Wednesday, July 31, 2013

Does Fruit Contain Too Much Sugar? Sugar In Fruit Ok, Says Boston Children's Hospital Doctor

My opinion:  I'm glad that Dr. Ludwig explained this clearly - I've always wondered if eating too much fruit could be bad, but it seems as if there might be no such thing.  Even if there is, I doubt it would be as dangerous as fruit substitutes, for example, fruit juices and fruit gummies.  A decent portion of fruit juice, like apple juice, contains the sugar of numerous apples, but provides much less nutrition than the actual apple itself.  Also, since simple sugars tend to be added to juices and snacks, it probably gets into the blood stream more quickly and is therefore a greater promoter of diabetes.  I remember the first time I tried natural lemonade - I couldn't believe how much less sweet it was than what I bought at the store!  Do most people understand this about processed fruit products?  And should we stop drinking fruit juice, or are some brands incorporating more nutrients into it?  Feel free to comment.

 

Making the Case for Eating Fruit

Tony Cenicola/The New York Times
Experts agree that we are eating too much sugar, which is contributing to obesity and other health problems. But in the rush to avoid sugar, many low-carb dieters and others are avoiding fruits. But fresh fruit should not become a casualty in the sugar wars, many nutrition experts say.
Dr. David Ludwig, the director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital, said that sugar consumed in fruit is not linked to any adverse health effects, no matter how much you eat. In a recent perspective piece in The Journal of the American Medical Association, he cited observational studies that showed that increased fruit consumption is tied to lower body weight and a lower risk of obesity-associated diseases.
Whole fruits, he explained, contain a bounty of antioxidants and healthful nutrients, and their cellular scaffolding, made of fiber, makes us feel full and provides other metabolic benefits. When you bite into an apple, for example, the fruit’s fiber helps slow your absorption of fructose, the main sugar in most fruits. But fiber is not the full story.
“You can’t just take an 8-ounce glass of cola and add a serving of Metamucil and create a health food,” Dr. Ludwig said. “Even though the fructose-to-fiber ratio might be the same as an apple, the biological effects would be much different.”
Fiber provides “its greatest benefit when the cell walls that contain it remain intact,” he said. Sugars are effectively sequestered in the fruit’s cells, he explained, and it takes time for the digestive tract to break down those cells. The sugars therefore enter the bloodstream slowly, giving the liver more time to metabolize them. Four apples may contain the same amount of sugar as 24 ounces of soda, but the slow rate of absorption minimizes any surge in blood sugar, which makes the pancreas work harder and can contribute to insulin resistance; both increase the risk for Type 2 diabetes.

From: http://well.blogs.nytimes.com/2013/07/31/making-the-case-for-eating-fruit/?_r=0

Monday, July 29, 2013

UVA Program Revives Doctor House Calls

My opinion:  Though I find it unfortunate that many doctors no longer do house calls, it may be because there is such a shortage of doctors that they cannot possibly have time to travel to their many patients.  I also think that the parent might have been exaggerating the problem in terms of taking a small child for a car ride, but since the baby needs healthcare every day, the house calls do give mom a much needed break.  Therefore, it is my hope that some doctors will be able to participate in programs like these around the country, but perhaps such programs should be expanded to include more types of patients.  For example, the elderly cannot always drive to an appointment, and some of the poor may have little access to any transportation.  On another note, the article doesn't fully explain how house calls are less expensive.  Does this mean that doctors perform more procedures than necessary in the office?  And how likely is it that a child will become sick from other patients' germs in the waiting room?  Feel free to comment.

 

UVA Medical Center Program Makes Pediatric House Calls

Posted: Jul 11, 2013 6:27 PM EST Updated: Jul 25, 2013 6:35 PM EST
 
Ashley Mackey, 3 months old, gets a home checkup
Ashley Mackey, 3 months old, gets a home checkup
Who says the days of the house call are long gone? You can still get a doctor to come to you, just like in the old days.
University of Virginia Medical Center is launching a new program a lot of parents will like, called UVA By Your Side Pediatrics. The doctors who are a part of the program have built a practice around treating children in their parents' homes. They say it's better for patients and actually saves medical costs.
Three-month-old Ashley Mackey got a full checkup right at home Wednesday by two UVA Medical Center pediatricians.
"Having them come here is amazing because the idea of taking her in a car to a doctor's office  being that tiny and little is very overwhelming," said Lauren Mackey, the child's mother.
Ashley was born prematurely and required almost daily doctors' visits.
"What was very important with Ashley is that she needed frequent visits. We can make an instantaneous home visit for a sick child," said Dr. Ina Stephens, an associate professor and pediatrician at UVA Medical Center.

From: http://www.nbc29.com/story/22820175/uva-medical-center-program-makes-pediatric-house-calls

Saturday, July 27, 2013

Does Fish Oil Cause Prostate Cancer in Men?

My opinion:  I think this study should be taken with a grain of salt.  Until multiple studies are done, there is no way of verifying this type of information.  The same may be said of many other cancer studies.  I can't even imagine how many headlines I've read listing foods that cause and reduce cancer.  Sometimes, I wonder if cancer is over-sensationalized, causing readers to buy into these studies and become unreasonably worried.  For example, many people fear that standing in front of the microwave causes cancer, even though many studies suggest otherwise, unless the door of the appliance is broken.  Though it doesn't take much effort to avoid a microwave for a few minutes as a precaution, it may be a pain to dispense of a plethora of foods from one's diet.  As health readers, we must remind ourselves to look beyond the anxiety and think about what makes a convincing study.  I hope that when researchers try to replicate this, the also try to examine why it occurs.  After all, correlation is not necessarily causation, and even if it is, we must learn of its pathway in order to determine its severity and possible treatments.  Any other thoughts?  Feel free to comment.

