Summer is finally here and it's the perfect time to take your exercise routine outdoors. However, the soaring temperatures can take a toll on even the most dedicated fitness enthusiast, so it is essential to take some precautions while exercising in warm weather.
Here are some helpful safety tips to follow while exercising during the summer:
Take it easy -- If you're used to exercising indoors or in cooler weather, start out slowly. As your body adapts to the heat, gradually increase the length and intensity of your workouts. It generally takes three to seven days for the body to adjust to significantly hotter weather.
Drink plenty of water -- While exercising in hot weather, you easily can lose up to a liter of water an hour. Drink water before, during and after exercising. Beverages containing electrolytes should be consumed during outdoor exercise sessions lasting more than 90 minutes.
Avoid the midday sun -- Exercise in the morning or evening, when it's likely to be cooler outdoors, rather than the middle of the day. If possible, exercise in the shade or in a pool.
Wear sunscreen -- Apply SPF 15 sunscreen at least 30 minutes before exercising outdoors. Protect your eyes with sunglasses that block the sun's UV rays. A sunburn decreases your body's ability to cool itself.
Choose the appropriate clothing -- Wear loose-fitting clothing to allow circulation of air between your skin and the environment. Also, light-colored clothing will reflect sunlight, while darker clothing will absorb the heat. Clothing designed to wick away perspiration also is a great way to keep cool in the hot weather.
If you are concerned about the level of heat outside, stay indoors. A good backup plan, such as walking laps inside a mall or climbing stairs in an air-conditioned building, can help you get exercise without putting yourself at risk of heat exhaustion or heat stroke.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Thursday, July 31, 2008
Wednesday, July 30, 2008
Millions at Risk with Pre Dementia
A milder type of mental decline that often precedes Alzheimer's disease is alarmingly more common than has been believed, and in men more than women, doctors reported Monday.
Nearly a million older Americans slide from normal memory into mild impairment each year, researchers estimate, based on a Mayo Clinic study of Minnesota residents.
That's on top of the half-million Americans who develop full-blown Alzheimer's or other forms of dementia – a problem sure to grow as baby boomers age. The oldest boomers turn 62 this year.
"We're seeing that in fact there's a much larger burgeoning problem out there" of people at risk of developing dementia, said Dr. Ronald Petersen, the Mayo scientist who led the study.
Dr. Ralph Nixon, a New York University psychiatrist and scientific adviser to the Alzheimer's Association, was blunt.
"We're facing a crisis," he said.
There are no treatments now to prevent this mental slide or reverse it once it starts.
But that may be changing. Researchers on Monday reported early, somewhat encouraging results from an experimental nose spray that seemed to improve certain memory measures in a study of mildly impaired people.
The drug, for now called AL-108, needs testing in a longer, larger study. It is being developed by Allon Therapeutics Inc., based in Vancouver, B.C.
Doctors said it shows the potential for new types of medicines that target the protein tangles that kill nerve cells, instead of targeting the sticky brain deposits that have gotten most of the attention up to now.
The studies were reported at the International Conference on Alzheimer's Disease in Chicago.
Petersen is the scientist who defined mild cognitive impairment, or MCI, as a transition phase between healthy aging and dementia. It is more than "senior moments" like forgetting where you parked the car, but not as severe as having dementia, where you forget what a car is for.
People with it have impaired memory but not other problems like confusion, inattention or trouble putting thoughts into words.
The Alzheimer's Association says more than 5 million Americans have Alzheimer's, but no estimate for this "pre-dementia" has been available until now.
Petersen's federally funded study involved about 1,600 people, ages 70 through 89, living in Olmstead County, Minn., which surrounds the Mayo Clinic. All tested normal when they were enrolled in the study, but more than 5 percent had developed mild impairment when evaluated a year later.
Men were nearly twice as likely as women to develop it. That's a surprise, because some studies have found more women with Alzheimer's than men. But there may be a simple explanation:
Even though more men may be impaired, women outlive them and therefore have more time to develop full-blown dementia.
"This is a very large and important issue for our country and for the world," said Duke University psychologist Brenda Plassman. A smaller study she published earlier this year backs up the Mayo study's findings.
The mild impairment rate is two to three times larger than many researchers had expected, Petersen said.
"It's the iceberg under the tip," agreed Dr. R. Scott Turner, incoming director of the memory disorders program at Georgetown University Medical Center. A prime goal is finding drugs to treat the mild impairment before Alzheimer's develops.
The AL-108 study tried to do that. Scientists gave 144 people with mild impairment either a low or high dose of the drug or a dummy drug for 12 weeks. The study missed its main goal – a composite of various memory scores – and the low dose showed no effect. But those on the higher dose improved on some memory tasks after one month and benefits lasted a month after they stopped treatment, said the study's leader, Dr. Donald Schmechel of Duke University.
The study was sponsored by the drug maker.
In another study presented at the conference on Sunday and published on the Internet by the British medical journal The Lancet, researchers reported that dementia rates in developing countries may be considerably higher than official estimates and closer to rates in wealthy countries.
Scientists used a more liberal definition of dementia more suitable to poorer, less educated populations, where respect for family often means relatives don't regard dementia as a burden and may be less likely to report problems.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Nearly a million older Americans slide from normal memory into mild impairment each year, researchers estimate, based on a Mayo Clinic study of Minnesota residents.
That's on top of the half-million Americans who develop full-blown Alzheimer's or other forms of dementia – a problem sure to grow as baby boomers age. The oldest boomers turn 62 this year.
"We're seeing that in fact there's a much larger burgeoning problem out there" of people at risk of developing dementia, said Dr. Ronald Petersen, the Mayo scientist who led the study.
Dr. Ralph Nixon, a New York University psychiatrist and scientific adviser to the Alzheimer's Association, was blunt.
"We're facing a crisis," he said.
There are no treatments now to prevent this mental slide or reverse it once it starts.
But that may be changing. Researchers on Monday reported early, somewhat encouraging results from an experimental nose spray that seemed to improve certain memory measures in a study of mildly impaired people.
The drug, for now called AL-108, needs testing in a longer, larger study. It is being developed by Allon Therapeutics Inc., based in Vancouver, B.C.
Doctors said it shows the potential for new types of medicines that target the protein tangles that kill nerve cells, instead of targeting the sticky brain deposits that have gotten most of the attention up to now.
The studies were reported at the International Conference on Alzheimer's Disease in Chicago.
Petersen is the scientist who defined mild cognitive impairment, or MCI, as a transition phase between healthy aging and dementia. It is more than "senior moments" like forgetting where you parked the car, but not as severe as having dementia, where you forget what a car is for.
People with it have impaired memory but not other problems like confusion, inattention or trouble putting thoughts into words.
The Alzheimer's Association says more than 5 million Americans have Alzheimer's, but no estimate for this "pre-dementia" has been available until now.
Petersen's federally funded study involved about 1,600 people, ages 70 through 89, living in Olmstead County, Minn., which surrounds the Mayo Clinic. All tested normal when they were enrolled in the study, but more than 5 percent had developed mild impairment when evaluated a year later.
Men were nearly twice as likely as women to develop it. That's a surprise, because some studies have found more women with Alzheimer's than men. But there may be a simple explanation:
Even though more men may be impaired, women outlive them and therefore have more time to develop full-blown dementia.
"This is a very large and important issue for our country and for the world," said Duke University psychologist Brenda Plassman. A smaller study she published earlier this year backs up the Mayo study's findings.
The mild impairment rate is two to three times larger than many researchers had expected, Petersen said.
"It's the iceberg under the tip," agreed Dr. R. Scott Turner, incoming director of the memory disorders program at Georgetown University Medical Center. A prime goal is finding drugs to treat the mild impairment before Alzheimer's develops.
The AL-108 study tried to do that. Scientists gave 144 people with mild impairment either a low or high dose of the drug or a dummy drug for 12 weeks. The study missed its main goal – a composite of various memory scores – and the low dose showed no effect. But those on the higher dose improved on some memory tasks after one month and benefits lasted a month after they stopped treatment, said the study's leader, Dr. Donald Schmechel of Duke University.
The study was sponsored by the drug maker.
In another study presented at the conference on Sunday and published on the Internet by the British medical journal The Lancet, researchers reported that dementia rates in developing countries may be considerably higher than official estimates and closer to rates in wealthy countries.
Scientists used a more liberal definition of dementia more suitable to poorer, less educated populations, where respect for family often means relatives don't regard dementia as a burden and may be less likely to report problems.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Tuesday, July 29, 2008
Cell Phone Texting Can Lead to Injuries
The warning came too late for Barack Obama's adviser: Don't walk and text at the same time.
Obama aide Valerie Jarrett fell off a Chicago curb several weeks ago while her thumbs were flying on her Blackberry.
"I didn't see the sidewalk and I twisted my ankle," Jarrett said. "It was a nice wake-up call for me to be a lot more careful in the future, because I clearly wasn't paying attention and I should have."
Jarrett got off easy and didn't need medical attention.
But in an alert issued this week, the American College of Emergency Physicians warns of the danger of more serious accidents involving oblivious texters. The ER doctors cite rising reports from doctors around the country of injuries involving text-messaging pedestrians, bicyclists, Rollerbladers, even motorists.
Most involve scrapes, cuts and sprains from texters who walked into lampposts or walls or tripped over curbs.
Still, ER doctors who responded to a recent informal query from the organization reported two deaths, both in California. A San Francisco woman was killed by a pickup truck earlier this year when she stepped off a curb while texting, and a Bakersfield man was killed last year by a car while crossing the street and texting.
The U.S. Consumer Product Safety Commission has no national estimate on how common texting-related injuries are. But among the reports it has received: A 15-year-old girl fell off her horse while texting, suffering head and back injuries, and a 13-year-old girl suffered belly, leg and arm burns after texting her boyfriend while cooking noodles.
Giancarlo Yerkes texted his way across a busy Chicago street Tuesday and escaped unscathed. But the 30-year-old advertising employee admitted he once walked straight into a stop sign while texting and bumped his head.
Yerkes said that he texts while walking to maximize his time, and that the emergency doctors' warning probably won't stop him.
"There's a lot of things you shouldn't do — this is another one on my list," Yerkes said.
Dr. James Adams, chairman of emergency medicine at Northwestern Memorial Hospital in Chicago, said he has treated minor injuries in several texters.
Common sense isn't always common," Adams said.
Sometimes even among doctors.
"I have to admit that I started a text while I was driving and then I said, 'This is so stupid,' so I stopped," Adams said.
Dr. Patrick Walsh, an emergency physician in Bakersfield, Calif., said he is a texter, too, but tries to remind himself to do it intelligently.
"We think we're multitasking, but we're not," he said. "You're focusing on one task for a split second, then focusing on another one, and with something moving 40 miles an hour like a car, it just takes a couple of seconds to be hit."
Walsh, a native of Ireland, said that on a recent visit there he noticed an effective government TV ad campaign against texting and walking, aimed at teenagers.
The message echoes the new advice from U.S. emergency doctors.
"We don't want to sound like some stern schoolmistress, telling people don't text on your cell phone," Walsh said. "But when you're texting, look around," he said.
The ER group also says people should never text while driving, and should avoid talking on a cell phone or texting while doing other physical activities, including walking, biking, boating and Rollerblading.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Obama aide Valerie Jarrett fell off a Chicago curb several weeks ago while her thumbs were flying on her Blackberry.
"I didn't see the sidewalk and I twisted my ankle," Jarrett said. "It was a nice wake-up call for me to be a lot more careful in the future, because I clearly wasn't paying attention and I should have."
Jarrett got off easy and didn't need medical attention.
But in an alert issued this week, the American College of Emergency Physicians warns of the danger of more serious accidents involving oblivious texters. The ER doctors cite rising reports from doctors around the country of injuries involving text-messaging pedestrians, bicyclists, Rollerbladers, even motorists.
Most involve scrapes, cuts and sprains from texters who walked into lampposts or walls or tripped over curbs.
Still, ER doctors who responded to a recent informal query from the organization reported two deaths, both in California. A San Francisco woman was killed by a pickup truck earlier this year when she stepped off a curb while texting, and a Bakersfield man was killed last year by a car while crossing the street and texting.
The U.S. Consumer Product Safety Commission has no national estimate on how common texting-related injuries are. But among the reports it has received: A 15-year-old girl fell off her horse while texting, suffering head and back injuries, and a 13-year-old girl suffered belly, leg and arm burns after texting her boyfriend while cooking noodles.
Giancarlo Yerkes texted his way across a busy Chicago street Tuesday and escaped unscathed. But the 30-year-old advertising employee admitted he once walked straight into a stop sign while texting and bumped his head.
Yerkes said that he texts while walking to maximize his time, and that the emergency doctors' warning probably won't stop him.
"There's a lot of things you shouldn't do — this is another one on my list," Yerkes said.
Dr. James Adams, chairman of emergency medicine at Northwestern Memorial Hospital in Chicago, said he has treated minor injuries in several texters.
Common sense isn't always common," Adams said.
Sometimes even among doctors.
"I have to admit that I started a text while I was driving and then I said, 'This is so stupid,' so I stopped," Adams said.
Dr. Patrick Walsh, an emergency physician in Bakersfield, Calif., said he is a texter, too, but tries to remind himself to do it intelligently.
"We think we're multitasking, but we're not," he said. "You're focusing on one task for a split second, then focusing on another one, and with something moving 40 miles an hour like a car, it just takes a couple of seconds to be hit."
Walsh, a native of Ireland, said that on a recent visit there he noticed an effective government TV ad campaign against texting and walking, aimed at teenagers.
The message echoes the new advice from U.S. emergency doctors.
"We don't want to sound like some stern schoolmistress, telling people don't text on your cell phone," Walsh said. "But when you're texting, look around," he said.
The ER group also says people should never text while driving, and should avoid talking on a cell phone or texting while doing other physical activities, including walking, biking, boating and Rollerblading.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Monday, July 28, 2008
Free Vasectomies?
From 15-cent train rides to excellent $1 meals, Thailand's tropical capital is teeming with budget options for the penny-pinching traveler. Where else in the world can you get a free vasectomy?
It's easy to spend hundreds of dollars a day in Bangkok, home to some of the most luxurious hotels in the world. But following some guidelines, you can enjoy the city at a fraction of the price.
Accommodations: Most budget tourists head straight for Khao San Road, a lively, colorful area where you can pay the equivalent of just $4.50 a night for a bed in a dorm room. Despite the low price, the accommodations are perfectly decent. It's heaven for backpackers, but more recently is attracting more upmarket tourists as well.
In Bangkok's prime residential area of Sukhumvit Road, one budget option is Suk 11, a quirky guesthouse legendary among backpackers, where the halls have been remade with creaking wooden planks and hanging lanterns to look like old Bangkok alleyways. A bed in a clean, air-conditioned dorm room starts at $7.50.
Getting around: Buses in Bangkok charge only 15 cents for non-air-conditioned service, and up to 50 cents for air-conditioned vehicles.
Traveling in Bangkok during rush hour is an exercise in Zen patience, so tourists in a hurry would do best to use the excellent BTS Skytrain and underground Metro, with trips starting at 45 cents.
