have been successes in treating hepatitis – notably a vaccine for hepatitis B offered to children in 178 countries. The vaccine is estimated to prevents 700,000 deaths a generation. The vaccine also eliminates the risk of contracting hepatitis D. And there’s a newer vaccine for hepatitis A and one is in development for E.

Tests for the viruses also make the blood supply safer. And access to screening and treatment is better for those who are infected, the groups say.

Now efforts are being made to make people aware that they may have hepatitis so they can be screened and treated. And in poorer countries, the focus in on getting people clean water and safe food. Perhaps by next World Hepatitis Day there will be some more progress.

Posted by Meredith Cohn at 2:50 PM | Permalink | Comments (0)
Categories: General Health
        

Join us noon July 27 at baltimoresun.com/healthchat for a live chat on non-surgical treatments for sciatica with Dr. Steven Cohen of Johns Hopkins. Injury to the sciatic nerve will cause leg pain, weakness, numbness, or tingling, according to the U.S. National Library of Medicine. Treatments vary, depending on the underlying cause, but can include over-the-counter pain killers and physical therapy.

Cohen is an associate professor and researcher with Hopkins School of Medicine and professor of anesthesiology at Uniformed Services University of the Health Sciences and director of Pain Research at Walter Reed Army Medical Center.

Can't make the chat? Come back later to read the transcript.

Posted by Kim Walker at 6:45 AM | Permalink | Comments (0)
Categories: General Health
        

Jennifer Aniston told Jon Stewart last night that her dentist plays the guitar for her while she gets treatment. While I suspect it's probably because she's a major movie star (plus "That's Hollywood" as Aniston put it), I wonder if there are local doctors or dentists who have special -- even quirky -- methods to either put a patient at ease or just make a routine visit stand out. Some gynecologists have funny posters on their ceilings. And I'm sure pediatricians have many tricks up their sleeves.

Have an interesting story about your doctor? Share it in the comments.

Getty Images photo of Jennifer Aniston

Posted by Kim Walker at 12:54 PM | Permalink | Comments (5)
Categories: General Health
        

The management of postoperative pain has been in the news recently. A study authored by Hopkins Drs. Christopher Wu and Srinivasa Raja found that pain management for patients after surgery remains inadequate. (Read more from ABC News.)

If you have a question about dealing with pain after surgery, join our live chat on Wednesday with Hopkins pain specialist Dr. Paul Christo.

Christo is director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine. He also has a radio talk show Saturday nights on WBAL.

Can't make the chat? Email questions in advance to healthcalendar@baltsun.com, and come back here to read the transcript.

Comments are for informational purposes only and do not represent or substitute as medical advice. Patients are advised to consult their own physician or pharmacist for advice, diagnosis and treatment.

(Getty Images file photo)

Posted by Kim Walker at 6:30 AM | Permalink | Comments (0)
Categories: General Health
        

Lt. Gov. Anthony Brown announced today a state group to look at curbing racial health disparities.

It is no secret that disparities exist. Minorities suffer from more chronic diseases then whites. Brown said the group wasn't there to rehash statistics we all already know.

Instead, they hope to come up with subanstive policy changes that will address the problem. Financial incentives to hospitals, doctors and others in the industry is one thing the group will look at.

E. Albert Reece, Dean of the University of Maryland School of Medicine, will head the group.

Read more here.

Posted by Andrea Walker at 7:14 PM | Permalink | Comments (0)
Categories: General Health
        

Do you subscribe to our weekly health newsletter? This week, we launched our new version, which has a new look and comes out on Mondays instead of Thursdays. Check it out here.

If you don't subscribe yet, our newsletter offers the top local and national health news and trends every Monday. In addition you'll find links to upcoming web chats, local events and our health blogs. To subscribe, click here.

Posted by Kim Walker at 2:03 PM | Permalink | Comments (0)
Categories: General Health
        

The steamy temperatures can be dangerous for everyone, but even more so for the elderly.

Exposure to extreme heat results in hundreds of deaths each year and those older than age 65 are most vulnerable. Six seniors died heat-related deaths in Maryland last year.

Doctors at Johns Hopkins say there are precautions seniors should take when it's extremely hot outside.

“The elderly can’t feel the heat or cool down as easily and they are less likely to feel thirsty even when they are almost dehydrated,” Alicia I. Arbaje, assistant professor and associate director of transitional care research in the Division of Geriatric Medicine and Gerontology at the Johns Hopkins University School of Medicine, said in a statement. “The chronic medical problems that most seniors face, in addition to the medicines used to treat them, can make it more difficult to be in the heat.” Arbaje’s advises the following safety tips for seniors:

• “Staying hydrated is key,” she explains, but “water is not enough when you are sweating. Replenish your body with sports drinks, because they contain the salt that your body is losing in sweat.”

• Avoid demanding or exhausting activities in the heat. But, if you must be outside, dress in lightweight, light-colored clothing.

• Dizziness, confusion, weakness, headache, muscle cramps, nausea/vomiting, a fast pulse, sweating, or passing out are warning signs that could signal dehydration or heat stroke.

• “Anyone who is taking medications should speak to their doctor if they are spending a great deal of time in the heat. The doctor may suggest lowering the dose or even advise you to stop taking the medicine until you can get out of the heat,” Arbaje says.

Along with these tips, the CDC suggests that “air-conditioning is the number one protective factor against heat-related illness and death.” If an individual does not have access to air conditioning, they should spend their time at public facilities, such as the library, mall, or senior center that is air-conditioned.

Posted by Andrea Walker at 1:08 PM | Permalink | Comments (1)
Categories: General Health
        

More than 1,000 Maryland doctors have signed up to adopt electronic medical records, state officials said today.

The primary care physicians are using records through a state network called the Chesapeake Regional Information System for our Patients (CRISP). They will receive state and federal incentives for using the computerized records.

Hundreds of other doctors are also using electronic records but may not have signed onto the state exchange.

Lt. Governor Anthony Brown made the announcement during a visit to the Charlestown Retirement Community in Cantonsville.

 Governor Martin O’Malley and Brown have a goal to create a a health information exchange by the end of 2012 and encourage widespread use of electronic medical records. The records are also being pushed under federal healthcare reform.

Maryland has received nearly $27 million in federal funds to assist in the expansion of electronic records.

Advocates of the records say that patients will get better care because phyisicans have better access to the drug and medical history of the patients. They also say it will cut down costs. There are some concerns over privcay in using the digitized systems.

 CRISP was formed as a not-for-profit collaborative in 2009 by Erickson Living, Johns Hopkins Medicine, MedStar Health, and the University of Maryland. CRISP received a federal grant of $6.4 million in 2010 to help electronically connect at least 1,000 healthcare providers.

Posted by Andrea Walker at 3:28 PM | Permalink | Comments (0)
Categories: General Health
        

Wonder what geniuses think about?

Johns Hopkins is launching a free speaker series today with seven recipients of MacArthur “genius” fellowships from Maryland, Virginia and Washington.

The first annual event, open to the public, will center on communication, specifically how the geniuses get peers, policymakers and the public to pay attention to their work and ideas. Organizers at Hopkins say they aim to inspire lively exchange and creative collaboration.

No reservations or tickets are required for the panel discussion, question-and-answer session and reception this evening from 4 p.m.-6 p.m. at the Anne and Mike Armstrong Medical Education Building of the Johns Hopkins University School of Medicine, 1600 McElderry St. in Baltimore. Parking is available in the McElderry Street Garage. See a map.

On the panel, chaired by Atul Nakhasi, a first-year Johns Hopkins medical student, and moderated by Joann Rodgers, veteran science journalist and senior communications advisor at the Johns Hopkins Berman Institute of Bioethics:

+Marin Alsop, conductor, Baltimore Symphony Orchestra (MacArthur Fellow ’05)
+Dr. Lisa Cooper, internist and epidemiologist, the Johns Hopkins University (MacArthur Fellow ’07)
+Ruth DeFries, environmental geographer, University of Maryland (MacArthur Fellow ‘07)
+Janine Jagger, epidemiologist, University of Virginia (MacArthur Fellow ’02)
+Liz Lerman, choreographer and founder, Dance Exchange (MacArthur Fellow ’02)
+Dr. Peter Pronovost, patient safety expert, the Johns Hopkins University (MacArthur Fellow ’08)
+Adam Reiss, astrophysicist, the Johns Hopkins University (MacArthur Fellow ’08)

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

Join us June 1 at noon EST at baltimoresun.com/healthchat for a live chat on hand pain issues with Dr. Paul Christo a pain specialist at Johns Hopkins. Many people suffer from arthritis, carpal tunnel syndrome, tendinitis of the wrist, ganglion cysts and other conditions. Recently, research out of The University College London said crossing your arms will confuse the brain and relieve pain. If you have questions on these or other topics, then mark your calendar.

Christo is director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine. He also has a radio talk show Saturday nights on WBAL.

Can't make the chat? Email questions in advance to healthcalendar@baltsun.com and come back to read the transcript.

Posted by Kim Walker at 10:44 AM | Permalink | Comments (0)
Categories: General Health
        

Saint Agnes Hospital today celebrated the grand opening of its new patient tower.

The 200,000-square-foot "South Tower' building is part of a $200 million renovation at the West Baltimore hospital.

Other improvements include new main entrance with a custom Mary Ann Mears sculpture in the rotunda, five new state-of-the-art operating rooms and 120 private rooms.

The new tower will be open to patients May 22.

Key features of the new tower are:

• Private rooms designed by physicians and nurses to improve patient safety, privacy and staff efficiency

• An expansive new main lobby with floor to ceiling glass windows and a circular drive with a porte-cochere

• Five additional operating rooms

• A seven-story lighted cross, the largest of its kind in Maryland

• Three family waiting areas per floor

• Decentralized nurses stations, increasing efficiency and access

Saint Agnes also has plans for a new 60,000-square-foot medical office building and expanded Cancer Institute, a new parking garage and completion of the Hackerman-Patz House, which broke ground in March and is expected to be completed next spring.

Posted by Andrea Walker at 4:40 PM | Permalink | Comments (0)
Categories: General Health
        

Join us here May 18 at noon for a live chat on thoracic outlet syndrome with Dr. Paul Christo of Johns Hopkins. The condition, which affects approximately 8 percent of the population, involves compression of nerves between the base of the neck and armpit, causing neck pain, headache, numbness and weakness down the arm. Meredith Cohn did an article last year about using botox to treat the condition. Christo is director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine. He also has a radio talk show Saturday nights on WBAL.

Can't make the chat? Send a question in advance to healthcalendar@baltsun.com and come back to read the transcript. We have an archive of all of our pain live chats at baltimoresun.com/healthchat.

Baltimore Sun file photo

Posted by Kim Walker at 6:30 AM | Permalink | Comments (0)
Categories: General Health
        

The University of Maryland Baltimore and the University of Maryland Medical Center unveiled a new logo today that they hope shows a more visually unified front.

The two institutions have always been intertwined - sharing faculty and staff - but officials said there was a perception in the public that they weren't related. The new logo is part of an effort to rebrand the relationship between the two.

The logo is a modernized version of Davidge Hall, the historic building at Lombard and Greene Streets that was the institution's founding medical school building. It is also the oldest medical facility in the country continuously used for medical education.

Banners featuring the new logo were rolled down the front of Davidge Hall today for display. The new logo was a year in the making and replaces dozens of logos used by the individual schools within the university as well as by the medical system.

The medical system is a tax-exempt entity that is legally separate from the university. But the two share in many other ways.

UMB students and faculty conduct research and provide clinical care at UMMC facilities. UMMC doctors teach at the university. The two campuses are also physically connected through various buildings.

Posted by Andrea Walker at 2:42 PM | Permalink | Comments (0)
Categories: General Health
        

Calls to 911 can drive up medical costs, but a pilot program in Baltimore that targets the people who call the most seems to help save some money.

The program, Operation Care, assigned a case worker to the people who called 911 most often.

These callers often didn't have medical insurance and access to care or weren't able to navigate the complicated medical system. They often had chronic conditions or mental and substance abuse issues.

Caseworkers assigned to 10 callers under the pilot, created by non-profit Baltimore Healthcare Acess, put them in touch with primary care physicians and support programs and taught them only to dial 911 in case of a true emergency.They were referred to programs such as Meals on Wheels and support groups for alcoholism.

After the counseling, calls by these individuals were cut by nearly half. In the three months the program was implemented, it saved $14,300, with more than $6,300 in savings at the fire department.

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

If you have an elderly or disabled person that needs long term care, you might not be happy about the results of a new survey.

The cost of assisted living facilities in the state is higher than the natural average and has risen in cost in recent years, according to a survey done by Genworth.

The median annual cost of a long term care assisted living facility was $39,135 nationally, an increase of 6 percent over the past six years. The cost is $39,600 in Maryland, an increase of 6.2 percent.

The median hourly rate for care at home was $20 an hour in Maryland, a 3.5 percent increase over the past six years. Nationally, it cost $19 an hour, a 1.4 percent increase.

The median cost of a private nursing home room in Maryland has risen 4.1 percent annually in the past six years to $89,972 per year. The national rate is $77,745, an increase of 4.4 percent.

Genworth offers these tips to help contain costs:

Fee waiver - Assisted living facilities may charge a one-time fee prior to move-in. They may waiver fees or offer other financial incentives such as free rent if there are many vacant units in the market. Don't be afraid to ask for a deal.

Room upgrade - Try for a more expensive room at a lower price if vacancies are high.

Special rates- See if there are discount rates for moving in at a certain time of the month.

Shop Around - Agencies may lower their rate if they know you are looking elsewhere.

Posted by Andrea Walker at 3:47 PM | Permalink | Comments (1)
Categories: General Health
        

Many patients experiencing chronic pain are concerned about the addictive nature of their medications. If you have questions or concerns, join us at noon ET for a live chat on the subject with Johns Hopkins pain specialist Dr. Paul Christo.

Can’t make the chat? Send questions in advance to healthcalendar@baltsun.com and come back to baltimoresun.com/healthchat to read the transcript.

Posted by Kim Walker at 10:12 AM | Permalink | Comments (0)
Categories: General Health
        

State health officials are planning on collecting some core health information to assess the state of the state and what can be done to improve it.

The officials collect all kind of health statistics now, but much of it gets lost “amid the sea of data,” said Dr. Josh Sharfstein, secretary of the state Department of Health and Mental Hygiene.

He wanted to pick the most important measures and then work with the city and counties to come up with plans on how to improve public health. Many of the localities produce their own reports and plans, but Sharfstein said a statewide report can give them some context.

Before the state moves ahead with a final plan, it is seeking public input to make sure officials are looking at the right information.

Categories include reproductive health and birth outcomes, infectious disease control, safe indoor and community environments, chronic disease control and health care access.

No new resources or collections will need to be made – the state and federal government already collect all the data that the state is looking for.

Sharfstein said the reports are encouraged in the federal health care reform law and Maryland will collect new data and produce a report every three years or so. He doesn’t remember another such report in recent years.

To review the draft report or comment through May 12 on this Maryland State Health Improvement Plan (SHIP) 2011-2014, go to http://dhmh.maryland.gov/ship/. A final report including strategies is expected in July. Local implementation plans are expected by December.

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

Donate Life Maryland is using the month of April to try and encourage more people to register as organ, eye and tissue donors.

They are reminding people that they can sign up at Motor Vehicle Assocation offices. A heart will be placed on their license showing they are a donor.

People can also sign up online through the organization and get a registration card.

