As the Senate begins debate on its version of a health care overhaul bill, big questions remain on hot-button topics like abortion and the public option.

But another issue that will intensify debate is whether the proposal controls skyrocketing health care costs.

In a story yesterday, we examine how lawmakers are taking aim at high-cost hospitals with provisions that worry large -- and expensive-- academic medical centers such as Johns Hopkins and the University of Maryland.

Lawmakers are drawing on influential research from Dartmouth that shows huge disparities in Medicare costs in hospitals nationwide as evidence of waste in the system. Maryland ranks sixth highest in Dartmouth research of Medicare spending in the last years of a chronically ill patients' life. Hopkins and Maryland are the state's priciest hospitals.

The health care bills would examine differences in costs and could limit how much expensive hospitals get from Medicare. In addition, the bills would clamp down on overall Medicare payment rates.

All that worries hospitals who say they are expensive to run because they are responsible for training the next generation of doctors and pioneering life-saving techniques. They fear reforms will endanger their missions.

But others don't buy those arguments and say sweeping reforms -- and lower payments -- are needed to reduce waste.

In addition to these provisions, expect serious debate in the Senate about whether the bill goes far enough to cut costs. The White House has already defended the bill's cost-cutting measures. Stay tuned to see how it all shakes out.

And here's a tidbit for all the health care wonks: Check out these little-noticed reform provisions, from encouraging time off at work for breastfeeding moms to more money for sex ed.

Posted by Kelly Brewington at 12:30 PM | Permalink | Comments (4)
Categories: Health care reform
        

Pediatricians recommend that all toddlers get screened for autism. And for years studies have shown that the disorder can be diagnosed in children as young as 14 months.

Everyone seems to agree that early intervention is key in managing the puzzling neurodevelopmental disorder. But are there effective treatments for children diagnosed as young as their first birthday?

New research appearing in today's Pediatrics suggests there are. A very small five-year study found interventions starting as early as 18 months improved IQ, language ability and social interaction in autistic children.

The study, by researchers with Autism Speaks, the University of Washington and UC Davis Mind Institute, is based on a clinical trial of 48 18-to-30 month old children. Half got intensive two-hour therapy sessions with a specialist five days a week and five hours of parent therapy. The control group received only annual assessments from doctors and referrals to therapies already available in their communities.

The children who received the interventions had an average increase of 18 IQ points over the study period and made gains in language skills and social interaction. Only one child in the control group had an improved diagnosis, the authors found.

"Infant brains are quite malleable so with this therapy we're trying to capitalize on the potential of learning that an infant brain has in order to limit autism's deleterious effects, to help children lead better lives," said Sally Rogers, of the UC Davis MIND Institute, and a co-author of the study.

Clearly the small study size is a limitation of the research. It's unclear whether children will sustain these gains over the long term, the authors acknowledge. And I wonder how many autistic children have parents have the time and the ability to engage in intense therapy sessions with their children. Many autistic parents I have spoken to for previous articles tell me they are already stretched thin, and understandably so.

Researchers say they hope the findings influence more research, and hopefully, answers to this complex disorder.

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

After heaping plates of turkey and trimmings the last thing you may be in the mood for is a greasy burger at the airport fast food joint. But often, when traveling, the pickings are slim.

This just in for the Thanksgiving travel holiday: airport food can rank seriously low on the health scale, according to a new survey.

Our very own BWI Thurgood Marshall ranked near the bottom of the list of the nation's 17 busiest airports for healthy food. Our colleagues at B'more Green give us the full scoop on the findings, complete with a full list of the rankings.  

Apparently diners can find more healthy foods loaded with veggies in Detroit, which got a perfect score from the Physicians Committee for Responsible Medicine, than they can in Baltimore. Who knew?

Baltimore Sun photo

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Categories: Diet and exercise
        

We at Picture of Health will be stuffing our faces, er, taking a break for the holiday. Happy and healthy holiday wishes to all!

stock.xchng photo

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Have you fallen in the Medicare drug doughnut hole? The state of Maryland wants to help you find out and possibly provide some help.

The Maryland Senior Prescription Drug Assistance Program, part of the Maryland Health Insurance Plan, will hosts FREE workshops to help you determine your eligibility for subsidies. There are tens of thousands of Maryland residents on Medicare and not taking advantage of the assistance, according to data on drug plan enrollment from the Center for Medicare and Medcaid Services.