Trains in Bangkok are cheap. A third-class trip from some suburban areas to the heart of town cost as little as 15 cents.
Or hop aboard one of the public ferries along the Chao Phraya River for some spectacular views from the water for 27 cents.
Food: You can pay as little as $1 per meal at a neighborhood street stand. Follow the crowds. Any place packed with customers is bound to offer tasty, fresh fare. Try the stalls at the Banana Family Park, near the Ari Road Skytrain stop, for tasty vegetarian options. Two meatless dishes cost 75 cents.
Massage: For a cheap and novel Thai massage, head to the Skills Development Center for the Blind, where sightless trainees charge just $3 per hour. The center is located just north of the city in Pak Kret.
Madame Joe's, staffed by graduates of the famous Wat Po Massage School, offers affordable massage in the Khao San area, at about $5.40 for one hour.
Bars: Cheap Charlie's, a ramshackle but atmospheric outdoor bar in the Sukhumvit area, has been popular with frugal expatriates for years. Just $1.80 for a small bottle of local brew.
Some bars have ladies-night specials. Try Coyote on Convent Road, where waiters will keep your margarita glass overflowing for free from 6 to 8 p.m. Wednesdays. The trendy Q Bar, in Sukhumvit, allows women to forgo the $15 cover on Wednesday nights.
Attractions and events: Museums and the more notable Buddhist temples in Bangkok are cheap, generally charging $1 or $2 for entry, while parks, art galleries, less famous temples and outdoor shrines are free.
In the wee hours of the morning, the centrally located Lumpini Park fills up with fitness buffs. Look for groups practicing yoga or tai chi. Instruction is in Thai, but most classes will allow you to join in for free. The fun ends at 8 a.m., when the national anthem is played, but crowds return at sundown for more exercise, including aerobics classes.
The Lingam Shrine, filled with phallic symbols, is a must-see among Bangkok's free oddities.
Traditional dances are performed without charge at the Erawan Shrine, near the Grand Hyatt Erawan hotel.
At Siam Square, a popular hangout for the younger crowd, free break-dancing competitions and concerts take place in the shadows of chichi malls and high-end apartment complexes.
Check out BK Magazine (www.bkmagazine.com/)or the "Real Time" section of Friday's English-language Bangkok Post for up-to-date schedules of free performances and other events in the city.
Inside info: Just saying "hello" ("sawadee kha" if you are a woman; "sawadee krap" if you are a man) and "thank you" ("khopkhun kha/krap") may well get you a lower price, especially when bargaining in markets.
Never throw the grown-up version of temper tantrums. Thais abhor them — and may add a bit on to your bill in revenge.
As for those free vasectomies?
The Population and Community Development Association offers them to any man, any nationality, who has fathered two children already.
How's that for a good deal?
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
It's easy to spend hundreds of dollars a day in Bangkok, home to some of the most luxurious hotels in the world. But following some guidelines, you can enjoy the city at a fraction of the price.
Accommodations: Most budget tourists head straight for Khao San Road, a lively, colorful area where you can pay the equivalent of just $4.50 a night for a bed in a dorm room. Despite the low price, the accommodations are perfectly decent. It's heaven for backpackers, but more recently is attracting more upmarket tourists as well.
In Bangkok's prime residential area of Sukhumvit Road, one budget option is Suk 11, a quirky guesthouse legendary among backpackers, where the halls have been remade with creaking wooden planks and hanging lanterns to look like old Bangkok alleyways. A bed in a clean, air-conditioned dorm room starts at $7.50.
Getting around: Buses in Bangkok charge only 15 cents for non-air-conditioned service, and up to 50 cents for air-conditioned vehicles.
Traveling in Bangkok during rush hour is an exercise in Zen patience, so tourists in a hurry would do best to use the excellent BTS Skytrain and underground Metro, with trips starting at 45 cents.
Trains in Bangkok are cheap. A third-class trip from some suburban areas to the heart of town cost as little as 15 cents.
Or hop aboard one of the public ferries along the Chao Phraya River for some spectacular views from the water for 27 cents.
Food: You can pay as little as $1 per meal at a neighborhood street stand. Follow the crowds. Any place packed with customers is bound to offer tasty, fresh fare. Try the stalls at the Banana Family Park, near the Ari Road Skytrain stop, for tasty vegetarian options. Two meatless dishes cost 75 cents.
Massage: For a cheap and novel Thai massage, head to the Skills Development Center for the Blind, where sightless trainees charge just $3 per hour. The center is located just north of the city in Pak Kret.
Madame Joe's, staffed by graduates of the famous Wat Po Massage School, offers affordable massage in the Khao San area, at about $5.40 for one hour.
Bars: Cheap Charlie's, a ramshackle but atmospheric outdoor bar in the Sukhumvit area, has been popular with frugal expatriates for years. Just $1.80 for a small bottle of local brew.
Some bars have ladies-night specials. Try Coyote on Convent Road, where waiters will keep your margarita glass overflowing for free from 6 to 8 p.m. Wednesdays. The trendy Q Bar, in Sukhumvit, allows women to forgo the $15 cover on Wednesday nights.
Attractions and events: Museums and the more notable Buddhist temples in Bangkok are cheap, generally charging $1 or $2 for entry, while parks, art galleries, less famous temples and outdoor shrines are free.
In the wee hours of the morning, the centrally located Lumpini Park fills up with fitness buffs. Look for groups practicing yoga or tai chi. Instruction is in Thai, but most classes will allow you to join in for free. The fun ends at 8 a.m., when the national anthem is played, but crowds return at sundown for more exercise, including aerobics classes.
The Lingam Shrine, filled with phallic symbols, is a must-see among Bangkok's free oddities.
Traditional dances are performed without charge at the Erawan Shrine, near the Grand Hyatt Erawan hotel.
At Siam Square, a popular hangout for the younger crowd, free break-dancing competitions and concerts take place in the shadows of chichi malls and high-end apartment complexes.
Check out BK Magazine (www.bkmagazine.com/)or the "Real Time" section of Friday's English-language Bangkok Post for up-to-date schedules of free performances and other events in the city.
Inside info: Just saying "hello" ("sawadee kha" if you are a woman; "sawadee krap" if you are a man) and "thank you" ("khopkhun kha/krap") may well get you a lower price, especially when bargaining in markets.
Never throw the grown-up version of temper tantrums. Thais abhor them — and may add a bit on to your bill in revenge.
As for those free vasectomies?
The Population and Community Development Association offers them to any man, any nationality, who has fathered two children already.
How's that for a good deal?
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Friday, July 25, 2008
High Risk of Injury for Young Athletes
A 14-year-old gymnast with a stress fracture in her lower back. A 12-year-old who tore his ACL in a soccer game. A 16- year-old runner with a leg stress fracture. A 15-year-old who tore his meniscus playing basketball.
A single morning's patients for Harvard's Dr. Mininder Kocher provides a window into a troubling trend: Injuries once seen mostly in adult athletes are becoming distressingly common in youth athletes -- not just in high school, but in Little League and Pee Wee Football.
These aren't simple injuries. In the past decade, "Tommy John" surgeries to repair elbows blown out playing baseball -- an operation named for a Hall of Famer -- have almost tripled among adolescents at a high-profile Alabama clinic, a meeting of sports medicine specialists were told by researchers last week.
Worse, some injuries don't have good treatments for young patients. The surgery that fixed the torn ACL in Tiger Woods' knee, for instance, can thwart the growth of a young child's leg.
Kocher, an orthopedic surgeon at Children's Hospital Boston, is about to begin a government-funded study to figure out the best treatment for children who tear that anterior cruciate ligament while growth plates around the knee still are active.
But no matter how well certain injuries heal for now, Kocher worries about the long-term consequences for little joints.
"I wonder what these kids are going to be like 20 to 30 years down the road," he says. "Will we have a whole generation of middle-aged adults with early arthritis?"
Why the sudden influx? Orthopedic surgeons say that today's youth sports are more intense, with players often picking just one to specialize in as young as 8. And they can play and train in some sports virtually year-round -- with a school team, recreation league, travel league, summer camp.
"Youth athletes are not the same as small adults," says Dr. Lyle Cain Jr. of the Andrews Sports Medicine & Orthopaedic Center in Birmingham, Ala. Certain types of injuries "can cause permanent damage that affect their future growth."
More than 3.5 million children 14 and under receive medical treatment for sports-related injuries each year. Along with the typical sprains and strains are a lot of overuse injuries -- stress fractures, tendonitis, cartilage damage.
Pitching offers a prime example. The Andrews clinic counts a five- to sixfold increase in serious shoulder and elbow injuries in youth baseball and softball since 2000.
The worst is a torn ulnar collateral ligament on the inside of the elbow. By 2006, nearly a third of Tommy John surgeries to repair it were on patients under 18, Cain told a meeting of the American Orthopaedic Society for Sports Medicine.
Prompted by such research, Little League Baseball last year limited how many pitches youngsters of different ages are allowed to throw before mandatory rest periods.
Then there's the notoriously painful torn ACL -- not an overuse injury but one that can happen to anyone who lands wrong while pivoting on a knee.
It was long thought a rarity in childhood. But among males, 20 percent of torn ACLs occur before age 18; the figure is 30 percent among females, Kocher says.
In 2006, McCall Maddox of Jacksboro, Texas, tore his ACL during Pee Wee Football at age 12. Three doctors refused to do surgery until he was 16 and had quit growing, ordering no running until then. Join the swim team, one advised.
Why? Standard ACL repair involves drilling through the leg's growth plates, risking a stunting of any still-to-come growth.
McCall, a good athlete, was devastated. And in his small town, said his mother, Roxanna Maddox, "We don't have a swim team. We don't have a chess club. We don't have any other options."
She sought out Kocher in Boston, who repairs children's ACLs in a different way: Winding the new ligament around the shinbone instead of drilling. Kocher reports patients doing well five to eight years later but acknowledges a big question: "Will it hold up 20, 30 years down the line" as the adult surgery does?
McCall took a chance with the operation and, after six months of sometimes grueling physical therapy, he was back playing football and basketball and running track in seventh grade.
"Was his mother nervous? Absolutely," Maddox says with a laugh. But her son had "no trouble, none. ... It was a risk worth taking."
Such success stories, however, don't make scientific proof. So Kocher is joining Dr. Allen Anderson of Nashville -- whose own pediatric ACL repair involves drilling near but not through growth plates -- and about 10 hospitals around the country to compare the different surgeries or waiting to operate, to find the best approach.
Until then, Kocher has some easy advice: Try old-fashioned play, such as jumping rope, playing hopscotch, climbing trees. High school teams now are trained to avoid ACL tears with core-body conditioning and tips on bending knees for jumping -- things younger children can learn on their own just by having fun.
"A lot of the stuff kids used to do in free play was ACL prevention," he says. "Now they don't get that, and they jump into high-level soccer."
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
A single morning's patients for Harvard's Dr. Mininder Kocher provides a window into a troubling trend: Injuries once seen mostly in adult athletes are becoming distressingly common in youth athletes -- not just in high school, but in Little League and Pee Wee Football.
These aren't simple injuries. In the past decade, "Tommy John" surgeries to repair elbows blown out playing baseball -- an operation named for a Hall of Famer -- have almost tripled among adolescents at a high-profile Alabama clinic, a meeting of sports medicine specialists were told by researchers last week.
Worse, some injuries don't have good treatments for young patients. The surgery that fixed the torn ACL in Tiger Woods' knee, for instance, can thwart the growth of a young child's leg.
Kocher, an orthopedic surgeon at Children's Hospital Boston, is about to begin a government-funded study to figure out the best treatment for children who tear that anterior cruciate ligament while growth plates around the knee still are active.
But no matter how well certain injuries heal for now, Kocher worries about the long-term consequences for little joints.
"I wonder what these kids are going to be like 20 to 30 years down the road," he says. "Will we have a whole generation of middle-aged adults with early arthritis?"
Why the sudden influx? Orthopedic surgeons say that today's youth sports are more intense, with players often picking just one to specialize in as young as 8. And they can play and train in some sports virtually year-round -- with a school team, recreation league, travel league, summer camp.
"Youth athletes are not the same as small adults," says Dr. Lyle Cain Jr. of the Andrews Sports Medicine & Orthopaedic Center in Birmingham, Ala. Certain types of injuries "can cause permanent damage that affect their future growth."
More than 3.5 million children 14 and under receive medical treatment for sports-related injuries each year. Along with the typical sprains and strains are a lot of overuse injuries -- stress fractures, tendonitis, cartilage damage.
Pitching offers a prime example. The Andrews clinic counts a five- to sixfold increase in serious shoulder and elbow injuries in youth baseball and softball since 2000.
The worst is a torn ulnar collateral ligament on the inside of the elbow. By 2006, nearly a third of Tommy John surgeries to repair it were on patients under 18, Cain told a meeting of the American Orthopaedic Society for Sports Medicine.
Prompted by such research, Little League Baseball last year limited how many pitches youngsters of different ages are allowed to throw before mandatory rest periods.
Then there's the notoriously painful torn ACL -- not an overuse injury but one that can happen to anyone who lands wrong while pivoting on a knee.
It was long thought a rarity in childhood. But among males, 20 percent of torn ACLs occur before age 18; the figure is 30 percent among females, Kocher says.
In 2006, McCall Maddox of Jacksboro, Texas, tore his ACL during Pee Wee Football at age 12. Three doctors refused to do surgery until he was 16 and had quit growing, ordering no running until then. Join the swim team, one advised.
Why? Standard ACL repair involves drilling through the leg's growth plates, risking a stunting of any still-to-come growth.
McCall, a good athlete, was devastated. And in his small town, said his mother, Roxanna Maddox, "We don't have a swim team. We don't have a chess club. We don't have any other options."
She sought out Kocher in Boston, who repairs children's ACLs in a different way: Winding the new ligament around the shinbone instead of drilling. Kocher reports patients doing well five to eight years later but acknowledges a big question: "Will it hold up 20, 30 years down the line" as the adult surgery does?
McCall took a chance with the operation and, after six months of sometimes grueling physical therapy, he was back playing football and basketball and running track in seventh grade.
"Was his mother nervous? Absolutely," Maddox says with a laugh. But her son had "no trouble, none. ... It was a risk worth taking."
Such success stories, however, don't make scientific proof. So Kocher is joining Dr. Allen Anderson of Nashville -- whose own pediatric ACL repair involves drilling near but not through growth plates -- and about 10 hospitals around the country to compare the different surgeries or waiting to operate, to find the best approach.
Until then, Kocher has some easy advice: Try old-fashioned play, such as jumping rope, playing hopscotch, climbing trees. High school teams now are trained to avoid ACL tears with core-body conditioning and tips on bending knees for jumping -- things younger children can learn on their own just by having fun.
"A lot of the stuff kids used to do in free play was ACL prevention," he says. "Now they don't get that, and they jump into high-level soccer."
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Thursday, July 24, 2008
Beware of Fragranced Products
The scented fabric sheet makes your shirts and socks smell flowery fresh and clean. That plug-in air freshener fills your home with inviting fragrances of apple and cinnamon or a country garden.
But those common household items are potentially exposing your family and friends to dangerous chemicals, a University of Washington study has found.