 

Does Fish Oil Increase Prostate Cancer Risk?

Study finds link, but some doctors say there is no cause for alarm.

Published
July 26, 2013
FishOil
Omega-3s’ anti-inflammatory properties have made fish oil a go-to supplement for runners. Research indicates that the polyunsaturated fats help ease joint pain associated with exercise. Omega-3s' heart-health benefits are also well-established.

But a study published earlier this month in the Journal of National Cancer Institute concluded that omega-3s were linked with an increased risk for prostate cancer in men.

The study analyzed data gathered from 2001 to 2004 as part of a cancer prevention trial called SELECT. It compared that data with subsequent follow-up information on the men’s prostate cancer diagnoses, and found an association between higher levels of long-chain fatty acids, including those found in fish, and greater prostate risk.

The subjects’ dietary habits and supplement use were not collected, meaning the source of the omega-3s are unknown. But the findings leave study author Theodore Brasky, Ph.D., a research assistant professor at Ohio State University Comprehensive Cancer Center, concerned.

“Our study is consistent with others of blood measures of long chain omega-3, including similar research that we published in 2011,” he said in an email to Runner’s World Newswire. “There are a few takeaway messages: Men should consider limiting their intake of fatty fish to about two servings per week. We infer that fish oil supplements should be avoided due to their supraphysiological doses of omega-3.”

But Durado Brooks, M.D., M.P.H, director of prostate and colorectal cancer for the American Cancer Society, said that although it sounds scary, the study doesn’t warrant changes in diet or supplement intake for male runners, or any men.

“I don’t think this is the type of study that should encourage men to overhaul their diet,” he said, noting that the research on fatty acids and cancer has been inconsistent and inconclusive for some time. He emphasized that, in a larger context, the study should not be cause for alarm.

“At most [omega-3s] may have an association, but what is that association?” said Brooks.

From: 

Thursday, July 25, 2013

Do Physicians Care Too Much About The Numbers While Treating Patients?

My opinion:  There are a variety of problems that this topic may revolve around.  First off, the pathway to get to the ideal health numbers differs with each treatment, and the quickest and easiest path may not be the best.  For example, the most powerful drugs often are also the most dangerous.  Additionally, if the drug sparks a physiological response too quickly, sometimes other parts of the body fail to adapt.  Finally, the numbers differ with each person, and even approximate ranges may not accurately account for every situation.  In my own experiences, I've heard doctors admit that some of their colleagues go by cookie-cutter test results.  Fortunately, I've been learning how different factors can influence these numbers, although I still think I have a long way to go until I develop a decent thought process.  Part of the doctor's job is to think through complex scenarios to arrive at a probable treatment - there are often no clear answers.  If there were, maybe doctors wouldn't need so much training.  Hope everyone remembers this before "crunching the numbers" gets the best of us.  Feel free to comment.

Accountable Prescribing

Nancy E. Morden, M.D., M.P.H., Lisa M. Schwartz, M.D., Elliott S. Fisher, M.D., M.P.H., and Steven Woloshin, M.D.
N Engl J Med 2013; 369:299-302July 25, 2013DOI: 10.1056/NEJMp1301805


Physicians spend a lot of time treating numbers — blood pressure, cholesterol levels, glycated hemoglobin levels. Professional guidelines, pharmaceutical marketing, and public health campaigns teach physicians and patients that better numbers mean success. Unfortunately, better numbers don't reliably translate into what really matters: patients who feel better and live longer. Often the health benefit gained by reaching a goal depends on how it is reached. When physicians strive for numerical goals without prioritizing the possible treatment strategies, patients may get less effective, less safe, or even unnecessary medications.
Many quality measures reinforce a focus on numerical goals. For example, performance-measure targets for hypertension control, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) and the Physician Quality Reporting System (PQRS), are met if a blood pressure below 140/90 mm Hg is reached after treatment with any antihypertensive medication, without a trial of dietary and exercise interventions (see table Selected Quality Measures That Encourage Different Levels of Accountable Prescribing.). Medications are the quickest and easiest way to reach the goal. Targets for cholesterol-control measures are met if a low-density lipoprotein (LDL) cholesterol level below 100 mg per deciliter is achieved in patients with coronary artery disease using ezetimibe before trying simvastatin, even though only the latter has been shown to reduce myocardial infarction risk. Similarly, for patients with diabetes, the performance target can be met if the glycated hemoglobin level drops below 8.0% with pioglitazone treatment before metformin has been tried — so clinicians are rewarded for using a less effective, less safe drug. Pioglitazone and the other thiazolidinediones carry black-box warnings indicating that they may cause or exacerbate congestive heart failure; they have never been shown to improve outcomes, and they cost more than seven times as much as generic metformin.1
From: http://www.nejm.org/doi/full/10.1056/NEJMp1301805 

Tuesday, July 23, 2013

What Causes an Itch?

My opinion:  It sounds like there are too many reasons to count for why humans itch.  I have my own input that involves psychology.  Many psychologists cite gate-control theory when describing itches.  The spinal cord may send itch messages through certain nerves, or the open gate, and it requires a level of itching to stop these signals to stop them, or close the gate.  However, this theory is used more for pain than itching, and as the article reveals, pain may turn to itch.  Not to mention, since some itches are severe, and many people feel compelled to scratch them to no end, itch may also turn to pain.  Ultimately, there are many types of itches, but it may be most important to focus on the severe, chronic itches, since 10% of people suffer from them.  Since itches often appear to be of little medical worry, however, I'm not sure people care to do the research, or that the necessary funds are granted toward this purpose.  Maybe this is why the current treatments for itches are rather ineffective.  Does our society not consider skin care important because it is largely for cosmetic purposes?  Are other conditions that are only severe on occasion also ignored?  Or is this topic too complex to delve into?  Feel free to comment.