This Maryland program can reduce cost of Part D drug coverage for moderate-income seniors (making less than $32,490 as an individual and $43,710 as a couple) and disabled people. Open enrollment is from Nov. 15-Dec. 31 for benefits beginning Jan. 1. The benefits for those eligible include a $1,200 subsidy (for those who fall in the $2,700 doughnut hole) and a $300 yearly premuim subsidy paid on a monthly basis.

To the 14 workshops, you'll need to bring your Medicare ID card, list of current prescription drugs, current prescription drug plan statement, if available, proof of state residency such as a driver's license or 6-month old utility bill or rental agreement and proof of household income from last-year tax return or other relevant document.

For more information, call 1-800-215-8038 from 9 a.m.-5 p.m. Monday through Friday, including dates and locations. 

Posted by Meredith Cohn at 11:44 AM | Permalink | Comments (0)
Categories: News roundup
        

Burnout is common among surgeons and the results can be harmful for patients, new research suggests.

In a survey of 7,900 surgeons, 9 percent said they had committed a major medical error in the last three months, according to the study by researchers from Johns Hopkins and the Mayo Clinic.

Surgeons who reported burnout or depression said they were more likely to commit medical mistakes, according to the study appearing in the Annals of Surgery. Overall, 40 percent of surgeons who responded to the survey said they were burned out.

And here's a fascinating point that drives home the big picture: while surgeons don't appear to make more errors than other doctors, the consequences of these mistakes can be more severe, the article says. Some estimate that as many as 10 percent of patients are affected by such errors.

The survey, commissioned by the American College of Surgeons, asked participants about  emotional exhaustion and questions that screened for depression.

Because the survey relied on self-reporting, the study has a major limitation, the authors acknowledged: It was hard to tell whether depression and burnout led to medical errors or the other way around.

Depression and burnout may be more problematic than fatigue -- often blamed for medical errors, the study concludes. The authors urge surgeons to be on the lookout for colleagues who may need help. 

"The most important thing for those of us who work with other surgeons who do not appear well is to address it with them so that they can get the help they need," said Dr. Julie A. Freischlag, one of the study's authors, in a statement.

AP photo

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Categories: Surgery
        

Just two weeks after Maclaren recalled more than 1 million strollers, another baby product line is recalling its products in what is being called the biggest crib recall in U.S. history.

Our colleagues at Charm City Moms break down the specifics: More than 2.1 million drop-side cribs made by Stork Craft Manufacturing are being recalled after reports that four infants suffocated.

The problem is with the crib hardware, the Associated Press reports. The drop-side can detach, creating a space between the side and the mattress, where a baby can become trapped. Scary stuff.

For more information: Contact the company, 877-274-0277, to order the free repair kit, or log on to www.storkcraft.com.

Posted by Kelly Brewington at 11:11 AM | Permalink | Comments (2)
Categories: Pediatrics
        

I've always wondered if doctors are more or less apt to seek treatment for medical conditions. Well, when it comes to plastic surgery, the doctor is often the patient, a new study finds.

In a survey of 276 members of the American Society of Plastic Surgeons, 62 percent said they had gone under the knife for at least one procedure. Most receive minimally invasive procedures such as laser hair removal chemical peels and Botox -- no word of whether they throw Botox parties. A third had gone under a surgical procedure, with liposuction being the most common.

Women surgeons were more likely than men to have cosmetic surgery. The study about the survey -- appearing in the December issue of Plastic and Reconstructive Surgery -- suggests they can be an asset to patients who are trying to decide which kind of reconstructive surgery to receive.

Is this the result of sheer vanity, having all these nifty tools within an arm's reach, or true medical necessity? I wonder.

AP photo

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Categories: Surgery
        

A mall Santa's job is never easy. You're inundated by hordes of children lining up to sit on your lap to ask for outlandish material things. And once they reach you, all they do is sob and pull your beard with their germy hands.

This year, Santas nationwide say there's an added occupational hazard -- the swine flu. And they want protection from it, the Associated Press reports. 

They're not asking to jump ahead of everyone in line for swine flu vaccines. But they do think they deserve to be along side child care providers and others who are around children all the time.