Trouble is, you have no way of knowing it. Manufacturers of detergents, laundry sheets and air fresheners aren't required to list all of their ingredients on their labels -- or anywhere else. Laws protecting people from indoor air pollution from consumer products are limited.
When UW engineering professor Anne Steinemann analyzed of some of these popular items, she found 100 different volatile organic compounds measuring 300 parts per billion or more -- some of which can be cancerous or cause harm to respiratory, reproductive, neurological and other organ systems.
Some of the chemicals are categorized as hazardous or toxic by federal regulatory agencies. But the labels tell a different story, naming only innocuous-sounding "perfume" or "biodegradable" contents.
"Consumers are breathing these chemicals," she said. "No one is doing anything about it."
Industry representatives say that isn't so.
"Dr. Steinemann's statement is misleading and disingenuous," said Chris Cathcart, president of the Washington, D.C.-based Consumer Specialty Products Association, in a statement.
"Air fresheners, laundry products and other consumer specialty products are regulated under the Federal Hazardous Substances Act and subsequently have strict labeling requirements," he said. "Companies producing products that are regulated under FHSA must name on the product label each component that contributes to the hazard."
Millions are spent annually to ensure that fragrances in the products are safe, according to a joint statement from the Fragrance Materials Association, which represents fragrance manufacturers, and the Research Institute for Fragrance Materials, which works closely with the association.
Ingredients are routinely tested, and chemicals that are considered dangerous are present at levels much too low to cause harm, according to the groups.
But there are numerous reports of people -- particularly those with asthma, chemical sensitivities and allergies -- having strong adverse reactions, researchers said.
That's a problem when public restrooms in restaurants or airplanes use air fresheners, or when hotels wash towels and sheets in scented laundry supplies. And even when the concentrations are low in individual products, people are exposed to multiple sources on a daily basis.
Aileen Gagney, Asthma and Environmental Health Program manager with the American Lung Association in Seattle, herself an asthma sufferer, has a rule of thumb to help avoid exposure: "If it smells bad, it's bad; if it smells good, it's bad."
But even that won't always work.
According to Steinemann, even products labeled "unscented" sometimes contain a fragrance and a "masking" fragrance to make them odor-free.
With fears growing over chemicals in consumer products -- lead in toys, bisphenol A in plastic baby bottles, phthalates in shower curtains and cosmetics -- environmentalists and health advocates are calling for stricter regulations of chemicals in everyday goods. They also want shoppers to have more readily accessible information.
Manufacturers and trade groups representing consumer products routinely counter that there's plenty of testing and oversight from within the industries and from government regulations to ensure safety.
In the fragranced-products arena, they point to industry Web sites with information on product ingredients and suggest contacting companies with specific questions.
Critics maintain that's not enough.
"There's obviously a loophole," said Michael Robinson-Dorn, a UW law professor who aided Steinemann's research. "We regulate many of these chemicals in other circumstances, yet when they're in products that we're in contact with daily, in some cases, we don't wind up finding out about them."
He said the items can slip between regulatory cracks by falling into the jurisdiction of multiple government agencies, none taking ownership.
"Any time you have a product that is regulated by many different agencies, it's easy for them not to react," he said.
In the absence of strong laws, the marketplace is starting to regulate itself.
After the Natural Resources Defense Council last fall found troubling levels of phthalates -- plasticizing chemicals that can potentially harm developing babies -- in air fresheners, Walgreens pulled the products from its shelves.
Last month, NRDC and other environmental groups sued the Environmental Protection Agency to force manufacturers to test air freshener safety and label products with a full ingredient list.
Steinemann's study could push the process along.
"Consumer demand for less-toxic products will encourage companies to reformulate their products," she said. "This is a case where a little information could have a great public benefit."
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
But those common household items are potentially exposing your family and friends to dangerous chemicals, a University of Washington study has found.
Trouble is, you have no way of knowing it. Manufacturers of detergents, laundry sheets and air fresheners aren't required to list all of their ingredients on their labels -- or anywhere else. Laws protecting people from indoor air pollution from consumer products are limited.
When UW engineering professor Anne Steinemann analyzed of some of these popular items, she found 100 different volatile organic compounds measuring 300 parts per billion or more -- some of which can be cancerous or cause harm to respiratory, reproductive, neurological and other organ systems.
Some of the chemicals are categorized as hazardous or toxic by federal regulatory agencies. But the labels tell a different story, naming only innocuous-sounding "perfume" or "biodegradable" contents.
"Consumers are breathing these chemicals," she said. "No one is doing anything about it."
Industry representatives say that isn't so.
"Dr. Steinemann's statement is misleading and disingenuous," said Chris Cathcart, president of the Washington, D.C.-based Consumer Specialty Products Association, in a statement.
"Air fresheners, laundry products and other consumer specialty products are regulated under the Federal Hazardous Substances Act and subsequently have strict labeling requirements," he said. "Companies producing products that are regulated under FHSA must name on the product label each component that contributes to the hazard."
Millions are spent annually to ensure that fragrances in the products are safe, according to a joint statement from the Fragrance Materials Association, which represents fragrance manufacturers, and the Research Institute for Fragrance Materials, which works closely with the association.
Ingredients are routinely tested, and chemicals that are considered dangerous are present at levels much too low to cause harm, according to the groups.
But there are numerous reports of people -- particularly those with asthma, chemical sensitivities and allergies -- having strong adverse reactions, researchers said.
That's a problem when public restrooms in restaurants or airplanes use air fresheners, or when hotels wash towels and sheets in scented laundry supplies. And even when the concentrations are low in individual products, people are exposed to multiple sources on a daily basis.
Aileen Gagney, Asthma and Environmental Health Program manager with the American Lung Association in Seattle, herself an asthma sufferer, has a rule of thumb to help avoid exposure: "If it smells bad, it's bad; if it smells good, it's bad."
But even that won't always work.
According to Steinemann, even products labeled "unscented" sometimes contain a fragrance and a "masking" fragrance to make them odor-free.
With fears growing over chemicals in consumer products -- lead in toys, bisphenol A in plastic baby bottles, phthalates in shower curtains and cosmetics -- environmentalists and health advocates are calling for stricter regulations of chemicals in everyday goods. They also want shoppers to have more readily accessible information.
Manufacturers and trade groups representing consumer products routinely counter that there's plenty of testing and oversight from within the industries and from government regulations to ensure safety.
In the fragranced-products arena, they point to industry Web sites with information on product ingredients and suggest contacting companies with specific questions.
Critics maintain that's not enough.
"There's obviously a loophole," said Michael Robinson-Dorn, a UW law professor who aided Steinemann's research. "We regulate many of these chemicals in other circumstances, yet when they're in products that we're in contact with daily, in some cases, we don't wind up finding out about them."
He said the items can slip between regulatory cracks by falling into the jurisdiction of multiple government agencies, none taking ownership.
"Any time you have a product that is regulated by many different agencies, it's easy for them not to react," he said.
In the absence of strong laws, the marketplace is starting to regulate itself.
After the Natural Resources Defense Council last fall found troubling levels of phthalates -- plasticizing chemicals that can potentially harm developing babies -- in air fresheners, Walgreens pulled the products from its shelves.
Last month, NRDC and other environmental groups sued the Environmental Protection Agency to force manufacturers to test air freshener safety and label products with a full ingredient list.
Steinemann's study could push the process along.
"Consumer demand for less-toxic products will encourage companies to reformulate their products," she said. "This is a case where a little information could have a great public benefit."
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Wednesday, July 23, 2008
Foreign TB Cases Need Better Control
Tuberculosis cases continue to fall in the United States, but some immigrants have disturbingly high rates of the disease, according to a study released Tuesday that called for more aggressive action.
TB rates were highest among residents from lower Africa and parts of Southeast Asia. Most drug-resistant TB cases also were from foreign-born residents, the study noted.
The researchers called for wider testing, including efforts to seek out latent cases of TB from long-term immigrant residents in certain populations.
Rates of at least 250 TB cases per 100,000 were found among people from African countries such as Ethiopia, Kenya and Somalia and from Southeast Asian nations including Vietnam, Cambodia and the Philippines.
By comparison, the overall rate of TB in the U.S. is fewer than 5 per 100,000, according to researchers at the Centers of Disease Control and Prevention, whose study is based on data from 2001-06. Their findings are being published in Wednesday's Journal of the American Medical Association.
Dr. Henry Blumberg of Emory University's medical school, said the research shows "that it's in the interest of the United States to try to enhance global TB efforts."
Of those infected, drug-resistant TB was found in 20 percent of recent immigrants from Vietnam and 10 percent of foreign-born residents overall, compared with a little more than 4 percent of U.S.-born residents.
Public health officials worry that drug-resistant TB could become a worldwide scourge because of global travel and immigration. The issue made headlines last year when an Atlanta attorney with drug-resistant TB flew to several countries. Tests later showed he did not infect anyone on those flights.
U.S. law requires TB screening for people who want to immigrate to the United States, said the CDC's Dr. Kevin Cain, the study's lead author.
Another step that would help curb the rise of tuberculosis, he said, would be to find and treat latent TB infections. He said the study helps identify which foreign-born groups would be most appropriate for such an effort.
While most TB cases come from recent arrivals, a significant number involve people who have lived in the United States for at least 20 years, the study authors said. Most of these likely resulted from latent infections acquired years earlier abroad, they wrote.
Latent, non-contagious infections mean germs are present but the body is able to fight off symptoms. Latent infections can morph into active disease, causing contagious illness, at any time, particularly as people age and their immune systems weaken.
Latent infections are detected with skin tests and treated with nine months of antibiotics. Foreign-born U.S. residents aren't routinely tested for latent TB. And with more than 37 million foreign-born people living in the United States, giving all of them skin tests "would be daunting to say the least," Cain said.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
TB rates were highest among residents from lower Africa and parts of Southeast Asia. Most drug-resistant TB cases also were from foreign-born residents, the study noted.
The researchers called for wider testing, including efforts to seek out latent cases of TB from long-term immigrant residents in certain populations.
Rates of at least 250 TB cases per 100,000 were found among people from African countries such as Ethiopia, Kenya and Somalia and from Southeast Asian nations including Vietnam, Cambodia and the Philippines.
By comparison, the overall rate of TB in the U.S. is fewer than 5 per 100,000, according to researchers at the Centers of Disease Control and Prevention, whose study is based on data from 2001-06. Their findings are being published in Wednesday's Journal of the American Medical Association.
Dr. Henry Blumberg of Emory University's medical school, said the research shows "that it's in the interest of the United States to try to enhance global TB efforts."
Of those infected, drug-resistant TB was found in 20 percent of recent immigrants from Vietnam and 10 percent of foreign-born residents overall, compared with a little more than 4 percent of U.S.-born residents.
Public health officials worry that drug-resistant TB could become a worldwide scourge because of global travel and immigration. The issue made headlines last year when an Atlanta attorney with drug-resistant TB flew to several countries. Tests later showed he did not infect anyone on those flights.
U.S. law requires TB screening for people who want to immigrate to the United States, said the CDC's Dr. Kevin Cain, the study's lead author.
Another step that would help curb the rise of tuberculosis, he said, would be to find and treat latent TB infections. He said the study helps identify which foreign-born groups would be most appropriate for such an effort.
While most TB cases come from recent arrivals, a significant number involve people who have lived in the United States for at least 20 years, the study authors said. Most of these likely resulted from latent infections acquired years earlier abroad, they wrote.
Latent, non-contagious infections mean germs are present but the body is able to fight off symptoms. Latent infections can morph into active disease, causing contagious illness, at any time, particularly as people age and their immune systems weaken.
Latent infections are detected with skin tests and treated with nine months of antibiotics. Foreign-born U.S. residents aren't routinely tested for latent TB. And with more than 37 million foreign-born people living in the United States, giving all of them skin tests "would be daunting to say the least," Cain said.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Tuesday, July 22, 2008
Is it a cold or is it an allergy?
THE BELIEF:
It's a cold. No, it's an allergy.
A stuffy head, a sore throat and sneezing fits that could leave you with a migraine: According to some surveys, about 20 percent of Americans report experiencing symptoms such as those at the same time every year.
That would suggest they are because of an allergy, not a cold. But how to tell the difference?
Symptoms of seasonal allergies and colds overlap, but studies suggest there are ways to tell them apart.
The first is the onset of symptoms. Colds move more slowly, taking a day or longer to set in and gradually worsening -- with symptoms such as loss of appetite and headache -- before subsiding after about a week and disappearing within 10 days. But allergies begin immediately. The sneezing is sudden and overwhelming, and the congestion, typically centered behind the nose, is immediate. Allergy symptoms also disappear quickly -- almost as soon as the offending allergen, like pollen, is no longer around.
Then there are hallmark symptoms of each. Allergies virtually always cause itchiness, in the eyes, the nose, the throat, whereas a cold generally does not. Telltale signs of a cold are a fever, aches and colored mucus.
If confusion persists, consult your family tree: Studies show that having a parent with allergies greatly increases your risk, particularly if that parent is your mother.
THE BOTTOM LINE:
There are a few slight differences that can help you separate allergies from a cold.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
It's a cold. No, it's an allergy.
A stuffy head, a sore throat and sneezing fits that could leave you with a migraine: According to some surveys, about 20 percent of Americans report experiencing symptoms such as those at the same time every year.
That would suggest they are because of an allergy, not a cold. But how to tell the difference?
Symptoms of seasonal allergies and colds overlap, but studies suggest there are ways to tell them apart.
The first is the onset of symptoms. Colds move more slowly, taking a day or longer to set in and gradually worsening -- with symptoms such as loss of appetite and headache -- before subsiding after about a week and disappearing within 10 days. But allergies begin immediately. The sneezing is sudden and overwhelming, and the congestion, typically centered behind the nose, is immediate. Allergy symptoms also disappear quickly -- almost as soon as the offending allergen, like pollen, is no longer around.
Then there are hallmark symptoms of each. Allergies virtually always cause itchiness, in the eyes, the nose, the throat, whereas a cold generally does not. Telltale signs of a cold are a fever, aches and colored mucus.
If confusion persists, consult your family tree: Studies show that having a parent with allergies greatly increases your risk, particularly if that parent is your mother.
THE BOTTOM LINE:
There are a few slight differences that can help you separate allergies from a cold.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Monday, July 21, 2008
Hydrate The Right Way
Summertime brings many opportunities for outdoor activity, but exercising in heat and humidity for prolonged periods of time can overtax the body. We all know how important it is to avoid dehydration, especially when exercising in extreme temperatures. So what's the best way to stay hydrated?
- Water or sports drink? Water is the best choice when it comes to normal fluid loss, that is, when going about everyday activities such as running errands, housecleaning and other routine tasks. Consuming sports drinks is generally recommended as a suitable fluid replacement in cases in which physical activity is of long duration (generally more than one hour) or where there is excessive sweating. With sweating, the body loses salts and other valuable minerals, which must to be replaced. In this case, a sports drink can be a good idea. Try chocolate milk, many sports nutritionists are beginning to tout it's benefits after a workout and prefer it over sports drinks.
