The health care reform debate keeps on churning, new cautions on swine flu and ... doctors giving up their lab coats? Here are the health news highlights from this week. 

+   The CDC suggests that the key to bringing down health care costs is to get people to lose weight, raising a bunch of questions about how the government and businesses can push Americans to shed the pounds. How about a fat tax? Could a tax on fatty foods help cover the cost of reform? Or, maybe employers should give discounts to their workers who slim down? Meanwhile, others ask, why should employers have a say in our health care at all? 

+   A federal panel advises pregnant women, children and health care workers should be among the five priority groups to be vaccinated against the H1N1 virus. But how will they convince folks to get the shot? And are the priorities fair?

+   Tanning beds are as dangerous as cigarettes, says a new study. That hasn't stopped people from using them, however.

+    Rice Krispies help improve immunity? The new box claims it is loaded with vitamins that can do just that, begging an interesting question of FDA regulators.

+  And you thought doctors were up in arms about health care reform... Well, here's something that might surprise you. There's a debate in docs circles about whether they should ditch their trademark white coats. This is my favorite quote from the story: "When a patient shares intimacies with you and you examine them in a manner that no one else does, you’d better look like a physician — not a guy who works at Starbuck’s.”

And with that, have a happy and healthy weekend!

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: News roundup
        

Do you take natural supplements to ease your joints, visit a chiropractor for an achy back or do a little yoga here and there to find your Zen? Count yourself among the Americans who spent $34 billion last year on alternative medicine, according to a new study from the National Institutes of Health.

About $22 billion of that total was spent on everything from yoga classes and acupuncturists' visits to natural supplements such as fish oil, glucosamine and Echinacea (multivitamins and mineral supplements don't count).

For context, about $14.8 billion went to the supplements -- that's about one-third the total out of pocket spending on prescription drugs. Meanwhile, another $12 billion went to practitioners such as chiropractors and massage therapists -- roughly a quarter of out-of-pocket spending on doctors visits.  

So do they work?

Critics say more study is needed on lots of alternative therapies, known as CAM.

 “With so many Americans using and spending money on CAM therapies, it is extremely important to know whether the products and practices they use are safe and effective,” said Dr. Josephine P. Briggs, director of the National Center for Complementary and Alternative Medicine. 

Still, I think we all know people in our lives who swear by some of these remedies.

Confession: I'm partial to yoga myself and have been for years. Now, don't get me wrong, I don't shun modern medicine in favor of the so-called healing properties of my sticky mat. But I've found that yoga increases my strength and flexibility and does wonders for stress.

So what about you? Who here has taken Echinecea to ward off a cold, or even taken a Tai Chi class?

photo courtesy of Getty Images

Posted by Kelly Brewington at 4:55 PM | Permalink | Comments (8)
Categories: Healthy Living
        

Two weeks ago, I walked into Mercy Medical Center with a gallbladder and was wheeled out without one.

Already, the surgery is minimally invasive. You end up with just a few small scars on your tummy. But this surgeon is among those trying to make the surgery even less invasive than that. He is among the pioneers of single-incision gallbladder surgery -- just one cut into the belly button. That's it. The result is essentially scarless. (I'd take a picture of my navel to show you, but after two children I'm not quite ready to get that personal here.) Aside from the vanity stuff, recovery times are supposed to be better (I was back at work 11 days after surgery and Kelly wants me to tell you I'm doing just fine).

Since the technique is new, lots of docs want to learn how to do it. So my surgeon wasn't the only one in the room that morning. In fact, there were half a dozen surgeons on hand, I am told. They were there for a class and I was the featured guest. Since I am so thin and it is apparently easier to show how to do the procedure on someone with little excess fat, he asked me to be his model. I happily agreed.

You would have read about this on the blog sooner, but he rejected my request to have Kelly come into the operating room so she could write about the surgery. I asked him, "Why can your friends come and mine can't?" He just sort of laughed. I don't think he wanted that kind of audience.

To read more about procedures like the one I had, check out this story I did earlier this year.

Photo/Baltimore Sun

Posted by Stephanie Desmon at 12:00 PM | Permalink | Comments (5)
Categories: Surgery
        

So last week, I asked who might want to roll up their sleeve for the swine flu vaccine trials happening in a few weeks here at the University of Maryland. A few of you raised your hands, and some said you'd even volunteer your children.

Well, my friends, you are not alone. So far, university officials say the response has been "wonderful" and that "hundreds" of people have signed on up. (And here I thought people might be too freaked out to be guinea pigs.) At other testing sites, the same is true -- some 3,000 people nationwide are already clamoring to be part of the effort.

Among the eager Maryland volunteers is a pediatrician from Annapolis who wants the vaccine tested on himself and his four children. The family spoke to Good Morning America yesterday about their plans. (See the "Swine Flu Vaccine in Demand" clip)

Perhaps it's no surprise that people who work in medicine are eager to do their part for public health. So far, David Paulson, the state health department's spokesman, plans to sign up. So does Dr. Andrew Pekosz, a flu expert at the Johns Hopkins' school of public health.

"This is a heck of a lot better than throwing a flu party," said Paulson, who admits he is a little scared of getting sick. "I figure being vaccinated is easier than having the flu... and I don't have a fear of needles."

Then there are volunteers like CantonKate, who said in the comments below that as a healthy 25-year-old she wants the vaccine now, because she doesn't fit the priority groups who are likely to get it come fall. (A CDC advisory panel said yesterday that pregnant women, health care workers and children are among the five target groups for the shot) Kate also says she's fascinated by the idea of being in a trial.

So, I wonder, any other takers?

photo courtesy of the Associated Press

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (3)
Categories: Swine flu/H1N1
        

Here's another interesting look at racial disparities in cancer. Researchers have wondered for years why black patients have worse survival from head and neck cancers than whites.

These cancers were once thought to be diseases of older men -- typically smokers and drinkers. But in recent years, experts have noticed a rise in younger men with such cancers and found that the sexually-transmitted human papillomavirus (HPV) is the cause.  Head and neck cancers can be devastating and disfiguring and researchers have been paying close attention to the HPV link for clues to better understand the cancers and the racial disparity. 

Here's the latest effort: A new study from University of Maryland researchers finds that, surprisingly, cancer patients who also tested positive for HPV had better prognosis than patients without the virus. Blacks had very low rates of HPV, and therefore, far worse survival than whites, according to the study, published in the journal Cancer Prevention Research. Researchers think this might explain why blacks have traditionally had worse outcomes with head and neck cancers. HPV could make all the difference. 

"For the first time, we have evidence that the major difference in survival between black and white patients with head and neck cancer appears to be the rate of HPV infection," said Dr. Kevin J. Cullen, director of Maryland's Greenebaum Cancer Center.

The study analyzed data from more than 200 patients in Baltimore and compared them with another group of 230 patients in a clinical trial elsewhere.  Overall survival for whites -- 71 months-- was more than three-fold higher than for blacks -- 21 months.

All of this begs the question: why?

In short, researchers aren't sure. Cullen said differences in sexual behavior might play a role. Or it could be biological differences in immunity, access to care, lack of insurance, or all of the above. That's the quandary of racial disparities -- so many factors could play a role. Researchers plan to probe further.

For now, Cullen thinks the study's findings can help doctors better treat black patients and perhaps increase their survival.

Posted by Kelly Brewington at 3:07 PM | Permalink | Comments (0)
Categories: Cancer
        

Pregnant women appear to be at greater risk of complications -- and death -- from the swine flu than the general population, according to a study released this morning. The women who died were otherwise healthy.

The women were diagnosed quickly, but didn't get prompt treatment, write the authors of the study, done by the Centers for Disease Control and Prevention and appearing in the online edition of the journal The Lancet.

Doctors might have been reluctant to treat pregnant women with antiviral drugs, because "as with most drugs, information about the safety and effectiveness of these anti-influenza drugs during pregnant is scarce.

"In view of the expected effects of pandemic H1N1 influenza virus on the pregnant women, the benefits of treatment with these drugs are likely to outweigh potential risks to the fetus."

Pregnant women are always concerned about what they put in their bodies -- I could think of little else from the minute the test turned pink -- so it's no surprise they'd be worried about taking a medication that hasn't been tested in pregnant women.

