For years health authorities have warned of the growing threat posed by drug-resistant bacteria, but most of us have been half-listening. Not anymore.
A virulent strain of bacteria that resists many antibiotics appears to be killing more people annually than AIDS, emphysema or homicide, taking an estimated 19,000 lives in 2005, according to a study published last week in the Journal of the American Medical Association. The recent death of a 17-year-old high school football player in Virginia is a tragic reminder that methicillin-resistant Staphylococcus aureus, or MRSA, can prey on otherwise healthy people.
The best defense against the potentially deadly infection is common sense and cleanliness. “We need to reinvent hygiene for the 21st century,’’ said Dr. Charles Gerba, professor of environmental microbiology at the University of Arizona at Tucson. “You go to a grocery store, and hundreds of thousands of people have touched those surfaces every day. Microorganisms are evolving very rapidly.’’
Here are answers to common questions about community-acquired staph infections, or CA-MRSA.
What does CA-MRSA look like?
CA-MRSA is primarily a skin infection. It often resembles a pimple, boil or spider bite, but it quickly worsens into an abscess or pus-filled blister or sore. Patients who have sores that won’t heal or are filled with pus should see a doctor and ask to be tested for staph infection. They should not squeeze the sore or try to drain it — that can spread the infection to other parts of the skin or deeper into the body.
Who is at risk?
The vast majority of MRSA cases happen in hospital settings, but 10 percent to 15 percent occur in the community at large among otherwise healthy people. Infections often occur among people who are prone to cuts and scrapes, such as children and athletes. MRSA typically spreads by skin-to-skin contact, crowded conditions and the sharing of contaminated personal items. Others who should be watchful: people who have regular contact with health care workers, those who have recently taken such antibiotics as fluoroquinolones or cephalosporin, homosexual men, military recruits and prisoners. Clusters of infections have appeared in certain ethnic groups, including Pacific Islanders, Alaskan Natives and Native Americans.
What can I do to lower my risk of contracting MRSA?
Bathing regularly and washing hands before meals is just a start. Wash your hands often or use an antibacterial sanitizer after you’ve been in public places or have touched handrails and other highly trafficked surfaces. Make sure cuts and scrapes are bandaged until they heal. Wash towels and sheets regularly, preferably in hot water, and leave clothes in the dryer until they are completely dry. “Staph is a pretty hardy organism,’’ said Dr. Gerba.
Remind kids and teenagers that personal items shouldn’t be shared with their friends, he added. This includes brushes, combs, razors, towels, makeup and cell phones. A teenager in Dr. Gerba’s own family once contracted MRSA, he said, and he eventually traced the bacteria to her cell phone. She had shared it with a friend whose mother worked in a nursing home. Dr. Gerba went on to discover MRSA on the friend’s cell phone and makeup compact and on a countertop in her home.
Where does MRSA lurk?
Staph bacteria may be found on the skin and in the noses of nearly 30 percent of the population without causing harm. Experts believe it survives on surfaces in 2 percent to 3 percent of homes, cars and public places.
But the bacteria are evolving, and the statistics may already underestimate the prevalence of MRSA. Be especially vigilant in health clubs and gyms — staph grows rapidly in warm, moist environments. The risks of infection and necessary precautions should be explained to student athletes, particularly those in contact sports who often suffer cuts and spend time in locker rooms. When working out at the gym, make sure you wipe down equipment before you use it. Many people clean just the sweaty benches, but Dr. Gerba notes that MRSA also has been found on the grips of workout machines. And if you have a scrape or sore, keep it clean and bandaged until it heals. Minor cuts and scrapes are the way MRSA takes hold.
What is the single best thing I can do to protect myself from MRSA?
Without question, people need to show far more respect for antibiotics. Misuse of antibiotics allows bacteria to evolve and develop resistance to drugs. But parents often pressure pediatricians to prescribe antibiotics even when they don’t help the vast majority of childhood infections. When you do take an antibiotic, finish the dose. Antibiotic resistance is bad for everyone, but your body can also become particularly vulnerable to resistant bacteria if you are careless with the drugs.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
Monday, March 31, 2008
Sunday, March 30, 2008
Antibiotics and Ear Infections
The old medical approach has been to routinely give antibiotics for acute ear infections. Ear infections are the top reason that antibiotics are given to children and the top reason that children get general anesthesia for surgery. It’s quick, easy and convenient for doctors to write an antibiotic prescription for ear infections, and parents want quick relief for their kids.
Simply giving antibiotics for ear infections doesn’t take into account where ear infections and ear pain come from. Nor does it take into account the consequences of these antibiotics — for us or the environment.
When antibiotics are given, kids are a bit more likely to get another ear infection sooner. And each time a child takes a course of antibiotics, future infections become harder to treat.
A typical healthy child carries a pound or two of rapidly evolving microscopic bacteria in his or her body. Antibiotics cause the selective breeding of the more resistant strains, which leads to the use of newer, harsher, more expensive antibiotics, with more side effects, creating a negative cycle. And some of the antibiotics given will end up in our water supply, as we’ve heard in the news recently, perhaps affecting wildlife as well as us.
Parents often want to start antibiotics for the ear infection because we’ve mistakenly taught them to think this will reduce their child’s pain. In the first 24 hours, though, there is no difference in pain level whether or not the child gets antibiotics.
We’ve also taught them to think that these medicines will help their child to recover. However, of about 10 million annual antibiotic prescriptions for ear infections, somewhere between 8.5 million and 9.5 million prescriptions didn’t actually help the children, according to the American Academy of Pediatrics.
Put another way, we have to treat between seven and 20 children with antibiotics for ear infections before one child benefits from the medicine. About 80 percent of ear infections will clear up easily without antibiotics.
In 5 to 14 percent of children, the antibiotics will take one day off the length of the ear infection. But by comparison, up to 15 percent of children who take antibiotics will develop vomiting or diarrhea, and up to 5 percent will have allergic reactions, some of which may be quite serious.
I believe antibiotics to be among the greatest inventions of the 20th century, but most children would be better off without the routine use of them.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
Simply giving antibiotics for ear infections doesn’t take into account where ear infections and ear pain come from. Nor does it take into account the consequences of these antibiotics — for us or the environment.
When antibiotics are given, kids are a bit more likely to get another ear infection sooner. And each time a child takes a course of antibiotics, future infections become harder to treat.
A typical healthy child carries a pound or two of rapidly evolving microscopic bacteria in his or her body. Antibiotics cause the selective breeding of the more resistant strains, which leads to the use of newer, harsher, more expensive antibiotics, with more side effects, creating a negative cycle. And some of the antibiotics given will end up in our water supply, as we’ve heard in the news recently, perhaps affecting wildlife as well as us.
Parents often want to start antibiotics for the ear infection because we’ve mistakenly taught them to think this will reduce their child’s pain. In the first 24 hours, though, there is no difference in pain level whether or not the child gets antibiotics.
We’ve also taught them to think that these medicines will help their child to recover. However, of about 10 million annual antibiotic prescriptions for ear infections, somewhere between 8.5 million and 9.5 million prescriptions didn’t actually help the children, according to the American Academy of Pediatrics.
Put another way, we have to treat between seven and 20 children with antibiotics for ear infections before one child benefits from the medicine. About 80 percent of ear infections will clear up easily without antibiotics.
In 5 to 14 percent of children, the antibiotics will take one day off the length of the ear infection. But by comparison, up to 15 percent of children who take antibiotics will develop vomiting or diarrhea, and up to 5 percent will have allergic reactions, some of which may be quite serious.
I believe antibiotics to be among the greatest inventions of the 20th century, but most children would be better off without the routine use of them.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
Thursday, March 27, 2008
Medicare Opens up to the Disabled under 65 in Illinois June 1st
With the passage of Public Act 95-0436, persons under 65 with disabilities who become eligible for Medicare will have additional rights. Beginning June 1, 2008, Illinois residents under age 65 who receive Medicare because of disabilities have the same open enrollment rights as seniors. That is to say, a person under 65 who qualifies for Medicare because of disabilities and who applies for a Medigap policy within six months after enrolling in Medicare Part B has a six-month open enrollment period beginning the day they enroll in Medicare Part B.
During open enrollment, a company must allow you to buy any of the Medigap plans it offers. This right is also available for persons who are retroactively enrolled in Medicare Part B due to a retroactive eligibility decision made by the Social Security Administration if they apply within 6 months after receiving notice of retroactive eligibility.
Open enrollment will apply to all under 65 Medicare eligible individuals even if they have existing Medicare supplement insurance. If you fit this description you will be able to choose from any plan offered by companies selling Medicare Supplement insurance in Illinois until December 1, 2008.
Loss of Other Coverage.