- Pre- and post-workout drinks. Whey is a protein-rich liquid component of milk, produced as a byproduct of the cheese-making process. Whey protein has been called the ultimate functional food and is used as a key ingredient in many pre-and post-workout drinks and shakes to help promote adequate muscle recovery and repair. Designer Whey is one of the most popular and recognized brands of this type, with ready-todrink products as well as easy-tomix powders.
- Energy drinks. There is much controversy as to whether energy drinks are safe. Energy drinks are typically carbonated beverages with stimulants such as caffeine, certain herbs and other ingredients, and high amounts of sugar, although sugar-free energy drinks are now available. Caffeine is a diuretic, which increases fluid loss and accelerates the rate of urination.
Sunday, July 20, 2008
Travel Immunizations
Passport? Check. Plane tickets? Check. Immunizations? Uh-oh."
Most people are so absorbed in the passport and tickets and reservations at the hotel that they don't think about health," said physician Phyllis Kozarsky, a consultant for the U.S. Centers for Disease Control and Prevention and a professor of medicine at Emory University in Atlanta.
Thinking about immunizations is not something travelers can consider on the way to the airport. Most inoculations should be planned at least four weeks before travel so the vaccines can become active in the body, said physician Kamaljit Singh, an infectious-disease specialist at Rush University Medical Center in Chicago.
Whether a traveler even requires a vaccine depends on the travel location, itinerary, lifestyle and season of travel, said Singh, who heads the Rush Travel Medicine and Immunization Clinic.
He added that an increasing number of people heading for more exotic locations has surprised him, and they are prime candidates for vaccinations.
"Are you staying in a five-star hotel and wearing suits and jackets or will you have on a backpack and climb on a bicycle?" Singh said, explaining that being out in the elements is more likely to require vaccinations.
A recent trip to China was all business for Chet Kondas, who traveled for nine days in May to major cities such as Beijing. Singh said business travelers such as Kondas usually do not require vaccinations.
Kondas wore a business suit all day, stayed in upscale hotels and spent most of his time indoors.
"We were going from one meeting to the next, and the lunches and dinners were really formal," said Kondas of Chicago.
Having considered the clean conditions he would be in, Kondas did not receive any vaccines before traveling but said he might for future trips. "We stayed in a very nice hotel," he said. "The only thing was you had to be careful about the [drinking] water.
"But travelers planning an outdoor adventure or time in rural areas are more likely to require vaccinations. Singh, for example, will be traveling to Uganda this summer to practice medicine in an underserved area.
His itinerary requires vaccinations against rabies, Hepatitis A, Hepatitis B, yellow fever and a polio booster. Additionally, travelers are advised to be sure they are up to date with shots of U.S.-recommended vaccines such as tetanus, Singh said.
Having as many vaccines as Singh is getting may seem excessive, but travel-medicine physicians argue that the shots protect against dangerous diseases. Typhoid, for example, is transmitted by contaminated food and water and is recommended for travelers heading to most foreign destinations, including Eastern Europe. Likewise, Hepatitis A is transmitted by food and water and is recommended for people traveling to those same places.
Hepatitis B is transmitted by blood and bodily secretions and is advised for patients who expect to receive a tattoo, have contact with needles or have sex with locals while traveling, Kozarsky said.
Other vaccines such as yellow fever and Japanese encephalitis are transmitted by mosquitoes, so if a person's travel itinerary won't lead them to infested places, such vaccinations may be unnecessary. But Kozarsky said medical professionals tend to recommend shots for travelers planning time in rural areas, such as a biking trip through Vietnam.
Rabies pre-exposure shots also may be recommended for travelers heading into rural areas or for travelers with children, who are more likely to pet animals and may not report a bite. But the pre-exposure vaccination does not eliminate the need for post-exposure shots.
The pre-exposure vaccination simply makes the post-exposure treatment easier to receive, Kozarsky said, because the pre-exposure vaccination contains a product that is not always available in countries such as China or India and is required for post-exposure treatment."You face the risk of rabies or having to leave the country and going to another country to find the medication," Kozarsky said.
One shot recommendation that may surprise American travelers is the polio booster. Polio has not been eradicated in other countries, Kozarsky said, but fortunately one booster covers a person for adulthood.
While some diseases can be prevented with vaccines, others can be treated only with medicine. Malaria, for example, does not have a vaccine, so travelers are given pills to take before, during and after travel as prevention. Again, Kozarsky said, a person's itinerary determines which drug will be used, because malaria parasites in some areas are resistant to certain drugs.
So travel-medicine specialists can help a traveler determine whether vaccinations are needed. According to Singh, this is what a traveler should explain to a doctor about the itinerary:
Local clinics
Need malaria pills or a polio booster? Here are some travel medicine and immunization clinics in the Chicago area:
Healthy Trust Immediate Medical Care
342 S. Milwaukee Avenue
Wheeling, IL 60090
847-243-0333
Most people are so absorbed in the passport and tickets and reservations at the hotel that they don't think about health," said physician Phyllis Kozarsky, a consultant for the U.S. Centers for Disease Control and Prevention and a professor of medicine at Emory University in Atlanta.
Thinking about immunizations is not something travelers can consider on the way to the airport. Most inoculations should be planned at least four weeks before travel so the vaccines can become active in the body, said physician Kamaljit Singh, an infectious-disease specialist at Rush University Medical Center in Chicago.
Whether a traveler even requires a vaccine depends on the travel location, itinerary, lifestyle and season of travel, said Singh, who heads the Rush Travel Medicine and Immunization Clinic.
He added that an increasing number of people heading for more exotic locations has surprised him, and they are prime candidates for vaccinations.
"Are you staying in a five-star hotel and wearing suits and jackets or will you have on a backpack and climb on a bicycle?" Singh said, explaining that being out in the elements is more likely to require vaccinations.
A recent trip to China was all business for Chet Kondas, who traveled for nine days in May to major cities such as Beijing. Singh said business travelers such as Kondas usually do not require vaccinations.
Kondas wore a business suit all day, stayed in upscale hotels and spent most of his time indoors.
"We were going from one meeting to the next, and the lunches and dinners were really formal," said Kondas of Chicago.
Having considered the clean conditions he would be in, Kondas did not receive any vaccines before traveling but said he might for future trips. "We stayed in a very nice hotel," he said. "The only thing was you had to be careful about the [drinking] water.
"But travelers planning an outdoor adventure or time in rural areas are more likely to require vaccinations. Singh, for example, will be traveling to Uganda this summer to practice medicine in an underserved area.
His itinerary requires vaccinations against rabies, Hepatitis A, Hepatitis B, yellow fever and a polio booster. Additionally, travelers are advised to be sure they are up to date with shots of U.S.-recommended vaccines such as tetanus, Singh said.
Having as many vaccines as Singh is getting may seem excessive, but travel-medicine physicians argue that the shots protect against dangerous diseases. Typhoid, for example, is transmitted by contaminated food and water and is recommended for travelers heading to most foreign destinations, including Eastern Europe. Likewise, Hepatitis A is transmitted by food and water and is recommended for people traveling to those same places.
Hepatitis B is transmitted by blood and bodily secretions and is advised for patients who expect to receive a tattoo, have contact with needles or have sex with locals while traveling, Kozarsky said.
Other vaccines such as yellow fever and Japanese encephalitis are transmitted by mosquitoes, so if a person's travel itinerary won't lead them to infested places, such vaccinations may be unnecessary. But Kozarsky said medical professionals tend to recommend shots for travelers planning time in rural areas, such as a biking trip through Vietnam.
Rabies pre-exposure shots also may be recommended for travelers heading into rural areas or for travelers with children, who are more likely to pet animals and may not report a bite. But the pre-exposure vaccination does not eliminate the need for post-exposure shots.
The pre-exposure vaccination simply makes the post-exposure treatment easier to receive, Kozarsky said, because the pre-exposure vaccination contains a product that is not always available in countries such as China or India and is required for post-exposure treatment."You face the risk of rabies or having to leave the country and going to another country to find the medication," Kozarsky said.
One shot recommendation that may surprise American travelers is the polio booster. Polio has not been eradicated in other countries, Kozarsky said, but fortunately one booster covers a person for adulthood.
While some diseases can be prevented with vaccines, others can be treated only with medicine. Malaria, for example, does not have a vaccine, so travelers are given pills to take before, during and after travel as prevention. Again, Kozarsky said, a person's itinerary determines which drug will be used, because malaria parasites in some areas are resistant to certain drugs.
So travel-medicine specialists can help a traveler determine whether vaccinations are needed. According to Singh, this is what a traveler should explain to a doctor about the itinerary:
- Places the person will travel, including whether in cities or farming areas.
- The season.
- Lodging—for example, a hotel or a tent.
- Time to be spent outdoors.
Local clinics
Need malaria pills or a polio booster? Here are some travel medicine and immunization clinics in the Chicago area:
Healthy Trust Immediate Medical Care
342 S. Milwaukee Avenue
Wheeling, IL 60090
847-243-0333
Saturday, July 19, 2008
Secondhand Tobbaco Smoke Drastically Drops
Nearly half of nonsmoking Americans are still breathing in cigarette fumes, but the percentage has declined dramatically since the early 1990s, according to a government study released Thursday.
A main reason for the decline in secondhand smoke is the growing number of laws and policies that ban smoking in workplaces, bars, restaurants and public places, said researchers with the Centers for Disease Control and Prevention.
Another factor is the drop in the number of adult smokers: It has now inched below 20 percent, according to 2007 CDC data.
The new study found about 46 percent of nonsmokers had signs of nicotine in their blood in tests done from 1999 through 2004. That was a steep drop from 84 percent when similar tests were done in the late 1980s and early 1990s.
But health officials stopped short of celebrating. "It's still high," said Cinzia Marano, one of the study's authors. "There is no safe level of exposure."
Cigarettes cause lung cancer and other deadly illnesses not only in smokers, but also in nonsmokers who breathe in smoke, studies have shown.
For nonsmoking adults, secondhand smoke increases their lung cancer risk by at least 20 percent and their heart disease risk by at least 25 percent. Children exposed to secondhand smoke are at increased risk of asthma attacks, ear problems, acute respiratory infections and sudden infant death syndrome, health officials say.
The new CDC report drew its data from the National Health and Nutrition Examination Survey, a unique government study that sends mobile trailers out to communities.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
A main reason for the decline in secondhand smoke is the growing number of laws and policies that ban smoking in workplaces, bars, restaurants and public places, said researchers with the Centers for Disease Control and Prevention.
Another factor is the drop in the number of adult smokers: It has now inched below 20 percent, according to 2007 CDC data.
The new study found about 46 percent of nonsmokers had signs of nicotine in their blood in tests done from 1999 through 2004. That was a steep drop from 84 percent when similar tests were done in the late 1980s and early 1990s.
But health officials stopped short of celebrating. "It's still high," said Cinzia Marano, one of the study's authors. "There is no safe level of exposure."
Cigarettes cause lung cancer and other deadly illnesses not only in smokers, but also in nonsmokers who breathe in smoke, studies have shown.
For nonsmoking adults, secondhand smoke increases their lung cancer risk by at least 20 percent and their heart disease risk by at least 25 percent. Children exposed to secondhand smoke are at increased risk of asthma attacks, ear problems, acute respiratory infections and sudden infant death syndrome, health officials say.
The new CDC report drew its data from the National Health and Nutrition Examination Survey, a unique government study that sends mobile trailers out to communities.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Friday, July 18, 2008
When Should You See a Dietician?
A registered dietitian, or RD, is a food and nutrition expert who translates the science of nutrition into practical solutions for healthful living. Taking a highly personalized approach to diet and health, a dietitian can work within the context of your values and daily life patterns to help you achieve your nutrition goals.
RDs undergo rigorous training and must hold a bachelor's or master's degree in dietetics from an accredited college or university, complete a six- to 12-month dietetic internship, and pass a national examination administered by the Commission on Dietetic Registration. Most often they are up to date on the latest research surrounding the connection between diet and health and can provide guidance to integrate a healthy diet into your lifestyle.
A dietician can provide guidelines for digestive and immune support and offer recommendations for weight-related dietary changes. He or she also can offer customized dietary recommendations to treat chronic illnesses such as heart disease and diabetes and support healthy living.
During the initial meeting with a dietitian, he or she will work with you to paint a complete picture of your overall nutritional status. The dietitian will ask questions about your health history and your eating habits. He or she will then work with you to problem solve and develop a customized plan to help you achieve optimal health through nutrition.
Consult your physician to find out if a registered dietitian may be a good addition to your health care team.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
RDs undergo rigorous training and must hold a bachelor's or master's degree in dietetics from an accredited college or university, complete a six- to 12-month dietetic internship, and pass a national examination administered by the Commission on Dietetic Registration. Most often they are up to date on the latest research surrounding the connection between diet and health and can provide guidance to integrate a healthy diet into your lifestyle.
A dietician can provide guidelines for digestive and immune support and offer recommendations for weight-related dietary changes. He or she also can offer customized dietary recommendations to treat chronic illnesses such as heart disease and diabetes and support healthy living.
During the initial meeting with a dietitian, he or she will work with you to paint a complete picture of your overall nutritional status. The dietitian will ask questions about your health history and your eating habits. He or she will then work with you to problem solve and develop a customized plan to help you achieve optimal health through nutrition.
Consult your physician to find out if a registered dietitian may be a good addition to your health care team.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Thursday, July 17, 2008
Cipro a Risk for Tendons?
Drug safety officials Tuesday imposed the government's most urgent safety warning on Cipro and similar antibiotics, citing evidence that they may lead to tendon ruptures, a serious injury that can leave patients incapacitated and needing extensive surgery.
The Food and Drug Administration ordered makers of flouroquinolone drugs - a potent class of antibacterials - to add a prominent "black box" warning to their products and develop new literature for patients emphasizing the risks.
Tendon ruptures are normally thought of as sports injuries, generally occurring among men in their mid-30s. The link to treatment with the antibiotics is highly unusual, and scientists still don't fully understand why it happens. However, FDA officials stressed that many of the serious injuries appear to be preventable if patients stop taking the drug at the first sign of pain or swelling in a tendon, call their doctor, and switch to another antibiotic.
The two leading drugs covered by the warning are Cipro, made by Bayer, and Levaquin, which is made by Ortho-McNeil. Cipro became a household name during the anthrax attacks of 2001. It is effective against that deadly bacteria, and is among the drugs stockpiled by the government in case of a bio-terror attack. In everyday medicine, Cipro is often used to treat urinary tract infections. Levaquin is generally used to treat respiratory infections. The FDA warnings do not apply to fluoroquinolone drops used to treat eye infections.
The FDA's action came after the consumer group Public Citizen petitioned - and later sued - the agency for such warnings. Regulators took too long to act, complained Sidney Wolfe, head of the consumer group's health section. Many injuries "would have been prevented if patients and doctors had known a pain in the tendon is an early sign that leads to rupture," Wolfe said. Public Citizen's original petition was filed nearly two years ago.
FDA officials pointed out that prescribing literature for the drug class already carried clear warnings of the risk of tendon rupture. They said the agency acted to emphasize the warnings because continued reports of injuries indicated that the message may not have gotten through to doctors and patients.