But the CDC recommends that pregnant patients get antiviral drugs as soon as possible after the onset of flu symptoms.  When treated within 48 hours, none of the pregnant women in the study died.

Researchers found that during the first two months of the pandemic, there were 45 U.S. deaths from H1N1, six of them (13 percent) pregnant women. It is unknown how many of the deaths since then have been pregnant women. The CDC says more than 300 people have died from the swine flu since it appeared in mid-April.

Pregnant women are expected to be a high-priority group should a swine flu vaccination campaign be put in place. Traditionally, this group has been among the least likely to get seasonal flu vaccine, with just 14 percent getting shots in 2004. Pregnant women have said concerns about the safety of the flu shot have kept them from getting vaccinated, according to the Lancet study. 

Photo from stock.xchg

Posted by Stephanie Desmon at 7:00 AM | Permalink | Comments (0)
Categories: Swine flu/H1N1
        

It's time to roll up your sleeve. 

We're not talking about swine flu this time, just the plain-old, run-of-the-mill seasonal flu, a killer in its own right of 36,000 Americans each year. Several major manufacturers of seasonal flu vaccine have announced over the last two days that they have started shipping doses to distributors, earlier than usual. Vaccine could be in the hands of health care providers as early as next week.

The manufacturer of Flu-Mist -- Gaitherburg-based MedImmune -- says it hopes that by getting their nasal spray vaccine into doctors' offices over the summer, physicians will be able to administer it to kids at back-to-school check-ups and more well visits than if they waited until later in the fall.

The seasonal flu vaccine will provide no protection from swine flu. Here's hoping it offers protection from seasonal flu. One early report suggests that one of the strains in the vaccine may not match up to the one that is circulating in the Southern Hemisphere.

Hundreds of millions of doses of swine flu vaccine -- which will be entirely separate from the seasonal flu vaccine -- are expected to be available come fall. Vaccinating that many people will be a major undertaking as officials try to keep a global pandemic from becoming a global crisis.

Baltimore Sun photo

Posted by Stephanie Desmon at 2:51 PM | Permalink | Comments (1)
Categories: General Health
        

My story yesterday on the racial disparity in breast cancer deaths highlighted the debate over whether biology or environment is the cause of the problem. A recent study suggests that access to care alone can't explain the disparity, reopening a long-brewing discussion about whether genetics is the reason black women are more likely to die of the disease than white women.

Using genetics to explain racial disparities in health is a touchy topic. When I spoke to Dr. Otis Brawley at the American Cancer Society, he said he worried that the issue hearkens back to the old argument about blacks and genetic inferiority.

Yet, others insist genetic research is key to unlocking the mysteries of racial disparities and, most importantly, finding a cure. There's a great piece in CNN's Black in America 2 series, about  Dr. Lisa Newman, an African-American female surgeon, who travels to Ghana searching for genetic clues to why black women are twice as likely to get a rare and aggressive form of breast cancer known as triple negative.

Newman found that some 60 percent of Ghanaian women who have breast cancer have the triple negative type. Women with this type lack the three hormone receptors that are the target of the most effective drug treatments we have now and must rely on standard chemotherapy, which often isn't as effective.

The CNN piece is as much about Newman's journey as it is about the science behind her discoveries:

Newman gathers samples at a local Detroit, Michigan, hospital and at events held by the Sisters Network, an organization for black breast cancer survivors. She runs DNA comparisons to the samples gathered in Ghana and one day hopes to correlate African ancestry with the risk of being diagnosed with triple negative breast cancer in African-Americans. If this happens, according to Newman, it will open doors to new treatments.

photo courtesy of CNN

Posted by Kelly Brewington at 12:10 PM | Permalink | Comments (8)
Categories: Cancer
        

For a while now, parents, physicians and researchers have debated whether children with autism have more digestive problems than their non-autistic peers. As parents search for therapies for a mysterious disorder with no cure, many have placed their children on gluten-free and other restrictive diets.

But little research has been done on the diets or the link between gut problems and autism. Until now.

A new study out of the Mayo Clinic finds that autistic children don't have more gastrointestinal problems than other kids. And researchers warn that children should not be put on such restrictive diets unless appropriate tests are done that discover a digestive issue. 

The study, published in the journal Pediatrics, notes that while autistic children are more likely to be constipated and picky about what they eat, they are not more likely than non-autistic children to have vomiting, bloating, reflux and diarrhea. Researchers followed 124 autistic children from birth to 18 and compared them to 242 kids without the disorder.

Don't expect this paper to be the last word on the issue. So much about autism sparks intense debate. A commentary that ran with the article notes while the study is important, more research is needed.

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (6)
Categories: Pediatrics
        

Much of the health-care reform talk on Capitol Hill right now is about cost savings. How can the amount of money spent on health care be reduced?

The authors of a study published online today say the answer could be in reducing obesity.

"There is an undeniable link between rising rates of obesity and rising medical spending," write the authors from the Reseach Triangle Institute and the Centers for Disease Control and Prevention.

They calculate that the cost of treating obesity and the disorders related to it may be as high as $147 billion a year, up from an estimate of $78.5 billion in 1998. Roughly half of that is financed by government spending through Medicare and Medicaid.

The proportion of all annual medical costs due to obesity increased from 6.5 percent in 1998 to 9.1 percent in 2006, according to the study, which is published in the journal Health Affairs. Overall, obese people spent $1,429 more for medical care in 2006 than did normal weight people -- that's 42 percent more.

Most of the money isn't being spent to treat obesity itself. Instead, the costs are almost all a result of costs generated from treating the diseases obesity promotes.

If people slim down, maybe the ballooning costs of health care will as well, they say.

"The take-home message is that without a strong and sustained reduction in obesity prevalence, obesity willl continue to impose major costs on the health system for the foreseeable future," the authors conclude. "And although health reform may be necessary to address health inequities and rein in rising health spending, real savings are more likely to be achieved through reforms that reduce the prevalence of obesity and related risk factors, including poor diet and inactivity."

The study was presented at the CDC's Weight of the Nation Conference today in Washington, D.C.

Photo via AFP/Getty Images

Posted by Stephanie Desmon at 11:39 AM | Permalink | Comments (5)
Categories: General Health
        

Let's say this swine flu business got really serious and a pandemic flu emergency took hold. You might expect an army of doctors and nurses would flock to hospitlas to serve the public at a time of crisis -- right?

Well, according to a new study, one in six public health workers said they would NOT go to work during a pandemic flu emergency, regardless of how severe it is, according to a new survey by researchers at Johns Hopkins Bloomberg School of Public Health.

And those findings are an improvement from a 2005 report that found more than 40 percent of public health employees were unlikely to go to report for duty such an emergency.

Now, there are some limitations to the study: The findings come from a survey of 1,835 public health workers in just three states -- Minnesota, Ohio and West Virginia. Just because people say something in an internet survey, doesn't mean they won't rise to the challenge if an actual emergency happened.

Workers' own fears and perceptions about the severity of the emergency were key factors in whether they would respond. For instance, those who said they were concerned about the threat of the pandemic and those who said they were "confident" that their roles would have a meaningful impact were 31 times more likely to respond than workers who didn't think the threat was big or that they could make a difference.

Experts think the study will help them strengthen emergency plans and devise ways to reinforce the vital role that health care providers play in a crisis. "This study is important in that it both documents the problem and points the way towards specific interventions -- those that increase both concern and confidence -- to increase willingness to respond," said Jonathan Links, director of Hopkins' public health preparedness programs.

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

It happened just three weeks after the 9/11 attacks -- mysterious white powder was turning up in letters to the media and politicians in congress. The powder turned out to be deadly, the sender unknown.

The anthrax attacks ended up killing five people and alarming everyone about the threat of biological terrorism. As the FBI tackled the case, they enlisted some unexpected crime-fighters: scientists. They helped trace the powder to its origins. Among them was Claire Fraser-Liggett, director of the University of Maryland's Institute for Genome Sciences, who worked on the project while at the director of the Institute for Genomic Research in Rockville.

She and her team will star in a documentary airing at 9 p.m. Sunday on National Geographic, discussing how they cracked the case. Last month, PBS ran a special on NOVA and there's an online video snippet. It's a fascinating detective story that highlights the use of a new field -- forensic genomics. It's also, as Fraser-Liggett said to me in an interview recently, "really cool."