 

Why do we itch?

Kate Lunau on the latest research and the close connection between pain and itch
by Kate Lunau on Tuesday, July 23, 2013 9:56am - 0 Comments
Why do we itch?
iStock
Between the mosquitoes, poison ivy and sunburn, summer is a season of itch. Virtually all of us experience it on a daily basis, yet scientists are still trying to unravel exactly what “itch” is. Long believed to be low-level pain, it’s increasingly clear that itch is a unique sensation of its own—one hard-wired right into our nervous system, with a direct “land line to the brain,” says Mark Hoon, a scientist at the U.S. National Institutes of Health and author of one of two recent studies on this little-understood sensation.
What are some of the reasons we itch? “Oh my gosh, there are a million,” says Dr. Lisa Kellett, a dermatologist at the DLK on Avenue clinic in Toronto. Beyond the common ones—skin problems such as eczema or psoriasis, an allergic reaction to a bug bite, or contact dermatitis caused by poison oak or ivy—it could be a “neurologic issue,” she says, such as the phantom pain some patients feel after a limb is amputated. Liver disease, kidney failure and cancer cause itch, even when the skin appears normal. Stress and emotional upset will also bring it on; even talking about itch might lead to a bout of scratching.
About one in 10 people will, at some point, experience severe chronic itch. Right now, “the drugs are not very good,” says Diana Bautista, an itch and pain researcher at the University of California at Berkeley, and author of the other new study. “There’s no treatment, and certainly no cure.” Even in the case of mosquito bites, poison oak or ivy, “antihistamines are only partially effective,” she says. “For chronic itch, they do nothing whatsoever.” Certain pain medications (such as opioids) cause severe itch, so much so that patients would sometimes rather go off their meds. People would rather put up with pain than an itch, Kellett notes; most of us, at some point, have scratched an itch till it bleeds.

The relationship between itch and pain is a complicated one. “Some things that cause pain turn to itch,” Bautista says, and vice versa. “Pain can also override itch,” such as when we scratch or apply heat or cold to chase an itch away. “Things that are painful actually feel good under the conditions of itch,” she says. “It’s a big mystery.” The sensation of itch is followed by an urge to scratch; however, the sensation of pain is accompanied by the opposite urge, to withdraw.

From: http://www2.macleans.ca/2013/07/23/why-do-we-itch/

Sunday, July 21, 2013

New App Could Prevent Patients from Missing Medication

My opinion:  Despite the fact that I think this is a fabulous idea, there remains one big flaw - many of the people who are missing medications are seniors, who probably don't own smartphones.  Even if they did, it is likely that they would not understand how to use them.  Cell phones like Jitterbug, which are more commonly used be the elderly, need to be equipped with this program.  Also, doctors and pharmacists should make themselves familiar with the interface, as they may have to teach their patients how to use the app.  On another note, the article mentions that many people skip their medication intentionally.  If this is so, then this app cannot fix that problem.  Rather, it may take social therapy and/or a trusted friend or relative who can persuade the patient to take their medication.  Finally, sometimes the issue is that patients don't understand the directions they are given.  Doctors and pharmacists should use the "teach back" approach in which the patient tells the healthcare professional what he or she thinks the directions mean.  Any other tips to help fix the problem?  Feel free to comment.

 

Minnesota doctor's app may become a popular medicine reminder

  • Article by: STEVE ALEXANDER , Star Tribune
  • Updated: July 20, 2013 - 3:48 PM

Many people forget to take their prescribed medications and wind up at risk of serious illness.
Dr. Rajiv Shah, a physician and founder of the Minneapolis tech firm MyMeds, wants to use a little psychology and a smartphone app to gently nudge patients to take their pills.
“This is considered one of the biggest problems in health care today,” said Shah, 41, who juggles his work as a full-time kidney specialist at Intermed Consultants in Edina with being the CEO of MyMeds.
Researchers agree. Failure to take prescribed medications, either accidentally or deliberately, “causes approximately 33 percent to 69 percent of medication-related hospitalizations and accounts for $100 billion in annual [U.S.] health care costs,” a group of University of Arkansas researchers said in the Journal of the American Pharmacists Association this year. Others estimate such costs at as much as $300 billion.
The Arkansas researchers said that about half of all U.S. patients taking prescription drugs for chronic diseases don’t take them as prescribed.

From: http://www.startribune.com/business/216205121.html

Friday, July 19, 2013

Medical School May Not Be Option For Washington Illegal Immigrant

My opinion:  Despite the fact that many Americans are against illegal immigration, many of these same people also believe that the immigrant may stay if he or she proves worthy enough.  I'd say this guy here is certainly capable - I've never even heard of a teenager who became a professional in nursing to get more medical experience.  It is interesting that the school does accept illegal immigrants for undergrad, but not for medical school.  Perhaps medical schools do not want people who may not get licensed/into a residency, although the article never mentions if this is also a problem for illegal immigrants.  So does this argument justify the school's policy?  And what should America do about illegal immigrants who did not choose to come here, for example, if they were infants during immigration?  Could this be combined with the rule that deems anyone born here a citizen, even if their parents are illegal immigrants?  Feel free to comment.