Organs that can be donated include: heart, liver, kidneys, lungs, pancreas and small intestine.

Tissue that can be donated include: corneas, eyes, skin, bone, tendons, ligaments, vessels and heart valves.

More than two million Maryland residents are registered as donors, or 48 percent of those eligible.

About 4,000 people are waiting for donated organs in the Maryland/Washington area.

To read a story about efforts to overtun a ban transplanting HIV-infected organs into others who are already infected, click here.

Posted by Andrea Walker at 12:00 PM | Permalink | Comments (1)
Categories: General Health
        

Don't judge a person by his or her appearance.

Especially, if you're intimate with them.

A new study on herpes found that your sexual partner may be free of symptoms such as genital lesions, but that doesn't mean he or she is not carrying the sexually transmitted disease.

And yes, they can pass it on to you even if it doesn't "look" like they have it, according to the study to be published in tomorrow's Journal of the American Medical Association. About 16 percent of adults in the United States have the herpes simplex type 2 virus, but only 10 to 25 percent with herpes show symptoms, the study said.

Scientists found that viral shedding on the genital skin that can't necessarily be seen could cause the disease to be passed on.

Many people are engaging in sexual activity not knowing they are  at risk of passing the virus on to their partners.

Herpes is one of the most common sexually transmitted diseases in the world with an estimated 536 million people infected with it.

The researchers said condom use, drug therapy and disclosure of the disease to partners can help curb the spread of herpes.

But these methods have had limited impact because so many people don't know they have herpes.

So get tested and make sure your partner does too.

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

The warmer weather can be difficult for knee pain sufferers who want to go outside and get active. If you are experiencing knee pain and have questions about treatment, check out our live chat today at noon with a pain specialist from Johns Hopkins.

Dr. Paul Christo, director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine, will be taking reader questions from noon-1 p.m. (ET) Not sure if you can make the chat? Send questions in advance to healthcalendar@baltsun.com and come back to the chat to read the transcript.

Learn about other pain topics in Pain: Time to Take Charge.

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

Johns Hopkins Health System announced this morning it has completed its merger with All Children's Hospital in St. Petersburg Fla.

It is the first time Hopkins has joined with a hospital outside of the Washington Baltimore area.

Industry experts have said the non-cash transaction would bolster the prestigious Baltimore health system's visibility in the highly specialized pediatric field.

It could also give Hopkins a new revenue source as it and other healthcare providers try to contain rising health costs. Hospital officials have said they would combine resources to apply for medical research funding and build on each institution's strengths.

Hopkins already operates a children's division, but the merger is expected to further enhance a well-established pediatric branch.

Plans for the merger were first announced in July.

All Children's Hospital retains its name under the deal. Donations made to the hospital's foundation remain for the benefit of All Children's and leadership and the day-to-day operations of the 259-bed freestanding pediatric hospital and outreach facilities in eight west Florida counties are not expected to change.

All Children's will also maintain its voluntary medical staff and physician organizations, including the University of South Florida physicians who are practicing at the hospital. The university and All Children's plan to continue the residency program with the university through 2014. They are discussing whether to extend the program beyond that.

Local community leaders will continue to have majority voting rights on the board of All Children's. The chairman of the board of All Children's Hospital will become a member of the board of Johns Hopkins Medicine. Board members at All Children's Hospital will also have the opportunities to serve on various Hopkins boards.

All Children's will operate under the direction of the Hopkins health system governance structure much like its other hospitals, including The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Suburban Hospital and Sibley Memorial Hospital.

Posted by Andrea Walker at 11:24 AM | Permalink | Comments (0)
Categories: General Health
        

Our next live chat will be today at noon about nerve pain. Dr. Steven Cohen of Johns Hopkins will be taking question about nerve pain, including neuralgia, nerve damage, sciatica, diabetic neuropathy and other neuropathic pain.

Cohen is an associate professor and researcher with Hopkins School of Medicine and professor of anesthesiology at Uniformed Services University of the Health Sciences and director of Pain Research at Walter Reed Army Medical Center. Ask question about treatments and managing nerve pain.

Click here for the chat. If you can't make the chat, send questions to healthcalendar@baltsun.com and read the transcript later.

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

Baltimore trial lawyer Francis B. Burch Jr. has been elected chairman of the board of Johns Hopkins Medicine.

Burch, who holds several executive roles at DLA Piper law firm in Baltimore, will take on his new position July 1.

Burch will  succeed C. Michael Armstrong at Hopkins, who has been chairman since 2005.

Burch has a long relationship with Hopkins Medicine, having served as a member of its board of trustees since its inception in 1996. He also has ties to The Johns Hopkins University, where he was a trustee and also served on the board of overseers of its Carey Business School. He recently served on the search committee that selected the current university president, Ronald J. Daniels.

At Piper, Burch has helped expand the company from a regional law firm with 250 employees to one with more than 3,500 lawyesr working in 71 offices in 29 countries. He is chairman of Piper's global board and co-chairman of its U.S. board.

“We are extremely honored during these times of tremendous growth and change in our health care system, both locally and abroad, to have the wisdom and guidance of such an experienced global leader,” Edward D. Miller, dean of the medical faculty of the Johns Hopkins University School of Medicine and CEO of Johns Hopkins Medicine, said in a statement.

Miller said Burch "highly respects and understands our commitment to patient care, education and research, and holds a deep understanding of our history in Baltimore and the United States."

Posted by Andrea Walker at 11:21 AM | Permalink | Comments (0)
Categories: General Health
        

"American Idol" contestant Casey Abrams missed the show last night because he was in the hospital. Several media outlets are reporting he is suffering from ulcerative colitis, an inflammatory bowel disease.

Last September, we did an article on how the disease is striking more children. Read about it here.

The story said "the number of children afflicted by colitis and another inflammatory bowel disease, Crohn's disease, has increased 50 percent in the past decade, according to the Crohn's & Colitis Foundation of America. About 1.5 million Americans suffer from colitis and Crohn's, about 10 percent of them under the age of 18."

Abrams, age 20, is by no means a child, but if you're curious about what people go through with the disease, the article will give you a good idea.

(Photo by Reuters)

Posted by Kim Walker at 2:55 PM | Permalink | Comments (0)
Categories: General Health
        

Our next live chat on pain issues will be at noon EST today on the common pains that senior citizens experience, including (but not limited to) arthritis, spinal fractures, low back pain and pain after surgery. Dr. Paul Christo, director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine, returns to answer reader questions on problems and treatments. The link for the chat is here.

Can't make the live chat? Send a question in advance to healthcalendar@baltsun.com and come back to this page later to read the transcript.

Posted by Kim Walker at 6:15 AM | Permalink | Comments (0)
Categories: General Health
        

At noon Feb. 23  Dr. Paul Christo of Johns Hopkins will participate in a live chat on fibromyalgia here. The disorder, which causes muscle pain throughout the body and fatigue, affects 5 million Americans 18 or older, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. We'll talk about the latest and common treatments such as medications and lifestyle changes.

Christo, director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine, will take reader questions on the nature of the disease and the latest treatments. Can't make the chat? Send us questions in advance to healthcalendar@baltsun.com and come back to baltimoresun.com/healthchat at a later time to read the transcript.

Posted by Kim Walker at 9:52 AM | Permalink | Comments (1)
Categories: General Health
        

About one in four Americans don't spend any of their free time being active, and people who live in Appalachia and the South are least likely to get out and move, according to new estimates from the Centers for Disease Control and Prevention.

The CDC data provides county-level stats on physical activity and levels of diabetes and obesity nationwide. Physical activity was defined as doing any form of exercise outside of one's job, such as walking,  running or even gardening.

Counties in Maryland varied widely. Somerset County had the highest percentage of adults who are physically inactive -- 31 percent. Baltimore wasn't far behind with 30 percent of adults being physically inactive. Meanwhile counties with the lowest percentage were Montgomery (18 percent) Howard (19 percent) and Anne Arundel (21 percent).

Not surprisingly, the areas where people did the least activity were also those where rates of diabetes and obesity were high. Even modest exercise -- taking a brisk walk every day for 20 minutes -- can help people with diabetes improve their health, the CDC suggests. 

The agency hopes community groups and policy makers use the data to promote communities with sidewalks and access to parks and recreation areas that encourage people to get out and exercise.

So, have you left your desk today?

Posted by Kelly Brewington at 7:07 AM | Permalink | Comments (6)
Categories: General Health
        

Join us at baltimoresun.com/healthchat noon Feb. 9 with Dr. Paul Christo of Johns Hopkins to discuss Complex Regional Pain Syndrome (also known as Reflex Sympathetic Dystrophy). The chronic pain condition is characterized by intense or burning pain, usually in the arms, hands, legs or feet. Doctors do not know the cause, but it can be related to an injury or even surgery.

Christo, director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine, will take reader questions on the nature of the disease and the latest treatments. Can't make the chat? Email questions in advance to healtcalendar@baltsun.com and visit baltimoresun.com/healthchat to read the transcript.

(Chicago Tribune file photo)

Posted by Kim Walker at 6:45 AM | Permalink | Comments (1)
Categories: General Health
        

Sen. Mike Miller has already made it loud and clear that no increase in alcohol taxes will pass under his watch.

But that is not stopping proponents of the dime a drink tax increase to push ahead with their fight.

Maryland Citizens’ Health Initiative held a press conference this morning with a Baltimore wine store owner who said he supports the tax.

David Wells, of The Wine Source in Hampden, said he is in favor of Senate Bill 168 sponsored by Senator Verna Jones-Rodwell and House Bill 121 sponsored by Delegate James Hubbard.

“I will sleep better at night,” Mr. Wells, said in a statement. “knowing that this dime a drink alcohol tax increase is reducing underage drinking and alcohol abuse.

Supporters of the tax want the $215 million it will raise to be used for health care, to fund programs for people with developmental disabilities and mental health needs, and for drug and alcohol prevention and treatment.

"It is time for our industry to do its fair share to reduce the deaths and societal problems caused by the misuse of our product,” Wells said in the statement.

Take our poll and tell us whether you think an alcohol tax is needed.

Posted by Andrea Walker at 11:29 AM | Permalink | Comments (5)
Categories: General Health
        

I came across a post the other day on the excellent Roni’s Weigh  blog that asked readers “What are your UNhealthy Habits?” It was interesting to see that a lot of readers picked the same things, and that many of the habits centered on a person’s bedtime routine, such as not flossing at night, not removing makeup and/or washing your face.

I shouldn’t be surprised, though, given that I’m guilty of the same things. I’ve tried to trick myself into doing these things more consistently such as brushing/flossing right after dinner or putting face moisturizer on the nightstand, but after long days at work, good intentions go by the wayside.

So, I was curious what doctors thought about nighttime habits. Dr. Richard Lamson, a family medicine physician with Greater Baltimore Medical Center, offered his tips.

Continue reading "A healthy bedtime routine" »

Posted by Kim Walker at 6:30 AM | Permalink | Comments (0)
Categories: General Health
        

A growing number of Maryland smokers are seeking help to quit through the state health department's tobacco Quitline, which offers counseling, support services and coaching sessions over the phone.

The free, confidential service received 1,429 calls as of January 25, up from 900 calls last November, according to the Maryland Department of Health and Mental Hygiene. Ads for the service feature Baltimore native and actress Nicole Ari Parker, who lost her grandmother to smoking-related cancer.

The Maryland Tobacco Quitline (1-800-QUIT-NOW) provides coaches who work with callers over four telephone sessions to devise a plan to help them break the addiction. Coaches follow up with printed materials to help you stay on track and while supplies last, callers can get free nicotine replacement therapy such as the patch or gum, mailed to their homes. The Quitline, which launched in June 2006 and has had about 64,000 calls, is manned 8 a.m. to 3 a.m. seven days a week.

For more information, check out www.smokingstopshere.com

I wonder if the spike in calls is due to folks making New Year's resolutions to quit. Have you? How are you doing so far? 

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

Still digging out from last night's nasty storm? We are too. My husband recently came in complaining that the storm dumped plenty of that wet, heavy kind of snow that makes shoveling safely extra challenging.

With that in mind, here are some good tips from the American Physical Therapy Association that came in handy during last February's Snowpocalypse.

Continue reading "How to dig out from the snow -- safely" »

Posted by Kelly Brewington at 8:43 AM | Permalink | Comments (1)
Categories: General Health
        

Nearly 26 million Americans have diabetes -- 7 million of whom don't even know it -- according to new data out today from the Centers for Disease Control and Prevention.

The new figures mark an increase from 2008, when the agency found 23.6 million Americans with diabetes, nearly 8 percent of the population. The disease, characterized by high blood sugar, puts people at risk for heart attack, stroke, high blood pressure and kidney failure. It's the seventh leading cause of death in the nation.

The CDC also found an increase for what can be a precursor to diabetes, known as prediabetes. Some 79 million adults in the U.S. have prediabetes in which blood sugar is elevated, just not to the threshold considered for a diabetes diagnosis, the CDC reports. Prediabetes increases a person's risk for not only diabetes, but also stroke and heart disease.

The findings suggest a real increase in cases as well as more people living longer with the disease. Changes in how testing is recorded could also play a role, the report stated.

Continue reading "CDC: Diabetes on the rise" »

Posted by Kelly Brewington at 2:17 PM | Permalink | Comments (1)
Categories: General Health
        

Join us noon Jan. 26 for a live chat on shingles, a viral infection that affects more than 1 million people a year. Anyone who's had the chicken pox can get the painful rash, though senior citizens are more at risk. A recent study says the vaccine for the infection reduced the incidence of shingles outbreaks by 55%.

Dr. Paul Christo, director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine, will take reader questions on how to protect yourself against shingles and how to cope with the pain. Go to baltimoresun.com/healthchat.

Can't make the chat? E-mail questions in advance to healthcalendar@baltsun.com. A transcript of the chat will be available on this page after it's finished.

(Los Angeles Times file photo)

Posted by Kim Walker at 6:30 AM | Permalink | Comments (0)
Categories: General Health
        

Life expectancy in the U.S. lags behind other prosperous nations and smoking and obesity are to blame, explains a new report from the National Research Council.

While over the last 25 years, U.S. life expectancy at age 50 has been on the rise, it's still behind such nations as Australia and Japan, despite outspending them on health care, the report explains. Concerned about the trend, the National Institute on Aging asked a global team of researchers for answers. The result is a massive report that delves into the differences and blames much of the disparities on Americans' past smoking habit and the nation's obesity epidemic.

That smoking is to blame in the states may sound odd, considering smoking bans are all the rage in the U.S. while Europe is just catching on. Well, Americans' smoking habit goes back some fifty years when smoking rates were higher here than in Europe or Japan. The consequences of that unhealthy behavior are playing out now, explains a summary of the report.

Nevertheless, the report predicts good news could be down the pike. Since major efforts to reduce smoking are underway now, life expectancy likely will improve 20 to 30 years from now. 

Rising obesity rates, however, paint a gloomier picture. Obesity alone accounts for between a fifth and a third of the shortfall in American's lifespans. And if that problem doesn't improve, it could offset the gains in life expectancy expected from people quitting smoking.

Continue reading "Smoking, obesity causes U.S. life expectancy to lag behind" »

Posted by Kelly Brewington at 3:18 PM | Permalink | Comments (0)
Categories: General Health, Medical studies
        

The state of Maryland received a grade of "F" from the American Lung Association for its efforts at stopping smoking and other uses of tobacco products.

Maryland wasn't alone though.