In addition, if you are under 65 and on Medicare, but declined a Medigap policy because you were still covered under an employer group health plan, you will have a 63 day open enrollment period if the employer plan terminates or ceases to provide health benefits that supplement Medicare. Similarly, if you are either currently enrolled in a Medicare Advantage plan or have a Medigap policy and the insurance company goes out of business, withdraws from the market, or misrepresented the product you purchased, you also will be eligible for a 63 day open enrollment period under most circumstances (see Guaranteed Issue Right below).
Cost of Coverage. For persons under 65 that become eligible to purchase a Medigap policy, companies may not be charge a rate higher than the highest rate on the company’s current rate schedule filed with the Illinois Division of Insurance.
During open enrollment, a company must allow you to buy any of the Medigap plans it offers. This right is also available for persons who are retroactively enrolled in Medicare Part B due to a retroactive eligibility decision made by the Social Security Administration if they apply within 6 months after receiving notice of retroactive eligibility.
Open enrollment will apply to all under 65 Medicare eligible individuals even if they have existing Medicare supplement insurance. If you fit this description you will be able to choose from any plan offered by companies selling Medicare Supplement insurance in Illinois until December 1, 2008.
Loss of Other Coverage.
In addition, if you are under 65 and on Medicare, but declined a Medigap policy because you were still covered under an employer group health plan, you will have a 63 day open enrollment period if the employer plan terminates or ceases to provide health benefits that supplement Medicare. Similarly, if you are either currently enrolled in a Medicare Advantage plan or have a Medigap policy and the insurance company goes out of business, withdraws from the market, or misrepresented the product you purchased, you also will be eligible for a 63 day open enrollment period under most circumstances (see Guaranteed Issue Right below).
Cost of Coverage. For persons under 65 that become eligible to purchase a Medigap policy, companies may not be charge a rate higher than the highest rate on the company’s current rate schedule filed with the Illinois Division of Insurance.
Red Wine Antioxidants Fighting Cancer
A new study shows an antioxidant found in red wine destroys cancer cells from the inside and enhances the effectiveness of radiation and chemotherapy cancer treatments.
Researchers say the antioxidant found in grape skins, known as resveratrol, appears to work by targeting the cancer cell's energy source from within and crippling it. When combined with radiation, treatment with resveratrol prior to radiation also induced cell death, an important goal of cancer treatment.
The researchers note that although resveratrol might reduce pancreatic cancer's resistance to chemotherapy, "the impact of red wine consumption on chemotherapy remains unclear."
Researcher Paul Okunieff, MD, chief of radiation oncology at the University of Rochester Medical Center, says red wine consumption during chemotherapy or radiation treatment has not been well studied, but it's not prohibited. Okunieff says if a cancer patient already drinks red wine moderately, most physicians wouldn't tell the patient to give it up. But perhaps a better choice might be to drink as much red or purple grape juice, which also contains resveratrol, as desired.
"Antioxidant research is very active and very seductive right now," Okunieff says in a news release. "The challenge lies in finding the right concentration and how it works inside the cell. In this case, we've discovered an important part of that equation. Resveratrol seems to have a therapeutic gain by making tumor cells more sensitive to radiation and making normal tissue less sensitive."
Resveratrol Targets Cancer Cells
In the study, published in Advances in Experimental Medicine and Biology, researchers examined the effects of a 50 microgram/milliliter dose of resveratrol on pancreatic cancer cells alone and in combination with radiation treatment. By comparison, the resveratrol concentration in red wine can be as high as 30 micrograms/milliliter.
The results showed that resveratrol had a variety of potentially valuable anti-cancer effects, including:
Making the cancer cells more sensitive to chemotherapy by hampering proteins that resist treatment
Triggering cancer cell death (apoptosis)
Injuring the cancer cell's energy source and decreasing its potential to function
"While additional studies are needed, this research indicates that resveratrol has a promising future as part of the treatment for cancer," Okunieff says.
Researchers say the antioxidant found in grape skins, known as resveratrol, appears to work by targeting the cancer cell's energy source from within and crippling it. When combined with radiation, treatment with resveratrol prior to radiation also induced cell death, an important goal of cancer treatment.
The researchers note that although resveratrol might reduce pancreatic cancer's resistance to chemotherapy, "the impact of red wine consumption on chemotherapy remains unclear."
Researcher Paul Okunieff, MD, chief of radiation oncology at the University of Rochester Medical Center, says red wine consumption during chemotherapy or radiation treatment has not been well studied, but it's not prohibited. Okunieff says if a cancer patient already drinks red wine moderately, most physicians wouldn't tell the patient to give it up. But perhaps a better choice might be to drink as much red or purple grape juice, which also contains resveratrol, as desired.
"Antioxidant research is very active and very seductive right now," Okunieff says in a news release. "The challenge lies in finding the right concentration and how it works inside the cell. In this case, we've discovered an important part of that equation. Resveratrol seems to have a therapeutic gain by making tumor cells more sensitive to radiation and making normal tissue less sensitive."
Resveratrol Targets Cancer Cells
In the study, published in Advances in Experimental Medicine and Biology, researchers examined the effects of a 50 microgram/milliliter dose of resveratrol on pancreatic cancer cells alone and in combination with radiation treatment. By comparison, the resveratrol concentration in red wine can be as high as 30 micrograms/milliliter.
The results showed that resveratrol had a variety of potentially valuable anti-cancer effects, including:
Making the cancer cells more sensitive to chemotherapy by hampering proteins that resist treatment
Triggering cancer cell death (apoptosis)
Injuring the cancer cell's energy source and decreasing its potential to function
"While additional studies are needed, this research indicates that resveratrol has a promising future as part of the treatment for cancer," Okunieff says.
Tuesday, March 25, 2008
Chemo Costs Rising Dramatically
Chemotherapy costs are rising dramatically, and oncologists this year will get their first guidelines on how to talk with patients about the affordability of treatment choices."These are awkward discussions," says Dr. Allen Lichter of the American Society of Clinical Oncology, which is writing the guidelines. "At least we can bring this out in the open."It's a particular issue for patients whose cancer can't be cured but who seek the longest possible survival and the best quality of life.
The prices can be staggering. There are two equally effective options, for example, to battle metastatic colon cancer, the kind spreading through the body—but one costs $60,000 more than the other, says Dr. Leonard Saltz of Memorial Sloan-Kettering Cancer Center.
The difference? The cheaper one, irinotecan, causes hair loss that makes it impossible for people trying to keep a job to hide their cancer treatment, he explains. The pricier oxaliplatin can cause nerve damage in hands and feet that might make it a worse option for, say, a musician or computer worker."As long as a therapy provides a benefit, it will tend to be offered to patients. Whether it's a small benefit or a moderate benefit, it may be offered with the same level of enthusiasm," says Dr. Neal Meropol, who is leading the panel writing the American Society of Clinical Oncology's new guideline on how to weigh treatment costs.
The idea: Treat cost essentially as another side effect to weigh in choosing a therapy.At a meeting of the standard-setting National Comprehensive Cancer Network this month, Sloan-Kettering's Saltz and other doctors urged adding chemo prices to treatment guidelines.In renewing her prescription plan last year, Helen Geiger, 71, didn't notice that coverage had been changed for Thalomid to treat multiple myeloma, a blood cancer. It now cost a $1,051 monthly co-pay that she couldn't afford.
"You don't need this kind of stress when you're sick," says Geiger, who found a program that provided free medicine.
The prices can be staggering. There are two equally effective options, for example, to battle metastatic colon cancer, the kind spreading through the body—but one costs $60,000 more than the other, says Dr. Leonard Saltz of Memorial Sloan-Kettering Cancer Center.
The difference? The cheaper one, irinotecan, causes hair loss that makes it impossible for people trying to keep a job to hide their cancer treatment, he explains. The pricier oxaliplatin can cause nerve damage in hands and feet that might make it a worse option for, say, a musician or computer worker."As long as a therapy provides a benefit, it will tend to be offered to patients. Whether it's a small benefit or a moderate benefit, it may be offered with the same level of enthusiasm," says Dr. Neal Meropol, who is leading the panel writing the American Society of Clinical Oncology's new guideline on how to weigh treatment costs.
The idea: Treat cost essentially as another side effect to weigh in choosing a therapy.At a meeting of the standard-setting National Comprehensive Cancer Network this month, Sloan-Kettering's Saltz and other doctors urged adding chemo prices to treatment guidelines.In renewing her prescription plan last year, Helen Geiger, 71, didn't notice that coverage had been changed for Thalomid to treat multiple myeloma, a blood cancer. It now cost a $1,051 monthly co-pay that she couldn't afford.
"You don't need this kind of stress when you're sick," says Geiger, who found a program that provided free medicine.
Monday, March 24, 2008
Diet and Type 2 Diabetes
As a disease Type 2 diabetes is getting more and more common in Western society, mainly due to diet and the down turn in many peoples lives of the amount of time that they spend exercising. It is a disease that you can prevent, and prevention is easier than a cure. Eat sensibly and exercise and you should be able to prevent it. It is a very serious disease but it can be treated easily, the earlier you catch it the easier the effects will be to manage in the long term.