"The continued reports demonstrate additional steps are warranted to better manage the risk of tendon rupture," said Renata Albrecht, director of an FDA office that focuses on unusual microbes.
FDA officials said they had received several hundred reports of tendon ruptures, but would not cite a specific number. Wolfe, of Public Citizen, said the number was 407 at the end of 2007, with another 341 reports of tendinitis. He continued to criticize the agency, saying it should also require drug makers to send individual letters to doctors about the risks. FDA officials said manufacturers could choose to send such letters on their own.
Tendons are cords of tissue that join muscles and bones, and are essential in movement. The most common kind of rupture reported to the FDA involved the Achilles tendon in the heel, but some also involved the rotator cuff in the shoulder, and tendons in the hands, biceps, and even the thumb.
Some of the ruptures reported to the FDA occurred without warning - the patient felt a snap or pop soon after starting treatment. That suggests flouroquinolone antibiotics may be toxic to some people, the FDA said.
But typically, patients felt some kind of pain or inflammation for a week or two before they suffered a tendon rupture. That suggests that many of the most serious problems can be avoided if patients stop the drug, officials said.
The FDA's analysis found that patients with the highest risk of problems include people over 60, those with kidney, heart and lung transplants, and those also taking steroids.
Manufacturers called the tendon ruptures a rare side effect. They said are complying with the FDA order and remain confident that the drugs' benefits outweigh their risks.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
The Food and Drug Administration ordered makers of flouroquinolone drugs - a potent class of antibacterials - to add a prominent "black box" warning to their products and develop new literature for patients emphasizing the risks.
Tendon ruptures are normally thought of as sports injuries, generally occurring among men in their mid-30s. The link to treatment with the antibiotics is highly unusual, and scientists still don't fully understand why it happens. However, FDA officials stressed that many of the serious injuries appear to be preventable if patients stop taking the drug at the first sign of pain or swelling in a tendon, call their doctor, and switch to another antibiotic.
The two leading drugs covered by the warning are Cipro, made by Bayer, and Levaquin, which is made by Ortho-McNeil. Cipro became a household name during the anthrax attacks of 2001. It is effective against that deadly bacteria, and is among the drugs stockpiled by the government in case of a bio-terror attack. In everyday medicine, Cipro is often used to treat urinary tract infections. Levaquin is generally used to treat respiratory infections. The FDA warnings do not apply to fluoroquinolone drops used to treat eye infections.
The FDA's action came after the consumer group Public Citizen petitioned - and later sued - the agency for such warnings. Regulators took too long to act, complained Sidney Wolfe, head of the consumer group's health section. Many injuries "would have been prevented if patients and doctors had known a pain in the tendon is an early sign that leads to rupture," Wolfe said. Public Citizen's original petition was filed nearly two years ago.
FDA officials pointed out that prescribing literature for the drug class already carried clear warnings of the risk of tendon rupture. They said the agency acted to emphasize the warnings because continued reports of injuries indicated that the message may not have gotten through to doctors and patients.
"The continued reports demonstrate additional steps are warranted to better manage the risk of tendon rupture," said Renata Albrecht, director of an FDA office that focuses on unusual microbes.
FDA officials said they had received several hundred reports of tendon ruptures, but would not cite a specific number. Wolfe, of Public Citizen, said the number was 407 at the end of 2007, with another 341 reports of tendinitis. He continued to criticize the agency, saying it should also require drug makers to send individual letters to doctors about the risks. FDA officials said manufacturers could choose to send such letters on their own.
Tendons are cords of tissue that join muscles and bones, and are essential in movement. The most common kind of rupture reported to the FDA involved the Achilles tendon in the heel, but some also involved the rotator cuff in the shoulder, and tendons in the hands, biceps, and even the thumb.
Some of the ruptures reported to the FDA occurred without warning - the patient felt a snap or pop soon after starting treatment. That suggests flouroquinolone antibiotics may be toxic to some people, the FDA said.
But typically, patients felt some kind of pain or inflammation for a week or two before they suffered a tendon rupture. That suggests that many of the most serious problems can be avoided if patients stop the drug, officials said.
The FDA's analysis found that patients with the highest risk of problems include people over 60, those with kidney, heart and lung transplants, and those also taking steroids.
Manufacturers called the tendon ruptures a rare side effect. They said are complying with the FDA order and remain confident that the drugs' benefits outweigh their risks.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Wednesday, July 16, 2008
Bullying Doctors
Bullying doctors can make nurses afraid to question their performance, resulting in medical errors, according to a hospital group that announced new requirements for cracking down on intimidating behavior.
Outbursts and condescending language threaten patient safety and increase the cost of care, according to a safety alert issued Wednesday by the Joint Commission, an independent organization that accredits most of the nation's hospitals.
Hospitals will be required by next year to have codes of conduct and processes for dealing with inappropriate behavior by staff, said the group's president, Dr. Mark Chassin. Hospitals without such systems risk losing their accreditation, he said.
Powerful doctors mean money for hospitals because they choose where to admit their patients, but they "should not be left off the hook," said Dr. Peter Angood, vice president of the group, which is based in suburban Chicago.
Grena Porto, a nurse involved in the group's efforts, said nurses need to be "appropriately assertive" and feel safe enough to ask a doctor, "Are you sure we're supposed to operate on the right leg, rather than the left?"
Nurses, pharmacists and hospital administrators also can be culprits, but it's the doctors who bully nurses that are the most significant for patient safety, said Dr. Alan Rosenstein, a researcher on the topic. He applauded the group's action.
Rosenstein, medical director of VHA West Coast, an alliance of nonprofit hospitals, surveyed 1,500 hospital employees for a 2005 study published in the American Journal of Nursing, and received comments like these:
Outbursts and condescending language threaten patient safety and increase the cost of care, according to a safety alert issued Wednesday by the Joint Commission, an independent organization that accredits most of the nation's hospitals.
Hospitals will be required by next year to have codes of conduct and processes for dealing with inappropriate behavior by staff, said the group's president, Dr. Mark Chassin. Hospitals without such systems risk losing their accreditation, he said.
Powerful doctors mean money for hospitals because they choose where to admit their patients, but they "should not be left off the hook," said Dr. Peter Angood, vice president of the group, which is based in suburban Chicago.
Grena Porto, a nurse involved in the group's efforts, said nurses need to be "appropriately assertive" and feel safe enough to ask a doctor, "Are you sure we're supposed to operate on the right leg, rather than the left?"
Nurses, pharmacists and hospital administrators also can be culprits, but it's the doctors who bully nurses that are the most significant for patient safety, said Dr. Alan Rosenstein, a researcher on the topic. He applauded the group's action.
Rosenstein, medical director of VHA West Coast, an alliance of nonprofit hospitals, surveyed 1,500 hospital employees for a 2005 study published in the American Journal of Nursing, and received comments like these:
- "Most nurses are afraid to call Dr. X when they need to, and frequently won't call. Their patient's medical safety is always in jeopardy because of this.
- "I have caught myself in the middle of mislabeling specimens after confrontations that have been upsetting.
Another survey in 2003 by the Institute for Safe Medication Practices found that 40 percent of health providers said they had kept quiet rather than question a known bully. Hospitals have pecking orders and are stressful work environments, but "there's a right way and a wrong way to manage that stress," Chassin said.
Tuesday, July 15, 2008
Overweight Men Have Bad Sperm?
Too many fatty foods are dangerous not only to men's waistlines, but to their sperm production.
In research presented Wednesday at a meeting of the European Society of Human Reproduction and Embryology, scientists found that obese men have worse sperm than normal-weight men.
"There is a very long list of health hazards from being overweight," said Ghiyath Shayeb, the study's lead researcher at the University of Aberdeen. "Now we can add poor semen quality to the list."
But experts aren't sure if that necessarily means obese men face major difficulties having children.
"If you have a man who isn't fantastically fertile with a normal partner who is fertile, her fertility will compensate," said Dr. William Ledger, a professor of obstetrics and gynecology at Britain's University of Sheffield, who was unconnected to the study.
But if both partners are heavy, Ledger said that could be a problem, since obesity is known to decrease women's fertility.
Shayeb and colleagues analyzed the sperm samples of more than 5,000 men in Scotland, and divided the men into groups according to their Body Mass Index. Men who had an optimal BMI (20 to 25) had higher levels of normal sperm than those who were overweight or obese.
Fat men had a 60 percent higher chance of having a low volume of semen, according to Shayeb's research. They also had a 40 percent higher chance of having some sperm abnormalities.
Shayeb and colleagues found that underweight men were just as likely to have the same problems as obese men. "But there were not many underweight men in Scotland," he noted.
The researchers adjusted their analysis to account for other factors that could have affected men's sperm count, like smoking, alcohol intake, history of drug abuse, and age.
"Male fitness and health are clearly linked to a man's fertility," said Neil McClure, professor of obstetrics and gynecology at Queen's University in Belfast.
The study supported results of an earlier sperm study done by doctors at hospitals and universities in Denmark.
There are several theories about why obese men might have bad sperm. Because fat tissue influences the metabolism of sex hormones, scientists think it might also disrupt sperm production.
It could also be a temperature problem. Sperm is best produced at a temperature two degrees cooler than normal body temperature. But because obese men have more fat, Shayeb said their bodies might be overheated.
Another study presented at the conference concluded that diabetes in men damages their sperm and is linked to male infertility.
Con Mallidis and colleagues at Queen's University in Belfast examined semen samples from nearly 40 men who were being treated for diabetes, but were not overweight. They found significant DNA damage linked to the excess sugar in the body from diabetes.
They found that diabetic men had twice the rate of DNA damage in their sperm as men without diabetes.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
In research presented Wednesday at a meeting of the European Society of Human Reproduction and Embryology, scientists found that obese men have worse sperm than normal-weight men.
"There is a very long list of health hazards from being overweight," said Ghiyath Shayeb, the study's lead researcher at the University of Aberdeen. "Now we can add poor semen quality to the list."
But experts aren't sure if that necessarily means obese men face major difficulties having children.
"If you have a man who isn't fantastically fertile with a normal partner who is fertile, her fertility will compensate," said Dr. William Ledger, a professor of obstetrics and gynecology at Britain's University of Sheffield, who was unconnected to the study.
But if both partners are heavy, Ledger said that could be a problem, since obesity is known to decrease women's fertility.
Shayeb and colleagues analyzed the sperm samples of more than 5,000 men in Scotland, and divided the men into groups according to their Body Mass Index. Men who had an optimal BMI (20 to 25) had higher levels of normal sperm than those who were overweight or obese.
Fat men had a 60 percent higher chance of having a low volume of semen, according to Shayeb's research. They also had a 40 percent higher chance of having some sperm abnormalities.
Shayeb and colleagues found that underweight men were just as likely to have the same problems as obese men. "But there were not many underweight men in Scotland," he noted.
The researchers adjusted their analysis to account for other factors that could have affected men's sperm count, like smoking, alcohol intake, history of drug abuse, and age.
"Male fitness and health are clearly linked to a man's fertility," said Neil McClure, professor of obstetrics and gynecology at Queen's University in Belfast.
The study supported results of an earlier sperm study done by doctors at hospitals and universities in Denmark.
There are several theories about why obese men might have bad sperm. Because fat tissue influences the metabolism of sex hormones, scientists think it might also disrupt sperm production.
It could also be a temperature problem. Sperm is best produced at a temperature two degrees cooler than normal body temperature. But because obese men have more fat, Shayeb said their bodies might be overheated.
Another study presented at the conference concluded that diabetes in men damages their sperm and is linked to male infertility.
Con Mallidis and colleagues at Queen's University in Belfast examined semen samples from nearly 40 men who were being treated for diabetes, but were not overweight. They found significant DNA damage linked to the excess sugar in the body from diabetes.
They found that diabetic men had twice the rate of DNA damage in their sperm as men without diabetes.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Monday, July 14, 2008
Salmonella in the food supply
Think of your favorite recipe for salsa. Three common ingredients now are suspects in the salmonella poisonings that have become the nation's largest foodborne outbreak in at least a decade.
And therein lies the frustration. Seven weeks into their investigation, federal health officials aren't shortening the list of potential culprits but adding to it. Now jalapeno pepper producers are being probed alongside tomato distributors, and even fresh cilantro is under suspicion too.
It's quite a departure from the 2006 E. coli outbreak in spinach, a mystery solved in about two weeks. "We really, really got spoiled, if you will, with the spinach outbreak," Dr. Robert Tauxe, food safety chief at the Centers for Disease Control and Prevention, told The Associated Press.
There aren't as many spinach lovers as tomato lovers, and the spinach consumers remembered eating came in bags, often still left in their refrigerators, bearing bar codes that were as good a clue as a fingerprint in helping investigators race to the very field that had been contaminated.
This time around, the suspects seldom are left over in the refrigerator or bear individual bar codes. Also, the victims are having a harder time remembering. They say, "'Well, I'm not sure, I may have had guacamole, or a garnish,'" Tauxe notes.
But this outbreak is lasting an unusually long time, with a record 1,017 cases confirmed by Wednesday - the first of whom fell sick April 10 and the latest so far on June 26.
Tauxe said that makes the toll of the current salmonella outbreak far surpass recent large outbreaks of any foodborne disease: salmonella linked to peanut butter in 2006 and hepatitis A from green onions in 2003. It's not quite as big as when cyclospora-tainted raspberries sickened well over 1,000 people in the mid-1990s.
The scope is bad both for public health and a battered tomato industry that estimates losses at $100 million. Yet it is giving federal investigators some apparently valuable new clues.
Early on, lots of individuals got sick, not clusters of people who all ate at the same restaurant or catered picnic. But by mid-May and continuing well into last month, those clusters of five or more people sickened in the same spot were appearing. That's good news for disease detectives, who find it easier to trace suppliers for a few restaurants than hundreds of stores and market.
Plus, the CDC just finished comparing 144 people who got sick in June with 287 people who live near them but didn't fall ill. That study of the June cases shows the sick are far more likely than the well to have eaten either raw tomatoes, raw jalapeno peppers or fresh cilantro. In one of the largest clusters, those sickened had consumed fresh tomatoes and fresh jalapenos mixed together. In two other large clusters, illnesses were linked only to a dish that contained fresh jalapenos but no tomatoes.
What does that mean?
"We are quite sure that neither tomatoes nor jalapenos explain the entire outbreak at this point. ... We're presuming that both of them have caused illness," Tauxe said.
That has the Food and Drug Administration looking furiously for intersections between peppers and tomatoes. Perhaps there are farms that grew tomatoes earlier in the spring and then switched to pepper harvesting, or distribution centers that handled both types of produce and contaminated incoming produce, said FDA's food safety chief, Dr. David Acheson.
The government's advice for now is to continue avoiding certain raw tomatoes - red round, plum and Roma - unless they were grown in areas cleared of suspicion.
People at highest risk of severe illness from salmonella should not eat raw jalapeno and serrano peppers, the CDC said Wednesday. The most vulnerable are the elderly, people with weak immune systems and infants. Serranos are on the list because they're hard to distinguish from jalapenos.
Did the CDC just miss a pepper connection early on?