The FBI gave researchers anthrax samples to investigate, but the feds told the scientists next to nothing about the samples or the details of their investigation. The suspense was huge. Security was thick. And the entire process was pretty tense.

"We all realized this was far more serious than anything we had done before," Fraser-Liggett told me. "Not to say we aren't serious about what we do. But we got a whole lot more serious about what we were doing."

In the end, her team successfully traced the sample to its source. But I won't give away the good parts...

photo courtesy of the AP

Posted by Kelly Brewington at 12:30 PM | Permalink | Comments (2)
Categories: General Health
        

Happy Friday! Here's your weekly installment of health news: the big stuff and the tidbits you may have missed.

+   In the latest health care news, President Obama made a personal plea for reform in a press conference Wednesday night asserting "it's not about me". This, after appearing on the Today show urging politicians to put away their swords. Then, congress said yesterday that it wouldn't pass a bill by the president's August deadline. Which begs the question: what does it all mean for us? Here are 10 questions that break down the nuts and bolts.

+   Stephanie blogged earlier this week about the fuss in the blogosphere that Regina Benjamin is too chunky to be a good surgeon general. But not all doctors are born fit and trim. Here's an interesting look at how physicians, too, struggle with their weight.

+  Up at night? You're not alone. Insomnia affects millions -- but what treatments work and which don't?  And here's a look at treating kids who struggle with sleep.

+   Hot dogs cause cancer? A vegan advocacy group in New Jersey is suing to get the big hot dog makers place warnings on their products saying consuming them increases the risk of cancer.  Advocates compare the processed meat-cancer link to cigarette's and lung cancer, while the hotdog industry insists the claims are bogus. Meanwhile, here's my favorite quote from the story: "Vegans complaining about hot dogs is like the Amish complaining about gas prices," said Susan Thatcher of Irvine.

+  Now here's one to scare all the hipsters: skinny jeans could be dangerous, says a medical advisor at Consumer Reports. Squeezing into a tight pair could possibly cause bladder infections, fertility problems and blood clots. Really?

And with that, have a great weekend!

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: News roundup
        

Electronic cigarettes -- smokeless devices marketed as a way to deliver nicotine without the harmful effects of tobacco smoke -- may be just as unsafe as the products they mimic, officials with the Food and Drug Administration said yesterday.

For months, the FDA has wanted to keep e-cigarettes, as they are known, from being sold in the United States. They have blocked shipments at the border. They have warned that people can't know what they are inhaling when they use the product. But their efforts are being held up, as an e-cigarette manufacturer questions in court whether the FDA has regulatory authority over the devices.

Now, the FDA is saying that a small sample of e-cigarettes that it analyzed contained carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze.

The FDA has no way of knowing what else is in the e-cigarettes -- including how much nicotine is in them -- because they have not been submitted to the agency for evaluation.

The products are sold at mall kiosks and online and contain no warnings of health risks, like the ones found on every pack of traditional cigarettes. Some even claim to be smoking-cessation tools.

"Relatively little is known about how they're used, how much nicotine gets into people, what other chemicals are coming along for the ride," Dr. Jonathan Samet, director of the Institute for Global Health at the University of Southern California, told me when I wrote a story about this in May. "To make a therapeutic claim, you need to do the proper testing."

Defenders of the products say they still contain way less of the bad stuff found in cigarettes. As one said in May: "If this was a form of vodka that didn't cause liver damage, would we be having the same sort of problems?"

Posted by Stephanie Desmon at 12:30 PM | Permalink | Comments (25)
Categories: Healthy Living
        

The government just kicked off plans to test whether a swine flu vaccine is safe and effective in adults and children. Volunteers in Australia are already rolling up their sleeves for the shot, as the country is in the depths of its winter flu season.

The U.S. effort, which will take place at eight sites -- including the University of Maryland's Center for Vaccine Development -- could start as soon as a few weeks. Researchers in Maryland are looking for 1,000 volunteers -- from the elderly to babies.

So, what do you say? Will you sign up?

I'm curious whether folks are wary of the idea, or if they will rush to be part of the effort. (If it makes any difference in your decision: word is the trial will pay volunteers, but at the press conference I went to yesterday officials didn't say how much. I'll keep you posted).

I'm especially interested to see the reaction of parents. Would you sign up your child for the vaccine trial? So far, some folks are already debating whether to vaccinate at all.

Posted by Kelly Brewington at 7:26 AM | Permalink | Comments (14)
Categories: Swine flu/H1N1
        

Two new studies by Harvard researchers affirm what doctors have been trying to drill into us for years: adopt a healthy lifestyle and you'll keep your heart healthy.

Sure, to all you diet and fitness buffs out there, this may not be earth shattering news. Still, the studies, which appear in this week's Journal of the American Medical Association drive home the link between behavior and health.

In the first paper, researchers used the Nurses Health Study -- a long-running research project -- to examine the connection between lifestyle and the risk of developing high blood pressure in some 84,000 women between 1991 and 2005. They measured how well the nurses followed advice on six lifestyle factors such as exercising for 30 minutes a day, having a body mass index of less than 25 and even drinking moderate alcohol. Women who followed all six, had about an 80 percent lower risk of developing high blood pressure than those who did not.

The second study, looked at heart failure in men by examining some 21,000 doctors in the Physicians' Health Study from 1982-2008.  Men with normal body weight, who never smoked and exercised regularly had a 10 percent risk of developing heart failure, versus a 21 percent risk for men who didn't follow healthy behaviors.

Of course, it may not be not surprising that a health study of doctors and nurses would reveal good results. (Better, than for say, reporters in an overworked newsroom.)

Still, the authors note that their findings are similar to other studies that have found a link between healthy habits and prevention of cardiovascular disease. An accompanying editorial calls for greater public health efforts to help people ward off these preventable illnesses.

"At this point, the national cost of treating cardiovascular diseases cannot be sustained, and prevention is urgent," said Dr. Veronique Roger of the Mayo Clinic. "These studies...underscore that healthy lifestyle will help prevent cardiovascular disease and greatly enhance health, which is a compelling reminder that health is a shared responsibility of individuals and communities."

Posted by Kelly Brewington at 8:29 AM | Permalink | Comments (3)
Categories: Cardiovascular Health
        

Public health officials worldwide are preparing for the onslaught of the fall flu season, expecting swine flu to come back with a vengance. So far, the virus has killed some 700 people around the globe and drug makers are working in a hurry to have a vaccine ready by October. 

But that's a good two months after school children -- one of the groups at highest risk for the virus, known as H1N1 -- return to their classrooms. What if an outbreak hits before vaccines are ready? Should schools be closed?

A study in the August issue of the British journal Lancet Infectious Diseases concludes it's a tough call and the decision to close schools depends on how severe the pandemic becomes.

On one hand, closing schools might slow transmission, giving more time for a vaccine to be finished while easing the burden on hospitals. But researchers also said that massive school closures are unlikely to have a major impact on the total cases. And closing schools has some serious economic and social costs, from the crush to a household's income from parents who must take off work to care for a child, to the larger economic impact on workplaces from massive absenteeism. (The economic toll alone: the cost of a 12-week school closure could be between 1 percent and 3 percent of GDP, according to the study. Yikes.)

So far, kids have been disproportionately affected by the virus, with some 60 percent of cases occurring in people 18 or younger.

Back when the outbreak started in the spring, U.S. health officials played it safe, ordering schools with a confirmed case of swine flu to close for a week. But they backed off that policy after it became clear that the virus was spreading rapidly and appeared no more severe than seasonal flu.

Still, medical experts warn the virus may become more severe this fall. Clearly, vaccine timing will be key. While health officials say they hope to have a vaccine by October, there are more questions than answers right now about who gets it and when. Here's an interesting timeline put together by WebMD on some possibilities.

So, for now, what do you think? Could closing schools help stop the flu?

Photo courtesy of AFP/Getty images

Posted by Kelly Brewington at 1:24 PM | Permalink | Comments (5)
Categories: Swine flu/H1N1
        

Two stories from last week really got me thinking -- and got tongues wagging.