Listed below are a few of the most common symptoms of Type 2 diabetes. If you have any of these symptoms please don't ignore them, go to a doctor. You could be saving your own life.
Raging thirst
If you find yourself regularly with a raging thirst then it might be time to consult your doctor. Increased urination It's normal to pass two litres a day, but diabetics pass at least twice that, this helped Egyptian and Greek physicians to first identify the disease. One described it as a melting down of the flesh and limbs into urine.
Extreme tiredness
If the body can't convert glucose to energy properly, this is the result. It may seem like an overreaction but visit your GP for a check-up if symptoms persist. Weight loss An unexpected loss of three to four kilo's may indicate diabetes. If the body cannot convert energy from glucose it will start to break down stores of fat instead.
Genital itching and thrush
Raised sugar in the urine causes irritation and allows fungal infections to thrive - and these mildly troubling ailments (common in non-diabetics too) are easily overlooked. It they're occurring often, ask your GP for a blood sugar test, Blurred vision As blood-glucose levels rise and a person becomes dehydrated, the eyes dry out; as levels return to normal, eyes are flooded with tears and vision blurs. A diabetic can help themselves greatly by watching what they eat.
Here are a few basic rules for a diabetic diet;
Carbohydrates
Confusingly diabetics need carbohydrates with every meal, even though they raise blood-sugar levels. Without carbohydrates, the body can't produce energy. The best are those with a low glycaemic index (GI), such as sweet potato, long-grain rice, wholegrain or rye bread, which all produce a nice slow release of energy to keep blood sugars down. Rolled porridge oats are ideal, because they also lower cholesterol.
High-GI carbohydrates such as white bread and mashed potatoes are best avoided, though some nutrition consultants do not put a total ban on them for diabetics. If you eat white bread with baked beans, which are a low-GI food source it shifts the GI.
Beans and lentils should be eaten often. As well as providing carbohydrates they're high in fibre and health-giving plant sterols.
Fruit Fruits should be low-GI; apples, oranges or a few grapes are better than dates and watermelon (which are high-GI). Try to eat no more than a handful at a time and spread them throughout the day.
Watch out for fruit juice, which can send blood sugars soaring. Fruit, with all its fibre and bulk, is more filling than juice so much better for weight loss. Sweets With diabetes, it's a low-sugar diet not a no-sugar diet. Small amounts of sucrose are okay.
Sometimes, diabetics need sugar to bring their blood sugars up after a hypo (hypoglycaemia is low blood sugar). Fructose [fruit sugar] is also fine if you're having a whole fruit; it works in a slower way than sucrose. Lactose [milk sugar] is low-GI, so it's fine for people to have milk or low-fat yogurt, Protein Diabetics need to limit eggs to three a week because they contain cholesterol and saturated fats.
Omega-3 oil-enriched fish is recommended - but men should eat no more than four portions a week, women two, Lean meats are best, ideally with skin removed to minimise fat. Fat Saturated fat is the one to avoid. Monosaturated fat, found in olive oil and spreads, brings down bad LDL cholesterol without touching the good HDL cholesterol.
Polyunsaturated fat, in foods like sunflower and corn oil, lowers both. You can't cut out saturated fat entirely because you even get it in lean meat, but try cutting your cheese intake in half or eat a reduced-fat version.
So as you can see it's not all doom and gloom where a diabetic diet is concerned but rather than getting to the stage where you have diabetes and stick to the above diet wouldn't it be better to make changes to your lifestyle and diet before to damage has been done?
Listed below are a few of the most common symptoms of Type 2 diabetes. If you have any of these symptoms please don't ignore them, go to a doctor. You could be saving your own life.
Raging thirst
If you find yourself regularly with a raging thirst then it might be time to consult your doctor. Increased urination It's normal to pass two litres a day, but diabetics pass at least twice that, this helped Egyptian and Greek physicians to first identify the disease. One described it as a melting down of the flesh and limbs into urine.
Extreme tiredness
If the body can't convert glucose to energy properly, this is the result. It may seem like an overreaction but visit your GP for a check-up if symptoms persist. Weight loss An unexpected loss of three to four kilo's may indicate diabetes. If the body cannot convert energy from glucose it will start to break down stores of fat instead.
Genital itching and thrush
Raised sugar in the urine causes irritation and allows fungal infections to thrive - and these mildly troubling ailments (common in non-diabetics too) are easily overlooked. It they're occurring often, ask your GP for a blood sugar test, Blurred vision As blood-glucose levels rise and a person becomes dehydrated, the eyes dry out; as levels return to normal, eyes are flooded with tears and vision blurs. A diabetic can help themselves greatly by watching what they eat.
Here are a few basic rules for a diabetic diet;
Carbohydrates
Confusingly diabetics need carbohydrates with every meal, even though they raise blood-sugar levels. Without carbohydrates, the body can't produce energy. The best are those with a low glycaemic index (GI), such as sweet potato, long-grain rice, wholegrain or rye bread, which all produce a nice slow release of energy to keep blood sugars down. Rolled porridge oats are ideal, because they also lower cholesterol.
High-GI carbohydrates such as white bread and mashed potatoes are best avoided, though some nutrition consultants do not put a total ban on them for diabetics. If you eat white bread with baked beans, which are a low-GI food source it shifts the GI.
Beans and lentils should be eaten often. As well as providing carbohydrates they're high in fibre and health-giving plant sterols.
Fruit Fruits should be low-GI; apples, oranges or a few grapes are better than dates and watermelon (which are high-GI). Try to eat no more than a handful at a time and spread them throughout the day.
Watch out for fruit juice, which can send blood sugars soaring. Fruit, with all its fibre and bulk, is more filling than juice so much better for weight loss. Sweets With diabetes, it's a low-sugar diet not a no-sugar diet. Small amounts of sucrose are okay.
Sometimes, diabetics need sugar to bring their blood sugars up after a hypo (hypoglycaemia is low blood sugar). Fructose [fruit sugar] is also fine if you're having a whole fruit; it works in a slower way than sucrose. Lactose [milk sugar] is low-GI, so it's fine for people to have milk or low-fat yogurt, Protein Diabetics need to limit eggs to three a week because they contain cholesterol and saturated fats.
Omega-3 oil-enriched fish is recommended - but men should eat no more than four portions a week, women two, Lean meats are best, ideally with skin removed to minimise fat. Fat Saturated fat is the one to avoid. Monosaturated fat, found in olive oil and spreads, brings down bad LDL cholesterol without touching the good HDL cholesterol.
Polyunsaturated fat, in foods like sunflower and corn oil, lowers both. You can't cut out saturated fat entirely because you even get it in lean meat, but try cutting your cheese intake in half or eat a reduced-fat version.
So as you can see it's not all doom and gloom where a diabetic diet is concerned but rather than getting to the stage where you have diabetes and stick to the above diet wouldn't it be better to make changes to your lifestyle and diet before to damage has been done?
Thursday, March 20, 2008
Family Health History Can Help You and Your Doctor
When the American Health Information Management Association urged the public in 2005 to keep updated medical records, the group rationalized that no one physician maintains a complete file of all of a patient's medical information. Patients who keep copies of their records ensure better care for themselves, according to the Association.
Another way to get better care is to keep an updated family health history, said Suzanne O'Neill, who has a doctoral degree in genetics and works as a clinical researcher and genetics counselor at Evanston Northwestern Healthcare's Center for Medical Genetics. The Center studies the role of family history and genetics in disease and also works with about 900 patients annually.
Physicians typically gather family history during new patient visits, but rarely during follow-up appointments. Technology now allows patients to update their history through an electronic health pedigree or family tree.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
Completing a history makes it "a lot easier for people to be systematic about finding the cause of death or disease history of each of their immediate relatives," O'Neill said. These tools allow people to print their pedigrees and discuss them later with their doctors, she said.
Helps doctors
"It's a great way to collect information before patients get here," said Dr. Jefferson Schott, a internist who practices in Long Grove. It also saves time, he said, because patients have an opportunity to think about their family history before they see their doctors.
"A lot of times, on the spot when you're asked these questions, the patients can't quite remember who had what and what cancer a grandmother had or an aunt had and they need to go check with family members about that," Schott said.
Also it's easier for physicians to interpret pedigrees than the typical forms doctors use to gather family history. "I tend to think of things graphically and I think most physicians do," Schott said. "With this kind of complex information it's much easier to understand when you're looking at a pedigree diagram."
Creating a family health history is simple, inexpensive and easy, O'Neill said, and can include everything from genetics to factors like smoking and diet.
"It's important that people who are at risk in terms of genetic disease realize that they are at risk, and not fall through the cracks, and get the kind of services they need," she said.