"It's very hard for us to say that peppers were absolutely not part of the problem initially. They may have been part of the problem initially but not large enough to catch the attention of the investigations," Tauxe acknowledges.
But there are clusters of illness where jalapenos "simply were not on the menu," he added. "Likewise tomatoes have not disappeared," and more sick people than their healthy neighbors continue to report having eaten them.
The geography offers a potentially good clue too. Patients live in 41 states, Washington, D.C., and even Canada - where three people got sick while traveling to the U.S. and a fourth case is under investigation. Most of the sick are in the Southwest, while parts of the Northwest have no cases and parts of the Southeast few.
"That begs the question is there something about the distribution of the product that contributes to that," Acheson said. "We've been trying to tease that apart."
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
And therein lies the frustration. Seven weeks into their investigation, federal health officials aren't shortening the list of potential culprits but adding to it. Now jalapeno pepper producers are being probed alongside tomato distributors, and even fresh cilantro is under suspicion too.
It's quite a departure from the 2006 E. coli outbreak in spinach, a mystery solved in about two weeks. "We really, really got spoiled, if you will, with the spinach outbreak," Dr. Robert Tauxe, food safety chief at the Centers for Disease Control and Prevention, told The Associated Press.
There aren't as many spinach lovers as tomato lovers, and the spinach consumers remembered eating came in bags, often still left in their refrigerators, bearing bar codes that were as good a clue as a fingerprint in helping investigators race to the very field that had been contaminated.
This time around, the suspects seldom are left over in the refrigerator or bear individual bar codes. Also, the victims are having a harder time remembering. They say, "'Well, I'm not sure, I may have had guacamole, or a garnish,'" Tauxe notes.
But this outbreak is lasting an unusually long time, with a record 1,017 cases confirmed by Wednesday - the first of whom fell sick April 10 and the latest so far on June 26.
Tauxe said that makes the toll of the current salmonella outbreak far surpass recent large outbreaks of any foodborne disease: salmonella linked to peanut butter in 2006 and hepatitis A from green onions in 2003. It's not quite as big as when cyclospora-tainted raspberries sickened well over 1,000 people in the mid-1990s.
The scope is bad both for public health and a battered tomato industry that estimates losses at $100 million. Yet it is giving federal investigators some apparently valuable new clues.
Early on, lots of individuals got sick, not clusters of people who all ate at the same restaurant or catered picnic. But by mid-May and continuing well into last month, those clusters of five or more people sickened in the same spot were appearing. That's good news for disease detectives, who find it easier to trace suppliers for a few restaurants than hundreds of stores and market.
Plus, the CDC just finished comparing 144 people who got sick in June with 287 people who live near them but didn't fall ill. That study of the June cases shows the sick are far more likely than the well to have eaten either raw tomatoes, raw jalapeno peppers or fresh cilantro. In one of the largest clusters, those sickened had consumed fresh tomatoes and fresh jalapenos mixed together. In two other large clusters, illnesses were linked only to a dish that contained fresh jalapenos but no tomatoes.
What does that mean?
"We are quite sure that neither tomatoes nor jalapenos explain the entire outbreak at this point. ... We're presuming that both of them have caused illness," Tauxe said.
That has the Food and Drug Administration looking furiously for intersections between peppers and tomatoes. Perhaps there are farms that grew tomatoes earlier in the spring and then switched to pepper harvesting, or distribution centers that handled both types of produce and contaminated incoming produce, said FDA's food safety chief, Dr. David Acheson.
The government's advice for now is to continue avoiding certain raw tomatoes - red round, plum and Roma - unless they were grown in areas cleared of suspicion.
People at highest risk of severe illness from salmonella should not eat raw jalapeno and serrano peppers, the CDC said Wednesday. The most vulnerable are the elderly, people with weak immune systems and infants. Serranos are on the list because they're hard to distinguish from jalapenos.
Did the CDC just miss a pepper connection early on?
"It's very hard for us to say that peppers were absolutely not part of the problem initially. They may have been part of the problem initially but not large enough to catch the attention of the investigations," Tauxe acknowledges.
But there are clusters of illness where jalapenos "simply were not on the menu," he added. "Likewise tomatoes have not disappeared," and more sick people than their healthy neighbors continue to report having eaten them.
The geography offers a potentially good clue too. Patients live in 41 states, Washington, D.C., and even Canada - where three people got sick while traveling to the U.S. and a fourth case is under investigation. Most of the sick are in the Southwest, while parts of the Northwest have no cases and parts of the Southeast few.
"That begs the question is there something about the distribution of the product that contributes to that," Acheson said. "We've been trying to tease that apart."
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Sunday, July 13, 2008
Carotid Artery Disease Treatment
The purpose of treatment for carotid artery disease is to prevent a stroke. But the type of treatment you receive depends on several factors, including the extent of the blockage, the signs and symptoms you're experiencing, and other medical conditions you may have.
The carotid arteries are a pair of blood vessels that deliver blood to your brain and head. When these blood vessels become clogged with fatty deposits (plaque) that restrict blood flow -- a condition known as carotid artery disease -- your risk of stroke increases. Most strokes associated with carotid artery disease are caused by small clots that form in the area of the restricted blood flow and travel to the brain.
With a 50-percent blockage, and if you haven't had any signs or symptoms of a stroke, I would generally recommend that your condition be treated with lifestyle changes and medication.
Eating healthy foods, exercising, losing weight and, in some cases, lowering the amount of sodium in your diet, may help slow the progression of carotid artery blockage (stenosis). Cigarette smoking is a risk factor for carotid artery disease and stroke. If you use tobacco, you should permanently stop.
Effectively managing chronic medical conditions also is important. High blood pressure (hypertension) is a key risk factor for stroke among people with carotid artery disease. Bringing your blood pressure down to approximately 120 over 70 mmHg can reduce your risk of stroke significantly. Controlling your blood sugar levels if you have diabetes and lowering your cholesterol levels with diet, exercise and, if necessary, a statin drug -- if you have high cholesterol -- may reduce your stroke risk, as well.
Taking an aspirin every day is often part of treatment for carotid artery disease, too. Aspirin is an effective blood-thinning medication that can help prevent blood clots from forming in the narrowed carotid arteries. If you can't take aspirin, your doctor can prescribe another drug that will have a similar effect.
You don't mention if you've had signs or symptoms of a stroke, such as sudden weakness, numbness or paralysis on one side of your body affecting the face, arm or leg; slurred speech; or sudden blindness in one eye. If you experience any of these, seek immediate medical attention.
Even if they last for only a short time, tell your doctor. Signs and symptoms of a stroke that last less than 24 hours, and after which you feel normal, may be the result of a temporary shortage of blood to part of your brain (transient ischemic attack or TIA). Having a TIA significantly increases your risk of having a stroke.
For people who have carotid artery disease and experience TIA or other stroke signs and symptoms, or for those who have a higher level of blockage than you do, such as 70 percent or more, lifestyle changes and medication usually aren't enough. Treatment in these situations typically involves a procedure to remove the blockage. A carotid endarterectomy is the most common operation. During this surgery, performed under general anesthesia, a surgeon opens the carotid artery and removes the plaque.
In some cases, a carotid endarterectomy may not be an option. The location of the blockage may be difficult to reach directly. Or, a patient may have a condition that makes surgery too risky, such as previous neck radiation or neck surgery, severe heart or lung disease, or kidney failure.
In these situations, carotid angioplasty and stenting may be appropriate. This procedure involves inflating a tiny balloon at the end of a long hollow tube (catheter) within the blocked artery, then inserting a wire-mesh metal stent into the artery to keep it open.
These are the general treatment guidelines for carotid artery disease but they don't apply in all situations. Factors such as your age, past medical history and underlying medical conditions also need to be taken into consideration. Talk to your doctor about a treatment plan that's best for you.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
The carotid arteries are a pair of blood vessels that deliver blood to your brain and head. When these blood vessels become clogged with fatty deposits (plaque) that restrict blood flow -- a condition known as carotid artery disease -- your risk of stroke increases. Most strokes associated with carotid artery disease are caused by small clots that form in the area of the restricted blood flow and travel to the brain.
With a 50-percent blockage, and if you haven't had any signs or symptoms of a stroke, I would generally recommend that your condition be treated with lifestyle changes and medication.
Eating healthy foods, exercising, losing weight and, in some cases, lowering the amount of sodium in your diet, may help slow the progression of carotid artery blockage (stenosis). Cigarette smoking is a risk factor for carotid artery disease and stroke. If you use tobacco, you should permanently stop.
Effectively managing chronic medical conditions also is important. High blood pressure (hypertension) is a key risk factor for stroke among people with carotid artery disease. Bringing your blood pressure down to approximately 120 over 70 mmHg can reduce your risk of stroke significantly. Controlling your blood sugar levels if you have diabetes and lowering your cholesterol levels with diet, exercise and, if necessary, a statin drug -- if you have high cholesterol -- may reduce your stroke risk, as well.
Taking an aspirin every day is often part of treatment for carotid artery disease, too. Aspirin is an effective blood-thinning medication that can help prevent blood clots from forming in the narrowed carotid arteries. If you can't take aspirin, your doctor can prescribe another drug that will have a similar effect.
You don't mention if you've had signs or symptoms of a stroke, such as sudden weakness, numbness or paralysis on one side of your body affecting the face, arm or leg; slurred speech; or sudden blindness in one eye. If you experience any of these, seek immediate medical attention.
Even if they last for only a short time, tell your doctor. Signs and symptoms of a stroke that last less than 24 hours, and after which you feel normal, may be the result of a temporary shortage of blood to part of your brain (transient ischemic attack or TIA). Having a TIA significantly increases your risk of having a stroke.
For people who have carotid artery disease and experience TIA or other stroke signs and symptoms, or for those who have a higher level of blockage than you do, such as 70 percent or more, lifestyle changes and medication usually aren't enough. Treatment in these situations typically involves a procedure to remove the blockage. A carotid endarterectomy is the most common operation. During this surgery, performed under general anesthesia, a surgeon opens the carotid artery and removes the plaque.
In some cases, a carotid endarterectomy may not be an option. The location of the blockage may be difficult to reach directly. Or, a patient may have a condition that makes surgery too risky, such as previous neck radiation or neck surgery, severe heart or lung disease, or kidney failure.
In these situations, carotid angioplasty and stenting may be appropriate. This procedure involves inflating a tiny balloon at the end of a long hollow tube (catheter) within the blocked artery, then inserting a wire-mesh metal stent into the artery to keep it open.
These are the general treatment guidelines for carotid artery disease but they don't apply in all situations. Factors such as your age, past medical history and underlying medical conditions also need to be taken into consideration. Talk to your doctor about a treatment plan that's best for you.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Saturday, July 12, 2008
The Incredible Edible Egg
Get thin, get smart. One little oval package helps you make both happen, and you don't even have to get a prescription for it (yes, it's legal).
Eggs were reinstated as a health food a while back, when major studies cleared them of increasing heart attack and stroke risk. Now there's evidence that people who scramble, boil or poach one for breakfast -- versus eating a bagel with the same number of calories -- bypass junk-food cravings and eat fewer calories for at least 24 hours. Without even trying.
While eggs are a good source of nutrients and protein, it turns out that they make your body feel fuller longer, for reasons that aren't completely clear.
Not only are you smart, as far as your waist is concerned, for eating them, but they're good brain food, too. Eggs are packed with selenium, a nutrient that can help keep your memory sharp and your thinking fast. In fact, people who get at least 55 micrograms (mcg) a day of selenium have cognitive test scores that put them in a league with people 10 years younger.
An egg (14 mcg) on whole-grain toast (10 mcg) gets you almost halfway there. Round out your day with some albacore tuna (63 mcg for 3 ounces and no mercury), turkey (27 mcg for 3 ounces) or Brazil nuts (a mother lode at 270 mcg per half-ounce). Repeat the next morning.
You know that line about "the incredible, edible ..."? Looks like the jingle writer had a clue.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Eggs were reinstated as a health food a while back, when major studies cleared them of increasing heart attack and stroke risk. Now there's evidence that people who scramble, boil or poach one for breakfast -- versus eating a bagel with the same number of calories -- bypass junk-food cravings and eat fewer calories for at least 24 hours. Without even trying.
While eggs are a good source of nutrients and protein, it turns out that they make your body feel fuller longer, for reasons that aren't completely clear.
Not only are you smart, as far as your waist is concerned, for eating them, but they're good brain food, too. Eggs are packed with selenium, a nutrient that can help keep your memory sharp and your thinking fast. In fact, people who get at least 55 micrograms (mcg) a day of selenium have cognitive test scores that put them in a league with people 10 years younger.
An egg (14 mcg) on whole-grain toast (10 mcg) gets you almost halfway there. Round out your day with some albacore tuna (63 mcg for 3 ounces and no mercury), turkey (27 mcg for 3 ounces) or Brazil nuts (a mother lode at 270 mcg per half-ounce). Repeat the next morning.
You know that line about "the incredible, edible ..."? Looks like the jingle writer had a clue.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Friday, July 11, 2008
Cholesterol Drugs For Children?
For the first time, an influential doctors group is recommending that some children as young as 8 be given cholesterol-fighting drugs to ward off future heart problems.
It is the strongest guidance ever given on the issue by the American Academy of Pediatrics, which released its new guidelines Monday. The academy also recommends low-fat milk for 1-year-olds and wider cholesterol testing.
Dr. Stephen Daniels, of the academy's nutrition committee, says the new advice is based on mounting evidence showing that damage leading to heart disease, the nation's leading killer, begins early in life.
It also stems from recent research showing that cholesterol-fighting drugs are generally safe for children, Daniels said.
Several of these drugs are approved for use in children and data show that increasing numbers are using them.
"If we are more aggressive about this in childhood, I think we can have an impact on what happens later in life ... and avoid some of these heart attacks and strokes in adulthood," Daniels said. He has worked as a consultant to Abbott Laboratories and Merck & Co., but not on matters involving their cholesterol drugs.
Drug treatment would generally be targeted for kids at least 8 years old who have too much LDL, the "bad" cholesterol, along with other risky conditions, including obesity and high blood pressure.
For overweight children with too little HDL, the "good" cholesterol, the first course of action should be weight loss, more physical activity and nutritional counseling, the academy says.
Pediatricians should routinely check the cholesterol of children with a family history of inherited cholesterol disease or with parents or grandparents who developed heart disease at an early age, the recommendations say. Screening also is advised for kids whose family history isn't known and those who are overweight, obese or have other heart disease risk factors.
Screening is recommended sometime after age 2 but no later than age 10, at routine checkups.
The academy's earlier advice said cholesterol drugs should only be considered in children older than 10 after they fail to lose weight. Its previous cholesterol screening recommendations also were less specific and did not include targeted ages for beginning testing.
Because obesity is a risk factor for heart disease and often is accompanied by cholesterol problems, the academy recommendations say low-fat milk is appropriate for 1-year-olds "for whom overweight or obesity is a concern."
Daniels, a pediatrician in the Denver area, agreed that could include virtually all children. But he said doctors may choose to offer the new milk advice only to 1-year-olds who are already overweight or have a family history of heart problems.
The academy has long recommended against reduced-fat milk for children up to age 2 because saturated fats are needed for brain development.