The American Lung Association said most states "failed miserably" at passing laws that would protect citizens from the ailments that come with tobacco use.

Maryland continues to inadequately fund tobacco use prevention and cessation programs, the lung association's Maryland chapter found. In 2011, $4.3 million was allocated for the programs, compared to $19.6 million two years ago.

The association also noted failed legislation that would have redefined the definition of cigarettes to include what they called "little cigars." Little cigars are wrapped in paper and contain tobacco, but weigh less. The lung association believes they are more likely to be bought because they resemble cigarettes. A bill regarding little cigars passed in the Senate of the General Assembly, but failed in the House.

Maryland got an "A" for its efforts at creating smokefree air, a "C" for its cigarette tax and an "F" for its cessation programs.

(photo courtesy of AFP/Getty)

Posted by Andrea Walker at 7:00 AM | Permalink | Comments (5)
Categories: General Health
        

The number of Marylanders without insurance has stayed pretty much the same for the last five years, according to a report by state health officials.

About 14.5 percent, or an average of 720,000, non-elderly Marylanders were uninsured from 2008 to 2009, according to the Maryland Healthcare Commission. Like most other years, that is below the national average of 18 percent. Maryland has a higher rate of employment-based coverage than the rest of the country, which contributes to the lower number of uninsured, state officials said.

Young people and those who dropped out of school are more likely to be uninsured, according to the report. For instance, 26 percent of people age 16 to 19 didn't have insurance and 42 percent of people in families where the adults didn't have a high school diploma also didn't have insurance.

Low-income families were also less likely to have insurance coverage. People living at or below 200 percent of the poverty line accounted for 48 percent of Maryland's uninsured, but are just 23 percent of the nonelderly population.

Hispanics make up just 9 percent of the nonelderly population, but 24 percent of the uninsured.

The report also indicated that small businessed may have a hard time providing insurance for their employees. Adults who work for firms with fewer than 100 workers make up 38 percent of all workers, but 62 percent of uninsured adult workers.

Posted by Andrea Walker at 5:35 PM | Permalink | Comments (1)
Categories: General Health
        

Maryland scored an "A" from the Center for Science in the Public Interest in a nationwide ranking of states' efforts to detect, investigate and report food-borne illnesses.

The report, All Over the Map, offers a 10-year review of food safety measures in the states based on data gleaned from the Centers for Disease Control and Prevention. Maryland was one of seven states that received top marks for its investigating and reporting systems. States that scored As reported eight and nine outbreaks per million people each year, the report found.

The more food-borne outbreaks states reported the higher their grade. Huh? You ask? Well, more reporting means more attention to safety, according to the folks at CSPI.

 “States that aggressively investigate outbreaks and report them to CDC can help nail down the foods that are responsible for making people sick,” said CSPI food safety director Caroline Smith DeWaal in a statement.  “But when states aren’t detecting outbreaks, interviewing victims, identifying suspect food sources, or connecting with federal officials, outbreaks can grow larger and more frequent, putting more people at risk.”

In Maryland, the health department examines outbreaks through its Infectious Disease and Environmental Health Administration, the Laboratories Administration and local health departments. The system helps identify threats, evaluate strategies to evaluate and prevent outbreaks, according to a statement by the Department of Health and Mental Hygiene. 

Posted by Kelly Brewington at 11:15 AM | Permalink | Comments (0)
Categories: General Health
        

The CDC released today a first of its kind analysis of racial disparities in health with the hope of drawing attention to some persistent gaps and shedding light on unexpected ones.

While race was the primary focus of the report, it also delved into differences in health outcomes by income, gender and geography. The report is huge and has plenty of interesting -- and disturbing -- findings. Among the biggest disparities:

     + Black babies are 1.5 to 3 times more likely to die than infants born to women of other races

     + Heart disease and stroke, the nation's leading causes of death, account for the largest proportion of inequality in life expectancy between whites and blacks, despite the existence of low-cost treatment.

     + Men of all races are nearly four times more likely to commit suicide than women. American Indians and whites have nearly twice the rate of suicide as that of blacks, Asians and Hispanics.

     + Prescription drugs kill more people than illegal drugs, a reversal from 15 to 20 years ago. Drug deaths increased from 2003 to 2007 among men and women of all races except Hispanics. Whites have the highest rates of drug-related deaths.

Many of the national statistics are mirrored here in Baltimore, where officials have been trying to combat similar disparities, notably between whites and blacks and rich and poor. This afternoon, in fact, Baltimore Health Commissioner Dr. Oxiris Barbot is giving a presentation to the city council on strategies to do so.

“Access to healthy foods, healthy housing, healthcare, safe neighborhoods, education and employment opportunities, and transportation – often collectively referred to as social determinants of health – play as important a role in keeping us healthy as they do in making us sick,” Barbot said in a statement. “Eliminating health disparities and achieving health equity in Baltimore City will only be possible through bringing together multiple public, private and community partners to address these issues collaboratively.”

Continue reading "CDC report sheds light on racial health disparities" »

Posted by Kelly Brewington at 3:03 PM | Permalink | Comments (0)
Categories: General Health
        

According to the Mayo Clinic, 1 of out 3 people undergoing cancer treatment experiences some level of pain. If you are one of those patients or know someone who is, visit baltimoresun.com/healthchat at noon Wednesday for our latest health live chat. Dr. Paul Christo, director, Multidisciplinary Pain Fellowship Training Program, Johns Hopkins University School of Medicine, will be taking reader questions.

Can't make it? A transcript of the chat will be available at the same link after the session ends. Send questions for consideration in advance to healthcalendar@baltsun.com.

Posted by Kim Walker at 9:32 AM | Permalink | Comments (0)
Categories: General Health
        

It’s the time of year when we like to look back before we look forward.

So here’s my list of the Top 10 health stories of the year that touched us locally. Please tell me if you disagree with my picks and if I missed any big stories.

10. The beloved state dessert, the Smith Island Cake, is declared one of the nation’s least healthy foods by Health magazine.

9. Baltimore hires a food czar, Holly Freishtat, to help the city figure out how to better feed itself and cut down on obesity-related illnesses.

8. Four Loko, the caffeinated alcohol drink, is pulled off national and local store shelves.

7. Everyone is told to get a flu shot by the U.S. Centers for Disease Control and Prevention for the first time.

6. A 12-year-old article in prestigious British medical journal that scared parents everywhere by making a link between autism and the mercury in childhood immunizations is retracted.

5. Haiti’s earthquake devastates a city and mobilizes many people to offer their time, skills and money to help the needy.

4. A federal judge blocks funding for embryonic stem cell research, and scientists fear potentially life-saving discoveries are jeopardized.

3. A doctor at Johns Hopkins Hospital is shot by the distraught son of a patient, who later killed himself and his mother.

2. St. Joseph Medical Center tells heart patients their stents may not have been necessary.

1. The health care reform law passes and begins to offer protections for consumers and the promise of coverage to the uninsured.

I got pretty close to this year-in-review list, compiled by the health editor here at The Sun. She also included bed bugs, doctor shortages, Mercy Medical Center's new hospital buidling and a record grant to the University of Maryland for celiac research, among other stories.

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

Young Kayla Murphy suffers from a debilitating cell disease that her family knows will one day take her life.

I first wrote about 6-year-old Kayla, who suffers from mitochondrial disease, in August as part of a story about a shortage in hospice care for children. The story received numerous responses from readers wanting to know how Kayla is doing.

Kayla is still in a home-based children's hospice at Gilchrist Kids and her condition hasn't changed much since the summer, said her hospice social worker Betsy Schindler. The disease causes Kayla to stop breathing and heart to stop beating for several seconds at a time. The most notable difference is that the amount of time she stops breathing has grown longer.

"She's pretty much been doing the same, so I was happy about that," said Kayla's mom Dawn. Last year, the family took Kayla to Disney because they didn't expect she would live that long.

"This is a disease that is hard to give a prognosis for," Dawn Murphy said. "Last year, they told us this might be our last chance to take her to Disney. I can't believe it's already been a year."

But things have taken a turn for the worse for Dawn Murphy, who was also recently diagnosed with mitochondrial disease. She is also in Hospice in Gilchrist's adult program as some of her symptoms have started to worsen in recent weeks. 

Dawn, 36, has had several digestive issues that make it hard for her to eat, among other ailments. Her cognitive ability has slowed as well. She has lost weight and keeps getting reoccuring respiratory infections. The infections make her weak.

Schindler said it is unusual to treat a mother and daughter at the same time. While it is hard for dad and husband Stephen to cope, Schindler and Dawn Murphy said he deals with it by turning the pain into laughter and jokes and keeping the mood around his family positive.

Dawn Murphy said the family is struggling financially because of all the medical bills. She used to work full-time but now has part-time job at home doing human resources.

Gilchrist wants the Murphy family to have a good holiday and will bring gifts for them later this week as part of its adopt-a-family program. Dawn's parents will also come to spend the holidays with the family.

Despite the family's health problems, Dawn Murphy said her daughter has seemed at peace lately.

"She has been very happy the last couple of months," Dawn Murphy said.

Posted by Andrea Walker at 3:26 PM | Permalink | Comments (2)
Categories: General Health
        

Between winter cold and sinus problems and the effects of holiday stress, now is a good time to talk about headaches. And that's what we'll be doing today at noon with Dr. Paul Christo, director, Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine.

You can send your questions in advance to healthcalendar@baltsun.com or go to baltimoresun.com/healthchat at noon to participate. Can't make it? A transcript of the chat will be at the same link afterward. 

Please note: Comments made during the chat are for informational purposes only and do not represent or substitute as medical advice. Patients are advised to consult their own physician or pharmacist for advice, diagnosis and treatment.

Posted by Kim Walker at 6:15 AM | Permalink | Comments (0)
Categories: General Health
        

Maryland scored a nine out of 10 in a new report aimed at gauging the emergency health preparedness of the states.

The states in general got their highest scores in the eighth annual report, by the Trust for America’s Health and the Robert Wood Johnson Foundation. But the groups said the gains are under threat of budget cuts.

The report is called Ready or Not? Protecting the Public from Diseases, Disaster and Bioterrorism. And the groups looked at key indicators of public health preparedness. Fourteen states scored nine or higher. Three scored a 10 – Arkansas, North Dakota and Washington state.

Another 25 states and Washington, D.C. scored seven or eight. No state scored lower than five.

The groups said since the Sept. 11, 2001 and anthrax attacks, there has been a lot of progress and the nation is now better able to prevent, identify and contain disease outbreak and bioterrorism threats. And responses are quicker to natural disasters and outbreaks. The H1N1 flu pandemic is an example.

But public health staffing and budget cuts may become a problem, the groups say. Thirty three states have already made cuts.

 “There is an emergency for emergency health preparedness in the United States,” said Jeff Levi, executive director of the Trust for America’s Health, in a statement. “This year, the Great Recession is taking its toll on emergency health preparedness. Unfortunately, the recent and continued budget cuts will exacerbate the vulnerable areas in U.S. crisis response capabilities and have the potential to reverse the progress we have made over the last decade.”

Posted by Meredith Cohn at 10:00 AM | Permalink | Comments (0)
Categories: General Health, Health care professionals
        

State officials said today that 200 medical professionals have signed up to participate in Maryland's electronic medical records system.

The state hopes to eventually recruit 1,000 primary care doctors to transition to the digitized system.

Maryland and its partners have received $25 million in federal funds to help implement health information technology. It was one of the first three states in early 2009 to have its State Health IT plan approved by the U.S. Department of Health and Human Services National Coordinator for Health Information Technology.

Posted by Andrea Walker at 2:19 PM | Permalink | Comments (0)
Categories: General Health
        

The University of Maryland Medical Center has been designated by the Leapfrog Group as a Top Hospital of the Decade for patient safety and quality of care.

The medical center shares the honor with Virginia Mason Medical Center in Seattle, Washington.

The awards were presented at a ceromony Tuesday in Washington, D.C.

The Leapfrog Group, which promotes hospital safety, used a survey that measured hospital performance in a range of areas including patient care outcomes, use of best practices and patient safety initiatives.  It is the only national, public comparison of hospitals on key issues including preventing medication errors and infections and standards for performing high-risk procedures.

Leapfrog adds new, more stringent performance measures and expands the criteria for hospitals to meet its standards each year.

 “It is a tremendous honor to be one of only two hospitals in the nation recognized as a Leapfrog Top Hospital of the Decade for safety and quality. It demonstrates that our entire staff— including clinical leaders, physicians, nurses, pharmacists, therapists and support staff—is focused on providing the best patient care every day,”  Jeffrey A. Rivest, president and chief executive officer of UMMC said in a statement.

The Leapfrog Group is a coalition of public and private purchasers of employee health coverage formed a decade ago to work for improvements (or “leaps”) in health care safety, quality and affordability. Initially organized by the Business Roundtable, it is now an independent advocacy group working with a broad range of partners, including hospitals and insurers.

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

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)

Posted by Kim Walker at 1:30 PM | Permalink | Comments (0)
Categories: General Health
        

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.

Posted by Andrea Walker at 11:08 AM | Permalink | Comments (0)
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

Posted by Andrea Walker at 10:36 AM | Permalink | Comments (0)
Categories: General 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
        

The University of Maryland plans to announce today that its Celiac Research Center is getting a $45 million donation from the family of a grateful patient.

The disease has been notoriously hard to diagnose because its symptoms are not always gastrointestinal. And even when they are, doctors sometimes believe it's an allergy or other malady.

But awareness is up, and this money ought to help more, says Dr. Alessio Fasano, the director of the center, and the doctor who diagnosed Shelia Cafferty, whose family is making the donation. The money, though, will mostly be used to develop new treatments -- and maybe a cure -- for celiac disase and other autoimmune diseases such as diabetes and multiple sclerosis.

That should be good news to those with the disease -- an estimated 1 in 133 people.

Research is expensive, and Maryland isn't stopping with the $45 million. Officials are selling awareness bracelets. (see above) You can buy one at www.celiaccenter.org.  And read the full story about celiac disease at baltimoresun.com.

So, think the bands will catch on? You have celiac disease or know someone who does? How long until you were diagnosed?

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

It’s Respiratory Care Week, and Johns Hopkins Bayview Medical Center is hosting a high-tech mobile motion simulator to show people the effects of smoking and pollutants on the lungs.

The COPD, or Chronic Obstructive Pulmonary Disease, Shuttle will be open to the public on Tuesday  from 10 a.m. to 4 p.m. offering a 5-minute virtual journey inside the human body. Afterward, there will be free screenings for lung disease, sponsored by the COPD Foundation.

The goal is to raise awareness and try and prevent COPD, the fourth leading cause of death in the United States and the only chronic disease growing in mortality. COPD, affecting 24 million around the country – half of whom are undiagnosed -- includes chronic bronchitis, emphysema and adult onset (refractory) asthma. Symptoms include breathlessness, wheezing and chronic coughing.

“Millions of Americans suffer from chronic obstructive pulmonary disease so it is important to educate people about its causes, symptoms, treatment and prevention,” said Dr. Robert Wise, professor of medicine and director of the pulmonary laboratory at the Johns Hopkins Asthma and Allergy Center, in a statement. “The Johns Hopkins Bayview respiratory department is proud to host the COPD Shuttle during Respiratory Care Week, so that we can inform more people in Baltimore about this disease.”

The shuttle will be parked outside of the Asthma and Allergy Center at Hopkins Bayview. Parking will be available in the Mid-Campus lot and parking garage. For more information go to copdfoundatio.org or call 866-316-COPD (2673).