While some genetic tests are available for some disorders such as hereditary breast and ovarian cancer, other more complex diseases like heart disease are likely caused by a combination of genetic and environmental factors, O'Neill said.
"Knowing your family history can help you to sort of be motivated to pay attention to your risk of certain diseases and adopt a healthier lifestyle."
MyGenerations
ENH began using the Web-based MyGenerations family health program in 2004, six years after O'Neill started developing it. MyGenerations lets users assess a history, flagging diseases such as colon cancer, and provides risk assessments based on that history.
Questions include listing the age of parents and their siblings, whether they had cancer and at what age they had it. The 15-minute survey produces an assessment of hereditary cancer risk and general cancer risk, along with recommendations. For example, a woman who has an average risk for hereditary cancer should have yearly mammograms starting at age 40, and tests for colon cancer at 50.
My Family Health Portrait
Another Web-based tool, My Family Health Portrait, (familyhistory.hhs.gov/), allows patients to assess their family history for heart disease, stroke, diabetes, breast cancer, ovarian cancer and colon cancer. The program, developed by the Surgeon General's Office and the National Human Genome Research Institute, part of the National Institutes of Health, asks participants for family history. It then furnishes them with a report that includes a printable pedigree on which relatives had which diseases. It allows for updates, and provides an informative chart report on family mortality causes and age of diagnosis.
Family Healthware
ENH is one of three medical centers studying whether one of the latest Web-based, family risk assessment programs, called Family Healthware, actually impacts a person's lifestyle choices, risk perceptions and communication habits with doctors or families. Family Healthware was created by the Centers for Disease Control and Prevention and is not yet available to the public.
The randomized clinical trial (Family Healthware Impact Trial, or FHITr) of 3,785 patients began in 2005 and ended last fall.
Like other programs, it surveys users for their history, then produces a family tree. It provides risk assessments and generates risk scores from "average" to "high" for six chronic conditions: Heart disease, diabetes, stroke, colon cancer, breast cancer and ovarian cancer. The program doesn't factor lifestyle behaviors into the risk scores, but does include them when creating personalized recommendations for screening and prevention.
The impact
Researchers extensively surveyed Family Healthware users before and after they used the program trying to learn how it impacts them.
For example, if a woman under age 40, who hadn't had a mammogram yet, used the program and found out she had a high risk for breast cancer, the goal would be to see if she would have made plans for a mammogram within six months of using Family Healthware, O'Neill said.
Researchers also hope the tool will promote more discussion between the woman and her doctor, as well as other women in her family who may also be at risk.
"So the goal is to see that if someone finds out that they are at increased risk for one of these diseases, if their physician management, if their personal management or their own lifestyle behaviors changes as a result of the tool," O'Neill said.
Whether Family Healthware becomes accepted by primary care doctors depends on how useful researchers determine it is.
Dr. Wendy Rubinstein, director of ENH's Center for Medical Genetics and another of the trial's principal investigators, said she believes the tool can help physicians and their patients.
"It's a time saver," she said, "particularly because the way that this tool works is that the patient fills it out themselves and then, with the physician and the patient, they can embark on a discussion right away."
Another way to get better care is to keep an updated family health history, said Suzanne O'Neill, who has a doctoral degree in genetics and works as a clinical researcher and genetics counselor at Evanston Northwestern Healthcare's Center for Medical Genetics. The Center studies the role of family history and genetics in disease and also works with about 900 patients annually.
Physicians typically gather family history during new patient visits, but rarely during follow-up appointments. Technology now allows patients to update their history through an electronic health pedigree or family tree.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
Completing a history makes it "a lot easier for people to be systematic about finding the cause of death or disease history of each of their immediate relatives," O'Neill said. These tools allow people to print their pedigrees and discuss them later with their doctors, she said.
Helps doctors
"It's a great way to collect information before patients get here," said Dr. Jefferson Schott, a internist who practices in Long Grove. It also saves time, he said, because patients have an opportunity to think about their family history before they see their doctors.
"A lot of times, on the spot when you're asked these questions, the patients can't quite remember who had what and what cancer a grandmother had or an aunt had and they need to go check with family members about that," Schott said.
Also it's easier for physicians to interpret pedigrees than the typical forms doctors use to gather family history. "I tend to think of things graphically and I think most physicians do," Schott said. "With this kind of complex information it's much easier to understand when you're looking at a pedigree diagram."
Creating a family health history is simple, inexpensive and easy, O'Neill said, and can include everything from genetics to factors like smoking and diet.
"It's important that people who are at risk in terms of genetic disease realize that they are at risk, and not fall through the cracks, and get the kind of services they need," she said.
While some genetic tests are available for some disorders such as hereditary breast and ovarian cancer, other more complex diseases like heart disease are likely caused by a combination of genetic and environmental factors, O'Neill said.
"Knowing your family history can help you to sort of be motivated to pay attention to your risk of certain diseases and adopt a healthier lifestyle."
MyGenerations
ENH began using the Web-based MyGenerations family health program in 2004, six years after O'Neill started developing it. MyGenerations lets users assess a history, flagging diseases such as colon cancer, and provides risk assessments based on that history.
Questions include listing the age of parents and their siblings, whether they had cancer and at what age they had it. The 15-minute survey produces an assessment of hereditary cancer risk and general cancer risk, along with recommendations. For example, a woman who has an average risk for hereditary cancer should have yearly mammograms starting at age 40, and tests for colon cancer at 50.
My Family Health Portrait
Another Web-based tool, My Family Health Portrait, (familyhistory.hhs.gov/), allows patients to assess their family history for heart disease, stroke, diabetes, breast cancer, ovarian cancer and colon cancer. The program, developed by the Surgeon General's Office and the National Human Genome Research Institute, part of the National Institutes of Health, asks participants for family history. It then furnishes them with a report that includes a printable pedigree on which relatives had which diseases. It allows for updates, and provides an informative chart report on family mortality causes and age of diagnosis.
Family Healthware
ENH is one of three medical centers studying whether one of the latest Web-based, family risk assessment programs, called Family Healthware, actually impacts a person's lifestyle choices, risk perceptions and communication habits with doctors or families. Family Healthware was created by the Centers for Disease Control and Prevention and is not yet available to the public.
The randomized clinical trial (Family Healthware Impact Trial, or FHITr) of 3,785 patients began in 2005 and ended last fall.
Like other programs, it surveys users for their history, then produces a family tree. It provides risk assessments and generates risk scores from "average" to "high" for six chronic conditions: Heart disease, diabetes, stroke, colon cancer, breast cancer and ovarian cancer. The program doesn't factor lifestyle behaviors into the risk scores, but does include them when creating personalized recommendations for screening and prevention.
The impact
Researchers extensively surveyed Family Healthware users before and after they used the program trying to learn how it impacts them.
For example, if a woman under age 40, who hadn't had a mammogram yet, used the program and found out she had a high risk for breast cancer, the goal would be to see if she would have made plans for a mammogram within six months of using Family Healthware, O'Neill said.
Researchers also hope the tool will promote more discussion between the woman and her doctor, as well as other women in her family who may also be at risk.
"So the goal is to see that if someone finds out that they are at increased risk for one of these diseases, if their physician management, if their personal management or their own lifestyle behaviors changes as a result of the tool," O'Neill said.
Whether Family Healthware becomes accepted by primary care doctors depends on how useful researchers determine it is.
Dr. Wendy Rubinstein, director of ENH's Center for Medical Genetics and another of the trial's principal investigators, said she believes the tool can help physicians and their patients.
"It's a time saver," she said, "particularly because the way that this tool works is that the patient fills it out themselves and then, with the physician and the patient, they can embark on a discussion right away."
Tuesday, March 18, 2008
Food Borne lllness From Leafy Greens Rising
An increase in the number of foodborne illnesses caused by contaminated spinach or lettuce over the past 35 years cannot be explained by increases in salad consumption over the same period, U.S. government researchers said on Monday.
They said the findings reinforce the need for local, state and federal health authorities to monitor preparation of leafy green vegetables from the point of harvest all the way through the food preparation process.
“Consumption of leafy greens has increased over the years, but it does not completely explain the increase in the proportion of foodborne outbreaks due to leafy green consumption,” Dr. Michael Lynch, a researcher with the U.S. Centers for Disease Control and Prevention, said in a statement.
A spate of high-profile food safety scares in the past two years raised concerns among consumers, Congress and federal health regulators about the safety of the U.S. food supply.
Prompted by E. coli outbreaks linked with spinach and lettuce in 2006, Lynch and colleagues set out to study past outbreaks and see if some patterns could emerge.
“We wondered whether it was just related to more people and more people eating more leafy greens,” Lynch said in a telephone interview.
Using CDC data, Lynch’s team analyzed more than 10,000 disease outbreaks reported between 1973 and 2006. They presented their findings on Monday at the International Conference on Emerging Infectious Diseases in Atlanta.