 

Medical school beyond reach of UW grad brought here illegally

More than anything else, Simon Mendoza wants to be a doctor.
He was 13 when the idea morphed from childhood ambition into a real goal — after his father suffered a workplace accident, and Mendoza as his interpreter accompanied him to appointments and helped direct his physical therapy.
At 16, he obtained a certified nursing assistant (CNA) license and, volunteering with the Red Cross, traveled to Louisiana to help provide medical care after Hurricane Gustav in 2008.
And just before he graduated with a bachelor’s degree in microbiology from the University of Washington last year, Mendoza started a free clinic to help deliver basic health care to those living in rural areas of the state — including the little town of Royal City, Grant County, where he grew up.
But for all he’s done to prepare, medical school remains only a distant hope for the 22-year-old Mendoza, whose parents brought him to the U.S. illegally from Mexico when he was less than a year old.
The UW School of Medicine, which he wants to attend, does not admit people who are in the country unlawfully — a policy that exists at all but one of the nation’s medical schools.
“If someone asked me to pick the one person I’d like to see admitted (to medical school), he would be my choice,” said Jaime Lara, a microbiology professor who retired in 2011 after nearly 40 years at the UW, many of them on the admissions committee of the medical school.
“He’ll make an excellent physician one day.”
For undergraduate and all other graduate programs, the UW not only accepts undocumented immigrants, but under state law also grants them in-state tuition.

From: http://seattletimes.com/html/localnews/2021395143_medicalschoolxml.html

Wednesday, July 17, 2013

Surgical Knife Mechanically Recognizes Cancerous Tissues

My opinion:  Not only may this help reduce hospital readmission rates and make surgeries faster, but I think this idea could lead to others.  For example, it isn't only that surgeons may leave some cancerous tissue, but sometimes they forget their tools inside the patient.  For this, perhaps hospital instruments could remind them to check as they complete the surgery, or the tools could beep and light up if they are surrounded by too much tissue, as if they were laying on the inside on the body. There are still a few things about the article that I don't understand.  How can a lab sample indicate if the tumor is still inside the body?  Also, I'm not sure this knife works for benign tumors, since they aren't considered cancerous, but these sometimes how to be removed.  Is there a way to make a knife for benign tumors?  Feel free to comment.

 

New surgical knife can instantly detect cancer

LONDON (AP) — Surgeons may have a new way to smoke out cancer.
An experimental surgical knife can help surgeons make sure they've removed all the cancerous tissue, doctors reported Wednesday. Surgeons typically use knives that heat tissue as they cut, producing a sharp-smelling smoke. The new knife analyzes the smoke and can instantly signal whether the tissue is cancerous or healthy.
Now surgeons have to send the tissue to a lab and wait for the results.
Dr. Zoltan Takats of Imperial College London suspected the smoke produced during cancer surgery might contain some important cancer clues. So he designed a ‘‘smart’’ knife hooked up to a refrigerator-sized mass spectrometry device on wheels that analyzes the smoke from cauterizing tissue.
The smoke picked up by the smart knife is compared to a library of smoke ‘‘signatures’’ from cancerous and non-cancerous tissues. Information appears on a monitor: green means the tissue is healthy, red means cancerous and yellow means unidentifiable.
To make sure they've removed the tumor, surgeons now send samples to a laboratory while the patient remains on the operating table. It can take about 30 minutes to get an answer in the best hospitals, but even then doctors cannot be entirely sure, so they often remove a bit more tissue than they think is strictly necessary.
If some cancerous cells remain, patients may need to have another surgery or undergo chemotherapy or radiation treatment.

From: http://www.boston.com/lifestyle/health/2013/07/17/new-surgical-knife-can-instantly-detect-cancer/WeC7vmWiQay8OUMdU2OW1L/story.html

Monday, July 15, 2013

Remaining in Workforce Could Prevent Alzheimer's Disease

My opinion:  I think this study misses some points as it does not attempt to analyze the lifestyles of these workers.  As it mentions later in the article on its website, some of those who continue to work might be self-employed, which may involve less stressful conditions than that of a large company.  Furthermore, the researchers must assess the activities of those who are retired.  Some of the retirees may not engage in socialization, puzzle games, and exercise, which could further skew the results.  By comparing the seniors who are more active with those who are less active, I think we'd find some intriguing results.  Even further, no one in the study was diagnosed in the same way.  To get even more reliable results, a research hospital could use the same few doctors to diagnose dementia patients over a matter of years.  Ultimately, I think it may still be healthy to retire at retirement age, but one must carefully consider how he or she retires.  It is ok to relax a bit, but not too much - keep your mind sharp and it is less likely to wither away.  Any other interesting causes of Alzheimer's?  Feel free to comment.

 

Putting Off Retirement May Help Stave Off Alzheimer's


MONDAY, July 15, 2013 (HealthDay News) —. As Americans increasingly delay retirement, a new French study indicates this scenario may have a silver lining: a lower risk of developing Alzheimer's disease.
Researchers analyzing health and insurance records of more than 429,000 self-employed workers found a 3 percent reduction in dementia risk for each extra year at the age of retirement. Workers evaluated had been retired for an average of more than 12 years, and 2.65 percent of the group had dementia.
"There's increasing evidence that lifestyle factors such as exercise, mental activities, social engagement, positive outlook and a heart-healthy diet may reduce the risk of developing Alzheimer's disease and other forms of dementia," said Dr. James Galvin. "Now we can add staying in the workforce to this list of potential protective factors."
Galvin, director of the Pearl Barlow Center for Memory Evaluation and Treatment at the NYU Langone School of Medicine, was not involved with the new research.
The study, led by Carole Dufouil, director of research in neuroepidemiology at the French National Institute of Health and Medical Research, is scheduled to be presented Monday at an Alzheimer's Association conference in Boston. Research presented at scientific conferences typically has not been peer-reviewed or published and results are considered preliminary.