"But now we have the obesity epidemic and people are thinking maybe this isn't such a good idea," said Dr. Frank Greer of the University of Wisconsin, co-author of the guidelines report, in the July edition of Pediatrics, the group's medical journal.
Very young children are increasingly getting fats from sources other than milk and Greer said the updated advice is based on recent research showing no harm from reduced-fat milk in these youngsters.
With one-third of U.S. children overweight and about 17 percent obese, the new recommendations are important, said Dr. Jennifer Li, a Duke University children's heart specialist.
"We need to do something to stem the tide of childhood obesity," Li said.
Li said that 15 years ago most of her patients with cholesterol problems had an inherited form of cholesterol disease not connected to obesity.
"But now they're really outnumbered" by overweight kids with cholesterol problems and high blood pressure, she said.
Dr. Elena Fuentes-Afflick, a pediatrics professor at the University of California at San Francisco, also praised the new advice but said some parents think their kids will outgrow obesity and cholesterol problems, and might not take it seriously.
"It's hard for people to really understand" that those problems in childhood can lead to serious health consequences in adulthood, Fuentes-Afflick said.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
It is the strongest guidance ever given on the issue by the American Academy of Pediatrics, which released its new guidelines Monday. The academy also recommends low-fat milk for 1-year-olds and wider cholesterol testing.
Dr. Stephen Daniels, of the academy's nutrition committee, says the new advice is based on mounting evidence showing that damage leading to heart disease, the nation's leading killer, begins early in life.
It also stems from recent research showing that cholesterol-fighting drugs are generally safe for children, Daniels said.
Several of these drugs are approved for use in children and data show that increasing numbers are using them.
"If we are more aggressive about this in childhood, I think we can have an impact on what happens later in life ... and avoid some of these heart attacks and strokes in adulthood," Daniels said. He has worked as a consultant to Abbott Laboratories and Merck & Co., but not on matters involving their cholesterol drugs.
Drug treatment would generally be targeted for kids at least 8 years old who have too much LDL, the "bad" cholesterol, along with other risky conditions, including obesity and high blood pressure.
For overweight children with too little HDL, the "good" cholesterol, the first course of action should be weight loss, more physical activity and nutritional counseling, the academy says.
Pediatricians should routinely check the cholesterol of children with a family history of inherited cholesterol disease or with parents or grandparents who developed heart disease at an early age, the recommendations say. Screening also is advised for kids whose family history isn't known and those who are overweight, obese or have other heart disease risk factors.
Screening is recommended sometime after age 2 but no later than age 10, at routine checkups.
The academy's earlier advice said cholesterol drugs should only be considered in children older than 10 after they fail to lose weight. Its previous cholesterol screening recommendations also were less specific and did not include targeted ages for beginning testing.
Because obesity is a risk factor for heart disease and often is accompanied by cholesterol problems, the academy recommendations say low-fat milk is appropriate for 1-year-olds "for whom overweight or obesity is a concern."
Daniels, a pediatrician in the Denver area, agreed that could include virtually all children. But he said doctors may choose to offer the new milk advice only to 1-year-olds who are already overweight or have a family history of heart problems.
The academy has long recommended against reduced-fat milk for children up to age 2 because saturated fats are needed for brain development.
"But now we have the obesity epidemic and people are thinking maybe this isn't such a good idea," said Dr. Frank Greer of the University of Wisconsin, co-author of the guidelines report, in the July edition of Pediatrics, the group's medical journal.
Very young children are increasingly getting fats from sources other than milk and Greer said the updated advice is based on recent research showing no harm from reduced-fat milk in these youngsters.
With one-third of U.S. children overweight and about 17 percent obese, the new recommendations are important, said Dr. Jennifer Li, a Duke University children's heart specialist.
"We need to do something to stem the tide of childhood obesity," Li said.
Li said that 15 years ago most of her patients with cholesterol problems had an inherited form of cholesterol disease not connected to obesity.
"But now they're really outnumbered" by overweight kids with cholesterol problems and high blood pressure, she said.
Dr. Elena Fuentes-Afflick, a pediatrics professor at the University of California at San Francisco, also praised the new advice but said some parents think their kids will outgrow obesity and cholesterol problems, and might not take it seriously.
"It's hard for people to really understand" that those problems in childhood can lead to serious health consequences in adulthood, Fuentes-Afflick said.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Thursday, July 10, 2008
Good Hygeine Can Diminish MRSA Threat
There are lots of stories in the news about healthy people getting antibioticresistant staph infections. And some parents are wondering how they might protect their children.
It will help, at the start, to gain an understanding of these infections. They actually have been happening for years, though there is evidence that the rate is increasing.
Methicillin-resistant Staphylococcus aureus, or MRSA (pronounced MERsuh), can be spread through skin-to-skin contact or by touching something that has MRSA bacteria on it.
Staph bacteria are everywhere. Some of you reading this likely have it right now, without ever knowing it or showing symptoms. According to a Mayo Clinic study, a variety of staph are normally found on the skin or in the nose of about three in every 10 people at any given time.
However, being "colonized" is not really a concern. Staph bacteria become a problem only when they cause infection, usually by entering the body through a cut or wound. For some people, especially those who are weak or ill, these infections can become serious.
MRSA infections are more difficult to treat than ordinary staph infections because they don't respond to many types of antibiotics.
The chances of resistant bacteria developing have been increased by people in a community who fail to finish a full course of antibiotics.
Symptoms of a MRSA infection depend on its location. If MRSA is causing an infection in a wound, the first sign of infection may look like a spider or insect bite. If you have pneumonia, you may develop a cough.
The best way to protect your child from staph bacteria is to teach him or her good hygiene. Thorough hand washing is very important -- teach your child to wash hands with lots of soap and warm water for the length of time it takes to sing the "Happy Birthday" song twice. Your child should learn to not share personal items such as towels, clothing, deodorants and athletic equipment.
At home, you can help by disinfecting common surfaces such as telephones, light switches, computer keyboards and toilets. Have antibacterial hand sanitizers at the ready in the car, backpack, sports bag and purse. Keep cuts and abrasions clean and covered with a bandage until they are healed.
If you are concerned your child is infected with MRSA, see the doctor right away. He or she may send a sample to a lab to see if there is bacteria and then test to see which kinds of antibiotics kill the bacteria. This test may take several days.
The chances are great that MRSA will never be a problem for your family, but instilling great hygiene habits is always beneficial. Also, be responsible when anyone in the family is prescribed an antibiotic -- complete the prescription, even if the infection is getting better. Don't share antibiotics with others or save unfinished antibiotics for another time. Inappropriate use of antibiotics contributes to resistance.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
It will help, at the start, to gain an understanding of these infections. They actually have been happening for years, though there is evidence that the rate is increasing.
Methicillin-resistant Staphylococcus aureus, or MRSA (pronounced MERsuh), can be spread through skin-to-skin contact or by touching something that has MRSA bacteria on it.
Staph bacteria are everywhere. Some of you reading this likely have it right now, without ever knowing it or showing symptoms. According to a Mayo Clinic study, a variety of staph are normally found on the skin or in the nose of about three in every 10 people at any given time.
However, being "colonized" is not really a concern. Staph bacteria become a problem only when they cause infection, usually by entering the body through a cut or wound. For some people, especially those who are weak or ill, these infections can become serious.
MRSA infections are more difficult to treat than ordinary staph infections because they don't respond to many types of antibiotics.
The chances of resistant bacteria developing have been increased by people in a community who fail to finish a full course of antibiotics.
Symptoms of a MRSA infection depend on its location. If MRSA is causing an infection in a wound, the first sign of infection may look like a spider or insect bite. If you have pneumonia, you may develop a cough.
The best way to protect your child from staph bacteria is to teach him or her good hygiene. Thorough hand washing is very important -- teach your child to wash hands with lots of soap and warm water for the length of time it takes to sing the "Happy Birthday" song twice. Your child should learn to not share personal items such as towels, clothing, deodorants and athletic equipment.
At home, you can help by disinfecting common surfaces such as telephones, light switches, computer keyboards and toilets. Have antibacterial hand sanitizers at the ready in the car, backpack, sports bag and purse. Keep cuts and abrasions clean and covered with a bandage until they are healed.
If you are concerned your child is infected with MRSA, see the doctor right away. He or she may send a sample to a lab to see if there is bacteria and then test to see which kinds of antibiotics kill the bacteria. This test may take several days.
The chances are great that MRSA will never be a problem for your family, but instilling great hygiene habits is always beneficial. Also, be responsible when anyone in the family is prescribed an antibiotic -- complete the prescription, even if the infection is getting better. Don't share antibiotics with others or save unfinished antibiotics for another time. Inappropriate use of antibiotics contributes to resistance.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Wednesday, July 9, 2008
Radio waves foil medical tools
Wireless systems used by many hospitals to keep track of medical equipment can cause potentially deadly breakdowns in lifesaving devices such as breathing and dialysis machines, researchers reported Tuesday.
The wireless systems send out radio waves that can interfere with equipment such as respirators, external pacemakers and kidney dialysis machines, the study said. Electromagnetic glitches occurred in almost 30 percent of 123 tests when microchip devices similar to those in many types of wireless medical equipment were placed within about 1 foot of the lifesaving machines. Patients were not using the equipment at the time.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
The wireless systems send out radio waves that can interfere with equipment such as respirators, external pacemakers and kidney dialysis machines, the study said. Electromagnetic glitches occurred in almost 30 percent of 123 tests when microchip devices similar to those in many types of wireless medical equipment were placed within about 1 foot of the lifesaving machines. Patients were not using the equipment at the time.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Tuesday, July 8, 2008
New Lung Cancer Treatment
A non-surgical procedure used to treat liver cancer also holds promise for lung cancer patients. Percutaneous image-guided radio frequency ablation, which takes less than an hour, targets large tumors with no harm to surrounding healthy tissue. Seventy percent of lung cancer patients treated with RFA survived at least one year with few side effects, according to a study expected to be published in the July edition of The Lancet Oncology.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Monday, July 7, 2008
Vomiting Linked to Irregular Periods
Teenage girls who vomit one to three times a month to control weight increase their risk of having irregular menstrual periods by 60 percent, a recent study reports; those who vomit once a week or more triple their risk. When researchers restricted the analysis only to girls of normal weight, the association was stronger.
Self-induced vomiting can cause electrolyte imbalance, dental enamel erosion, tears in the esophagus and other medical problems, according to background information in the study and an accompanying editorial. Irregular periods are an indication of hormonal disruptions that can affect bone health and mental function in ways that may not be reversible.Researchers analyzed self-reported data from 2,791 girls ages 14 to 19 nationwide. Almost 9 percent reported vomiting for weight control one to three times a month.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Self-induced vomiting can cause electrolyte imbalance, dental enamel erosion, tears in the esophagus and other medical problems, according to background information in the study and an accompanying editorial. Irregular periods are an indication of hormonal disruptions that can affect bone health and mental function in ways that may not be reversible.Researchers analyzed self-reported data from 2,791 girls ages 14 to 19 nationwide. Almost 9 percent reported vomiting for weight control one to three times a month.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Sunday, July 6, 2008
Generous Bartenders
A new study finds that bartenders pack a lot more booze into common drinks than many people realize. Researchers visited 80 bars and restaurants in Northern California last year and found that glasses of wine and spirits are often 50 percent larger than the "standard" size used in guidelines. That means people who follow recommendations about avoiding more than one drink an hour may be getting more booze than they bargained for, say researchers at the Public Health Institute's Alcohol Research Group.
Saturday, July 5, 2008
Big breakfast can lead to significant weight loss
A large breakfast packed with carbohydrates and lean protein can help lessen cravings and hunger the rest of the day, which can lead to significant weight loss, new research suggests. Obese, sedentary women who followed a "big breakfast" diet, in which the first meal accounted for about half their daily calories, lost nearly 40 pounds on average after eight months. Women on a high-protein, low-carbohydrate diet lost about 9 pounds each. The study was presented at the Endocrine Society's annual meeting in San Francisco.
Friday, July 4, 2008
New Combo Vaccines for Kids
New combination vaccines for infants and toddlers approved Thursday by the Advisory Committee on Immunization Practices will soon appear in doctors’ offices in Chicago and across the country.
And parents are sure to have a lot of questions.
Moms and dads will want to know if giving babies a single shot containing protection against four or five infections could be dangerous. Might it overwhelm an infant's immune system and are adverse side effects more likely?
Don’t worry, says Dr. Tina Tan, a pediatric infectious disease specialist at Children’s Memorial Hospital in Chicago.
The new vaccines are as safe and effective as individual vaccines already on the market, she adds, and combining existing immunizations into a single shot doesn’t raise the risk of harm.
“It’s not going to overload your infants’ immune system,” the physician says.
“If you think about what you or I or a baby is exposed to every day in the environment, you are being challenged by more antigens [proteins] than you get through these vaccines,” Tan explains.
But others are concerned.
“There are too many unknowns here; I’d like to see more research on the effects of combining so many vaccines at once,” said Anne Dachel, a member of the board of Advocates for Children’s Health Affected by Mercury Poisoning.
She and others suspect a link between thimerosal – a mercury-based preservative once used in vaccines -- and autism. More than 99 percent of vaccines no longer use the preservative.
But medical experts say research doesn’t support that suspicion.
“When you look at the science, there’s no evidence that there is any connection,” says Tan, who tells anxious parents that the illnesses they’re guarding babies against are a much more considerable threat.
The benefit of the new combination vaccines is a reduction in the number of shots babies get. Instead of four or five shots per visit at the age of 2 months, 4 months, 6 months, and 15 to 18 months, infants will now endure one or two needle sticks.
My Tribune colleague and fellow blogger, Julie Deardorff, notes today that many parents are alarmed by the sheer number of immunizations kids are now asked to get.
"In 1982, The Centers for Disease Control recommended 23 doses of 7 vaccines for children up to age 6," she writes. "Today, the CDC recommends that children get 48 doses of 12 vaccines by age 6." With flu shots, the total expands to 69 doses of 16 vaccines by age 18.
Pentacel, manufactured by Sanofi Pasteur, protects again five infections at the same time (diopththeria, tetanus, pertussis, polio and Haemophilus influenza type B) and was tested on more than 5,000 children.
Kinrix, made by GlaxoSmith Kline, protects against four infections (diphtheria, tetanus, pertussis, and polio).
Both vaccines were approved Thursday by the Advisory Committee on Immunization Practices, which advises the U.S. Centers for Disease Control and Prevention on vaccine policy.
And parents are sure to have a lot of questions.
Moms and dads will want to know if giving babies a single shot containing protection against four or five infections could be dangerous. Might it overwhelm an infant's immune system and are adverse side effects more likely?
Don’t worry, says Dr. Tina Tan, a pediatric infectious disease specialist at Children’s Memorial Hospital in Chicago.
The new vaccines are as safe and effective as individual vaccines already on the market, she adds, and combining existing immunizations into a single shot doesn’t raise the risk of harm.
“It’s not going to overload your infants’ immune system,” the physician says.
“If you think about what you or I or a baby is exposed to every day in the environment, you are being challenged by more antigens [proteins] than you get through these vaccines,” Tan explains.