The first one, out of Spain, was about a woman who less than three years ago became the oldest new mother in the world at the grandmotherly age of 66. She had lied about her age and convinced an American doctor to help her conceive her twins. Last week, the single mom died of cancer at the age of 69, leaving her toddlers without any parents. Having the technology to extend child-bearing years is a wonderful tool under some circumstances, but is there a point when you're just too old to become a parent?

The second story comes out of the inspiring tale of Dr. Regina Benjamin, the family doctor picked to be President Obama's surgeon general. Last week, we wrote about how Benjamin has spent her career in rural Alabama, seeing patients who sometimes paid her for her services in oysters, if at all. She built a clinic for those in need, and built it again and again when Hurricane Katrina and then a fire stood in the way.

But some are complaining about something far more superficial: Benjamin's weight. They argue that a plus-size doctor sets a lousy example for a nation struggling with an obesity epidemic. They say she is simply too fat to preach about healthy living.

Slow down, says Dr. Arthur Caplan, a leading bioethicist at the University of Pennsylvania. "You would think the entire population of the blogosphere had suddenly reverted to the seventh grade," he wrote in her defense.

Perhaps, Caplan argues, her weight could have an upside, earning street cred with a nation that could use to shed a few pounds: "People need to relate to the surgeon general, and if she can battle her weight on the job, she will do more to curb obesity then all the salads added to the menus of burger joints everywhere.

"In fact, if this Alabama physician can connect with fat Americans of all ethnic groups because of her own weight, she stands a very good chance of reaching them about the problem."

What do you think?

Photos via Associated Press

Posted by Stephanie Desmon at 8:08 AM | Permalink | Comments (7)
Categories: General Health
        

A fancy new tool from the Centers for Disease Control and Prevention enables users to track environmental health hazards across the country.

The National Environmental Public Health Tracking Network collects information on environmental hazards, how people are exposed to them and if they lead to serious illnesses. The goal is to help people understand how the environment may play a roll in their health.

Scientists have known that air pollution and lead can contribute to illness, but many other environmental and health connections remain unproven. This site attempts to gather more information to better understand the possible connections.

The site collects information from state and local agencies and breaks them down into various topics. For instance, you can learn about how the CDC tracks lead poisoning, its effect on health and efforts to combat it. You can learn more about air quality status, details on arsenic in water and their links to health outcomes. You can also run individual "reports" on the impact of certain health problems in your area. After a bit of clicking, I learned there were 8,724 hospitalizations for asthma in Maryland in 2006.

There's also a link to Maryland's own tracking network, where you can get even more detailed information as well as tables, maps and downloads.  Maryland is one of 16 states selected by the CDC in this effort.

“For the first time, the members of the public can be active and informed participants,” said John M. Colmers, Maryland's health secretary. “Anyone will have access to the same information that policy makers and public health professionals use to better understand the complex relationships between our health and our environment and rely on that information to make informed decisions.”

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

Nine-year-old Kathryn Chenaille spent three months living at the Ronald McDonald House in Baltimore after a bone marrow transplant made necessary by her battle with aplastic anemia.

Her immune system was nearly wiped out by the procedure so her family worried about the air she would be breathing in the communal residence. Her father went out and bought for her room a high-powered air purifier that uses a UV filter to kill germs. The family thinks the filter kept Kathryn from getting sick while she was at Ronald McDonald. Now that she is in remission, Kathryn wanted to give something back to the place she left in February -- air purifiers.

Any day now, the Baltimore facility will get 37 purifiers, a gift from a company that makes the Secure Air 1200. When they heard Kathryn's story -- and her goal to bring clean air to other sick kids -- they donated the first batch. Now, Kathryn and her family are trying to raise money to buy air purifiers for Ronald McDonald Houses across the country. With every $45 raised, another room at a Ronald McDonald House will get an air purifier.

"If we could do it all across the country, that'd be great, but that's pretty big so we'll start with Pennsylvania," said Kathryn's mother Carolyn.

Kathryn, who lives in Chambersburg, Pa., said she is feeling good these days. She is spending her summer outside, mostly in her new pool, courtesy of the Make-A-Wish Foundation. And she will return to her studies next month, when her mother resumes home-schooling.

Posted by Stephanie Desmon at 7:59 AM | Permalink | Comments (1)
Categories: General Health
        

Happy TGIF! We hope everyone had a great week. Here's your Friday rundown of health news.

+   Don't expect news on the perils of swine flu to let up, even if fall flu season is still months away. The World Health Organization says the H1N1 pandemic is spreading too fast to count. Meanwhile, summer camps continue to report swine flu cases and Maryland recorded its third death from the virus on Wednesday. With everyone looking to a vaccine being ready this fall or winter, some folks are asking: will you vaccinate?

+   The latest health care reform news points to more partisan wrangling to come on a proposal that is not anywhere near final. The folks at Kaiser Health News offer a look at how reform could make it difficult for folks who currently have employer-based coverage to swap plans. And the New York Times magazine offers a philosphical approach at rationing health care.

+   The Alzheimer's Association met this week and issued a flurry of new findings on the illness. Stephanie blogged below about genetic testing for the disease. There were also interesting findings on a promising new drug and whether moderate drinking could cut the odds of getting the disease. And here's a great piece that attempts to understand dementia and "wandering."

+   The New York Times Well blog looks at a study on mothers of children with developmental disabilities. Here's an interview with a researcher who ponders the unique stress of raising a child with autism.

+   We've all been known to ask Dr. Google to help us diagnose our health problems. But one doc explains why Wiki isn't the best medical resource.

And with that, have a wonderful weekend!

Posted by Kelly Brewington at 1:30 PM | Permalink | Comments (0)
Categories: News roundup
        

OK, OK, this entry is a little late. Here's a little secret: I can't stay up past 10 p.m. So I never see "The Daily Show with Jon Stewart" until it is re-run the next day. Still, I had to share this great piece from Wednesday night's show, one that -- aside from a pretty funny riff about the president throwing out the first pitch at this week's All-Star Game -- focused on health care reform.

Sure, there was the obligatory interview with Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services. But check out this hilarious piece of satire on universal health care in other countries.

I can't decide if my favorite part is when "reporter" Samantha Bee, who hails from Canada, shows off the C-section scar on her NECK as she discusses the single-payer system in her home country. Or if it is Wyatt Cenac standing in front of an ER with a cleaver stuck in his head, calling himself an uninsured American. When Stewart points out he is insured, Cenac explains he was until he was injured, that he was thrown off his plan because of this "pre-existing condition." Kitchen tools, he is told, have been around longer than he has.

Posted by Stephanie Desmon at 10:30 AM | Permalink | Comments (0)
Categories: General Health
        

AP Photo

In recent years, research studies done in three African countries have conclusively showed that being circumcised reduces a man's risk of acquiring HIV by roughly 50 percent. Could a man's circumcision also protect his partner from getting infected? The answer appears to be no.

A Ugandan study, led by Dr. Maria J. Wawer from Johns Hopkins Bloomberg School of Public Health and published in this week's issue of The Lancet, was stopped short after 2 years when it was determined that HIV-infected men who were newly circumcised were just as likely to spread the disease to their partners as those who remained uncircumcised. ...

Circumcision is catching on in Africa as a way to keep HIV transmission in check, promoted by the World Health Organization and other public health groups. Anecdotal reports from the continent, according to The Lancet, say interest in circumcision from young men is being driven by women who want circumcised partners.

Is the news all bad news for women? Not according to the study's authors. They say that more circumcision (accompanied by HIV counseling, condoms and education on HIV prevention) will mean fewer men with HIV -- fewer men to spread HIV to their women.

Posted by Stephanie Desmon at 8:30 AM | Permalink | Comments (6)
Categories: General Health
        

The teen pregnancy rate increased in 2006 and again in 2007, after 14 years of declines, according to a report released today from the Centers for Disease Control and Prevention.

It's among a string of worrisome statistics released today that indicate after recent years of improvements, some trends are getting worse. Among the findings in the CDC's analysis of youth sexual and reproductive health: 

+   The rate of AIDS diagnoses in young men (15-19 years old) is on the rise, nearly doubling from 1.3 cases per 100,000 population in 1997 to 2.5 cases per 100,000 population in 2006.

+   In 2006, about 1 million teens and young adults had chlamydia, gonorrhea or syphilis. And the rates of syphillis, for men and women, are on the rise.