Kids are not just more susceptible to this flu, they are germ magnets known for spreading all kinds of bugs. 

Santas are worried for other reasons too. Real Santas -- we're talking members of Santa trade groups such as the Amalgamated Order of Real Bearded Santas -- tend to be pudgy in the mid-section, just like the one and only real Santa Claus. Being obese is a H1N1 risk factor.

No word from the CDC if the Santas will get their Christmas wish. (Although one Santa group has in fact asked a member of Congress for support) For now, Santas are taking precautions. They're ditching those germ-catching white gloves and installing hand sanitizer for Santas use as well as for the kiddies to use before they take a seat on Santas lap. Santa slathering on hand santizer? Well, aren't we all. Santas, they're just like us!

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

Cigarette smoke and lead are known to have bad effects on children. Some studies have shown a link to between the exposures and Attention Deficit Hyperactivity Disorder.

A new study shows those downsides begin as early as in the womb. Children exposed to cigarette smoke and to lead in utero were eight times more likely to be diagnosed with ADHD, according to an article appearing in today's Pediatrics.

For years, researchers have known too much lead exposure in pregnancy can lead to a host of developmental and behavioral problems once the child is born. And other research has shown a link between tobacco and attention problems. This study takes a look at both exposures to reveal a significant impact.

The team of researchers from around the country studied a national health survey of 2,588 children 8 to 15 years old. They measured lead levels in a child's blood and measured tobacco exposure based on how much smoking a woman reported during pregnancy. Children exposed to tobacco or lead alone were more likely to have ADHD. The risk was even greater when exposed to both toxins.

The findings may not be surprising -- we've known for years that lead exposure and smoking are bad during pregnancy. But consider that some 15 percent of women smoke during pregnancy, according to a 2004 study the article states. And nearly 2 percent of children nationwide have lead levels above what the CDC says are "levels of concern."

Understanding the causes of ADHD has been a challenge for researchers. They believe a mix of genes and environmental factors is at play. The authors say the new research could play an important role in tackling the condition.

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Pediatrics
        

The volatile issue of abortion has come front and center to the health care reform battle with wrangling over health insurance coverage of the procedure.

But a new poll suggest that while most Americans don't support public funding for abortions, the issue plays only a small role among those who oppose reform, according to the poll, by the Pew Research Center.

When asked directly about whether abortion should be a benefit of a government health care reform plan, the majority -- 55 percent -- said no way. But when asked to explain in their own words their opposition to health care reform, just 3 percent of opponents said their objection to reform was because of abortion, the poll found. 

While it may not be the sole reason for discontent with the health overhaul, it was among a few. About 56 percent of opponents listed abortion as one of the major factors in their opposition, the poll found. Still, concern about costs and the expanded role of the government ranked far higher.

The poll, conducted between Nov. 12 and 15 asked a little over 1,000 people their thoughts on abortion and health care reform.

Two weeks ago, the House voted to probhibit federal subsidies for insurance that covers abortion in its version of the health care bill. The Senate's version does not have that stipulation at the moment. Expect the issue to be fought hard in the Senate. An interesting side note, this Politico story explains how taxpayers already provide subsidies for health care plans that cover abortions.

Back to the poll. While many Americans had strong feelings on the legislation proposed in Congress, lots of folks said the bills were too complicated and a good 19 percent said they didn't know what to think of them. Go figure.

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

With the mammogram controversy showing no signs of simmering, HHS Secretary Kathleen Sebelius issued a statement yesterday afternoon in an attempt to distance the administration from the guidelines that have sparked so much debate.

If you haven't heard, a federal panel of medical experts said Monday that women should delay mammograms until age 50 and doctors shouldn't bother teaching women to do breast self exams. The U.S. Preventive Services Task Force said its goal was to reduce the harms of unnecessary treatment.

But critics are saying it's a glimpse of health care rationing soon to come under health reform. A group of Republican congresswomen said the guidelines are "a step back for women" and the beginning of rationing. The panel, critics fear, will influence policy and insurance companies won't cover the screens. Many of you expressed similar worries in my last blog post on this issue.

Sebelius tries to debunk this right away: The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don't determine what services are covered by the federal government. ... Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.