But others are concerned.
“There are too many unknowns here; I’d like to see more research on the effects of combining so many vaccines at once,” said Anne Dachel, a member of the board of Advocates for Children’s Health Affected by Mercury Poisoning.
She and others suspect a link between thimerosal – a mercury-based preservative once used in vaccines -- and autism. More than 99 percent of vaccines no longer use the preservative.
But medical experts say research doesn’t support that suspicion.
“When you look at the science, there’s no evidence that there is any connection,” says Tan, who tells anxious parents that the illnesses they’re guarding babies against are a much more considerable threat.
The benefit of the new combination vaccines is a reduction in the number of shots babies get. Instead of four or five shots per visit at the age of 2 months, 4 months, 6 months, and 15 to 18 months, infants will now endure one or two needle sticks.
My Tribune colleague and fellow blogger, Julie Deardorff, notes today that many parents are alarmed by the sheer number of immunizations kids are now asked to get.
"In 1982, The Centers for Disease Control recommended 23 doses of 7 vaccines for children up to age 6," she writes. "Today, the CDC recommends that children get 48 doses of 12 vaccines by age 6." With flu shots, the total expands to 69 doses of 16 vaccines by age 18.
Pentacel, manufactured by Sanofi Pasteur, protects again five infections at the same time (diopththeria, tetanus, pertussis, polio and Haemophilus influenza type B) and was tested on more than 5,000 children.
Kinrix, made by GlaxoSmith Kline, protects against four infections (diphtheria, tetanus, pertussis, and polio).
Both vaccines were approved Thursday by the Advisory Committee on Immunization Practices, which advises the U.S. Centers for Disease Control and Prevention on vaccine policy.
Thursday, July 3, 2008
Municipal Questions about Fluoride use
The great American assault on tooth decay began here 63 years ago, earning Grand Rapids a special place in the annals of dental history: the first city in the world to fluoridate its public water system.
So it is more than a little head-scratching that fluoride, the chemical widely credited with dramatically cutting cavities and promoting oral hygiene, is having its scientific credentials questioned in the city that literally swallowed it first.
The belated questioning of fluoride in the most unlikely of places stems partly from unsettled questions—some new, some old—about possible links to cancer and thyroid and kidney problems if too much fluoride is ingested. But the push here mirrors a spreading nationwide awareness and re-examination of the health impact of a wide variety of chemicals added to food, health-care products and water, as well as the use of pesticides.
Unusual findings
Local and state governments around the nation are taking a second — and in some cases a first — look at chemical practices and their potential impact. A county in Utah has stopped encouraging people to flush unused prescription drugs down the toilet because they might contaminate the water system. That action was taken after a report from the U.S. Geological Survey found chemicals from prescription drugs in streams and rivers.
A Tribune examination of Chicago's drinking water this year found traces of pharmaceuticals and personal-care products.
In California, several communities are cracking down on aerial pesticide spraying because of its potential impact on humans and animals. Experts predict that in-depth examinations of chemicals formerly considered benign will become more frequent.
"I think this pattern has been growing because there is better environmental health research that draws connections between low levels of chemical exposure and changes in our bodies," said Dr. Howard Hu, chairman of environmental health sciences at the University of Michigan.
"As the research has become more sophisticated, it shows that environmental toxicants can do other things beyond just kill you—they can stunt your growth, change behavior and increase the risk of cardiovascular disease," Hu said.
'On my radar screen'
Fluoride fights stretch back more than a half-century. Recent studies, though, suggest a possible link to thyroid trouble and problems for people on dialysis. The U.S. Centers for Disease Control and Prevention maintains that water fluoridation is a safe and cost-effective way to prevent tooth decay, but some scientists say questions about the long-term impact cannot be dismissed.
Recent studies, while not conclusive, convinced Corky Overmyer, the director of environmental sustainability for Grand Rapids, that a review was needed to study fluoride's impact on the 11 communities served by the city's water system.
"This has been on my radar screen for a while," said Overmyer, who several years ago led the effort to remove chlorine from the city's water. Overmyer insists he has drawn no conclusions about the safety of fluoride.
Grand Rapids commemorates the 1945 fluoridation with a 30-foot sculpture in the heart of downtown, and the questioning of fluoride has stirred controversy. Dentists have doubted or condemned the effort, and the Grand Rapids Press counseled caution in an editorial.
Grand Rapids, long known as a furniture-making city, is working to reinvent itself as a center of medical research. The timing of the fluoride examination is, at best, awkward because some of the most prominent groups in the medical establishment—the American Dental Association, the American Medical Association and the CDC—have endorsed fluoride.
"They tend to look at little bits of information that are taken out of context," Dr. Howard Pollick, a dentist and chief spokesman for the ADA, said of fluoride opponents.
Overmyer said he is taking heat."I had no idea [fluoride] was that sensitive an issue," he said, noting he has "teeth marks" in his backside from his dentist and the city's mayor, who declined to return phone calls to discuss fluoride.About two-thirds of Americans, including those in Chicago and most major metropolitan areas, are served by fluoridated water. Resistance to fluoride usually is localized, with battles occurring in small towns. In May, voters in two Massachusetts towns overwhelmingly rejected efforts to fluoridate the water.
The Internet has effectively re-energized the former ragtag group of activists by making new information—valid or not—instantly available.And the re-examination by Grand Rapids, the mother of fluoride, has provided an unanticipated boost for opponents.
"If Grand Rapids falls, that could be the beginning of the end of fluoride," said Paul Connett, a retired chemistry professor and director of the Fluoride Action Network, which advocates against fluoridation.
There is strong political and medical resistance to reversing the fluoride policy. Dr. Tim Gietzen, who has practiced dentistry in Grand Rapids for 30 years, said he can tell which of his patients grew up with fluoridated water just by looking in their mouths.
Gietzen said fluoride should remain in the water system "unless someone is causing problems."That's the question to be pursued by Overmyer, who said, "I'm just trying to be honest and open, and I've become a lightning rod."
So it is more than a little head-scratching that fluoride, the chemical widely credited with dramatically cutting cavities and promoting oral hygiene, is having its scientific credentials questioned in the city that literally swallowed it first.
The belated questioning of fluoride in the most unlikely of places stems partly from unsettled questions—some new, some old—about possible links to cancer and thyroid and kidney problems if too much fluoride is ingested. But the push here mirrors a spreading nationwide awareness and re-examination of the health impact of a wide variety of chemicals added to food, health-care products and water, as well as the use of pesticides.
Unusual findings
Local and state governments around the nation are taking a second — and in some cases a first — look at chemical practices and their potential impact. A county in Utah has stopped encouraging people to flush unused prescription drugs down the toilet because they might contaminate the water system. That action was taken after a report from the U.S. Geological Survey found chemicals from prescription drugs in streams and rivers.
A Tribune examination of Chicago's drinking water this year found traces of pharmaceuticals and personal-care products.
In California, several communities are cracking down on aerial pesticide spraying because of its potential impact on humans and animals. Experts predict that in-depth examinations of chemicals formerly considered benign will become more frequent.
"I think this pattern has been growing because there is better environmental health research that draws connections between low levels of chemical exposure and changes in our bodies," said Dr. Howard Hu, chairman of environmental health sciences at the University of Michigan.
"As the research has become more sophisticated, it shows that environmental toxicants can do other things beyond just kill you—they can stunt your growth, change behavior and increase the risk of cardiovascular disease," Hu said.
'On my radar screen'
Fluoride fights stretch back more than a half-century. Recent studies, though, suggest a possible link to thyroid trouble and problems for people on dialysis. The U.S. Centers for Disease Control and Prevention maintains that water fluoridation is a safe and cost-effective way to prevent tooth decay, but some scientists say questions about the long-term impact cannot be dismissed.
Recent studies, while not conclusive, convinced Corky Overmyer, the director of environmental sustainability for Grand Rapids, that a review was needed to study fluoride's impact on the 11 communities served by the city's water system.
"This has been on my radar screen for a while," said Overmyer, who several years ago led the effort to remove chlorine from the city's water. Overmyer insists he has drawn no conclusions about the safety of fluoride.
Grand Rapids commemorates the 1945 fluoridation with a 30-foot sculpture in the heart of downtown, and the questioning of fluoride has stirred controversy. Dentists have doubted or condemned the effort, and the Grand Rapids Press counseled caution in an editorial.
Grand Rapids, long known as a furniture-making city, is working to reinvent itself as a center of medical research. The timing of the fluoride examination is, at best, awkward because some of the most prominent groups in the medical establishment—the American Dental Association, the American Medical Association and the CDC—have endorsed fluoride.
"They tend to look at little bits of information that are taken out of context," Dr. Howard Pollick, a dentist and chief spokesman for the ADA, said of fluoride opponents.
Overmyer said he is taking heat."I had no idea [fluoride] was that sensitive an issue," he said, noting he has "teeth marks" in his backside from his dentist and the city's mayor, who declined to return phone calls to discuss fluoride.About two-thirds of Americans, including those in Chicago and most major metropolitan areas, are served by fluoridated water. Resistance to fluoride usually is localized, with battles occurring in small towns. In May, voters in two Massachusetts towns overwhelmingly rejected efforts to fluoridate the water.
The Internet has effectively re-energized the former ragtag group of activists by making new information—valid or not—instantly available.And the re-examination by Grand Rapids, the mother of fluoride, has provided an unanticipated boost for opponents.
"If Grand Rapids falls, that could be the beginning of the end of fluoride," said Paul Connett, a retired chemistry professor and director of the Fluoride Action Network, which advocates against fluoridation.
There is strong political and medical resistance to reversing the fluoride policy. Dr. Tim Gietzen, who has practiced dentistry in Grand Rapids for 30 years, said he can tell which of his patients grew up with fluoridated water just by looking in their mouths.
Gietzen said fluoride should remain in the water system "unless someone is causing problems."That's the question to be pursued by Overmyer, who said, "I'm just trying to be honest and open, and I've become a lightning rod."
Wednesday, July 2, 2008
Rotavirus shot puts cases at new low
A rotavirus vaccine approved in 2006 is having a significant impact in the United States, delaying the onset of the rotavirus season by three months and reducing its severity by about half, federal officials said Wednesday.
The incidence of rotavirus activity during the first months of 2008 was the lowest it has been since the federal Centers for Disease Control and Prevention began monitoring the disease 15 years ago, researchers reported in the agency's Morbidity and Mortality Weekly Report.
The highly contagious rotavirus is the leading cause of severe vomiting and diarrhea in infants and young children around the world. Each year in the U.S., it causes as many as 272,000 emergency room visits, up to 70,000 hospitalizations and 20 to 60 deaths. Worldwide, an estimated 500,000 children die from the virus each year.
The RotaTeq vaccine has prevented 74 percent of all rotavirus infections, 98 percent of severe infections and about 96 percent of hospitalizations. The CDC recommends that all infants receive their first dose of the vaccine by 12 weeks old and all three required doses by the time they reach 32 weeks.
No good data exist about the number of children who have been vaccinated, but studies at selected sites suggest that about 50 percent of 12-week-olds have received one shot and that about one-third of 13-month-old infants have received all three doses.
The decline in new cases appears "greater than expected based on the protective effects of the vaccine alone," Dr. Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases, said in a statement. She speculated that vaccination was helping reduce the spread of the virus to unvaccinated people.In the past 15 years, the rotavirus season typically began in mid-November. Last winter, according to the report, it began in late February
The incidence of rotavirus activity during the first months of 2008 was the lowest it has been since the federal Centers for Disease Control and Prevention began monitoring the disease 15 years ago, researchers reported in the agency's Morbidity and Mortality Weekly Report.
The highly contagious rotavirus is the leading cause of severe vomiting and diarrhea in infants and young children around the world. Each year in the U.S., it causes as many as 272,000 emergency room visits, up to 70,000 hospitalizations and 20 to 60 deaths. Worldwide, an estimated 500,000 children die from the virus each year.
The RotaTeq vaccine has prevented 74 percent of all rotavirus infections, 98 percent of severe infections and about 96 percent of hospitalizations. The CDC recommends that all infants receive their first dose of the vaccine by 12 weeks old and all three required doses by the time they reach 32 weeks.
No good data exist about the number of children who have been vaccinated, but studies at selected sites suggest that about 50 percent of 12-week-olds have received one shot and that about one-third of 13-month-old infants have received all three doses.
The decline in new cases appears "greater than expected based on the protective effects of the vaccine alone," Dr. Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases, said in a statement. She speculated that vaccination was helping reduce the spread of the virus to unvaccinated people.In the past 15 years, the rotavirus season typically began in mid-November. Last winter, according to the report, it began in late February
Tuesday, July 1, 2008
Promoting Wellness Through Empowerment
The process of seeking medical treatment sometimes can feel hazardous to your health. From the days it takes to schedule an appointment, the hours spent in waiting rooms, and the all too brief face-to-face contact with doctors, it is easy to forget that we are capable of making important choices about our health. For all individuals, it is important to recognize the steps we can take to become our own health advocates.
First, consider what is most important for practitioners to know about you. Well-being extends beyond lab results and basic health questionnaires. For some, it will be important to share cultural traditions, religious beliefs and spiritual practices relevant to making health care decisions. For others, it may be important to share experiences of prejudice or discrimination adversely affecting their wellness. Since not all practitioners will ask questions about these areas, be prepared to offer this information.
Next, identify the steps you can take to support your well-being. These may include making certain your health care provider is meeting your current needs as well as engaging actively during your office visits. If you are contemplating whether your health care provider is a good fit for you, it is important to consider whether the practitioner respects and supports you, and if she or he understands and addresses your primary concerns.
The following suggestions may be helpful in advocating for your health care needs:
Prepare a list of questions to ask your practitioner.
When possible and appropriate, bring a family member or friend along to your appointment for support.
Bring a pen and paper to write down notes and information discussed during your appointment.
Insist on being fully informed on the proposed treatment, its risks and benefits, and alternative options.
Don't be afraid to seek a second opinion.
Through ensuring your health care providers are interested in and capable of relating to you as a whole person, you can work together to promote your optimal health.
First, consider what is most important for practitioners to know about you. Well-being extends beyond lab results and basic health questionnaires. For some, it will be important to share cultural traditions, religious beliefs and spiritual practices relevant to making health care decisions. For others, it may be important to share experiences of prejudice or discrimination adversely affecting their wellness. Since not all practitioners will ask questions about these areas, be prepared to offer this information.
Next, identify the steps you can take to support your well-being. These may include making certain your health care provider is meeting your current needs as well as engaging actively during your office visits. If you are contemplating whether your health care provider is a good fit for you, it is important to consider whether the practitioner respects and supports you, and if she or he understands and addresses your primary concerns.
The following suggestions may be helpful in advocating for your health care needs:
Prepare a list of questions to ask your practitioner.
When possible and appropriate, bring a family member or friend along to your appointment for support.
Bring a pen and paper to write down notes and information discussed during your appointment.
Insist on being fully informed on the proposed treatment, its risks and benefits, and alternative options.
Don't be afraid to seek a second opinion.
Through ensuring your health care providers are interested in and capable of relating to you as a whole person, you can work together to promote your optimal health.
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