+   The humanpapillomavirus, or HPV, is widespread. Between 2003 and 2006, nearly a quarter of girls 15-19 years old had an HPV infection. That figure was 45 percent for young women ages 20-24.

Now the big question is why?

"It is imperative that all of us at the national and community level work together to ensure STD and HIV prevention programs are reaching young people, particularly in communities with the greatest burden of disease," said Dr. Kevin Fenton with the CDC.

Posted by Kelly Brewington at 12:53 PM | Permalink | Comments (1)
Categories: Pediatrics
        

If you carried a gene that made it more likely you would someday get Alzheimer's disease, would you want to know?

How would you react to knowing that your risk for getting the progressive, fatal brain disorder was 50 percent?

A University of Michigan study out in today's New England Journal of Medicine suggests that people react much better to the news than expected. Disclosure of the genetic testing results in adult children of Alzheimer's patients did not have short-term psychological effects -- even in those who were told they carried the gene. Those who found out they did not carry the gene were relieved, though even without the gene, someone can still get Alzheimer's.

Widespread testing for the apolipoprotein E genotype is not done, mostly because there is nothing anyone can do with the information that they have the gene. Besides, plenty of people have the gene and never get Alzheimer's. If treatments progress in the future, this knowledge could be useful, but at this point it is not.

There is genetic testing for Huntington's Disease, a fatal neurodegenerative disorder. If you have the gene, sooner or later you will get this awful disease that has no cure. There has been a lot of debate over whether people who have a parent with the disease should be tested for the gene. Some people opt against it, not wanting to know they have a death sentence.

Dr. Constantine Lyketsos, an Alzheimer's expert at Johns Hopkins Bayview Medical Center, told me he thinks the most important finding in the New England Journal of Medicine paper could be that people generally take bad news pretty well. They may suffer temporary distress, "but most people get over it pretty quickly."

One drawback of the study, though, was that researchers weeded out people who suffered from any anxiety or depression. Those folks might have more trouble handling the news.

Posted by Stephanie Desmon at 8:30 AM | Permalink | Comments (2)
Categories: Medical studies
        

As members of Congress duke it out in the health care reform debate, a national consumer advocacy group releases this sobering statistic: an average of 740 Marylanders lose their health insurance every week, according to a new study by Families USA.

By the group's estimates, 114,780 people will lose health coverage in Maryland from 2008 through December 2010. Nationwide, that figure could climb to 6.9 million, according to the organization, which if you haven't noticed, is lobbying bigtime for Congress to hurry and pass a bill that will expand coverage to those without. In fact, just an hour ago, a Senate committee made a first step to do just that.

Rising premiums -- up 119 percent from 1999 to 2008 -- are causing more families to go without coverage, both in Maryland and nationwide, according to the report "The Clock is Ticking: More Americans Losing Health Insurance.

photo courtesy of Brooks Elliot @ flickr

Posted by Kelly Brewington at 12:31 PM | Permalink | Comments (1)
Categories: General Health
        

What brings us to this post is not some strained back or neck or leg that we treated with a sports cream that didn't work. No, we are here today, discussing the effectiveness of those remedies -- you know, the smelly stuff that warms or cools some ache or pain when rubbed on -- because of the quote in the press release.

Andrew Moore, a biochemist at the University of Oxford who led a systematic review of studies about whether these so-called salicylate creams work, was asked if he would recommend using them.

Calling them an unproven waste of money, Moore said: "You might as well rub your skin with a bit of spit."

Now that we've gotten that highlight out of the way, just a bit about the study, which was done by the Cochrane Collaboration, a highly regarded international organization that evaluates research. The review found that these popular over-the-counter creams, heat gels and other remedies for sports injuries and arthritis aches don't work, despite the many millions of dollars spent on them each year.

Familiar brands containing salicylate creams include Ben Gay, Icy Hot and Aspercreme balms. They are thought to work by distracting users from the pain with their warmth and redness. While some older smaller studies showed a measure of improvement after using the treatments, the newer, large, more rigorous trials showed no effect, Moore said.

Some creams, not covered by the review, do appear to work, Moore said, including topical capsaicin (derived from hot peppers) and some topical non-steroidal anti-inflammatory drugs.

Some people, though, will swear by their Ben Gay or Icy Hot no matter what a study says. And, naturally, companies have defended their products.

In these economic times, though, you can always just try some spit first.

Photo/Maryann James

Posted by Stephanie Desmon at 6:58 AM | Permalink | Comments (4)
Categories: Diet and exercise
        

The focus of the health care reform debate has been on Washington and insurance companies and hospitals. The talk has, so far, been about how expensive the current delivery system is.

Dr. Regina Benjamin comes to the debate from a different place, literally and figuratively.  Yesterday, President Obama made the family doctor, who for years has cared for the poor and uninsured in rural Alabama, his choice for surgeon general. In doing so, he put the spotlight -- if only for a news cycle -- on those communities that shouldn't be ignored as the debate continues.

Benjamin's work has been in a small clinic in the 2,500 resident Gulf Coast town of Bayou La Batre, 25 miles south of Mobile. And it hasn't been easy. Often, her patients are cash-strapped and she has accepted payment in the form of oysters or fish. She has moonlighted in emergency rooms in other towns to help keep her clinic afloat.  "You got treated if you had money or not," the town's mayor told NPR this morning. ...

She has made other sacrifices, too. "When Hurricane Georges sent five feet of water surging into the clinic in 1998, she made house calls until it was rebuilt," the NYT says today.  "When Hurricane Katrina destroyed the clinic again seven years later, she mortgaged her house to rebuild. And when a fire destroyed the rebuilt clinic the day before it was set to reopen, she sent out appeals across the country for aid to build again."

The details of Regina Benjamin's story may be unique, but her struggle isn't. She is one of thousands of rural family doctors who put the needs of their patients ahead of their own. And there aren't enough of them to serve the many poor communities out there. She becomes a national voice for rural health care in America.

Posted by Stephanie Desmon at 1:01 PM | Permalink | Comments (1)
Categories: General Health
        

We've heard it all before: the keys to staying healthy are a good diet and plenty of exercise. But just when are we supposed to make time for  physical fitness in our busy lives?

Walk to work. Or bike. People who ride a bike or walk to work are more fit, less fat and have healthier triglyceride levels, blood pressure and insulin levels, according to a new study in this week's issue of the Archives of Internal Medicine.

Researchers at the University of North Carolina at Chapel Hill studied about 2,300 men and women between 2005 and 2006 and recorded the length of their commute, how they got there and assessed their fitness levels with a treadmill test. 

Both men and women who biked or walked performed better on fitness tests but men tended to have even healthier body mass index numbers, and better blood pressure and insulin levels. Researchers weren't sure why women didn't reap all the same benefits as men, but said perhaps women did not exercise as intensely or commuted shorter distances.

Even people with the most hectic of schedules can benefit from just 60 minutes of brisk walking a day, researchers concluded.

Still, for all its supposed benefits, few Americans bother to bike or walk to work -- just 17 percent, the study found. With many cities lacking proper bike lanes and so many people living in far flung suburbs, it's no wonder. The researchers hope the study leads to policies that make neighborhoods safer for biking.

The authors call it "active commuting," but to me it may as well be called the Dutch model. I took a trip to Amsterdam this spring and was amazed at the sheer number of people going about their daily activities on two wheels -- commuting, grocery shopping, in rain or shine. There, biking is ingrained into the culture. Any signs of that happening here? Do you walk or bike to work?

Posted by Kelly Brewington at 8:00 AM | Permalink | Comments (15)
Categories: Diet and exercise
        

Most warnings about bathtub safety focus on making sure the water isn't too hot to scald children and that someone is always watching the kids to be sure they don't drown.

Turns out, the more common danger to kids in the tub or shower is slipping and falling. In fact, tens of thousands of children end up in the emergency room each year after being hurt in the tub or shower, according to a study published today in the online issue of the journal Pediatrics. Eighty-one percent of tub or shower injuries are slips and falls. And more than half of the injuries occur in children under the age of 4.

The researchers from the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio say that scalding and drownings have gotten the most attention because of the severity of these injuries. Legislation and educational efforts have helped make strides in those areas. But, the study's authors write, "bathtub slips and falls should not be overlooked."