From: http://www.everydayhealth.com/alzheimers/0715/putting-off-retirement-may-help-stave-off-alzheimers.aspx

Sunday, July 14, 2013

How to Get the Most Nutrition From Popcorn, Other Odd Foods

My opinion:  Though there may be some pieces and parts of the popcorn that are extremely healthy, I find it hard to believe that most people will eat the hulls of popcorn for dinner, not to mention while at the movies.  To make these nutrients more marketable, there may be a few solutions.  First of all, people could choose to eat dried corn, but I don't think this would be very appetizing.  Maybe there are some recipes out there, however, that are quite tasteful and call for dried corn.  Perhaps this is the true cornerstone of cooking - it can take good to ok foods and make them into something delectable while conserving nutrition.  There may be some cases in which the nutritional value is so small that the food or drink may not be worth using at all, like the antioxidants in red wine.  For this there may be vitamin pills, but I think that cooking is overall a more nutritious, appealing alternative.  Feel free to comment with your own experiences and tips.

 

Don't Forget to Eat Your Fruits, Veggies ... and Popcorn?

The whole-grain treat a good choice for guilt-free snacking, researchers say.



SUNDAY, March 25, 2012 (HealthDay News) — Want a healthy snack? Consider passing the popcorn. A new study says the whole-grain treat contains more of the "good for you" antioxidants called polyphenols than some fruits or vegetables.
The amount of polyphenols in popcorn was up to 300 milligrams (mg) per serving compared with 114 mg per serving of sweet corn and 160 mg per serving for all fruits, according to study findings to be presented Sunday at a meeting of the American Chemical Society in San Diego. This is because polyphenols are diluted in the 90 percent water that makes up many fruits and vegetables, whereas they are more concentrated in popcorn, which averages only about 4 percent water, the study authors said.
In the average U.S. diet, fruits provide 255 mg of polyphenols per day and vegetables provide 218 mg per day. One serving of popcorn would provide 13 percent of the average daily intake of polyphenols per person in the United States, the Pennsylvania researchers said in a society news release.The levels of polyphenols in popcorn reported in this study were higher than previously believed. The levels were similar to those found in nuts and 15 times the levels found in whole-grain tortilla chips, the researchers said.  The investigators also found that the hulls of popcorn — the bits that tend to get caught in the teeth — have the highest concentrations of polyphenols and fiber.

Those hulls deserve more respect," study author Joe Vinson, of the University of Scranton, said in the news release.
However, Vinson warned, adding butter, salt and other calorie-laden flavorings can turn this snack into a bucketful of trouble.

From: http://www.everydayhealth.com/diet-and-nutrition/0326/dont-forget-to-eat-your-fruits-veggies-and-popcorn.aspx?xid=tw_everydayhealth_sf

Saturday, July 13, 2013

Northwestern University Project "Radars" Hidden, Deadly Drug Reactions

My thoughts:  The importance of this project cannot be overstated.  In many situations, especially with the elderly, patients may have multiple illnesses, which calls for the use of multiple drugs.  In polypharmacy, some patients take up to thirty different drugs at a time!  Almost certainly, some of those drugs must adversely react with each other.  It could be that the drugs cancel one another out, combine to cause an even stronger affect, or something even worse altogether.  The issue is, when patients have so many conditions, it becomes too difficult for health providers to pinpoint all drug reactions.  One may consider this as merely "review" research, but frankly, this is probably saving more lives than many primary research studies out there.  To improve the project, I wonder if the detectives are using additional information from other countries?  Also, do they have contact with the people who publish and/or experience such cases?  Any other input?  Feel free to comment.

 

Project Continues to Bring to Light Unreported Drug Reactions

June McKoy, MD, MPH, JD, MBA, associate professor in general internal medicine and geriatrics and preventive medicine, is a senior member of the RADAR project, which acts as an independent supplement to Food and Drug Administration drug surveillance.
When a group of scientists came together in the late ’90s to launch the Research on Adverse Drug Events and Reports (RADAR) project, its focus was on the quality and not quantity of reports.
Meant to be a powerful supplement to existing Food and Drug Administration (FDA) surveillance, RADAR has since grown into a successful enterprise, saving thousands of lives along the way.
In its first decade, the project issued findings on 33 serious adverse drug or device reactions, proactively warning physicians about their concerns.
“To this day, our findings continue to alert clinicians and the public to the sometimes severe side effects of medication,” said June McKoy, MD, MPH, JD, MBA, associate professor in general internal medicine and geriatrics and preventive medicine, and a senior member of the project. “This in turn continues to decrease morbidity and mortality for many patients around the world.”
Since its inception, the group of RADAR “detectives” has been sifting through copious amounts of information. The goal is to develop a consensus in identifying serious and unexpected clinical events suitable for further investigation. RADAR collaborators derive case information from physician queries, published and unpublished clinical trials, case reports, FDA databases, and manufacturer sales figures.
Developed at Northwestern University Feinberg School of Medicine, the project has successfully identified often-fatal drug reactions associated with commonly used drugs, including Plavix®, thalidomide, and drug-coated cardiac stents.

From: http://www.feinberg.northwestern.edu/news/2013/07/radar.html

Thursday, July 11, 2013

Health of 90 Year Olds Increasing Each Decade, But How?