Photo courtesy of the COPD Foundation

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

Maryland health officials said they have opened the first connections in the statewide health information exchange - a system that gives doctors and other medical professionals computerized access to patients' records.

The initial connections are among hospitals and other medical facilities in Montgomery County. But it is expected to spread rapidly through the state with 48 hospitals having signed up to join the system.

The system allows doctors immediate access to patient records. Advocates hope it will help cut down on medical mistakes, particularly during an emergency.

It links physicians, hospitals, medical laboratories and pharmacies.

Chesapeake Regional Information System for our Patients built the exchange. The organization is a nonprofit collaboration among Erickson Retirement Communities, Johns Hopkins Medicine, MedStar Health and the University of Maryland Medical System.

The Montgomery County hospitals and other medical facilities wired into the system are: Holy Cross Hospital, Suburban Hospital, Montgomery General Hospital, Quest Diagnostics, Laboratory Corporation of America, American Radiology Services and Community Radiology and Advanced Radiology.

Several other providers and services will connect in the next few weeks.

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

The West Cecil Health Center is getting a $3.3 million federal grant as part of an effort to improve community health centers under health care reform.

The money is part of $727 million the department of Health and Human Resources said today it is giving to 143 community health centers for upgrades and expansions.

Community health centers serve 19 million patients, about 40 percent of those people don't have health insurance, HHS said. They are often a life line for people who have lost coverage or are in between jobs. The expanded center will provide care to about 745,000 more patients.

The money is the first in a series of awards that will be made to community health centers under the Affordable Care Act. About $11 billion will go to health centers in the next five years under health care reform.

Posted by Andrea Walker at 2:39 PM | Permalink | Comments (0)
Categories: General Health
        

Scientists from Johns Hopkins Children's Center and Morgan State University have joined forces to increase diversity in reproductive research using a $3.2 million federal grant.

The grant from the National Institutes of Health will allow five researchers from the institutions to partner on research projects. It will also be used to recruit and train minority students with interest in reproductive science research.

Race and ethnicity can play a crucial role in how people's bodies develop diseases and respond to treatment. Diversifying those who do the research will help strengthen the science, the researchers believe. And ultimately it could help better treat patients.

"Ultimately, diversity in research talent will help eliminate health disparities, whether they stem from socioeconomic gaps, from differences in access to healthcare or from purely biologic factors," Andrew Wolfe, director of research training in the Division of Pediatric Endocrinology at Hopkins Children's Center, said in a statement.

The grant will allow undergraduates to train alongside graduate and medical students and postdoctoral trainees in endocrinology.

Hopkins has already begun recruiting minority freshman and sophomores interested in careers in the field. Email Michael Summa at msumma1@jhmi.edu or Gloria Hoffman at Gloria.Hoffman@morgan.edu for applications.

The partnership between Hopkins and Morgan is one of two pairings between a major hospital and a historically black institution on this subject. Emory University and the Morehouse School of Medicine in Atlanta have a simliar partnership.

(Baltimore Sun file photo)

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

The University of Maryland School of Pharmacy today celebrated the opening of a new teaching and lab building.

The $62 million Pharmacy Hall building is located adjacent to Martin Luther King J. Blvd. on Baltimore's West side.

The seven-story building has lecture halls equipped with technology for distance learning, experiential learning facilities and research laboratories. The facility also includes a dispensing laboratory that uses robotics -- allowing pharmacists to spend more time on critical care patient duties such as medication management.

Four floors of the building will be dedicated to clinical and translational research in pharmacogenetics, nanomedicine and drug discovery.

The Maryland General Assembly approved funding for the building in 2008. The pharmacy school was looking to educate more pharmacists and "carry out more cutting-edge research."

Posted by Andrea Walker at 3:05 PM | Permalink | Comments (0)
Categories: General Health
        

Maryland’s hospitals have already endeavored to get more doctors to wash their hands, and now they are moving onto another means of passing infection. The hospitals are joining a nationwide initiative to eliminate bloodstream infections.

Called On the CUSP (Comprehensive Unit-based Safety Program), the program is voluntary. It was developed by Johns Hopkins safety guru Dr. Peter Pronovost, and is administered in the state by the Maryland Hospital Association and the Maryland Patient Safety Center.

It’s based on checklists, staff education and expert consultation. The goal is to reduce central line-associated bloodstream infections. There are now some 250,000 of them occurring every year across the country.

“The program works,” said Pronovost, director for the Quality and Safety Research Group at Hopkins, in a statement. “On the CUSP will help ensure that Maryland patients received safer hospital care.”

The infections often result from a central line or central vascular catheter, which is the tube used to provide sick patients with medicine, fluids, nutrients or blood.

The Hospital Association points to a recent CDC report that shows Maryland had 222 preventable infections in the first six months of 2009 – an unacceptable number, officials say.

During a pilot program in Michigan, infections dropped by 60 percent. Maryland is among 30 states that have since signed on.

So, think a voluntary program is enough?

Continue reading "Hospitals find new ways to cut down on infections" »

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Categories: General Health
        

As part of a national effort to get more people health care, the University of Maryland Medical System is bringing doctors to the community for a “Take a Loved One to the Doctor Day.”

Today, there will be free health screening from 10 a.m. to 3 p.m. at the University Plaza, across from the University of Maryland Medical Center at 22 S. Greene St. 

There will be screenings for blood pressure, diabetes, cholesterol, among others. Doctors will also use an ultrasound machine to look for signs of blockages in the veins. There will be the chance to talk one-on-one with a doctor from University Family Medicine.

Along Paca Street, health care providers will offer flu shots, HIV testing and interactive fitness activities.  And urologists will also offer free prostate screenings inside the medical center.

The national Take a Loved One to the Doctor Day aims to encourage people to take charge of their own health and then to encourage their loved ones to do the same, Maryland officials say. It’s a message of prevention.

Sponsors include five of the 11 hospitals in the University of Maryland Medical System -- the University of Maryland Medical Center, Maryland General Hospital, Kernan Orthopaedics and Rehabilitation Hospital, University Specialty Hospital and Mt. Washington Pediatric Hospital. Other sponsors include Maryland Physicians Care, the Baltimore City Health Department, Coppin State University Helene Fuld School of Nursing and the Reginald F. Lewis Museum of Maryland African History and Culture.

AFP/Getty Images

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Categories: General Health
        

The rate of tuberculosis infection in the United States has been going down because of prevention and treatment efforts, but the country may now be more susceptible to new nastier drug-resistant form, according to Johns Hopkins researchers.

The researchers used computer modeling to show an increased risk for epidemics of multi-drug resistant tuberculosis, or MDR-TB. The model also showed that without proper treatment of TB cases, there is also an increased risk.

The results were published in the Sept. 22 journal PLoS ONE.

MDR-TB is a kind resistant to at least two of the primary antibiotics used to treat tuberculosis. It affects 500,000 to 2 million people a year, according to the World Health Organization. There were 111 cases in the United States in 2006.

“The ability of MDR-TB to spread depends on the prevalence of drug-susceptible TB,” said Dr. David Bishai, senior author of the study and associate professor in the departments of Population, Family and Reproductive Health and International Health at the Johns Hopkins Bloomberg School of Public Health, in a statement. “The most successful approach to reduce this risk for MDR-TB epidemics in the U.S. would be to ensure that populations around the world combine high rates of case findings that are tightly coupled to high compliance with directly observed drug therapy.”

David Bishai conducted the research with his brother Dr. William Bishai, professor with the Johns Hopkins School of Medicine and co-director of the Johns Hopkins Center for Tuberculosis Research, and David Bishai’s son Jason D. Bishai, an undergraduate student at Stanford University.

The research was funded with an award to Jason Bishai from the Robert Wood Johnson Foundation Young Epidemiology Scholars Contest and by the National Institutes of Health.

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Mercy Hospital is located in the heart of downtown Baltimore, but despite its urban location will have a green oasis for patients to relax while recovering.

 That's because the new Mary Catherine Bunting Center to open on Calvert Street in Dec. will include three rooftop gardens.

Studies have shown that when patients have visual or physical access to nature the therapeutic value helps them heal better, hospital officials said.

The Bunting building will replace the 50-year-old, outdated facilty where the main hospital is now located. The hospital was also outgrowing the old building.

"It was not in the cards to continue renovating the old building," said Thomas R. Mullen, Mercy President and CEO.

The media got a preview of the building, which is nearly complete, today.

The 20-story building will have 259 private patient rooms - no sharing with people you don't know. Single rooms also cut down on the spread of infectious diseases, hospital officials said. There are sofa sleepers for patient families to stay the night.

The building will also have a computerized system where patients can order a meal or talk to their nurse using their television remote. The information technology staff was installing the new computer system today.

Hospital staff will begin wheeling patients into the new building on Dec. 19. It's a Sunday, which is the slowest day for the hospital. It becomes fully operational that Monday.

The Bunting building will initially house the main surgical operations and the intensive care unit and have 190 beds available. Anything related to maternity, transitional care and detox will remain in the old building. Maternity will eventually move from the old building, which will be used primarily for ambulatory services in the future.

Mullen said the new facility will allow the hospital to see more patients. While plans for the new building were put in place before healthcare reform, Mullen said the new building will help with the changes reform will bring.

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The largest health workers union said today it is endorsting Governor Martin O'Malley in the upcoming election.

The group, 1199 SEIU, made the announcement at the Eubie Blake Jazz Center in Baltimore.

In endorsing O'Malley, union representatives cited his commitment to creating middle class jobs, advocating for free and fair union elections and ensuring affordable, quality healthcare care for Maryland.

The union said its members will hit the streets to canvas neighborhoods as well as organize a direct mail and paid media campaign. The group will focus on key races in Prince George’s County, including county executive, and several Maryland State Senate seats.

Issues of importance for health care workers include the union’s “Heart of Baltimore” campaign, an effort to improve jobs and care through ensuring free and fair union elections in the city’s health care institutions; access to quality, affordable health care; expanding coverage for uninsured Marylanders; increasing Medicaid reimbursements to the state’s nursing homes and hospitals; remediating Medicaid fraud; and keeping the Prince George’s hospitals open and expanding.

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The National Institutes of Health has awarded a University of Maryland scientist an $11.4 million, five-year grant to study whether anti-platelet drugs that prevent blood clots based on a patient's genetic makeup can be used to treat cardiac arrest.

The grant was given to Alan R. Shuldiner, a professor of medicine and director of the Program in Genetics and Genome Medicine at the University of Maryland School of Medicine.

The study of the 2,400 cardiac patients at 5 sites will build on previous research by Shuldiner. The research found that the anti-platelet drug Plavix is not effective for people who have a certain variant of gene. The variant appears to affect a person's ability to activate the drug.

Plavix prevents platelets from clumping together and causing blood clots that can lead to heart attacks and strokes.

People with the gene variant who take Plavix after angioplasty or having a stent implanted have more than twice the risk of dying or having cardiac problems from a blocked artery, Shuldiner said.

The Food and Drug Administration issued a warning to physicians and patients in March about the reduced effectiveness of the drug in patients with the gene variant.

Shuldiner will use the grant money to look at whether treatments geared to a patient's genetic makeup are more effective in treating cardiac ailments.

The grant is funded by the National Institute of Health National Heart, Lung and Blood Institute. The agency is is expanding its focus on understanding how a person's genes respond to certain medicines.

Shuldiner will work with other institutions including Johns Hopkins University and Sinai Hospital in Baltimore.

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About 85 percent of workers rate workplace safety first among labor standards they care about, above maternity leave, overtime pay and paid sick days, according to a study by the National Opinion Research Center at the University of Chicago.

The study aimed to see what workers think about workplace safety issues. It looked at dozens of other studies from 2001 to 2010 done by the center and was conducted for the Public Welfare Foundation, which has a workers’ rights program.

The study found that workers’ concern about safety was, not surprisingly, heightened after an accident such as the BP oil rig explosion in the Gulf of Mexico. Yet, the interest also often quickly waned among workers and the media.

But given the level of concern about safety in general, officials at the foundation said that it should be a higher priority for government and employers.

The U.S. Department of Labor reported last month that the number of workers who died on the job last year fell 17 percent from 2008 but workers also put in fewer hours during the recession. And workplace injuries are still high. Another study for the foundation found about 12 percent of workers reported an injury while on the job in the past year and 37 percent said they have needed medical care at while working.

And while the new study found most workers say they are satisfied with safety conditions at work, they report a lot of stress, which could contribute to injury. A separate 2006 study for the foundation showed 13 percent of workers find their jobs always stressful, and 21 percent find it often stressful.

So, is your work more dangerous than it should be? Have you been hurt? You think safety is the highest concern?

Associated Press photo of Deepwater Horizon oil rig burning

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A father and son team are spending the next 14 days hiking Mt. Kilimanjaro in Arusha, Tanzania to raise money for juvenile diabetes.

Matthew R. Weir, director of the division of nephrology at the University of Maryland School of Medicine, and his son, M. Ryan Weir, a business banking officer for M&T Bank in Towson, began their journey Thursday and plan to finish on Sept. 16.

The pair became interested in diabetes research after a close family friend was diagnosed with Type 1 of the disease and almost went into a coma.

"It was an eye-opening experience," M. Ryan Weir said. The Weirs hope to raise a dollar for every foot of the 19,341-foot ascent they climb. The money will go towards research for the Maryland chapter of the Juvenile Diabetes Research Foundation.

Kilimanjaro is the tallest peak in Africa and is challenging because of varying weather conditions.

Dad, 57, claims his son coerced him into taking on the adventure.

"Either it's a midlife crisis or stupidity, but I allowed him to convince me to do it," said Matthew Weir.

The Weirs are both athletic and used activities such as running and skiing to train for the climb.

"There is certainly some nervousness," said M. Ryan Weir, 25. "As much as you train and run it is as much about how your metabolism handles the altitude."

When asked if he thought this would be harder than a marathon, dad Matthew said, "If I'm alive when we get back, ask me the question."

The Weirs plan to give updates about their climb at http://twitter.com/cureatopkili. To donate visit http://jdrfevents.donordrive.com/index.cfm?fuseaction=donorDrive.eventDetails&eventID=569

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Returning to work after having a baby can be a challenge in general, but what about breastfeeding?

The American Academy of Pediatrics recommends breastfeeding for at least a year. And the state says a few area hospitals are making it easier for new moms to stay on schedule.

The Maryland Department of Health and Mental Hygiene is honoring Greater Baltimore Medical Center, Anne Arundel Medical Center and Johns Hopkins Hospital for programs and policies that support the practice after the moms return to work.

Their “Breastfeeding-Friendly Workplace” provides short breaks and a private space for the mothers to pump and store breast milk among other programs. (Those two provisions are now required by the new health care reform law, though employers don’t have to pay for the time and small companies are exempt if it would cause an undue hardship.)

Health and Mental Hygiene Secretary John M. Colmers said there are benefits to companies to aid new moms: Parental absenteeism is lower and so are healthcare costs because breastfed infants are sick less often. He said studies estimate a $400 savings on health care in baby’s first year. It’s not bad for morale and productivity, too, he said.

Colmers points to a U.S. Department of Labor stat: nearly three-quarters of all mothers are in the work force, including 60 percent of mothers of very young children.

The state health department can offer guidance. Find more information on setting up support programs at work or an application for the workplace award at www.marylandbreastfeeding.org.

So, what's the situation in your office?