In the case of slips and falls, they add, the answer isn't only better supervision. Children should always be watched closely in the tub or shower but many injuries happen right in front of their parents.

Something as simple as better non-slip mats or slip-resistant surfaces in tubs, or grab bars in showers could make getting clean safer.

Now if the kids could just keep the water inside the tub.

Posted by Stephanie Desmon at 12:30 PM | Permalink | Comments (1)
Categories: Pediatrics
        

The new caution about acetaminophen, the popular painkiller, isn't about it suddenly being more toxic. Rather, it highlights a fear that we may be taking too much of the stuff without even realizing it.  

Acetaminophen isn't just in Tylenol. It's in Nyquil. It's in Midol. It's in Vicks cough syrup. It is in dozens of cough and cold products. We may not be taking more Tylenol than is recommended, but we can push into the territory of liver damage when we take several acetaminophen-containing products at once. ...

Avoiding an overdose may not be as simple as it seems. Labels are printed in tiny type. They don't say the product contains Tylenol (which is a name people remember easily) but acetaminophen (more of a mouthful that can be confused with other medications). Sometimes, people just aren't paying attention. They figure that if they're taking over-the-counter medications, they'll be safe.

One doctor I spoke to said he wants to make sure that labeling issues are a priority as the Food and Drug Administration moves forward in coming weeks and months. The agency will be addressing several recommendations of an expert panel, including that the maximum daily dose of acetaminophen be lowered due to safety concerns.

"There are over 200 different products which contain acetaminophen and when I go to the drugstore and I want to pick up a cold medicine, the writing is too small," said Dr. Gilbert Fanciullo, director of pain management at Dartmouth Hitchcock Medical Center in New Hampshire.

One of his patients brings a magnifying glass with her when she chooses her medications, just so she can be sure of what she is getting.

"I can read what’s on my Corn Flakes box," Fanciullo said, "but not my Excedrin box."

Posted by Stephanie Desmon at 6:33 AM | Permalink | Comments (1)
Categories: General Health
        

As we celebrate the end of week two in blogdom -- thanks for reading all! -- we bring you some interesting health stories you might have missed.

+  This is a must read for anyone interested in the local food movement. This "Street farmer" brings organic produce to the inner city in a huge way. He's pragmatic, not preachy and even eats a doughnut every once and a while. And check out those worms!

+  In healthcare reform news, lots of updates: Hospitals agree to $155 million in cuts from government programs to cover the cost of reform. The Washington Post asks what are the limits to health care spending and who will make the tough choices about the cost limits? The Wall Street Journal's Health Blog breaks down reports about the many ways the reform effort may actually be stalling. Meanwhile, others say the entire reform question ignores illegal immigrants.

+  Stem cells to sperm?  British researchers claim it's possible. No proof whether these swimmers can fertilize an egg, but, well perhaps?

+  Consumer Reports breaks down underpayments by insurance companies and how out-of-network costs can rack up.

+  Lots of unsettling news about obesity, from soaring rates nationally to a study on how financial and work stress can make us load on the pounds, to this strange tidbit: living with a significant other can, ahem, make you fat.

And with that, we wish you a great weekend!

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

After meeting Dr. Robert Montgomery the other day, he of the record-setting domino kidney transplant surgery completed last week at Johns Hopkins, I got to Googling. Apparently, finding a way to transplant kidneys into an eight-person chain of patients at four separate hospitals just wasn't enough to occupy the surgeon over the past three weeks.

Between the third day of these surgeries on June 22 and the last day of surgery on July 6, when the chain was finally completed, the 49-year-old Montgomery went out and got married. On June 29. To opera superstar Denyce Graves.

"An intimate thing, just the two of us," is what she told The Washington Post's Reliable Source column. Second wedding for both. ...

Reliable Source goes on to tell the tale of how the pair met on a flight from Dulles to Paris four years ago, how the small wedding was just the first of three ceremonies they are planning --  with one a blessing next month in a Masai village in Kenya and a big to-do at Washington's National Cathedral to follow in September.

The 45-year-old diva, in a good way, sounds like she is just wild about the bearded surgeon. "I am myself in awe and in great reverence for the way he lives his life," she told the column.

Photo/Matt Mendelsohn Photography via Washington Post

Posted by Stephanie Desmon at 6:00 AM | Permalink | Comments (1)
        

Medication errors happen. They can and do occur at every step of the way from calculating dosages to prescribing, dispensing and giving drugs not only to adults but to children. Take one of the more famous cases: Actor Dennis Quaid's newborn twins who somehow survived being given a blood-thinner at 1,000 times the proper dose.

A study published this week in the journal Pediatrics looked at medication errors specifically involving heart drugs dispensed to children. What they found was, er, heart-stopping. They found that in a single year, half of the errors made were in children under the age of 1 and 90 percent of those were in children younger than six months. The littlest seem to be most vulnerable because health care providers may miscalculate and give them more medication than someone of their weight can handle or they may prescribe a drug not meant for someone so young. ...

Johns Hopkins researchers, who led the study of data from 2003-2004, pointed out that 96 percent of the 821 errors never caused harm, but 4 percent did. No one was killed. But in one instance, the patient's weight in pounds was mistaken for weight in kilograms, resulting in an overdose of three different heart drugs, which sent the child into cardiac arrest, researchers said.

One thing that's missing from the study: A calculation of how often medication errors actually occur. Previous studies have estimated that 1.5 million people a year (adults and children) may be impacted.

These heart drugs are used more often in children than you might think. Four in 1,000 U.S babies are born with congenital heart disease. According to the study, most of the harmful errors involved diuretics, used to treat heart failure and lower blood pressure by ridding the body of excess water, and drugs for lowering blood pressure. Not only are these medications used in those infants but they are being given more often to older children and teens with high blood pressure.

"Medication errors are inevitable," the study says, "given the human factor in patient care."

But how can these errors be reduced? Double- and triple-checking doses, labels and safety warnings can be a start. Hospitals are encouraged to put any mechanisms in place that will reduce the chance that mistakes will happen.

Posted by Stephanie Desmon at 12:00 PM | Permalink | Comments (2)
Categories: Pediatrics
        

See the guy on the far right? The one decked out in aviator shades rocking out next to Aerosmith’s Joe Perry? President Barack Obama just picked him to lead the National Institutes of Health.

Dr. Francis S. Collins, who led the government’s successful effort to decode the human genome (he also happens to play the guitar) is among a handful of preeminent researchers featured in a slick six-page photo spread in the June issue of GQ. The photos are part of a larger ad campaign called “Rock Stars of Science” designed to celebrate scientists, highlight the importance of their research and draw attention to the funding needed to make their work possible.

Collins did his groundbreaking work while as director of the National Human Genome Institute in Bethesda. He’s featured with such other notables as Dr. Harold Varmus, the former director of NIH, who won the Nobel Prize for his discovery of cancer genes, and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

By featuring some of the nation’s renowned researchers alongside the likes of rockers Sheryl Crow and Seal, the hope is to make these science gurus more accessible and dare we say, cool, to the average American.

As Collins says in an interview on the Rock Stars of Science site, “I think it's a great idea to show that scientists are not all a bunch of oddball nerds.”

His fellow scientists couldn’t agree more.

“As hokey as this might be, it’s very important to portray scientists as something other than the white haired old man sitting in the lab,” said Dr. Claire Fraser-Liggett, director of the University of Maryland’s Institute of Genome Sciences and a pioneering genetic researcher in her own right.

She shared a copy of the photo spread with me yesterday while I was in her office interviewing her about some of her latest work. (Stay tuned. I’ll be writing here soon about the work she did to map the genome of the deadly anthrax microbe).

Fraser-Liggett, however, noted the spread lacked some diversity. Being GQ, a men’s magazine, that was understandable, she reasoned. But a female colleague of hers wondered, could a women in science magazine spread be next? We'll see.  

Photo courtesy of GQ

Posted by Kelly Brewington at 6:05 PM | Permalink | Comments (7)
Categories: General Health
        

With all of the talk about kidney transplants in recent days, one thing has been left unsaid: Many kidney transplants don't last forever.

About 50 percent of kidney transplants from live donors are still working at 20 years, which means many people will need repeat transplants. With more transplants being done than ever before, and being done so successfully, the number of repeat transplants has been on the rise in recent years.