Outbreaks increase 39 percentThey found about 5 percent of outbreaks were related to leafy greens. About 60 percent of those were caused by the norovirus, which causes “stomach flu,” but 10 percent were caused by Salmonella bacteria and 9 percent were caused by E. coli 0157, a dangerous strain of the usually benign bacteria.
They found the number of cases of disease linked to leafy greens far outpace increases in salad consumption.
U.S. leafy green consumption rose 17 percent during 1986-1995 compared with the previous decade, but outbreaks of foodborne disease caused by leafy greens increased by 60 percent in that period.
In the 1996-2005 time frame, leafy green consumption rose 9 percent over the prior decade, but foodborne diseases outbreaks increased by 39 percent.
“Consumption is probably playing some role but it can’t explain all of the increase in these leafy green outbreaks,” Lynch said.
While some outbreaks can be traced to a local food preparation source, many are widespread, suggesting a problem in farm processing or at the processing plant,” Lynch said.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
They said the findings reinforce the need for local, state and federal health authorities to monitor preparation of leafy green vegetables from the point of harvest all the way through the food preparation process.
“Consumption of leafy greens has increased over the years, but it does not completely explain the increase in the proportion of foodborne outbreaks due to leafy green consumption,” Dr. Michael Lynch, a researcher with the U.S. Centers for Disease Control and Prevention, said in a statement.
A spate of high-profile food safety scares in the past two years raised concerns among consumers, Congress and federal health regulators about the safety of the U.S. food supply.
Prompted by E. coli outbreaks linked with spinach and lettuce in 2006, Lynch and colleagues set out to study past outbreaks and see if some patterns could emerge.
“We wondered whether it was just related to more people and more people eating more leafy greens,” Lynch said in a telephone interview.
Using CDC data, Lynch’s team analyzed more than 10,000 disease outbreaks reported between 1973 and 2006. They presented their findings on Monday at the International Conference on Emerging Infectious Diseases in Atlanta.
Outbreaks increase 39 percentThey found about 5 percent of outbreaks were related to leafy greens. About 60 percent of those were caused by the norovirus, which causes “stomach flu,” but 10 percent were caused by Salmonella bacteria and 9 percent were caused by E. coli 0157, a dangerous strain of the usually benign bacteria.
They found the number of cases of disease linked to leafy greens far outpace increases in salad consumption.
U.S. leafy green consumption rose 17 percent during 1986-1995 compared with the previous decade, but outbreaks of foodborne disease caused by leafy greens increased by 60 percent in that period.
In the 1996-2005 time frame, leafy green consumption rose 9 percent over the prior decade, but foodborne diseases outbreaks increased by 39 percent.
“Consumption is probably playing some role but it can’t explain all of the increase in these leafy green outbreaks,” Lynch said.
While some outbreaks can be traced to a local food preparation source, many are widespread, suggesting a problem in farm processing or at the processing plant,” Lynch said.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
Monday, March 17, 2008
Tainted Prescription Drugs from China
After a contaminated medicine from China was linked to as many as 17 deaths in the United States, members of Congress clamored for changes while regulators defended their actions.
The drug was a common antibiotic, and the year was 1999. But in recent weeks, the Food and Drug Administration has faced an almost identical crisis.
Nineteen deaths have been linked to contaminated heparin, a crucial blood thinner manufactured in China. Again the drug agency became aware of the problem only after hundreds were sickened. Again Congress is investigating.
The F.D.A. admitted that it violated its own policies by failing to inspect the China plant, and on Friday it said it had alerted border agents to detain suspect heparin shipments.
“This heparin problem has happened before with other drugs,” said William Hubbard, a former F.D.A. deputy commissioner, “and it’s going to keep happening until Congress fixes this problem.”
The Institute of Medicine, the Government Accountability Office and the F.D.A.’s own Science Board have all issued reports saying poor management and scientific inadequacies make the agency incapable of protecting the country against unsafe drugs, medical devices and food.
Indeed, in the years since the last China drug scandal, the share of drugs coming from that country has soared while the F.D.A.’s inspections of overseas drug plants have dropped. There are 566 plants in China that export drugs to the United States, but the agency inspected just 13 of them last year.
The agency does not have the money to inspect many more, and the Bush administration has no plans to fix this most basic of problems. The administration’s budget calls for a 3 percent increase in allocated funds next year, not enough even to keep up with rising costs.
Congress, though, may finally heed the calls of Mr. Hubbard and others and allocate far more money. The Senate passed a budget resolution on Friday to give the F.D.A. an additional $375 million, a 20 percent increase over this year.
“Congress has a responsibility to close the glaring gaps in food and drug safety that have begun to overwhelm the F.D.A.,” said Senator Edward M. Kennedy, Democrat of Massachusetts, who pushed for the new financing.
Several top legislators in the Senate and House said they supported the increase.
“F.D.A. needs a serious infusion of resources and strong leadership dedicated to reforming the agency,” said Representative Henry A. Waxman, Democrat of California, who is chairman of the House oversight committee.
Representatives John D. Dingell and Bart Stupak, powerful Democrats from Michigan, said they would fight to support the increase in the agency’s budget.
But the new money is far from assured. President Bush has threatened to veto appropriations that go beyond his requests, and there are powerful interests in Congress that are skeptical of increased agency financing.
Among the skeptics is Representative Rosa DeLauro, Democrat of Connecticut, who leads the House appropriations subcommittee with authority over the agency. Ms. DeLauro said that although the F.D.A. was in crisis, “I don’t want to throw money at an agency that doesn’t have the infrastructure to carry out its mission.”
Some top agency officials are simply “incompetent,” she added, and real change can occur only with a new administration.
An F.D.A. spokeswoman, Julie Zawisza, said the agency was “looking at a number of options in addition to more foreign inspections to increase our presence abroad and our ability to detect problems.” For instance, the agency is opening an office in China to conduct audits and inspections.
The uncertain prospects of the increased financing have led many in Congress to consider a user-fee system to pay for foreign inspections. The agency already relies heavily on user fees to pay for new drug reviews. Mr. Stupak said such a system might be the only way to pay for the necessary inspections of an industry rapidly moving to places like China.
“Why should the taxpayer pay for these inspections so that you can close a plant here and open it over there to ship it back?” Mr. Stupak said. “It will be sustainable income so that we don’t have to get into these budget battles every year.”
Eighty percent of the active pharmaceutical ingredients of drugs consumed in the United States are manufactured abroad; 40 percent are made in China and India. Meanwhile, the F.D.A. has cut back on its foreign drug inspections, which declined to 341 in 2006 from 391 in 2000.
Among the only foreign inspections that the F.D.A. still conducts are those done before a drug’s approval. Spot foreign inspections are rare. For logistical reasons, the agency warns foreign plants when its inspectors intend to visit, something not done domestically. All of this needs to change, said Mr. Stupak, who wants the oversight of foreign plants to be as strict as those governing domestic ones.
Dr. Sidney Wolfe, director of Public Citizen’s health research group, said a fee-based inspection system was “a terrible idea” because it would lead the agency to become more lax with those who pay their salaries.
“The F.D.A. is too important to be left to the industry to fund it,” Dr. Wolfe said.
Manufacturers would support a user-fee system in hopes of making medicines safer and competition fairer, said Guy Villax, chief executive of Hovione, a drug maker based in Portugal with plants in Europe, the United States, China and Macao.
Plants in China and India are rarely inspected by Western governments, which can reduce costs dramatically, Mr. Villax said. Even the Chinese did not inspect the plant making contaminated heparin because, regulators there said, everything made at the plant was shipped overseas.
“The globalization of active pharmaceutical ingredients has happened very quickly,” Mr. Villax said, “and the government agencies are very slow at adapting to changing circumstances.”
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
The drug was a common antibiotic, and the year was 1999. But in recent weeks, the Food and Drug Administration has faced an almost identical crisis.
Nineteen deaths have been linked to contaminated heparin, a crucial blood thinner manufactured in China. Again the drug agency became aware of the problem only after hundreds were sickened. Again Congress is investigating.
The F.D.A. admitted that it violated its own policies by failing to inspect the China plant, and on Friday it said it had alerted border agents to detain suspect heparin shipments.
“This heparin problem has happened before with other drugs,” said William Hubbard, a former F.D.A. deputy commissioner, “and it’s going to keep happening until Congress fixes this problem.”
The Institute of Medicine, the Government Accountability Office and the F.D.A.’s own Science Board have all issued reports saying poor management and scientific inadequacies make the agency incapable of protecting the country against unsafe drugs, medical devices and food.
Indeed, in the years since the last China drug scandal, the share of drugs coming from that country has soared while the F.D.A.’s inspections of overseas drug plants have dropped. There are 566 plants in China that export drugs to the United States, but the agency inspected just 13 of them last year.