Baltimore Sun file photo/Chiaki Kawajiri

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Categories: Business of health, General Health, Health care reform
        

With open enrollment just around the corner, CareFirst BlueCross BlueShield is launching a line of health plans that will reward patients with cash for living healthy lifestyles and keeping in touch with their primary care physicians.

Maryland's largest insurer will begin offering the plans - called HealthyBlue - tomorrow for people to use beginning Oct. 1.

The plans are meant to promote preventive care. The hope is that it will result in healthier people and help drive down healthcare costs.

"If we are to keep health care affordable, it is essential that more focus be placed on keeping people healthy, not just treating them when they are sick," Chett Burrell, CareFirst president and CEO, said in a statement.

Once members enroll they choose a primary care physician and complete an online health assessment. They then have their primary care physician perform a health and wellness evaluation.

Patients who meet certain health criteria will get up to $300 for an individual or $700 for a family. The money will be paid as a gift card to be used toward a health savings account.

Patients who don't get the rewerd will work with their doctor to set up health goals. They will get the money once they meet those goals.

The plans, meant to promote preventive care, include routine visits with a primary physician at no cost, meaning patients don't have to pay a copay or deductible. Generic medications for ailments such as asthma, high blood pressure, cholesterol and diabetes will also be free.

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Categories: General Health
        

Mercy Medical Center has opened a new Center for Endocrinology.

 The new center combines the Diabetes Center with the Center for Bone Health. Previously, the divisions were in separate locations at the hospital's Mercy Tower building and the Weinberg Center at Mercy.

The new Center is about 5,000 -square-feet. That's compared to about 900-square-feet for the old Diabetes Center and 1,500-square-feet for previous the Center for Bone Health.

Three procedure rooms at the center will allow doctors to perform procedures such as thyroid ultrasounds and the testing of thyroid nodules for cancer. Three other exam rooms will be dedicated to thyroid/bone health, and five exam rooms on the endocrinology/diabetes side of the Center.

The Center also contains an oversized conference room to hold diabetes classes on topics such as diabetes care self management, weight loss, hypertension, high cholesterol and gestational diabetes issues.

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The government team responsible for all those statistics about Americans’ health and eating habits are in Baltimore for the next several weeks collecting data – but officials say the turnout has been below average so far.

The CDC’s 50-year-old National Health and Nutrition Examination Survey randomly selected the city as one of 15 it will visit this year and sent out notices to hundreds of residents also chosen randomly. Officials want about 370 of them to come for comprehensive testing and surveying in their four-trailer clinic set up Harbor East.

Participants get thousands of dollars worth of tests taken and interpreted by doctors, so people can learn, for example, if they have asthma, diabetes, brittle bones and bad teeth. They aren’t treated but can take the information to their doctors, or get a referral for low-cost care. They also get paid for their time – about two to four hours in the clinic and another hour or so in an in-home interview. The data is all confidential.

But officials are finding a lot of locked doors when they visit the randomly selected residents, and others aren’t showing up to appointments, said Janis Eklund, a study manager for the program. About 140 people have been interviewed and have appointments, about 60 shy of the norm.

In the study, each person examined represents 65,000 Americans. The data informs national policy setters and local officials looking to improve the health of residents. (The recent study saying one in five kids were losing their hearing, possibly from loud music through earbuds, came from this program. Older tests helped bring about folate recommendations for pregnant women, lead-free gasoline and healthier food at the grocery.)

“I knew the city would be tougher than the prairie,” said Eklund, referring to the program’s last stop in a small town in South Dakota known as home of the TV show Little House on the Prairie. “But this is a great opportunity for people to a comprehensive assessment of their health. It’s once in a lifetime.”

Baltimore Sun photo of the center parked in Harbor East/Meredith Cohn

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No, married people do not become more similar over time, a new study shows.

If people are like their spouses it’s most likely because that’s what drew them together to begin with, say researchers at Michigan State University and the University of Minnesota.

The study, published in the journal Personality and Individual Differences, looked at 1,296 married couples in one of the largest studies to date.

The research knew from existing research that married people are more similar than random people, according to Mikhila Humbad, lead investigator and a doctoral candidate in clinical psychology.

The researchers looked at several different personality characteristics and found most couples didn’t become more alike over time – with the exception of aggression. If one person was violent, the other sometimes also became more violent.

Humbad said that the finding could have implications for offspring. They are likely to inherit the similar traits.

Perhaps this is why match-making services work? They hook you up with people of similar characteristics.

So, are you like your spouse? Have you always been that way?

Getty Images photo of Brad Pitt and Angelina Jolie

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Categories: General Health
        

Maryland’s egg supply so far has no connection to the salmonella outbreaks plaguing a large portion of the country, according to state health officials.

Investigators have been out scanning the state’s grocery stores since hundreds of salmonella incidents across the country have been linked to eggs, said Alan Brench, the state’s chief of emergency response and food defects.

More than half a billion eggs have been recalled since Aug. 13, but none so far in Maryland.

Brench said that any company that packs eggs in the state must be registered with the Maryland Department of Agriculture. None of the plants in the recall are registered in the state, he said.

He said that doesn’t rule out the possibility of tainted eggs being sold in supermarkets.

Some may have gotten in by error or mistake,” Brench said. “But as far as the department of agriculture people are concerned they haven’t found any yet.”

Health officials will continue to monitor the situation as the recall list continues to expand, he said.

“It’s an ongoing situation and while we’re in touch with the situation you have no idea where developments go,” he said.

The companies that have recalled eggs include Luberski Inc., Hillandale Farms, Country Eggs Inc., Wright County Egg and NuCal Foods, Sunny Farms Sunny Meadow and Wholesome Farms, according to the U.S. Food and Drug Administration website.

The government agency has yet to find the cause of the contamination.

Consumers can find the plant number and Julian date stamped on the side of the box to see if the eggs they have bought have been recalled. A list of those recalled can be found on the FDA website.

If your eggs are recalled throw them out or return them to your grocery store for a refund. There are precautions consumers can take to prevent salmonella infections in the meantime.

Avoid raw or undercooked eggs, including soft-boiled and sunny side up eggs. Wash hands thoroughly when dealing with raw eggs and don’t mix cooked foods with uncooked foods. Don’t eat eggs left out for more than two hours and avoid restaurant foods made with raw eggs, such as Caesar salad or Hollandaise sauce, according to the Centers for Disease Control.

(Associated Press photo).

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A biomedical engineering student and faculty team from Johns Hopkins University that developed a system to make spinal surgery more successful in patients with osteoporosis will ring the Nasdaq Stock Market Closing Bell today.

A Johns Hopkins graduate who was also on the team and now attends the University of Pennsylvania Medical School will also join in the ringing of the bell. The Nasdaq closes at 4 p.m.

The team won the $20,000 Michelson Grand Prize in the 2010 Wharton Business Plan Competition. Patients with osteoporosis have softer bones which can cause spinal surgical screws to fall out, the team found. They developed a system to strengthen the procedure and make it less likely for screws to wiggle loose.

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 Update:  The Maryland Citizen's Health Initiative mistakenly said Jim Brochin, a Democrat in the 42nd district, signed a pledge to support an alcohol tax. He did not. Candidates still have until Aug. 27 to sign the pledge.

More than 130 candidates running for Maryland General Assembly have signed a pledge supporting a resolution to create an alcohol tax in the next legislative session.

The measure is being pushed by a number of advocacy groups, led by Maryland Citizen's Health Initiative. The groups sent out letters in July to all candidates running for state Senate or House of Delegates, urging them to support a 10-cent liquor tax increase.

The letter wasn't sent to gubernatorial candidates Gov. Martin O'Malley, who is running for re-election, or his Republican challenger, former Gov. Robert L. Ehrlich Jr.

In addition to those signing the pledge, 17 other candidates also filled out a questionaire saying they support "increasing the state alcohol taxes if the revenue is tied to expanding health coverage and access for Marylanders."

The advocacy groups want revenue earned from the tax to help pay for healthcare for those with mental health and developmental disabilities, as well as fund drug and alcohol cessation programs. A portion also would go to funding health insurance for poor adults without children, a measure that was passed in 2007 but never implemented because of lack of funding.

The groups believe $249 million could be raised.

Liquor tax proposals have failed in previous sessions, including last year, when a 10-cent liquor tax increase never made it out of committee. In 2008, a 5-cent increase also failed to pass. Taxes on wine and beer have not been raised since 1972. A tax on spirits hasn't been raised since 1955.

Continue reading "UPDATE: Candidates pledge to support alcohol tax" »

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Did you assume kids without siblings don't fit in?

Well, it might not be the case. A new study says being an “only child” isn’t a disadvantage for teens when it comes to social skills.

The study looked at more than 13,000 middle and high schoolers nationwide and found kids picked those without siblings as friends just as often and they did those with siblings.

 “I don't think anyone has to be concerned that if you don't have siblings, you won't learn the social skills you need to get along with other students in high school,” said Donna Bobbitt-Zeher, co-author of the study and assistant professor of sociology at Ohio State University's Marion campus, in a statement.

The study was presented this week at the annual meeting of the American Sociological Association.

She and a partner did the study because family size has gotten smaller in the industrialized world. And concern was going about what it would mean for only children. Maybe they were losing something because they weren’t interacting with brothers and sisters.

In 2004, the researchers had found that was the case with kindergarteners, based on ratings of social skills from teachers. But the new study shows that the advantage of having siblings doesn’t seem to persist into adolescence.

 “Kids interact in school, they're participating in extracurricular activities, and they're socializing in and out of school,” she said. “Anyone who didn't have that peer interaction at home with siblings gets a lot of opportunities to develop social skills as they go through school.”

Baltimore Sun file photo

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Categories: General Health
        

Men's Health magazine has ranked Baltimore as the third most unsafe city in the United States to raise a child.

The magazine determined its rankings by looking at five factors: accidental death rates, the number of car seat inspection locations per child, sex offenders per capita, the percentage of abused children protected from further abuse, and the strength of bike helmet and child restraint laws.

The researchers gathered the information from government agencies such as the Centers for Disease Control, the National Highway Traffic Safety Administration, the U.S. Department of Health and Human Services and the Insurance Institute for Highway Safety.

The magazine looked at 100 cities.

Baltimore ranked 98th for accidental deaths, 72nd for car-seat inspections, 75th for sex offenders and 73rd for abused children protection. The city received an overall grade of F. The unsafest city was Jacksonville, FL, and the safest was Madison, Wis.

Continue reading "Baltimore not safe for children, according to Men's Health study" »

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The first test-tube baby, Elizabeth Carr (now Comeau), has had her own baby, according to her own account in the Boston Globe.

She writes that she decided to write about her experience because she knew if she didn't, someone else would. (And as a journalist for the newspaper, she notes that this is the kind of story she would have written about someone else.)

She also wanted to let people know that IVF is an option for infertile women. The babies, like her, are normal. The 28-year-old conceived and delivered naturally.

In the story, she talks about how strange it was to grow up with so much media attention. Wonder if that's why she turned to a career that puts others in that kind of spotlight.

Now that IVF is so much more common, I wonder how much interest there will continue to be -- or if she will become just another byline.

Photo courtesy of the Boston Globe

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Categories: General Health
        

Maryland residents who need or want medical attention but don’t have insurance might want to try and catch a ride to Washington’s convention center today (801 Mount Vernon Place N.W.). There is a free clinic, and patients will be seen today on a first-come first-served basis.

There are about 2,000 slots, though some have been taken up by appointments. They won’t take same-day appointments.

The clinic is sponsored by the National Association of Free Clinics, and will run from 11 a.m. to 7 p.m.

"This free clinic is not just for the sick but also for anyone who is uninsured and has not seen a doctor recently,” said Nicole Lamoureux, the group’s executive director, said in a statement. “All participants will receive preventive primary medical care including medical exams (including physicals), HIV tests, EKGs, cholesterol blood tests, glucose tests for diabetes, blood pressure tests, muscular skeletal exams, urinalysis, pregnancy tests, hemoglobin tests and strep tests.”

The clinic will also provide mental health services and pharmacy counseling, which includes writing prescriptions that conform to generic programs offered by many drug stores. Patients will be referred to community resources for ongoing care.

For more information, go to www.freeclinics.us.

Baltimore Sun file photo

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Categories: General Health
        

Baltimore manufacturer Ellicott Dredges has agreed to buy $100,000 in malaria drugs and insecticide-treated bed nets to be used by women and children in Nigeria.

The company, which built all the original dredges in the original construction of the Panama Canal, is working with Baltimore non-profit Jhpiego. The medicine will go to women and children in the Akwa Ibom state in the Niger Delta region of Nigeria.

Malaria accounts for 11 percent of maternal deaths in Nigeria, according to Jhpiego. The organization believes it contributes to poverty, low productivity and absenteeism in the schools.

Peter Bowe, Ellicott Dredges president, said in a statement that his company was interested in helping Nigerians because it has been active in sand-dredging projects in the region.

"Women are the foundation of families throughout the world," Bowe said in a statement. "Their health is directly related to a nation's health."

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Doctors trained abroad provide medical care as good as that offered by U.S.-trained physicians, according to a study published in the August issue of Health Affairs.

However, Americans who trained overseas had higher patient death rates, according to the study.

The study looked at data in Pennsylvania and found no real difference in the death rates of patients treated by foreign-trained doctors when compared to U.S.-trained doctors.

The issue may become more relevant as healthcare reform pushes millions of more people onto the rolls, resulting in a need for more doctors.

The study's authors said that U.S. medical schools must continue to be viligant in their admissions process even as they expand to meet the needs healthcare reform will bring.

The study looked at 244,153 hospitalizations of patients with congestive heart failure or acute heart attack. The patients were treated by a U.S.-trained or foreign-trained doctor in family medicine, internal medicine or cardiology. Foreign-born medical graduates had the lowest death rates.

The study also looked at length of stay. Patients of U.S. graduates had the shortest length of stay. Patients of Americans trained overseas had the longest.

Posted by Andrea Walker at 12:00 PM | Permalink | Comments (1)
Categories: General 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?

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Categories: General Health
        

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

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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.

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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
        

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.

Continue reading "Hospitals put energy plans into motion when its hot" »

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

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
        

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
        

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
        

My colleague Hanah Cho just started writing the Charm City Moms blog.

Hanah, who has the most adorable six-month old ever, writes a lot about the obstacles of working and raising kids.

She found a study that said when companies provide child care benefits for their employees, they have less stressed, healthier workers.

Check out her post.

Posted by Andrea Walker at 6:12 PM | Permalink | Comments (0)
Categories: General Health
        

Remember in February when there was two feet of snow on the ground and we were all longing for hot weather.

Well, it's here folks. The next two days are supposed to be sweltering. The kind of heat where you sweat just by standing outside.

It is the kind of heat that can also be dangerous if you don't take the right precautions.

Here are some tips I gathered from the Centers for Disease Control, the American Red Cross and the Gatorade Sports Science Institute to stay cool and healthy during the heatwave.

1. Drink more fluids and don't wait until you're thirsty to do it.

2. Wear light-colored, lightweight, loose-fitting clothing

3. Limit activity, such as exercise, to early morning and evening hours

4. If you do exercise, drink two to four glasses of fluids per hour

5. Eat small meals and aovid high protein foods, which increase metabolic heat

6. If outside, try to rest often in shady areas

Posted by Andrea Walker at 8:00 AM | Permalink | Comments (0)
Categories: General Health
        

Former U.S. House Majority Leader Richard Gephardt was in town today to push a movement underway to increase medical research.