I wrote this story last year. In talking with some pediatric nephrologists (kidney docs), they mentioned something I never knew, that kidney transplants, especially in younger people, are a wonderful long-term fix but not necessarily a permanent one. And that's not always because patients may reject a new kidney or get some other severe illness.

"We can't get the grafts to last forever," Dr. Alicia M. Neu, a pediatric nephrologist at Johns Hopkins Children's Center, told me at the time. "We've kind of hit a wall. People live with one kidney all the time. They donate one, and they're fine. ...

The most interesting factoid (one of the best I have come across since I started covering medicine): When patients need a new kidney, surgeons typically don't remove the malfunctioning ones. They stay where they are and just shrivel up. One women quoted in the story had 6 kidneys, several of them implanted in her pelvic region. There is a limit: Doctors had told her there wouldn't be room for anymore if this last kidney stopped working.

Photo courtesy of ABC

Posted by Stephanie Desmon at 10:22 AM | Permalink | Comments (0)
Categories: General Health
        

When it comes to HIV/AIDS the mantra has always been: get tested.

But some doctors warn that not all tests are created equal. Sometimes a negative test can give a false sense of security to both doctors and patients, particularly for risk-taking teenagers, said Dr. Allison Agwu, a pediatric infectious disease specialist at Johns Hopkins Children’s Center.

Rapid HIV tests are designed to pick up antibodies to the virus, not the virus itself. It can take weeks or months for someone to produce antibodies. So a rapid test can come up negative the first time, but positive some weeks or months later. False negatives often happen during the earliest and most contagious stages of the infection.

And with teens, those crucial months matter.

“The test is only as good as when you get the test,” said Agwu. “I can’t tell you the number of times I spoke to a patient, and they say, ‘Well I’m negative. And they go on to doing whatever risky behaviors they’ve been doing.”

Of the 53,000 new HIV infections diagnosed each year in the United States, 14 percent of those occurred in 13 to 25-year-olds, according to the Centers for Disease Control and Prevention.

And the CDC reported last week that nearly half of all HIV positive teens don’t know they have the virus.

Agwu thinks doctors need to look further, probe deeper about their patients’ risk behaviors and consider a test that detects the virus’ genetic markers rather than relying on antibodies to the virus.

But testing is only part of the broader issue of getting teens to be aware of the dangers of HIV, said Agwu. Doctors and parents need to do a better job talking frankly to teens about sex and the risk for HIV, particularly in a city like Baltimore with higher than average rates of the disease, she said.

There's no doubt that it's touchy territory for parents. Today, an AIDS daignosis is no longer a death sentence and teens are often desensitized to the dangers or think it will never happen to them, Agwu said. There's no easy way to combat this, Agwu admits. But engaging teens in a constant frank conversation about the disease is a start.

Posted by Kelly Brewington at 8:00 AM | Permalink | Comments (5)
Categories: HIV/AIDS, Pediatrics
        

It all started with a Virginia man who offered his kidney to a woman from his parish who needed one. They had never met but Thomas F. Koontz thought the donation would be a good way to give back to God, whom he credited with saving his teenage daughter's brain cancer. The woman from church ended up finding a different donor. So Koontz called Johns Hopkins. He offered his kidney to anyone who might needed it,

His completely selfless act started a chain of events that would allow not just one person to get a desperately needed kidney, but eight people who needed new organs to keep them alive.

Surgeons at Johns Hopkins Hospital this morning held a press conference to announce that they -- along with doctors from hospitals in Oklahoma City, St. Louis and Detroit -- had performed a record feat. They completed an eight-way, multi-hospital, domino kidney transplant. This swap required seven pairs of people -- each made up of one person in need of a kidney and one willing to donate, but whose blood or tissue type was incompatible with the intended recipient. A computer program was fed all of the potential donor pairs and devised a complicated exchange that took place over the course of three weeks and involved several kidneys being flown around the country. At the end of the line was someone who didn't have a live donor offering a kidney, a woman who received her kidney at Hopkins last night. She was the ultimate recipient of Koontz's largesse.

"At the end of the chain, that kidney still goes to someone in great need," said Dr. Robert Montgomery, the Hopkins doc who led the transplant team. "But along the way, you're able to accomplish two, three, four, eight transplants. ...

"These are all ways of trying to optimize the number of people who are able to receive life-saving transplants."

Hopkins has been doing this for years and the number of kidneys transplanted each time seems to keep rising. At first, it may seem like a publicity stunt, an effort to outdo themselves just for the sake of it. But that is not what goes on here. The more people involved, the more people who benefit from a single kidney donation.

Montgomery says he hopes this will go a long way to address the biggest limitation in the number of kidney transplants that can be done: There aren't enough kidneys to go around.

"A transplant surgeon can maybe do 2,000 surgeries in a lifetime," he said. "The work that we're doing here will be responsible for thousands and thousands of transplants.

"What could be better?"

Baltimore Sun photo of Dr. Robert Montgomery

Posted by Stephanie Desmon at 2:24 PM | Permalink | Comments (0)
Categories: General Health
        

Long-distance travel may increase the risk of potentially deadly blood clots, a new study published today suggests, and the longer the trip, the greater risk of danger.

The relationship between venous thromboembolism -- clots that form in the veins, typically the leg, and can be deadly if they move to the lungs -- and travel has long been suggested. But previous studies have yielded contradictory findings. The study, published in this week's issue of Annals of Internal Medicine, looks back at previous data and finds that travel by any means is associated with a three-fold higher risk of these blood clots. And when limited to air travel, that relationship was even stronger: For every two additional hours on a plane was associated with a 26 percent increase in risk for blood clots.

Still, don't panic. These clots are still relatively uncommon. ...

Doctors aren't sure why the clots form more often during travel, but they suspect it has something to do with the fact that passengers spend so much time sitting still. They recommend moving around and staying hydrated to help stave off the clots.

And pay attention to symptoms: Leg pain, swelling, redness, and warmth in the affected limb. Of course these can be a sign of all sorts of things, but if you see a doctor for these symptoms soon after traveling, don't forget to tell your doctor you have been on a long trip. A college friend, otherwise healthy and in her mid-thirties, was complaining of pain in her leg after a many-hour flight from Mexico to New York over the holidays last year. Her pain even brought her to the doctor's office a few days later. He didn't ask her if she had been on a plane. The next day she died from a pulmonary embolism.

Posted by Stephanie Desmon at 8:00 AM | Permalink | Comments (1)
Categories: General Health
        

 My friend Rebecca posted something about her toe Friday night on her Facebook page. Rebecca wrote that she thought "it's broken; my husband thinks it's just bruised. Either way, my toe hurts."

What struck me about this was the response that came from her friend Tracy less than an hour later: "Post pix and let your FB MDs decide."

I loved this reply. Health topics that were once taboo (OK, maybe not broken toes) are now open for discussion -- on Facebook, no less. As a medical reporter, I've had more than one man start a conversation with me about his prostate exam and PSA numbers. But more often, in talking to friends, we discuss ours ailments or our kids' maladies and try to make armchair diagnoses. A lot of them figure our combined knowledge could be (nearly) as good as any docs. I wouldn't go that far, but that doesn't mean I don't engage in a little informal doctoring of my own.

Do you and your friends "play doctor," trying to diagnose one another? Do you use Facebook to do it? Twitter?

Photo/Getty Images

Posted by Stephanie Desmon at 12:06 PM | Permalink | Comments (2)
Categories: General Health
        

 "If you've seen one influenza season, you've seen one influenza season," Dr. William Schaffner, an infectious diseases expert at Vanderbilt University in Nashville, has told me more than once. It's an attempt at some medical humor, I guess, but there may be plenty of truth in his quip.

Researchers and public health officials have been trying to pin down this H1N1 virus since it hit the U.S. in April. They don't know if it will stay mild (it has sickened an estimated 1 million in the U.S. but killed 170 at last count). They thought it would go away over the summer since flu usually does, but in many places, more people keep coming down with it. The official number of new confirmed cases in Maryland, for example, has risen every week since the first case was confirmed here in May (and, officials say, those numbers are likely much higher since most people who get sick don't visit the doctor and most people who go to the doctor aren't getting tested for flu). Experts predict the virus could come back worse for flu season this fall and winter, like the Spanish Influenza of 1918 did. That remains to be seen, of course. ...