The agency does not have the money to inspect many more, and the Bush administration has no plans to fix this most basic of problems. The administration’s budget calls for a 3 percent increase in allocated funds next year, not enough even to keep up with rising costs.
Congress, though, may finally heed the calls of Mr. Hubbard and others and allocate far more money. The Senate passed a budget resolution on Friday to give the F.D.A. an additional $375 million, a 20 percent increase over this year.
“Congress has a responsibility to close the glaring gaps in food and drug safety that have begun to overwhelm the F.D.A.,” said Senator Edward M. Kennedy, Democrat of Massachusetts, who pushed for the new financing.
Several top legislators in the Senate and House said they supported the increase.
“F.D.A. needs a serious infusion of resources and strong leadership dedicated to reforming the agency,” said Representative Henry A. Waxman, Democrat of California, who is chairman of the House oversight committee.
Representatives John D. Dingell and Bart Stupak, powerful Democrats from Michigan, said they would fight to support the increase in the agency’s budget.
But the new money is far from assured. President Bush has threatened to veto appropriations that go beyond his requests, and there are powerful interests in Congress that are skeptical of increased agency financing.
Among the skeptics is Representative Rosa DeLauro, Democrat of Connecticut, who leads the House appropriations subcommittee with authority over the agency. Ms. DeLauro said that although the F.D.A. was in crisis, “I don’t want to throw money at an agency that doesn’t have the infrastructure to carry out its mission.”
Some top agency officials are simply “incompetent,” she added, and real change can occur only with a new administration.
An F.D.A. spokeswoman, Julie Zawisza, said the agency was “looking at a number of options in addition to more foreign inspections to increase our presence abroad and our ability to detect problems.” For instance, the agency is opening an office in China to conduct audits and inspections.
The uncertain prospects of the increased financing have led many in Congress to consider a user-fee system to pay for foreign inspections. The agency already relies heavily on user fees to pay for new drug reviews. Mr. Stupak said such a system might be the only way to pay for the necessary inspections of an industry rapidly moving to places like China.
“Why should the taxpayer pay for these inspections so that you can close a plant here and open it over there to ship it back?” Mr. Stupak said. “It will be sustainable income so that we don’t have to get into these budget battles every year.”
Eighty percent of the active pharmaceutical ingredients of drugs consumed in the United States are manufactured abroad; 40 percent are made in China and India. Meanwhile, the F.D.A. has cut back on its foreign drug inspections, which declined to 341 in 2006 from 391 in 2000.
Among the only foreign inspections that the F.D.A. still conducts are those done before a drug’s approval. Spot foreign inspections are rare. For logistical reasons, the agency warns foreign plants when its inspectors intend to visit, something not done domestically. All of this needs to change, said Mr. Stupak, who wants the oversight of foreign plants to be as strict as those governing domestic ones.
Dr. Sidney Wolfe, director of Public Citizen’s health research group, said a fee-based inspection system was “a terrible idea” because it would lead the agency to become more lax with those who pay their salaries.
“The F.D.A. is too important to be left to the industry to fund it,” Dr. Wolfe said.
Manufacturers would support a user-fee system in hopes of making medicines safer and competition fairer, said Guy Villax, chief executive of Hovione, a drug maker based in Portugal with plants in Europe, the United States, China and Macao.
Plants in China and India are rarely inspected by Western governments, which can reduce costs dramatically, Mr. Villax said. Even the Chinese did not inspect the plant making contaminated heparin because, regulators there said, everything made at the plant was shipped overseas.
“The globalization of active pharmaceutical ingredients has happened very quickly,” Mr. Villax said, “and the government agencies are very slow at adapting to changing circumstances.”
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
Saturday, March 15, 2008
Vitamin E is Hot!
Food experts have started to sing the praises of - can you believe it? - mayonnaise and margarine.
The reason is vitamin E, the hot nutrient of the moment. A pile of medical evidence, including a large study in today's New England Journal of Medicine, suggests this vitamin protects people from heart disease.
It turns out the top source of vitamin E in the American diet is margarine. No. 2 is mayonnaise.
These are high-fat foods, and for years the leading message about eating and health has been a simple one: Cut out fat and cholesterol. "One of the unfortunate parts of the fat phobia is that people eliminate major sources of vitamin E in their diets," said Dr. Walter Willett of the Harvard School of Public Health.
The newest piece of evidence is a study showing that women who get lots of vitamin E-rich food cut their chance of heart disease by almost two-thirds. Last month, British researchers reported that daily vitamin E pills seem to reduce heart attacks by 75 percent when taken by people with bad hearts.
The latest study looks at the effect of vitamin E in food alone.
Dr. Lawrence Kushi, an epidemiologist from the University of Minnesota, followed 34,486 postmenopausal women with no outward signs of heart trouble. During seven years of follow-up, 242 died of heart disease.
Diet seemed to play a big role. Women who consumed the most vitamin E in their food were 62 percent less likely than those who ate the least to die of coronary heart disease.
Those in the highest consumption group got at least 10 international units of vitamin E per day from food, which is the recommended daily allowance for women. Of course, too much high-fat food of any kind is not a good idea, and Kushi noted that the women who benefited didn't overdo it. For instance, mayonnaise consumption was considered to be too high if the women ate it four times a week.
Besides mayo, other good sources of vitamin E include margarine (especially if made from sunflower, safflower, canola or corn oil), salad dressings, vegetable oil, peanut butter, nuts, wheat germ and eggs.
The Minnesota study found Vitamin E supplements did not appear to reduce the risk, although the researchers cautioned that they did not know enough about how long the women had taken the pills to be sure of this finding.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
The reason is vitamin E, the hot nutrient of the moment. A pile of medical evidence, including a large study in today's New England Journal of Medicine, suggests this vitamin protects people from heart disease.
It turns out the top source of vitamin E in the American diet is margarine. No. 2 is mayonnaise.
These are high-fat foods, and for years the leading message about eating and health has been a simple one: Cut out fat and cholesterol. "One of the unfortunate parts of the fat phobia is that people eliminate major sources of vitamin E in their diets," said Dr. Walter Willett of the Harvard School of Public Health.
The newest piece of evidence is a study showing that women who get lots of vitamin E-rich food cut their chance of heart disease by almost two-thirds. Last month, British researchers reported that daily vitamin E pills seem to reduce heart attacks by 75 percent when taken by people with bad hearts.
The latest study looks at the effect of vitamin E in food alone.
Dr. Lawrence Kushi, an epidemiologist from the University of Minnesota, followed 34,486 postmenopausal women with no outward signs of heart trouble. During seven years of follow-up, 242 died of heart disease.
Diet seemed to play a big role. Women who consumed the most vitamin E in their food were 62 percent less likely than those who ate the least to die of coronary heart disease.
Those in the highest consumption group got at least 10 international units of vitamin E per day from food, which is the recommended daily allowance for women. Of course, too much high-fat food of any kind is not a good idea, and Kushi noted that the women who benefited didn't overdo it. For instance, mayonnaise consumption was considered to be too high if the women ate it four times a week.
Besides mayo, other good sources of vitamin E include margarine (especially if made from sunflower, safflower, canola or corn oil), salad dressings, vegetable oil, peanut butter, nuts, wheat germ and eggs.
The Minnesota study found Vitamin E supplements did not appear to reduce the risk, although the researchers cautioned that they did not know enough about how long the women had taken the pills to be sure of this finding.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
One in Four Teen Age Girls Have an STD
One in four teenage girls in the United States -- and nearly half of African-American girls -- has at least one sexually transmitted disease, according to a study released Tuesday.
Those numbers translate into an estimated 3.2 million adolescent females infected with one of the four most common STDs -- many of whom may not even know they have a disease or that they are passing it to their sex partners."What we found is alarming," said Dr. Sara Forhan, a researcher with the Centers for Disease Control and Prevention and the study's lead author. "This means that far too many young women are at risk for the serious health effects of untreated STDs, including infertility and cervical cancer."
The study's authors analyzed data on 838 girls between the ages of 14 and 19 who participated in the 2003-04 National Health and Nutrition Examination Survey, an annual study assesses a broad range of health issues.For the analysis, the teens were tested for human papillomavirus (HPV), chlamydia, trichomoniasis and herpes. By far, the most common sexually transmitted disease was HPV. Of those infected, 15 percent had more than one STD.
"It shows that what people have always suspected is true," said Dr. Emily Erbelding, an infectious diseases specialist at Johns Hopkins Bayview Medical Center. "Sexually transmitted infections have been called a hidden epidemic because a lot of these conditions are going to be asymptomatic when they're diagnosed but they're highly common."The study did not include teenage boys. The paper is being presented Wednesday at a CDC conference on STD prevention in Chicago.
Forhan said she was surprised to see how readily the risk to young women appears. Of those who said they had one sexual partner in their lifetime, the prevalence of STDs was 20 percent, she said.