Gephardt and others believe that pumping more dollars into finding cures for diseases and creating new drugs could provide a much needed engine to boost the economy and job growth.

Gephardt is chairman of the Council for American Medical Innovation, a group that is pushing for changes in federal policy that would encourage more medical research.

My colleague, political reporter Annie Linskey, also found that Gephardt's lobbying for the group is funded in part by Pharma, the group that represents drug companies.

Healthcare makes up about 17 percent of the country's GDP today and is expected to make up as much as 25 percent in coming years, Gephardt told a group of business leaders gathered at the World Trade Center in downtown Baltimore.

The former Congressman was joined by Gov. Martin O'Malley who talked about how Maryland is already ahead of the game with its robust bioscience industry, much of it headquartered in Montgomery County. There was no mention of creating new state policies to further the industry.

The two politicians were also joined by Fred Mason, president of the Maryland AFL-CIO, who said he believes medical innovation would create stable jobs.

Gephardt proposes several ways to encourage medical innovation including:

1. Creating public/private partnerships to better the chances of bringing research to market

2. Increasing and making permanent the research and development tax credit

3. Overhauling the FDA regulatory process

4. Improving bioscience education at the primary and secondary school level

Click here to hear part of Gephardt's presentation and here for O'Malley.

Posted by Andrea Walker at 3:32 PM | Permalink | Comments (1)
Categories: General Health
        

Hospitals and nursing homes in Maryland are banding together to reduce the number of painful bed sores patients can form from lying in beds too long.

The state’s prevalence of patients with bed sores is a little higher than the national average, prompting those in the health care field to respond.

Bed sores occurred among 14 percent of patients staying in Maryland nursing homes in the second quarter of 2009, according to the National Pressure Ulcer Advisory Panel. The national average for the same period was 11 percent.

When patients develop bed sores, their stay in the hospital can double and, in some cases, even triple, according to the Agency for Healthcare Research and Quality.

The cost of treating a severe bed sore can reach as much as $55,000.

Hospitals often don’t get reimbursed by insurers when they have to keep a patient for a longer stay because of bed sores.

But bed sores are also preventable.

 The Health Facilities Association of Maryland and the Maryland Hospital Association recently entered into a partnership to reduce the occurrence of bed sores at skilled nursing facilities and hospitals by offering educational program to train healthcare workers.

Participants in the training program developed by the two groups will learn how to best classify, measure and document bed sore wounds. They’ll also be able to better identify bed sores in patients with complex skin conditions that make such sores hard to spot.

The two groups say the training will provide patients with better hospital stays. But it could also help save Maryland’s health care system millions of dollars, particularly as the state prepares to add thousands of people to the rolls of public health care under national reform.

The Wound Care Education Institute will hold two one-week sessions on bed sores in 2011, under the partnership between the hospital and nursing home associations.

Posted by Andrea Walker at 7:30 AM | Permalink | Comments (0)
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Got back pain? Lots of American do, but they also have misconceptions about proper posture, according to Esther Gokhale, author of 8 Steps to a Pain Free Back.  

Here are a few of those myths, in her words:

--Myth #1 – I just have to remember to straighten up: “Just straighten up” is usually accompanied by muscle tension and distortion of the spine. It quickly leads to discomfort and fatigue, causing most of us to return to slouching.

--Myth #2 – The pelvis should be tucked to protect the back: Nearly everyone from fitness instructors and dance teachers to medical professionals makes the mistake of recommending a tucked pelvis. However, this is discordant with our natural structure; anteverting (tipping) the pelvis preserves the natural shape and protects from disc damage.

--Myth #3 – Chin up and chest out constitutes good posture: Not only does this create tension, it exaggerates the cervical and lumbar curves, hindering circulation to these areas and potentially pinching nerve roots.

--Myth #4 – Good posture takes mental and physical effort: The body wants to heal, and good posture feels good. As you practice new movements, they will become increasingly natural to your body. You also do not need to be young, strong, flexible or physically fit to have good posture.

--Myth #5 – It’s too late to change my posture: It is never too late to change your posture. The body is resilient and adaptable.

So, in sort, don't tuck your bum, don't stick out your chest and don't concentrate tension in your back while you're trying not to slump. Anything here surprising? Anyone been doing these things?

See a few more myths on the next page.

Photos of bad alignment and good alignment courtesy of Esther Gokhale

Continue reading "When it comes to back pain, don't believe the myths" »

Posted by Meredith Cohn at 11:33 AM | Permalink | Comments (2)
Categories: General Health
        

About 38 percent of U.S. adults and approximately 12 percent of children use some form of complementary medicine, according to a 2007 National Health Interview Survey. Ever wondered if homeopathy, osteopathy and other forms of holistic medicine would be right for you?

Join us at noon Tuesday for a live chat with Dr. Joyce Frye of the University of Maryland's Center for Integrative Medicine. According to her university bio, Dr. Frye welcomes problems in women's health care from infertility to menopause. Additionally, she will see men, women, and children for infections, recovery from trauma, and for peri-operative and cancer support.

Start sharing your questions now for a chance to win one of three books (winner's choice): "The Most Effective Natural Cures on Earth" by Jonny Bowden, "Yoga: Your Home Practice Companion" from the Sivananda Yoga Vedanta Center, or "The Yoga Body Diet" by Kristen Schultz Dollard and John Douillard.

Photo by Joe Raedle/Getty Images

Posted by Kim Walker at 5:48 PM | Permalink | Comments (0)
Categories: General Health
        

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

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

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

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

The story continues:

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

What do you think?

AP photo

Continue reading "Is it time to end the ban on gay men's blood donation?" »

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

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

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

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

Continue reading "Alfalfa sprouts linked to latest salmonella outbreak " »

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

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

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

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

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

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

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

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

Continue reading "Why don't more doctors use email? " »

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Continue reading "What's a food allergy? Even the experts can't agree." »

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

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

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

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

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

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

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

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

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

Continue reading "Risks could outweigh benefits of heartburn drugs" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (5)
Categories: General Health
        

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Baltimore Sun photo

Posted by Kelly Brewington at 12:15 PM | Permalink | Comments (0)
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The D.C. city council just approved a measure legalizing marijuana for medical use, The Washington Post reports

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

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

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

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

Exercise, dietary supplements and programs that claim to boost your brain power have all been marketed as ways to stave off Alzheimer's. But there's no evidence that any of them work, an independent panel of experts convened by the National Institutes of Health concluded yesterday.

So far, studies haven't been able to prove if any of these strategies work to prevent cognitive decline, the panel said. The news is discouraging, for certain. The unfortunate reality is so little is known about the illness and of the aging process in general, experts said. 

Researchers have identified certain risk factors such as age and the association of a genetic variant of a protein that plays a role in cholesterol -- apolipoprotein E -- that have shown links to developing Alzheimer's. And experts hope to soon understand what role genetics play in the disease. But much more research is needed.

In addition, the panel found that chronic diseases such as diabetes and depression, and risk factors such as smoking are associated with increased risk of both Alzheimer's and cognitive decline. But it's unclear from studies if these factors actually cause Alzheimer's or are simply related.

What's clear, however, is that a review of the interventions used to prevent the disease shows little evidence that they're effective. 

 "Alzheimer's disease is a feared and heart-breaking disease," said Dr. Martha L. Daviglus, conference panel chairwoman and professor of preventive medicine at Northwestern University. "We wish we could tell people that taking a pill or doing a puzzle every day would prevent this terrible disease, but current evidence doesn't support this."

Baltimore Sun photo

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Calling all insomniacs: Dr. Cynthia Soriano, a pulmonologist at the Sinai Sleep Center answered your questions live. 

Sleep disorders are common, ranging from the short-term tosses and turns to chronic problems that have links to anxiety, depression and a range of physical illnesses. A new study suggests that lack of sleep might even cause people to gain weight.

Here's a replay of the chat.

  

Continue reading "Live chat on sleep issues " »

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Trouble sleeping? Insomnia? Can't keep your eyes open during the day? We have help coming your way.

Join us Tuesday at noon for a live chat with Dr. Cynthia Soriano, a sleep expert and pulmonologist at the sleep center at Baltimore's Sinai Hospital.

Dr. Soriano will answer questions about any sleep concerns you may be having. 

You can start asking questions now in the comments section below, or email me directly at kelly.brewington@baltsun.com. See you then!

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With a nearly $3 million grant from the Vatican, University of Maryland researchers will lead an international group of scientists to study adult stem cells from the intestines with the hope of discovering treatments for diseases.

The partnership was announced this morning in Rome and you can find more details in this story I wrote for The Sun.  The Vatican will finance the project through the Italian children's hospital Bambino Gesu, with funding extending from there to the University of Maryland's Center for Stem Cell Biology and Regenerative Medicine and other Italian partners. 

I spoke with Maryland researchers about the announcement this week, who told me the study of adult intestinal stem cells could help scientists develop cures and treatment for gut-related diseases without the ethical debates that have embroiled stem cell research for a decade.

"We don't have to get into the issue of ‘Is this destroying life'?" said Dr. Curt Civin, director of Maryland's Center for Stem Cell Biology and Regenerative Medicine. "We just don't have to get there. This solution to obtaining cells in a totally ethically-unconflicted way is here."

Moral objections over stem cell research have focused on the use of embryonic stem cells. Scientists believe they hold promise because they can transform themselves, with the right prodding, into virtually any kind of tissue. But the Catholic church and religious conservatives object to such research because it involves destroying embryos. Adult stem cells, however, are less controversial, but up until recently were not thought to hold the same potential for medical advancement as embryonic stem cells.

Intestinal stem cells have potential because they appear to be different from many other kinds of adult stem cells because they are programmed to generate a variety of cells, said Dr. Alessio Fasano, a professor of pediatrics and physiology who is coordinating the partnership.

AP photo

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Computer games designed to boost cognitive function and memory won't make you any smarter, according to a new study from British researchers.

The large study, appearing in the new issue of Nature, recruited viewers of the BBC show "Bang Goes the Theory" to play online games 10 minutes a day, three times a week for six weeks.

The 11,430 participants ages 18 to 60, were divided into three groups. In one, the tasks focused on cognitive skills like reasoning and problem-solving. A second worked on games that focused on short-term memory, math and attention. The third -- the control group -- surfed the web for answers to random questions.

Tests given to the subjects after the six weeks found that those who specifically trained their brains for cognitive functions didn't improve those functions.

"There were absolutely no transfer effects" from the training tasks to more general tests of cognition, Adrian Owen, a neuroscientist at the Medical Research Council (MRC) Cognition and Brian Sciences Unit in Cambridge, UK, who led the study, said to the Nature news service. "I think the expectation that practicing a broad range of cognitive tasks to get yourself smarter is completely unsupported."

But don't expect this study to end the debate over whether such games work. Computer-based brain teasing games, marketed specifically as mind-boosting, are projected be a $1 billion industry in the next five years, the WSJ reports. Research is all over the map on the issue. Meanwhile, some experts say exercise, not brain games, is what really keeps that mind sharp. 

Stock.xchng photo

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Frequent users of tanning beds know that exposure to ultraviolet light is bad for them. But they do it anyway. And doing so may be an indication of addictive behavior, says new research appearing in the latest issue of  the journal Archives of Dermatology.

Researchers asked 421 college students about their tanning use with questionnaires designed to screen for addictive behavior. Of the 229 who said they used tanning beds, nearly 40 percent met the criteria for addiction on one measure and 31 percent met the criteria on another measure.

In addition, tanners who met these criteria were more likely to report anxiety and higher uses of alcohol and marijuana, the study found. 

Despite the warnings and calls for bans on the practice for minors (officials in Howard County, Maryland passed one last year) young people's usage of tanning beds is on the rise, the paper states. 

We know studies like these that rely on self-reporting have limitations. But the findings sure are thought provoking and probe what's the allure of tanning despite all the risks of skin cancer? 

"In addition to the desire for appearance enhancement, motivations for tanning include relaxation, improved mood and socialization," write the researchers from Sloan Kettering Cancer Center and the State University of New York at Albany. Given that kind of reinforcement, perhaps tanners return to the beds because they're motivated by the same kind of craving that addicts have for other substances, they authors suggest.

Baltimore Sun photo

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Swollen, stiff joints that make everyday activities painful are hallmarks of arthritis. Pain so debilitating that it limits work and other activities is especially common for blacks and Hispanics, even though they have less prevalence of the disease, new research from the CDC finds.

Blacks and Hispanics were twice as likely as other ethnic groups to report severe joint pain and work limitations, according to the study appearing in the latest issue of Preventing Chronic Disease, a publication of the Centers for Disease Control and Prevention.

Arthritis is the most common cause for disability in the United States, affecting one in five people, according to CDC statistics. While the prevalence for whites is about 24 percent, it's 19 percent among blacks and about 11 percent among Hispanics.

As with many racial health disparities, researchers don't know the reason for the difference. But they suggest it likely has to do with language barriers, problems with access to health care for minorities and minorities' increased risk factors for arthritis such as obesity or even working more demanding jobs. The findings point to the need for more culturally-sensitive care and more research to better tackle the problem, the authors said.

Continue reading "Arthritis takes a tougher toll on minorities" »

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The web has changed medical practice like nothing else in recent years. Diagnose yourself. Chat it up with people with similar health problems. Gain access to the websites that medical experts use to educate themselves on the latest health topic.

But there's a point when too much unfiltered surfing is a bad thing, warns a recent article in the New England Journal of Medicine. Misleading information, myths and downright falsehoods on the internet can steer patients down a dangerous path, warn the authors, researchers at Beth Israel Deaconess Medical Center in Boston. Don't navigate those health sites alone, they say. Be sure to consult with your doctor.

The study offers examples of where self-diagnosis online has led only to acute hypochondria and unnecessary fretting. Full disclosure: I do this. A lot. And who doesn't? It's so easy to ask Dr. Google, as I like to call it and get an instant answer.

But this isn't the only downside to relying on the web for medical information. The study also takes on the trend of hospitals and doctors' offices making lab results available on the web. Sure it's convenient. But patients can be confused by results. In short: nothing should take the place of a trained professional who can walk you through your health care, the study states. 

Besides, isn't medicine also about the relationship between patient and provider? Does the web get us away from that tradition?

What do you think? Do you use the web to navigate your health issues? Good or bad idea?

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (6)
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Our colleague Jacques Kelly has this obituary on Dr. Nicholas J. Fortuin, a popular John Hopkins cardiologist who died today. He was 69.

The physician and professor did research involving new concepts in the distribution of blood flow in heart. During his early years, he developed the first laboratory of echocardiography at Hopkins and promoted the use of this then new technique in a clinical setting.

Posted by Kelly Brewington at 4:30 PM | Permalink | Comments (0)
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It's in anti-bacterial soap, some toothpastes, and even socks. Triclosan is an antimicrobial additive you probably never heard of, but it's raising eyebrows at the Food and Drug Administration after recent animal studies have shown it could alter hormone regulation. 

The last time the FDA reviewed the chemical it found it caused no harm to humans.

But yesterday the agency said it would reexamine it in response to a letter from Rep. Edward J. Markey, a Mass. Democrat and chairman of the House Energy and Commerce Subcommittee on Energy and the Environment, who has been pushing for stricter federal regulation of the chemical.

Recent studies warrant a further review of triclosan, the agency said. 

The chemical is added to products to reduce bacterial contamination. But when it comes to washing your hands, the FDA has said that anti-bacterial soaps work no better than the regular old sudsy variety.