My opinion:  The fact that the quality of life for 90 year olds is going up with each decade clearly reflects our advancing society.  The main question is, how, though?  The article lists factors such as education and intellectual stimulation, but what else is going on?  I think that healthier habits are starting to gain ground.  After a dentist appointment today (I still have no cavities), my parents are as envious as ever of me (they have upward of 15 cavities each).  Back in their day, it was more common to eat sugary foods, smoke, and not brush teeth.  But frankly, many people do the same today, too.  I think this study is somewhat flawed in that it tested the Danes, which are often said to be the happiest people on Earth.  Health is very psychologically based, more than we currently realize.  Stress and depression clearly have physiological consequences, but can they effect cognition and long-term health?  I think these questions need to be answered until this research can be better applied toward other countries.  Any other flaws or factors?  Feel free to comment.


Want to live into your 90s? Your mind may have edge on people who hit age before you

Want to live into your 90s? Your mind may have edge on people who hit age before you
Researchers found that on tests of mental abilities, a group of 95-year-old Danes scored better than a group of Danes born 10 years earlier, who had been tested when they were about the same age.
Photograph by: Chris Hondros , Getty Images
NEW YORK, N.Y. - If you're lucky enough to live into your 90s, how well will your brain hold up? You may have an edge over people who got there ahead of you, a new study hints.
Researchers found that on tests of mental abilities, a group of 95-year-old Danes scored better than a group of Danes born 10 years earlier, who had been tested when they were about the same age.
In a standard simple test, for example, 23 per cent of them scored in the highest category, compared to 13 per cent of the earlier-born group. Out of the 30 questions and tasks, members of the later-born group averaged two more correct responses than the earlier-born group did. The results were released Wednesday by the journal Lancet.
Why the better mental performance? It wasn't just better education, but beyond that the researchers could only guess at things like more intellectual stimulation and better diets earlier in life.
More people are living to such old ages. The U.S. census counted 425,000 Americans age 95 and older in 2010, a 26 per cent increase over the total in 2000.
The mental testing compared 1,814 elderly Danes examined in 1998 to the later-born group of 1,247 Danes tested in 2010. The researchers also found that later-born Danes were better able to carry out basic living tasks like getting out of bed or a chair. So they were functioning better overall, the study concluded.
Lead author Dr. Kaare Christensen, head of the Danish Aging Research Center at the University of Southern Denmark in Odense, said he imagines that in the future, Danes who live into their 90s will continue to be better off than their predecessors. He was cautious about applying the results to the United States, although he said the availability of education in the U.S. after World War II would be a plus.

From: http://www.windsorstar.com/health/Want+live+into+your+Your+mind+have+edge+people+before/8642577/story.html

Tuesday, July 9, 2013

Do You Sit with Crossed Legs? This May Be Harmful for Your Spine


My opinion:  As someone who frequently crosses legs, this is something I'd like to change immediately.  The issue is, I don't think I'll easily get out of the habit.  However, I can think of a few tips which might help.  For example, one may find it difficult to cross legs if he or she is wearing shoes and sitting in a low or high chair.  Though I like the article's advice calling for crossed ankles, I'm also wondering if pretzel sitting is ok?  Furthermore, this brings up another topic - how the front should be positioned to avoid spinal injuries.  Sitting up straight and slightly into the back of a chair is probably better than most other postures.  This is usually discussed more, but I'm glad the article mentioned the legs - it is all parts of the body that need to be maneuvered to ensure the best overall structure.  Any additional tips?  Feel free to comment.

 

Why You Should Cross-Out Crossing Your Legs

Written by Kevin James
Posted August 29, 2011 - 8:33am
mansittingblogWhen you are sitting down, do you usually cross your legs? Many of us do this for extended periods of time without even thinking about or realizing that our legs are crossed. It has become second nature, which is troubling.
When you are in the sitting position, your spine is resting squarely on your pelvis. When you cross your leg over your knee, it raises one hip and puts pressure on the other which causes your back to be out of line. If you sit cross legged regularly or for long periods of time, this can result in lower back and hip pain.  This position also puts a great deal of pressure on the sciatic nerve, which runs through your lower back, rear, and down both legs. This is the largest nerve in the human body, and intense stress on the sciatic nerve is where a large portion of lower back pain resonates from.  Sitting cross legged can also inhibit circulation in your legs which leads to varicose veins and can turn into more serious problems.
It can be difficult to break a habit that is so hard wired into your daily routine, but this is one that is definitely worth breaking. Instead of crossing your legs at the knees, try crossing them at your ankles; this way you won’t feel as compelled to cross your legs and there are no mal effects. It may not be easy to break, but it could help you avoid back problems and possibly surgery down the road!

From: http://www.advancedspinesolutions.com/kevin-james/why-you-should-cross-out-crossing-your-legs

Monday, July 8, 2013

Patient Assumed Dead Wakes Up Before Organ Transplant

My opinion:  I'm kind of surprised this occurred - I know diagnosis is often very difficult, but here it seems as if doctors ignored a variety of signs.  Not to mention that there were some opportunities in which they could have treated her better, too.  This makes me wonder if emergency rooms physicians sometimes feel so used to their environment, that it becomes easier to miss warnings.  It is important to remember that, no matter the medical setting, each situation needs to be reviewed seriously in order to ensure the best possible treatment.  Also, there may be a lack of effective communication between staff members, like when the doctors ignored the nurses' advice.  Perhaps the state should also mandate that those involved receive training to help them avoid this again, although something tells me that the hospital is already doing so, if it hasn't let anyone go, yet.  Any other potential causes of this mess?  Feel free to comment.