The truth is, since this is a new strain of the flu, health officials haven't a clue how it will behave. They want us to be wary of the swine flu, but not afraid. They want us to be comforted by the fact that the symptoms are mild, but concerned enough to avoid catching it if at all possible. They want us not to cry out that a vaccine is needed unless they are able to mass-produce one in time for the coming flu season. Then they will want us to line up and get immunized.

Said Dr. David Blythe, the state's epidemiologist: "It's hard to know what to expect when you have a new flu virus."

Photo courtesy of CDC

Posted by Stephanie Desmon at 8:00 AM | Permalink | Comments (0)
Categories: Swine flu/H1N1
        

If you're anything like me, you had a super hectic week leading to this holiday weekend. Now that we've made it -- whew -- here are some great health and medicine stories you might have missed.

Fascinating read from Sunday about how the grant system for cancer research awards small projects unlikely to make huge strides in finding a cure.

On the healthcare debate front, here's a great piece that looks at the big ticket issue: costs. So what happens to costs when you expand health care? Do they really go down? Or do they go up?

Two anti-smoking drugs will carry the Food and Drug Administration's most serious warnings after reports of people exerpiencing mental health problems, including suicidal thoughts.

A big picture look at the FDA's new powers to regulate tobacco.

Here are a couple of the many takes on the medical details behind Michael Jackson's death and whether Steve Jobs should talk publically about his pancreatic cancer.

And here's one for all the nurses out there who are tired of stereotypes about their profession -- I know my Mom is reading, so it goes out to her too. ;)

Have a great weekend!

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: News roundup
        

Stephanie’s post below about making a vaccine for swine flu got me thinking about how the medical community is trying to treat this virus in the meantime.

This week, Danish health officials reported the first case of Tamiflu-resistant swine flu. The World Health Organization called it an isolated incident and Roche, the company that makes the drug, said the medicine is still effective in treating the virus, known as H1N1.

Still, the case begs an interesting question of state health officials and doctors everywhere: when is the right time to give someone Tamiflu?

So far, Tamiflu is the most prescribed antiviral to help fight the symptoms of the virus. Medical experts agree prescribing Tamiflu to someone who tests positive for the H1N1 virus is a no brainer. It’s the best treatment out there. But whether to use the drug in an effort to prevent the virus is tricky.

Giving Tamiflu as prevention doesn’t guarantee you won’t get the disease and it could make it more likely that the virus adapts and becomes resistant to drugs, said Dr. Clifford Mitchell, director of environmental health coordination for the Maryland health department.

“When you give out a medicine, you run the risk that if you don’t kill every bug, the bugs that are able to survive are those that are able to resist that particular medication,” he said. “You don’t want to give this to everyone in the population.”

Two weeks ago, when three teens were diagnosed with H1N1 at the Baltimore City Juvenile Justice Center, officials at the facility made prescriptions for antiviral medications available to any staff member who wanted one and even offered to pick up the tab.

But typically, Tamiflu is recommended only for medical professionals who have had close unprotected contact with someone with the virus, and for people who have been exposed to the virus and are at risk for complications if they acquire it, such as pregnant women, the elderly and people with compromised immune systems. (See these guidelines from the Centers for Disease Control.)

No cases of drug-resistant swine flu have been found in the U.S., but state health officials are paying close attention for possible drug-resistant samples when they do testing.

Drug resistance has been found in other types of flu.  The most common strain of flu that circulated over the winter was almost completely resistant to Tamiflu.

Photo courtesy of AFP/Getty Images

Posted by Kelly Brewington at 1:40 PM | Permalink | Comments (1)
Categories: Swine flu/H1N1
        

Long known to be a concern of aging women, osteoporosis turns out to be nearly as common in older men, a new study suggests.

Doctors routinely screen women in their sixties for thinning bones. But there are no guidelines for checking the bones of male patients. Physicians tend to look for osteoporosis in men only after a problem -- like a suspicious fracture -- occurs.

Dr. Sherita H. Golden, a Johns Hopkins epidemiologist and the author of the new study in the Journal of Clinical Endocrinology and Matabolism, said she and her colleagues were surprised by the findings.

Falling estrogen levels contribute to thinning bones in women and low testosterone levels have been linked to bone loss, Golden said, so it does make sense that the hormonal changes of aging, regardless of gender, could lead to osteoporosis. Osteoporosis makes bones fragile and more likely to break, which can leave sufferers debilitated and deformed.

Another surprising finding: Osteopenia, a less severe form of bone loss, is actually more prevalent in aging men than in aging women.

Golden would like to see the study of men duplicated. If the results match up, she thinks the answer is clear: Men should be screened just as carefully for bone loss as women.

Image courtesy of answers.com

Posted by Stephanie Desmon at 8:00 AM | Permalink | Comments (3)
Categories: General Health
        

A federal advisory panel’s vote Tuesday to pull two popular prescription drugs off the market has shed light on a problem with a common ingredient in over-the-counter painkillers: acetaminophen.

The Food and Drug Administration panel recommends banning drugs like Vicodin and Percocet which combine a stronger narcotic with acetaminophen – the key ingredient in medicine cabinet staples like Tylenol and Excedrin. (It’s unclear if will happen, though. The FDA isn’t required to follow the panel’s advice, but it often does).

The reason for the recommendation? Big concerns about overdoses related to acetaminophen.  A New York Times story explains not only can the painkiller cause liver damage, more than 400 people die and 42,000 are hospitalized every year in the United States from overdoses.

In an effort to confront such problems, the panel made a slew of other decisions about the painkiller. Experts voted to lower the maximum daily dosage to less than 4 grams, or eight tablets of Extra Strength Tylenol. Another vote recommended a prescription for a 1,000 milligram dose – or two tablets of Extra Strength Tylenol.

Although the drug has been on the market for half a century and is used by millions to treat fevers and headache, excessive use is a longstanding problem, said the FDA and other experts.

Still, much of the public isn’t aware of the potential harms of the painkiller, said Lynette Bradley-Baker, an assistant professor at the University of Maryland’s School of Pharmacy, who attended the hearings Monday.  

And many others don’t know which products actually contain acetaminophen and how much. Most cold and flu medicines use the ingredient in combination with others, but how many of us check the back of medicine labels before we buy?

So how much is too much? That’s unclear. Bradley-Baker said she hopes the FDA will look at research into the true safe dose of acetaminophen.

“Having some constraints in place is a good start,” Bradley-Baker said. For now, she also hopes that the panel’s advice will spark discussion among patients, doctors and pharmacists about the painkiller’s safety.

Posted by Kelly Brewington at 1:19 PM | Permalink | Comments (4)
Categories: General Health
        

Flu is not usually something summer camps have to worry about. Welcome to the Summer of '09.

An outbreak of swine flu led the directors of Sandy Hill Camp in Cecil County this week to send roughly 200 campers home about halfway through a two-week session. (Flu is seasonal and usually hits in the winter.) The new virus swept quickly through the overnight camp. During the first few days, six campers came down with flu-like symptoms (later confirmed as swine flu in two kids) and were sent home. On Saturday, six more campers got sick. All campers and staff on the two-week session had their temperatures taken the next morning and four had fevers. Nine more campers developed symptoms by Sunday night. With 10 percent of the kids sick and who knows how many others exposed, the session was called off and everyone went home Monday.

Not to worry, reads a letter sent to parents planning on sending their children to later sessions at Sandy Hill this summer. No one was seriously ill, the directors wrote. And the rest of the sessions this summer will go on. In fact, a one-week session that began Sunday is underway and so far no campers have gotten sick.

Campers across the country have seen their summer plans dashed as swine flu has caused closures in other locations. The Muscular Dystrophy Association canceled all of its camps nationwide  -- including two sessions at Camp Maria in Leonardtown -- for fear that a swine flu outbreak could be dangerous to the sick children it serves.

On page two of the Sandy Hill letter, the camp directors try to look on the bright side: "Although not necessarily initially comforting, many experts believe that the influenza A virus will come back in additional waves in the fall/winter during the traditional flu season. It is believed that campers who work through the virus now will increase their immunity against future exposures."

Posted by Stephanie Desmon at 8:00 AM | Permalink | Comments (8)
Categories: Swine flu/H1N1