Meanwhile, the agency did find advantages to the chemical. A review in 1997 found triclocan in Colgate Total toothpaste to help prevent gingivitis.

Still, Markey thinks the chemical should be banned from use in consumer products, particularly those marketed to children and those used in food preparation.

"The proliferation of triclosan in everyday consumer products is so enormous, it is literally in almost every type of product -- most soaps, toothpaste, cosmetics, clothes and toys," Markey told The Washington Post. "It's in our drinking water, it's in our rivers and as a result, it's in our bodies. . . . I don't think a lot of additional data has to be collected in order to make the simple decisions about children's toys and soaps that people use. It clearly is something that creates a danger."

EDITED to add: 

The Soap and Detergent Association, which represents the $30 billion cleaning products market in the U.S., contacted us and offered this statement about the FDA's concerns about the chemical...

Continue reading "FDA takes a closer look at your soap" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
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Looking for even more health and fitness news? The Sun recently launched a new Health & Style section in the print paper on Thursdays. It covers health, fitness, style and fashion and you can find many of the stories at www.baltimoresun.com/health. Follow us on Twitter @BaltSunHealth and become a fan on Facebook.

In addition, we'll be doing more regular "Ask an Expert" live chats on the blog, like the one we did earlier this week with a dentist and and another we did recently about health reform. Also, check out our new health calendar on to the right, where we featured all the latest health and medical happenings in the Baltimore area.

This is as good a time as any for us to ask for your feedback. Got a suggestion about how we can make Picture of Health even better? Let us know!

Posted by Kelly Brewington at 3:18 PM | Permalink | Comments (0)
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Faculty from the University of Maryland School of Pharmacy and Dental School will offer oral cancer screenings and review seniors' prescription medication today during a free dance and lunch event at St. Mary's Outreach Center in Baltimore.

Nicole Brandt, of the pharmacy school, is hoping to raise awareness about a new Maryland law she advocated for which requires assisted living facilities to have a pharmacists regularly review medication for each resident. 

The dance and health fair runs from 11 a.m. to 2 p.m. at St. Mary's Outreach Center at 3900 Roland Ave. in Baltimore. 

Posted by Kelly Brewington at 10:05 AM | Permalink | Comments (0)
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While previous studies have shown that doctors harbor negative attitudes toward their obese patients, new research finds that overweight people get the same care from their doctors as everyone else.

The study appearing in the latest issue of the Journal of the American Medical Association examined eight quality measures of 70,000 patients who received care from Medicare or the Veterans Health Administration.

The researchers from the University of Pennsylvania looked at how doctors treated patients when providing diabetes care, vaccines, mammograms and other screenings. Across all measures, overweight and obese patients got the same recommended care as everyone else, the study found.

In fact, in some cases, obese patients were more likely to get recommended care than their thin counterparts. Notably, the rates were higher among obese patients for diabetes screening, which you might expect, and vaccinations, which you might not.

Continue reading "Obese patients don't receive inferior care" »

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State budget cuts could mean permanent scaling back on key programs at local health departments across Maryland, according to this story in today's Sun. 

Pregnancy clinics, programs to treat chronic diseases and even food inspections could be weakened, local health department chiefs warn.

The General Assembly is likely to pass a spending plan that allots just $37 million for state health departments -- the same amount  they got back in 1997. In recent years, state funding to departments was $73 million.

Those big cuts come at a time when public health departments are already struggling, say officials. 

Decreased funding hurts more than just the poor, the story explains. In Howard County, the next round of cuts will hurt food inspections, meaning two reviews a year of restaurants instead of the state-required three, said Dr. Peter Beilenson, county health officer.

Howard's health department has lost 25 percent of its staff in the past two years, eliminated a maternity clinic that served up to 400 pregnant women a year, cut dental care and reduced and privatized AIDS services.

It's a familiar story playing out among cash-strapped states across the nation.

Posted by Kelly Brewington at 11:45 AM | Permalink | Comments (0)
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Some 73 percent of Americans say they support their state legalizing medical marijuana, a new survey from the Pew Research Center found. Interestingly enough, support tends to span gender, race, age, religion and political ideology, although people under 30 and Democrats support it by higher margins.

That doesn't mean people are for legalization without limits. Nearly half -- 45 percent -- said they would be concerned if a store selling medical marijuana opened in their area, according to the survey of 1,500 adults. Another 46 percent said they think legalizing the drug for medical purposes makes it easier for people to smoke pot even if they don't have a real medical need for it. 

Still, the percentage of people who support medical marijuana has grown over the lat 20 years, the study points out. 

The survey comes as states nationwide are considering legalizing the drug for medical purposes -- Maryland included. We told you about our state's effort a few months ago. However, with the legislative session in the home stretch, neither bill in the Senate or the House has gotten out of committee.

Continue reading "Marijuana survey: Legalize it" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (13)
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If you live in Baltimore, you also happen to live with plenty of pests. I don't know many people who have managed to avoid a roach or mice infestation from time to time. And in getting rid of them, many rely on toxic pest control sprays.

The Baltimore City Health Department aims to offer residents some relief -- in a less hazardous way. The department received a $250,000 grant from the Environmental Protection Agency to fund less-toxic pest control strategies for city homes, schools and businesses.

Called the Safe Pest Management for Health Initiative, the program aims to reduce the use of toxic pesticides in favor of a concept called integrated pest management, which is less harmful and more environmentally sensitive, according to health officials.

The strategy relies on preventive measures first – such as sealing cracks and properly storing food – continuing with less hazardous pest control options, if needed. A pilot program started last year in a city public housing development decreased cockroach infestation by 97 percent, health department officials said.

About 5,450 residents and government workers will be trained in the program, which over the next two years, will be rolled out to 100,000 residents with a goal of decreasing toxic aerosol pesticides by 75 percent.

Edited to add: The sites targeted for the new pest control program have largely been chosen and include day care centers and schools that have specified a problem with pests in the past. But if you're interested in finding out more about the program, contact the health department: 410-396-3558

Baltimore Sun photo

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A third of patients 65 and older endure long waits for kidney transplants because they are not being considered for riskier organs that could save their lives, new research from Johns Hopkins concludes. 

I wrote about the use of such kidneys, known as expanded criteria donors, or ECD, in a story in The Sun today.

ECD kidneys are typically from deceased older donors. They have riskier outcomes and last just half as long as younger kidneys. While such organs aren't suitable for younger patients, for older patients, for whom time is critical, they can be a good alternative, researchers say.

Patients waiting for kidneys often endure a punishing schedule of dialysis. The likelihood that people 65 and older will survive five years on the blood-filtering treatment is just 27 percent, said Dr. Dorry Segev, associate professor of surgery and epidemiology at the Hopkins School of Medicine and the lead author of the study.

But some transplant centers are skeptical of using such kidneys. Centers are rated by the federal government on their transplant outcomes. Using riskier kidneys can mean poor outcomes and poor ratings.

Still, with kidney transplant lists growing long and donor figures staying flat, using riskier kidneys can be a life saver, according to researchers. 

Baltimore Sun photo

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This from the B'More Green blog:

A coalition of 200 public health and environmental groups plan to rally outside of a conference of chemical execs Tuesday to draw attention to the issue of harmful chemicals in everyday products. 
 
The rally is slated for noon at the Pier Six Pavilion in the Inner Harbor, outside the hotel where the GlobalChem conference is happening.

The groups want the companies to adhere to some tougher rules and agree to more reporting about chemicals. Congress is about to consider  updating the Toxic Substances Control Act, which governs the chemicals and hasn't been updated since 1976.

The groups formed an organization called Safer Chemicals, Healthy Families to call for:

1) Safety information on all chemicals in use. The group says the chemical industry wants to prioritize just a few;

2) Reduction of the most dangerous chemicals now. The group says the industry wants more testing; and

3) Real-world analysis of chemical exposures to inform safety decisions. The group says now the law works as if people are exposed to one chemical and one source at a time.  
 
The group says the law now requires the Environmental Protection Agency to only test a few hundred of the 80,000 chemicals now in use. But they say health problems such as autism, cancer and reproductive disorders are linked to these chemicals and are on the rise.

Maryland PIRG, one of the lead organizations in the group, has been working to get harmful chemicals out of products, such as BPA in baby bottles and the flame retardant DecaBDE.  

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When it comes to being healthy in Baltimore, income and education can make all the difference, according to a new survey from the city health department.

The survey of 1,100 Baltimoreans shows stark differences by income and education in rates of chronic disease, health insurance and mental health problems.

Among the key findings:

• 34 percent of respondents said they were obese, 14 percent had diabetes  and 36 percent had high blood pressure. Those in the lowest income group were 2.4 times more likely to be obese than those in the highest income group, 3.7 times more likely to have diabetes and twice as likely to have hypertension.
  

• Mental health issues showed a wide racial disparity. Black respondents were 4 times more likely than whites to say they had an unmet mental health need in the last year. 
  

• People in the lowest income group were 12 times more likely to say they had trouble affording to eat healthily. The lowest income group was also 6 times more likely to report concerns about having enough food.

Health officials said they have known for years that such socioeconomic dynamics are important determinants of people's health. They hope the data helps them create programs to combat the disparities.

The survey, a first to combine questions about eating habits, the impact of violence on health and mental health problems, builds on previous studies about the city's huge health disparities. In 2008, a city report found a two-decade difference in life expectancy between residents of Hollins Market and the city's Roland Park neighborhood.

Continue reading "In Baltimore, big disparities in health by income" »

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Those grocery store cards and key chain hangers that save you money might be the next big tool in helping keep customers informed of food safety risks.

As reported in The Sun on Sunday by our colleague Liz Kay, food safety advocates say those customer loyalty cards are the best way to notify customers of recalled products and prevent illness.

In fact, the Centers for Disease Control and Prevention used the cards to track down the latest salmonella outbreak that sickened 245 people in 44 states.

Of course, not everyone's on board with the idea. Some opponents say privacy is a real concern. After all, barcodes on the back of those cards are linked to a mountain of personal data about shoppers.

With the recent recall of hydrolyzed vegetable protein possibly contaminated with a strain of salmonella, the debate over the best way to keep consumers informed of recalls rages on. 

For now, the story offers some tips consumers can use to take matters into their own hands:

•Recalled products should be discarded or returned to retailers for refunds.

•All food should be cooked according to the package instructions, including directions to let food stand after heating in the microwave.

•Conscientious eaters with computer access also could sign up for e-mail alerts about recalls at foodsafety.gov, but prepare to be inundated with messages.

AP photo

Continue reading "The key to food safety could be in your wallet" »

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The Baltimore health department is sponsoring free vision screenings tomorrow in honor of World Glaucoma Day.

You can get your screening from 9 a.m to noon at Good Samaritan Hospital's main lobby at 5601 Loch Raven Blvd, Baltimore. You don't need an appointment. If you're uninsured and the vision test discovers a problem, the health department will help you find resources to pay for treatment.

Glaucoma is serious -- about 3 million people nationwide are affected, and typically the disease has few warning signs. The condition leads to damage of the optic nerve and is the second most common cause of blindness in the United States. There's no cure, but if detected early, treatment can be effective.

For more information, check out the health department website at: www.baltimorehealth.org. 

Baltimore Sun photo

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Since HBO's "The Wire" went off the air more than two years ago, it's been a favorite topic of academia, spurring college courses on urban poverty, lectures on substance abuse and the like.

The latest takes place in The Wire's home here in Bmore. Wednesday, the folks at Johns Hopkins School of Public Health will kick off a lecture series that uses the gritty series to explore real public health challenges in the city in which it is based. 

Wednesday's talk will feature Sonja Sohn, who played Detective Kima Greggs on the drama. She'll discuss her program ReWired for Change, which uses the show's vivid portrayals of drugs, crime and poverty to help young people confront those very real challenges in their communities.

Over the course of the series, public health professors will examine the struggles of urban women and families as portrayed in the series, the problem of injection drug use and even thornier topics, including one session in April provocatively titled: "Is there a choice? Violence and Guns on The Street of Baltimore."

Susan Sherman, an epidemiologist with the Johns Hopkins Bloomberg School of Public Health, and self-professed "huge fan of the show" said the seminar is something she and professors David Holtgrave and Danielle German have wanted to do for years.

Wednesday's seminar will take place from 12:15 p.m to  1:15 pm in the Hampton House Auditorium at the school of public health in Baltimore. Click here for more info and details on the rest of the series.

Baltimore Sun photo of Sohn speaking to youth in the ReWired for Change program

Posted by Kelly Brewington at 7:03 AM | Permalink | Comments (0)
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Folks are still gabbing about Tiger Woods' public apology for his infidelity, not to mention his admission of spending 45-days in a treatment facility. And everyone's entered the fray: were his philandering ways evidence of a sex addiction? Does such a thing even exist?

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

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

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

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

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

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

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

AP photo

Continue reading "Is sex addiction a real disorder?" »

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

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

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

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

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

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

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
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The use of imaging technology such as MRI and CT scans tripled between 1996 and 2007, according to a new report by the Centers for Disease Control and Prevention's National Center for Health Statistics.

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

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

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

A few highlights:

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

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

Baltimore Sun photo

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

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

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

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

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

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

Continue reading "How a checklist can reduce hospital infections" »

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

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

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

Baltimore Sun photo by Kim Hairston

Continue reading "Hopkins team to help staff USNS Comfort" »

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

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

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

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

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

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

Posted by Kelly Brewington at 11:57 AM | Permalink | Comments (0)
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With the blizzard warning in effect, lots of closures to keep mind of. Among the latest, the University of Maryland Greenebaum Cancer Center is closing it's outpatient clinic at the Stoler Pavilion today and tomorrow. It plans to reopen Friday and Saturday for chemotherapy and urgent visits only. For more info: call 410-328-7609.

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

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

Continue reading "Snow-related closures and a request for help from hospitals" »

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

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

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

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

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

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

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

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

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

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

Continue reading "Hospitals brace for snow -- again!" »

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

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

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

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

So why don't we get vaccinations?

Continue reading "Adults need vaccines too" »

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

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

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

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

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

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

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

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

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

Baltimore Sun photo

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

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

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

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

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

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

Continue reading "How dialysis patients manage in a blizzard" »

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

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

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

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

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

So, how are you prepping for the big snow? 

Baltimore Sun photo

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Finding that you need fewer ZZZs?

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

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

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

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

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

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

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

Associated Press file photo of woman sleeping at an airport

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

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

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

AP photo

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A crew of 22 doctors, nurses and other health professionals from the University of Maryland Medical Center and the University of Maryland School of Medicine departed for Haiti this afternoon with plenty of medical supplies and medications. 

The group, which is working with Catholic Relief Services, includes surgical staff from the University of Maryland Shock Trauma Center and four infectious disease specialists from the University of Maryland Institute of Human Virology. They'll spend more than a week working at St. Francois de Sales hospital in Port-au-Prince, which was badly damaged in the earthquake.

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More dispatches from Haiti -- from the doctors themselves. Of the medical teams we've told you about who are on the ground in Haiti, several have been chronicling their missions with blogs of their own. 

Dr. Jean-Max Hogarth from St. Joseph Medical Center in Towson returned to his native Haiti. He shares this tale of a 9-year-old girl, found under the rubble after 3 days with both feet partially amputated. She had only her mother left, after her father and two siblings were killed by the disaster.

She is a beautiful loving child that has grabbed the hearts of everyone in the hospital. God Bless her. I will NEVER forget her. Never

Unfortunately, she is one of MANY. The emergency workers have ended their search and rescue missions.