 

St. Joe's "dead" patient awoke as docs prepared to remove organs

stjojob2.JPG
The state Health Department fined St. Joseph's Hospital $22,000 for nearly removing organs from a patient who was alive in 2009. (Photo by Paul Finch)
John O'Brien | jobrien@syracuse.com By John O'Brien | jobrien@syracuse.com
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on July 07, 2013 at 2:00 AM, updated July 07, 2013 at 2:43 AM





Email

By John O'Brien
and James T. Mulder

jobrien@syracuse.com
jmulder@syracuse.com
Syracuse, NY - Doctors at St. Joseph's Hospital Health Center were about to remove organs for transplant from a woman they thought was dead.
Then she opened her eyes. She was alive.
The state Health Department found St. Joe's care of patient Colleen S. Burns in 2009 unacceptable and a federal agency criticized the hospital for not properly investigating the cause. The hospital's mishandling of the case was part of the reason the state Health Department fined St. Joe's $22,000 last September -- the largest fine levied against a Central New York hospital since 2002.
St. Joe's was fined $6,000 over the Burns case and $16,000 for leaving a patient unattended before she fell and injured her head in 2011.
The state could not find a case similar to the Burns case after reviewing the past 10 years of inspection records, a spokesman said.
A series of mistakes that began shortly after Burns arrived in the emergency room suffering from a drug overdose led to the near catastrophe, the investigations showed. A review by the state Health Department found:
*Staff skipped a recommended treatment to prevent the drugs the patient took from being absorbed by her stomach and intestines.
*Not enough testing was done to see if she was free of all drugs.
*Not enough brain scans were performed.
*Doctors ignored a nurse's observations indicating Burns was not dead and her condition was improving.

From: http://www.syracuse.com/news/index.ssf/2013/07/st_joes_fined_over_dead_patien.html#incart_m-rpt-2

Sunday, July 7, 2013

Worms, Anyone? UN Recommends Eating Bugs for Healthier Lifestyle

My opinion:  While Northern Americans may consider bugs as a meal for people in more primitive countries, I believe the UN might have a point.  Many bugs are in fact quite healthy, and I find it unlikely that there would be a shortage of them, but thinking of the bee shortage, we might have to take some precautions.  For example, farming bugs instead of gathering them from the outside environment, where they may carry diseases.  But this would only occur if bugs became a staple in American produce.  Frankly, I can't see this happening - we hold a very strong stigma against bugs and would rather know that they are in a forest rather than a dinner plate.  Also, since Americans can typically afford more expensive food, bugs are out of the question.  Should Americans be open to foreign foods, even if they initially appear disgusting?  Perhaps this would solve obesity epidemic!  Maybe if these foods were incorporated into an American style of cooking, it would be easier to integrate them into our culture.  Feel free to comment.

 

United Nations recommends eating more bugs

May 19, 2013 | by Steven Rothrock MD

© FreeDigitalPhotos.net
Imagine your dinner plate filled with beetles, worms, wasps, and caterpillars. Yum, you say. Well, the United Nations (UN) states that a diet of insects can be nutritious since insects are high in protein, minerals, and fats. A diet high in insects may also decrease the rising levels of obesity.
This week, the UN’s Food and Agricultural Organization recommended eating more bugs to help address global food insecurity. These experts feel that eating insects could help to protect the environment and address the rapidly increasing demand for food worldwide. Farming insects will produce a much lower level of greenhouse gases compared to livestock. As an example, pigs produce up to 100 times more greenhouse gases per kilogram than mealworms.
Insects are actually a delicacy in many parts of the world. They are a staple of many diets in Asia, Africa, and parts of Latin America. Of the over 1 million known species of insects, nearly 2000 are consumed regularly by humans. They can be eaten whole or ground into a powder, paste, or made into a sauce.
Could you please pass the cricket sauce? I would like to spread it on my caterpillar and worm sandwich.

From: http://www.healthnewsobserver.com/articles/detail/united-nations-recommends-eating-more-bugs

Friday, July 5, 2013

Can New Laws Stop Tricky Medical Advertisements?

My opinion:  I believe the following actions merely constitute a starting point for changing these ads.  Though some patients may take the additional disclaimer seriously, I think that many will just let it go through the ears, especially if it is a very fast disclaimer.  Also, there's probably more to the story than the issue over who qualifies for the devices.  Viewers don't always care if they qualify or not - they care more about if they want it or not.  There have been some ads, such as the Lipitor ad with Dr. Jarvik, that twist or exaggerate the facts and hire body doubles to portray the drug users exercising.  Shouldn't laws be aimed at this?  Furthermore, even if the advertisements are perfect, and patients don't nag their doctors about having certain devices, medical representatives often visit doctors ad try to sway their opinions.  Even at offices where this isn't allowed, publications by other doctors maybe biased, hence influencing all readers.  So, in short, this AMA meeting may only be the tip of the iceberg.  Are there any other ways to stop tricky ads?  Feel free to comment.

 

AMA meeting: Tougher rules needed to stop misleading medical device ads

Delegates say DME distributors frequently misconstrue the process in which patients must follow to receive their supplies.

By Alicia Gallegos amednews staff — Posted July 1, 2013

Advertisers who promote durable medical equipment should follow tougher regulations to ensure that they do not mislead patients about how to obtain the products, according to a Board of Trustees report approved by the American Medical Association House of Delegates.
The report calls on the AMA to pursue legislation or regulations that require direct-to-consumer advertising for DME to include a disclaimer saying that eligibility for and coverage of DME is subject to specific criteria and that only a physician can determine if a patient meets the standards. Such ads also should list the actual criteria from an appropriate source.
Federal rules mandate that to be covered by Medicare, DME must be medically necessary and prescribed by a physician, among other criteria. Covered products include oxygen, wheelchairs, hospital beds, walkers and prosthetics. Delegates said advertisers frequently promote their products without explaining the qualification process.
Inaccurate ads lead to some patients believing they can obtain DME when they do not qualify for the supplies, said Mobile, Ala., urologist Jeff Terry, MD, a delegate for the Medical Assn. of the State of Alabama.
“The doctors have got to say it’s medically necessary,” he said. “We can’t say that without evaluating the patient and making sure it is appropriate. Then, if we don’t approve it, the patient gets mad at us, because the television ads say the doctor can just sign off on it.”