While parents may be surprised by the study, it's a reflection of what doctors have been seeing in their practices in recent years, said Dr. Ligia Peralta of the University of Maryland Hospital for Children in Baltimore.
She said parents need to know that the average age of a girl's first sexual intercourse is 15.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
We serve the Chicago North Shore Communites of Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Libertyville, Glenview, Highwood, Northfield, Libertyville, Winnetka, and Bannockburn.
Those numbers translate into an estimated 3.2 million adolescent females infected with one of the four most common STDs -- many of whom may not even know they have a disease or that they are passing it to their sex partners."What we found is alarming," said Dr. Sara Forhan, a researcher with the Centers for Disease Control and Prevention and the study's lead author. "This means that far too many young women are at risk for the serious health effects of untreated STDs, including infertility and cervical cancer."
The study's authors analyzed data on 838 girls between the ages of 14 and 19 who participated in the 2003-04 National Health and Nutrition Examination Survey, an annual study assesses a broad range of health issues.For the analysis, the teens were tested for human papillomavirus (HPV), chlamydia, trichomoniasis and herpes. By far, the most common sexually transmitted disease was HPV. Of those infected, 15 percent had more than one STD.
"It shows that what people have always suspected is true," said Dr. Emily Erbelding, an infectious diseases specialist at Johns Hopkins Bayview Medical Center. "Sexually transmitted infections have been called a hidden epidemic because a lot of these conditions are going to be asymptomatic when they're diagnosed but they're highly common."The study did not include teenage boys. The paper is being presented Wednesday at a CDC conference on STD prevention in Chicago.
Forhan said she was surprised to see how readily the risk to young women appears. Of those who said they had one sexual partner in their lifetime, the prevalence of STDs was 20 percent, she said.
While parents may be surprised by the study, it's a reflection of what doctors have been seeing in their practices in recent years, said Dr. Ligia Peralta of the University of Maryland Hospital for Children in Baltimore.
She said parents need to know that the average age of a girl's first sexual intercourse is 15.
Healthy Trust Immediate Medical Care Walk-in clinic administers immediate medical care during convenient hours. See our doctors for minor injuries or health problems, such as sprains, cuts, colds, flus, and for other convenient healthcare services.
We serve the Chicago North Shore Communites of Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Libertyville, Glenview, Highwood, Northfield, Libertyville, Winnetka, and Bannockburn.
Friday, March 14, 2008
Soap and Shots can Protect your Health
With school's back in session and cooler weather is here, many of us will be spending more time indoors. It's a time to make holiday plans. It's a time for togetherness. And it's a time when we share a lot of disease-causing germs. Fortunately, you can take simple steps to dodge germs and boost your chances of staying healthy.
Each year, from late fall through winter, the number of cold and flu cases in the U.S. climbs dramatically. When you're sick, each cough or sneeze can propel droplets laden with microbes into the surrounding air. These droplets can travel as far as 3 feet. Anyone in their path may be at risk for infection. That's why covering your mouth and nose -- with a tissue, the crook of your elbow or even your hand -- is the considerate thing to do.
Microbes can survive outside the body, too. Some can live for two hours or more on doorknobs, faucets, keyboards and other surfaces. If you touch a germ-covered surface and then touch your eyes, nose or mouth, you increase your chance of getting infected and getting sick.
By far the easiest and most effective way to prevent the spread of germs is to wash your hands often and well. Health care experts recommend scrubbing your hands vigorously with soap and water for at least 15 seconds -- about as long as it takes to recite the alphabet.
Antibacterial soaps are popular and plentiful on store shelves. They contain a chemical called triclosan, which can kill bacteria. But are they better than regular soaps? In one recent study, researchers reviewed all the scientific papers published between 1980 and 2006 that compared regular and antibacterial soaps in everyday use. They found that regular soaps were as effective as antibacterial soaps, both in blocking germ-related disease symptoms and in reducing the amount of bacteria measured on hands.
When soap and water are not available, you can use an alcohol-based gel -- usually called a hand sanitizer -- to clean your hands. These alcohol-based hand rubs significantly reduce the number of germs on skin.
Another great way to stay healthy during the cooler months is vaccination. Getting a flu vaccine each fall is the single best way to prevent the flu. Flu vaccines can be given as a shot or a nasal spray. Both provide protection against the strains of flu that experts predict are going to be the most common this winter.
Talk to your health care provider about flu vaccines and other strategies to help you beat back germs. Taking some simple steps will help you and your family stay healthy and enjoy the festivities this fall and winter.
Prevent the spread of germs
• Wash your hands often and well. If soap and water are not available, some health officials recommend rubbing your hands with alcohol-based gels.
• Cover your nose and mouth when you sneeze or cough.
• Avoid touching your eyes, nose or mouth.
• Keep doctor-recommended vaccinations -- for you and your children -- up to date.
• Stay home when you are sick and check with a health care provider when needed.
• Eat right, get enough sleep and exercise regularly to help strengthen your immune system and fight sicknesses.
Healthy Trust Immediate Medical Care offers flu shots, and prescriptions of Tamaflu at their Wheeling, Illinois clinic which serves the Chicago North Shore Suburbs of Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Libertyville, Glenview, Highwood, Northfield, Libertyville, Winnetka, and Bannockburn.
Each year, from late fall through winter, the number of cold and flu cases in the U.S. climbs dramatically. When you're sick, each cough or sneeze can propel droplets laden with microbes into the surrounding air. These droplets can travel as far as 3 feet. Anyone in their path may be at risk for infection. That's why covering your mouth and nose -- with a tissue, the crook of your elbow or even your hand -- is the considerate thing to do.
Microbes can survive outside the body, too. Some can live for two hours or more on doorknobs, faucets, keyboards and other surfaces. If you touch a germ-covered surface and then touch your eyes, nose or mouth, you increase your chance of getting infected and getting sick.
By far the easiest and most effective way to prevent the spread of germs is to wash your hands often and well. Health care experts recommend scrubbing your hands vigorously with soap and water for at least 15 seconds -- about as long as it takes to recite the alphabet.
Antibacterial soaps are popular and plentiful on store shelves. They contain a chemical called triclosan, which can kill bacteria. But are they better than regular soaps? In one recent study, researchers reviewed all the scientific papers published between 1980 and 2006 that compared regular and antibacterial soaps in everyday use. They found that regular soaps were as effective as antibacterial soaps, both in blocking germ-related disease symptoms and in reducing the amount of bacteria measured on hands.
When soap and water are not available, you can use an alcohol-based gel -- usually called a hand sanitizer -- to clean your hands. These alcohol-based hand rubs significantly reduce the number of germs on skin.
Another great way to stay healthy during the cooler months is vaccination. Getting a flu vaccine each fall is the single best way to prevent the flu. Flu vaccines can be given as a shot or a nasal spray. Both provide protection against the strains of flu that experts predict are going to be the most common this winter.
Talk to your health care provider about flu vaccines and other strategies to help you beat back germs. Taking some simple steps will help you and your family stay healthy and enjoy the festivities this fall and winter.
Prevent the spread of germs
• Wash your hands often and well. If soap and water are not available, some health officials recommend rubbing your hands with alcohol-based gels.
• Cover your nose and mouth when you sneeze or cough.
• Avoid touching your eyes, nose or mouth.
• Keep doctor-recommended vaccinations -- for you and your children -- up to date.
• Stay home when you are sick and check with a health care provider when needed.
• Eat right, get enough sleep and exercise regularly to help strengthen your immune system and fight sicknesses.
Healthy Trust Immediate Medical Care offers flu shots, and prescriptions of Tamaflu at their Wheeling, Illinois clinic which serves the Chicago North Shore Suburbs of Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Libertyville, Glenview, Highwood, Northfield, Libertyville, Winnetka, and Bannockburn.
Thursday, March 13, 2008
Illinois Hit Hard By Flu
Two unexpected strains of influenza, Brisbane and Yamagete, are rapidly spreading throughout the United States unhindered by flu vaccines, Director of Health Services Beverly Ballard said.
Ballard said that while last year the Health Center treated one or two confirmed cases of flu, this year she has treated approximately 20 confirmed cases. She also treated more than 20 students who tested negative for flu, but, she believes had a strain that could not be confirmed by the test.
According to The Washington Post, the new strains of flu account for 48 percent of all full cases this season. Neither of these strains are accounted for in the vaccine.
The Brisbane strain was active in Europe and the Southern Hemisphere last flu season, according to the Center for Disease Control's (CDC) website.
"I think most of it is just because of travel and I'm sure how we got the Brisbane one is from international travel - someone brought it from Australia to the United States," Ballard said.
"The flu is a terrible thing to have," Ballard said. "Our students say that they feel like their muscles are on fire ? some of them have a sore throat and most have a horrible headache."