What remains is a nation in great need of long term help. God Bless my beloved Haiti.

No pictures. Too graphic

Here's a dispatch from the folks at Jhpiego, with a tale from a nurse who say women in labor aren't getting the care they deserve in Haiti, because doctors are overwhelmed with trauma injuries. Among the challenges the Hopkins-affiliated global health doctors are encountering: not enough obstetricians, doctors performing c-sections in tents with dirt underfoot and Haiti's main school for nurses and midwifes leveled by the earthquake.

Continue reading "Docs blog from Haiti" »

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Our colleague Robert Little wrote recently about concerns that several hundred patients at St. Joseph Medical Center in Towson may have received coronary implants when they didn't need them.

The issue has sparked one lawsuit so far and highlighted a debate among cardiologists and confusion among patients about when stents are necessary. Some doctors told me with the exception of patients in the middle of a heart attack, the mesh tubes that prop open narrowed arteries may be overused.

So what does that mean for heart patients? Got questions about stents?

Well, we have answers. Dr. Claudia Hochberg, an interventional cardiologist at Boston Medical Center, will be here at noon on Tuesday to answer your questions.

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

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We've got more updates from Baltimore-area medical teams in Haiti: 

Remember that baby that Dr. Carol Ritter delivered? Well, the mom named her child after the doc. Awwwwww.

“I’ve never had one of my patients in the states in 35 years name a baby after me," said Ritter, an OBGYN at Greater Baltimore Medical Center. ‘I mean in the middle of all the sorrow you can still find the joy and, that was, that was just a gift."

Meanwhile, Dr. Guesly Delva of the University of Maryland School of Medicine’s Institute for Human Virology, returned to his native Haiti earlier this week and gave us this update via Lane Hartill from Catholic Relief Services.

"I was dreadful of coming here because of what I was seeing on TV," he said. "I broke down the first night." The relief effort is both personal and professional for Dr. Delva. In the first days after the quake he feared the worst when he hadn't heard from his mother, other relatives and friends scattered in his native Gonaives and in Port-au-Prince. Since then, he's learned his mother is fine, but he is still searching for other relatives.

After arriving in the city and working with patients, he said: "I feel a sense of desperation."

"There's so much to do. I know probably we're not going to have enough time or resources to relive all of the pain or suffering."

top photo from the Ritters: Dr. Carol Ritter and baby Carol 

bottom photo from Lane Hartill: Delva checks on a woman whose leg was amputated

Continue reading "More updates from Haiti" »

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Medical teams from the Baltimore area have flocked to Haiti to provide much-needed relief to the quake-stricken nation. As we get them, we'll fill you in with on-the-ground updates. Here are a few:

Dr. Carol Ritter, an OBGYN who delivered a baby in Haiti over the weekend, reports on her blog that the clinic she's working in on the Haiti/Dominican Republic border has seven operating rooms packed with medical teams from such countries as Germany, Japan and France. They face daunting circumstances, she writes:

A day filled with many fresh orphans. children losing parents and parents losing children all day. No one wants to stop working. Would give us time to think about it.

Dr. Guesly Delva, a fellow at the University of Maryland School of Medicine’s Institute of Human Virology, left Tuesday for his native Haiti, where he's working at St. Francois Hospital, one of Haiti's oldest hospitals that was nearly completely destroyed. Staff at Catholic Relief Services and IHV, which has an HIV/AIDS program in Haiti, have worked to create a makeshift emergency center out of the rubble.

They thought they would have to shut down, but volunteers helped get food, water and fuel for the hospitals and delivered medical supplies, according school of medicine and CRS spokespeople who compiled details from teams there and gave us this update. Now, three operating rooms are up and running staffed by Haitian, Belgian and Italian teams.

Doctors dragged a refrigerator out of the rubble to try to start a blood bank (with blood from the U.N.), they said. There are lots of amputations and bad burns and major wounds. Their focus: people in critical condition, who could die within 24 hours.

Continue reading "Baltimore medical teams provide updates from Haiti" »

Posted by Kelly Brewington at 7:16 AM | Permalink | Comments (0)
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Or does it just get you high?

The Obama administration may have eased federal policy on marijuana enforcement, but the experts are still debating whether the drug has all the medical properties that proponents claim.

Two new stories in the NYT and the WSJ lay out the basics:

In a nutshell, there's not enough scientific evidence that pot's medical uses are valid. Studies show that smoking marijuana can improve nausea in cancer patients and others suggest that it help patients with neurological problems such as multiple sclerosis, the NYT reports. However, the story goes on to say:

But there is no good evidence that legalizing the smoking of marijuana is needed to provide these effects. The Food and Drug Administration in 1985 approved Marinol, a prescription pill of marijuana’s active ingredient, T.H.C. Although a few small-scale studies done decades ago suggest that smoked marijuana may prove effective when Marinol does not, no conclusive research has confirmed this finding.

Access to marijuana is increasing nationwide. New Jersey's governor just signed a medical marijuana bill into law on Monday, adding that state to 13 others with similar laws and down the road in Washington, there's a bill to allow some dispensaries in the district.

Maryland has a strange setup with a little-known law that while forbids medical use, could open the door for it one day, advocates hope.

AP photo 

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Or more importantly, should they?

Since arriving to quake-devastated Haiti, network medical reporters have been shifting back and forth between doctor and reporter. Those dual roles have sparked criticism around the Web, notably from experts on journalism ethics who argue doctor/reporters put themselves in an ethical quanadry by trying to save lives one minute and tell the story the next.

"I think it's very hard for an individual who is professionally and emotionally engaged in saving lives to be able to simultaneously step back from the medical work and practice independent journalistic truth-telling," Bob Steele, journalism values scholar at the Poynter Institute, told the LA Times in this great piece about that ethical dilemma.

After Dr. Sanjay Gupta swooped in to perform brain surgery on a 12-year-old Haitian girl, Steele questioned CNN's motives in airing the story. “Frankly, it isn’t much of a story,” Steele told the LA Times. “You can’t help but look at this and worry there is a marketing element in it.”   If he's going to be a doctor, do so, but then he needs to stop being a reporter, Steele argued.

Continue reading "In Haiti, can doctors be reporters too? " »

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Dr. Carol Ritter, an OBGYN at Greater Baltimore Medical Center who rushed to Haiti last week to help aid earthquake victims, delivered a baby there over the weekend.

She and her husband Dr. Tom Ritter, a dentist, left last week for Haiti. You can read about their efforts in Haiti on their blog: www.carolandtominhaiti.com. (That's them on the left)

The Ritters have long ties to Haiti and humanitarian efforts around the globe. Tom Ritter was actually supposed to fly to Haiti this week for a scheduled lecture at one of Haiti's dental schools to which he has long given donations and support, he told me during an interview last week. Then, disaster struck and the couple made quick plans to join the relief effort.

Here's what Tom Ritter wrote on his blog upon arriving in Haiti Saturday:  Wow - we've got our work cut out for us! No one should come here unless they can feed and house themselves. 100 fully equipped docs just came with no way to feed themselves, and their hotel is 3 hours away. The public hospital is not a nice place to be. Chaos is the order of the day, but good things come in every hour to help ease the suffering.

They're not alone. Last week folks at Johns Hopkins told me they hoped to send teams to Haiti soon. GBMC also made a $10,000 donation to purchase medical supplies for the region. And a team of three medical professionals from St. Joseph Medical Center in Towson, including a Haitian-American anesthesiologist, are expected to leave for Haiti tomorrow for a week-long aid mission.

photo from Tom and Carol Ritter

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I wrote last week about the public health disaster that Haiti will likely endure for months. Help is on the way including medical reinforcements from Baltimore.

Our colleagues Robert Little and Kim Hairston are making their way to earthquake-ravaged Haiti aboard the USNS Comfort and chronicling its rescue mission. The massive floating emergency center has two decades of military and humanitarian missions under its belt.

But the enormity of the task at hand will test the 894-foot ship, which will reach its full operational capacity for the first time since it was delivered to the Navy in 1987.

Will it be ready? Will the help be enough?

While the world has certainly ratcheted up its aid response to the Haitian disaster in recent days, the situation grows desperate with reports of scarce medical supplies, overwhelmed medical teams and critics such as Doctors Without Borders, who say that the response is insufficient.

What do you think? Should governments and aid groups have acted sooner?

Continue reading "Medical aid rushes to Haiti, but bottlenecks persist" »

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Americans are fat. We've known this for years. But new research suggests that the obesity rate -- while still high -- might be slowing.

About a third of adults were obese in 2007-2008, but the rate appears to be leveling off after decades of surging obesity rates, certainly for women and probably for men, according to a new study appearing today in the Journal of the American Medical Association.

The study of 5,555 men and women 20 and older found no difference in obesity levels for women from the 2007-2008 survey period to another survey done in 1999. For men, the most recent data was unchanged from estimates from 2003-2004.

In children, a separate analysis of 3,281 kids 2 through 19, found the rates of obesity also were slowing. That study is also appearing in today's JAMA. Both the child and adult studies were done by researchers from the CDC's National Center for Health Statistics.

Sure this is encouraging news, but it's no cause for celebration, warns an accompanying editorial. Both rates are too high. Even if trends stay the same, some 68 percent of adults are overweight or obese and nearly 32 percent of school aged kids are at or above the 85th percentile of body mass index.

"Given the risk of obesity-related major health problems, a massive public health campaign to raise awareness about the effects of overweight and obesity is necessary," writes Dr. J. Michael Gaziano, a contributing JAMA editor. "The longer the delay in taking aggressive action, the higher the likelihood that the significant progress achieved in decreasing chronic disease rates during the last 40 years will be negated, possible even with a decrease in life expectancy."

AFP/Getty images

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There's some big news in the world of ophthalmology:

The Wilmer Eye Institute of Johns Hopkins Medicine  announced a partnership today with the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia. The eye specialists will collaborate on research, education and patient care.

“We at the Wilmer Institute have long been interested in the study and cure of blinding eye diseases around the world, and the King Khaled Eye Specialist Hospital is certainly one of the most impressive eye hospitals outside of the United States,” said Dr. Peter J. McDonnell, William Holland Wilmer Professor of Ophthalmology and the director of the Wilmer Institute, in a statement.

“Working in close collaboration with the excellent experts at the King Khaled Eye Specialist Hospital, and combining the expertise of our two institutions, will allow for more rapid evaluation of potential new therapies than would be possible with either hospital working alone”.

One major focus for the centers will be training the next generation of leaders in ophthalmology. They hope to develop new procedures and treatments for eye diseases that are difficult or not currently curable, such as diabetic eye disease.

The Wilmer Institute says it has produced more than a hundred chairpersons in departments of ophthalmology around the globe.

“We are delighted to enter into this affiliation with the Wilmer Institute,” said Dr. Abdul Elah Al-Towerki, executive director of the King Khaled Eye Specialist Hospital, in a statement. “We chose the Wilmer Institute because of its commitment to excellence and track record of advancing the field of ophthalmology. Both of our institutions have great strengths, and working closely together in this affiliation will allow us to accomplish more, in a shorter period of time, than we could working alone. This affiliation is supported at the highest levels within the government of Saudi Arabia”.

The Saudi government is providing some financial support and several Wilmer faculty members will head over to train in that country. There will also be a new endowed professorship at Johns Hopkins established to support the work.

The internationally known Wilmer Institute has more than 130 full-time faculty and is one of the largest medical institutes devoted to treatment and cure of eye diseases in this country.

The King Khaled Eye Specialist Hospital is the largest eye hospital in the Kingdom of Saudi Arabia, and is a top-ranked medical facility in the Middle East. 

Baltimore Sun file photo of final construction of the new Wilmer building/Gene Sweeney Jr. 

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It's been nearly a year since former city Health Commissioner Dr. Joshua M. Sharfstein left Baltimore for the Food and Drug Administration and a permanent replacement has yet to be found.

Since then, swine flu, health care reform and all manner of every day city health problems have been in the forefront. So when will Baltimore get a new health commissioner? And who might that person be?

Sharfstein left "very big shoes to fill," incoming Mayor Stephanie C. Rawlings-Blake told the Baltimore Sun's editorial board this morning. "I'm looking for that type of energy and leadership at the health department."

Sharfstein targeted manufacturers of cold and cough medicines, convincing the FDA there was little evidence the drugs worked in children younger than 4. And he took on the hazards of lead, banning its use in candy, cosmetics and jewelry sold in the city.

Rawlings-Blake didn't offer any more specifics on her preference for health commissioner, other than to say she's hopeful that there will be many resumes coming to her desk as she seeks a "top notch" person to fill the job. "There is a lot of interest from people all over to work in the city and work for the city," she said.  

It will be interesting to see how she handles this post. Public health is a huge issue for Baltimore, whose high poverty rate makes the city a magnet for all sorts of health ills.

Rawlings-Blake should stick to three major areas as she focuses the health department: substance abuse, primary care and getting kids prepared for school, advised Dr. Peter L. Beilenson, Howard County's health officer who served as Baltimore's health commissioner for 13 years.

What do you think should be the focus of the next health commissioner?

Baltimore Sun photo

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Baltimore's Sinai Hospital recently opened a center designed to teach patients with diabetes how to manage their disease and improve their lifestyle with advice and support.

With glucose monitoring instruction, nutritional counseling and insulin and medication training, the Diabetes Resource Center offers people one-on-one time with doctors, nurses and specialists to discuss their condition and create a treatment plan. It also offers group session for continued support.

With some 18 million people nationwide struggling with diabetes -- nearly 360,000 of them in Maryland alone -- the needs for support are huge. Many more are living with diabetes and have not been diagnosed.

For more information about the center, call 410-601-WELL

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Depictions of medical professionals have come a long way since General Hospital first aired. But when it comes to nurses, too often they are relegated to tired stereotypes, say authors Sandy Summers and Harry Jacobs Summers.

The pair, who penned the book Saving Lives: Why the Media Portrayals of Nurses Put US All at Risk, and are behind the Baltimore-based group The Truth About Nursing ,have come out with a list of the best and worst portrayals of nurses of 2009.

The good ones offer compelling portrayals of nurses who go all out for the care of their patients. They also rise above one-dimensional stereotype of nurses, such as "the handmaidens, the naughty nurse, the angel and the battle axe," writes Sandy Summers, a Hopkins-trained nurse.

Topping the best list: Edie Falco's Nurse Jackie on Showtime. She's tough as nails, with a few, um, issues -- an addiction to painkillers and an affair with a coworker, for starters -- but she's human and fights for the best care for her patients, Summers writes.

Interestingly enough, some nurse organizations have been no fans of Jackie's, while others said they were willing to take the good with the bad -- as long as there's more positive aspects in future episodes.  

Continue reading "TV nurses -- the good and the bad" »

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The temperatures have been below normal for some time now, in Maryland and around the country, so it seems like a good time to remind everyone to stay safe and warm.

The Centers for Disease Control and Prevention say the cold air makes everyday activites challenging, if not dangerous. Young children, older adults and the chronically ill are most at risk, so make sure to check on these peolpe regularly. 

Exposure to cold temperatures can cause frostbite and hypothermia, which can be life-threatening. The CDC advises seeking immediate medical attention if you suspect you have either. 

Frostbite causes skin to appear red and feel painful.  Without medical attention, skin will then turn white or grayish and feel firm, waxy or numb.  Symptoms of hypothermia include shivering, exhaustion, confusion, fumbling hands, memory loss, slurred spe