From: http://amednews.com/article/20130701/house/130709955/7/

Wednesday, July 3, 2013

Child Birth is One of the Most Expensive Types of Healthcare - Why?

My opinion:  Healthcare in general is very, VERY costly - this story merely represents a fraction of what is going on the the medical universe.  However, I have never thought that OB/GYN might be one of the costliest types of healthcare.  Later on in the article, the author mentions that many of the treatments that women receive may be useless.  This makes me wonder - maybe women are very stressed during pregnancy and feel that they should have everything possible done.  However, I also understand that women without such an attitude would probably pay quite a bit, anyway.  One of the major issues might be that there is no defined price.  Just this week, a tree had to be cut down on my lawn, and the lumberjack gave us a price range before he started working.  When it was done, though, we were charged a price that was higher than the top of the range.  It seems like pregnant women have to deal with this, too, but in much more expensive situations!  We need to start investigating the legality of having price ranges instead of exact prices, and also the differences between American healthcare and that of other nations.  So will Americans begin to have fewer babies because of this?  Feel free to comment. 

 

American way of birth is costliest in world




LACONIA, N.H. — Seven months pregnant, at a time when most expectant couples are stockpiling diapers and choosing car seats, RenĂ©e Martin was struggling with bigger purchases.

At a prenatal class in March, she was told about epidural anesthesia and was given the option of using a birthing tub during labor. To each offer, she had one gnawing question: "How much is that going to cost?"

Though Martin, 31, and her husband, Mark Willett, are both professionals with health insurance, her current policy does not cover maternity care. So the couple had to approach the nine months that led to the birth of their daughter in May like an extended shopping trip though the American health care bazaar, sorting through an array of maternity services that most often have no clear price and — with no insurer to haggle on their behalf — trying to negotiate discounts from hospitals and doctors.

When she became pregnant, Martin called her local hospital inquiring about the price of maternity care; the finance office at first said it did not know, and then gave her a range of $4,000 to $45,000. "It was unreal," Martin said. "I was like, How could you not know this? You're a hospital."

Midway through her pregnancy, she fought for a deep discount on a $935 bill for an ultrasound, arguing that she had already paid a radiologist $256 to read the scan, which took only 20 minutes of a technician's time using a machine that had been bought years ago. She ended up paying $655. "I feel like I'm in a used-car lot," said Martin, a former art gallery manager who is starting graduate school in the fall.

Like Martin, plenty of other pregnant women are getting sticker shock in the United States, where charges for delivery have about tripled since 1996, according to an analysis done for The New York Times by Truven Health Analytics. Childbirth in the United States is uniquely expensive, and maternity and newborn care constitute the single biggest category of hospital payouts for most commercial insurers and state Medicaid programs. The cumulative costs of approximately 4 million annual births is well over $50 billion.

And though maternity care costs far less in other developed countries than it does in the United States, studies show that their citizens do not have less access to care or to high-tech care during pregnancy than Americans.

From: http://www.telegram.com/article/20130703/NEWS/307039996/1312

Tuesday, July 2, 2013

1/3 of People Don't Return to Restaurants with Unsanitary Bathrooms

My opinion:  Given these statistics, it is crucial that restaurant owners maintain their facilities.  Maybe they don't have to look over-the-top, but cleanliness definitely should be a priority.  Here's some ideas to make it better: Make the bathroom doors automatic!  Though automatic features in bathrooms are becoming commonplace, I've never been in one where I didn't have to touch the door handle while going out.  Also, perhaps the trash bins can be placed below the soap dispensers, so soap doesn't drip on the floor or counters.  Finally, many people think that public computer keyboards are even dirtier than these bathrooms.  I'd like to see some spray and paper towels at the media center - they're not just for cleaning exercise machines at the gym.  Any more improvements in the bathroom or in other places?  Feel free to make a suggestion.

 

One-third won't go back to a restaurant with a dirty bathroom

Hands-free bathrooms the new germ-free restaurant trend. (UPI Photo/A.J. Sisco)
Hands-free bathrooms the new germ-free restaurant trend. (UPI Photo/A.J. Sisco)
Published: June 30, 2013 at 4:07 PM
PHOENIX, June 30 (UPI) -- Almost 30 percent of U.S.adults say they will never return to a restaurant with a dirty bathroom, a survey indicates.
Elliott Greenberg, owner of www.TouchFreeConcepts.com said a recent survey conducted by Harris Interactive for SCA Tissue North America found 50 percent of restaurant patrons who have a negative experience with the restroom -- bad odors, grimy soap dispensers, dirty toilets and other cleanliness problems -- will discuss it to friends and family.
Every restaurant wants to provide customers with a clean, hygienic restroom, but they can become soiled quickly. Traditional soap dispensers require hand pumping, spread germs; and they also tend to leak, resulting in an unappealing congealed blob on the sink, Greenberg said.
Toilet levers notoriously spread germs and restrooms don't always smell good, Greenberg added.
Touch-free systems offer a solution to all these problems, and more restaurants and businesses are adopting them as are hospitals, health clubs and churches, Greenberg said

Read more: http://www.upi.com/Health_News/2013/06/30/One-third-wont-go-back-to-a-restaurant-with-a-dirty-bathroom/UPI-80701372622838/#ixzz2XvGUc7Q6