At the Health Center if a student is believed to have the flu, they are prescribed Tamaflu, an antiviral medicine that is used to treat flu, Ballard said.
Students who have high stress lives, poor nutrition and lack sleep are highly susceptible to catching the flu, especially if they have not had a flu shot, Ballard said. After receiving a flu shot, there is a two week period until the shot's recipient will build immunity.
"The main thing I think that gets people in trouble is if they already have an existing illness, medical problems or a depressed immune system," Ballard said. "That's where I worry about our students because they are notorious for not taking care of themselves."
To prevent flu, students should get a flu shot, use the inside of their elbow or a tissue to cough or sneeze into (not into the hands) and, most importantly, wash their hands multiple times a day, Ballard said.
At the start of the 2008 flu season, the entire supply of 650 flu shots offered by the Health Center were used to vaccinate students, with some students unable to receive the shot due to short supply, Ballard said. The Health Center requested from the student fees committee authorization for an additional 500 flu vaccines for next year, but only 200 additional vaccines were approved.
Ben Dower, President of Student Government and Chair of the Student Fee Committee said 300 of the vaccines were not granted because there is not enough money available in the Medical Services Fee.
Healthy Trust Immediate Medical Care offers flu shots, and prescriptions of Tamaflu at their Wheeling, Illinois clinic which serves the Chicago North Shore Suburbs of Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Libertyville, Glenview, Highwood, Northfield, Libertyville, Winnetka, and Bannockburn.
Ballard said that while last year the Health Center treated one or two confirmed cases of flu, this year she has treated approximately 20 confirmed cases. She also treated more than 20 students who tested negative for flu, but, she believes had a strain that could not be confirmed by the test.
According to The Washington Post, the new strains of flu account for 48 percent of all full cases this season. Neither of these strains are accounted for in the vaccine.
The Brisbane strain was active in Europe and the Southern Hemisphere last flu season, according to the Center for Disease Control's (CDC) website.
"I think most of it is just because of travel and I'm sure how we got the Brisbane one is from international travel - someone brought it from Australia to the United States," Ballard said.
"The flu is a terrible thing to have," Ballard said. "Our students say that they feel like their muscles are on fire ? some of them have a sore throat and most have a horrible headache."
At the Health Center if a student is believed to have the flu, they are prescribed Tamaflu, an antiviral medicine that is used to treat flu, Ballard said.
Students who have high stress lives, poor nutrition and lack sleep are highly susceptible to catching the flu, especially if they have not had a flu shot, Ballard said. After receiving a flu shot, there is a two week period until the shot's recipient will build immunity.
"The main thing I think that gets people in trouble is if they already have an existing illness, medical problems or a depressed immune system," Ballard said. "That's where I worry about our students because they are notorious for not taking care of themselves."
To prevent flu, students should get a flu shot, use the inside of their elbow or a tissue to cough or sneeze into (not into the hands) and, most importantly, wash their hands multiple times a day, Ballard said.
At the start of the 2008 flu season, the entire supply of 650 flu shots offered by the Health Center were used to vaccinate students, with some students unable to receive the shot due to short supply, Ballard said. The Health Center requested from the student fees committee authorization for an additional 500 flu vaccines for next year, but only 200 additional vaccines were approved.
Ben Dower, President of Student Government and Chair of the Student Fee Committee said 300 of the vaccines were not granted because there is not enough money available in the Medical Services Fee.
Healthy Trust Immediate Medical Care offers flu shots, and prescriptions of Tamaflu at their Wheeling, Illinois clinic which serves the Chicago North Shore Suburbs of Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Libertyville, Glenview, Highwood, Northfield, Libertyville, Winnetka, and Bannockburn.
Understanding Urgent / Immediate Care
Urgent care is the delivery of ambulatory care in a facility dedicated to the delivery of care outside of a hospital emergency department, usually on an unscheduled, walk-in basis. Urgent care centers are primarily used to treat patients who have an injury or illness that requires immediate care but is not serious enough to warrant a visit to an emergency room. Often urgent care centers are not open on a continuous basis, unlike a hospital emergency room that would be open at all times.
The initial urgent care centers opened in the 1970s. Since then this sector of the healthcare industry has rapidly expanded to an approximately 17,000 centers. Many of these centers have been started by entrepreneurial physicians who have responded to the public need for convenient access to unscheduled medical care. Other centers have been opened by hospital systems, seeking to attract patients. Much of the growth of these centers has been fueled by the significant savings that urgent care centers provide over the care in a hospital emergency department. Many managed care organizations (MCOs) now encourage their customers to utilize the urgent care option.
Allowing walk-in patients is not a sufficient criterion to define a physician office as an urgent care. If the office does not offer the expanded services and significant after-hours care, then the physician office would not fit the definition of an urgent care center.
In the state of Illinois Urgent Care Ceneters are required by law to call themselves Immediate Care Centers so there is no confusion between an Urgent Care Center and an Emergeny Room.
Healthy Trust Immediate Medical Care offers Urgent Care Services at their Wheeling, Illinois clinic which serves the Chicago North Shore Suburbs of Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Libertyville, Glenview, Highwood, Northfield, Libertyville, Winnetka, and Bannockburn.
Allergies
Animal/Insect Bites
Coughs/Colds/Sore Throats
Sinus Infections/Bronchitis
Cuts/Lacerations
Diarrhea/Vomiting
Flu Shots
Vaccinations
No Wait Physical Exams
Ear/Eye Infections
Flu/Fevers
Minor Burns/Rashes
Simple Fractures/Sprains/Strains
Back Pain
Chemical Exposure
On Site Lab for Immediate Results
On Site X-Ray
Medication Dispensing Services
If you are in an immediate life threatening situation there is no substitute for a hospital Emergency Center, but 70% of all patients who go to a emergency Center can be better served at an Urgent Care Center for a fraction of the cost, and in a few minutes, rather than a few hours.
The initial urgent care centers opened in the 1970s. Since then this sector of the healthcare industry has rapidly expanded to an approximately 17,000 centers. Many of these centers have been started by entrepreneurial physicians who have responded to the public need for convenient access to unscheduled medical care. Other centers have been opened by hospital systems, seeking to attract patients. Much of the growth of these centers has been fueled by the significant savings that urgent care centers provide over the care in a hospital emergency department. Many managed care organizations (MCOs) now encourage their customers to utilize the urgent care option.
Allowing walk-in patients is not a sufficient criterion to define a physician office as an urgent care. If the office does not offer the expanded services and significant after-hours care, then the physician office would not fit the definition of an urgent care center.
In the state of Illinois Urgent Care Ceneters are required by law to call themselves Immediate Care Centers so there is no confusion between an Urgent Care Center and an Emergeny Room.
Healthy Trust Immediate Medical Care offers Urgent Care Services at their Wheeling, Illinois clinic which serves the Chicago North Shore Suburbs of Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Libertyville, Glenview, Highwood, Northfield, Libertyville, Winnetka, and Bannockburn.
Allergies
Animal/Insect Bites
Coughs/Colds/Sore Throats
Sinus Infections/Bronchitis
Cuts/Lacerations
Diarrhea/Vomiting
Flu Shots
Vaccinations
No Wait Physical Exams
Ear/Eye Infections
Flu/Fevers
Minor Burns/Rashes
Simple Fractures/Sprains/Strains
Back Pain
Chemical Exposure
On Site Lab for Immediate Results
On Site X-Ray
Medication Dispensing Services
If you are in an immediate life threatening situation there is no substitute for a hospital Emergency Center, but 70% of all patients who go to a emergency Center can be better served at an Urgent Care Center for a fraction of the cost, and in a few minutes, rather than a few hours.
Healthy Trust Immediate Medical Care
Healthy Trust Immediate Medical Care in Wheeling, Illinois services the Chicago North Shore Communities of Wheeling, Prospect Heights, Deerfield, Bannockburn, Lincolnshire, Northbrook, Northfield, Glenview, Long Grove, Highland Park, Buffalo Grove, Palatine, Highland Park, Vernon Hills, Des Plaines, Winnetka, Highwood, Riverwoods, and Libertyville.
Whether your situation is a non-emergency injury, an employee screening or just a health concern, you can rely on Healthy Trust to provide an immediate and professional response.
Immediate care services, or walk in clinics typically are for urgent medically necessary services which are required for an illness or injury that would not result in further disability or death if not treated immediately, but require professional attention and have the potential to develop such a threat if treatment is delayed longer than 24 hours.
Our physicians have extensive emergency medicine or family practice experience and are board certified. Our support staff includes nurses, laboratory and X-ray techs and certified medical assistants. Our staff members are experts in their fields, focusing on treating the patient as well as the problem.
Why Choose Healthy Trust Immediate Medical Care?
Fast, Convenient, Immediate Attention
No Appointments Neccesary
Extended Hours
Convenient Location
Board Certified Physicians
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