She explains there has been debate for years about whether women in their 40s should get mammograms. I wrote about the issue last year, in fact. And we've shared with you here on the blog the latest debates over the merits of breast and prostate cancer screening. 

Sebelius ends her statement by underscoring that mammograms are an important screening tool and that women should consult with their doctor about the tests.

Still, don't expect Sebelius' plea to stop this issue from being political. Some say lawmakers have every intention of passing reform that supports effective treatments that also control costs, and would rely on advice from experts such as the task force to make those decision. This Chicago Tribune story lays out those arguments.

Chicago Tribune photo

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Categories: Cancer
        

Adults with high levels of artery-clogging "bad" cholesterol decreased by a third between 1999 and 2006, new research finds.

At the same time, though, researchers found that many adults still have very high cholesterol levels and are not being treated for them. This, despite the widespread use of drugs known as statins, which lower bad cholesterol levels.

While the use of such medications increased from 8 percent to 13.4 percent over the study period, screening rates remained unchanged at less than 70 percent, the researchers write in the article published in today's Journal of the American Medical Association,

Researchers from the CDC studied 7,044 men and women 20 years and older and examined their levels of "bad" cholesterol, or LDL.

Overall, the prevalence of people with bad cholesterol decreased from 31.5 percent in 1999 to 21 percent in 2006. But about two-thirds of people in the highest risk categories -- susceptible to heart attack and other problems -- were not on medication, the authors found.

Why are so many people at risk not getting treated?

An accompanying editorial suggests that screening guidelines are too confusing and need to be simplified. Doctors evaluate patients with a fixed threshold of LDL levels. As a result, doctors sometimes miss people with high risk factors for developing heart disease even if their LDL levels aren't high enough to meet the threshold. In another editorial, other experts suggest factoring age into the equation -- offering generic statins (cheaper than the name brands and therefore more accessible) to all adults above a particular age.

Baltimore Sun photo

Posted by Kelly Brewington at 7:07 AM | Permalink | Comments (2)
Categories: Cardiovascular Health
        

A government panel's new recommendation that women start mammograms at age 50, not 40, is has sparked angst, confusion, and even anger -- among health advocates and medical experts alike.

As we told you in a story today, the U.S. Preventive Services Task Force reversed existing recommendations that women get mammograms every one or two years starting at 40. Now, it says, start in your 50s, and do them every two years.

And remember how doctors have urged women to do breast self-exams? Well, skip those too. There's no evidence that teaching women to examine their breasts actually saves lives, the panel now says. 

So what's a woman in her 40s to think? That's the tenor of the emails I've been getting in response to this story. Women are confused. For years, doctors, patient advocates and every public service announcement with a pink ribbon on it has urged women to get annual mammograms and check their breasts for lumps. So, now what? Talk to your doctor, says the panel.

But many doctors are against the new recommendations, especially cancer specialists. CNN notes that the panel of 16 medical experts includes no oncologists.

There are no clear cut answers, even among doctors. One tells the WSJ health blog that there is no downside to breast self-exams, regardless of what the data show.

Another doc, who backs the guidelines, tells NPR that he tells is patients if they find lumps in their breasts to bring them to his attention. But then he says: The harm is twice as many women finding a lump, being anxious and having a surgical procedure to remove the lump or at least to put a needle into the lump. And if this doesn't result in any improvement in mortality, were not doing these women any favors.

Others fear insurance companies will stop covering mammograms for women in their 40s.  

The new guidelines aim to prevent the harms of overtreatment. Mammograms give a lot of false positives to women in their 40s and the detect cancers in women that may not harm them, putting them at risk for unnecessary biopsies, treatment and psychological stress.

To be clear, the guidelines are advice, nothing is binding. And they apply only to women with an average risk of breast cancer -- not women who may have a genetic mutation or family history, making them susceptible to the disease.  

Still, there are many stories out there from cancer survivors who say had they not done a self-exam, or gotten a mammogram in their 40s, they wouldn't be alive today.

What do you think?

AFP/Getty Images

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Categories: Cancer
        

Comprehensive heart screening could save the lives of more young athletes, according to a new study by Johns Hopkins researchers. 

The data, presented at this week's American Heart Association conference in Orlando Fla.,found benefits in testing athletes with both an echocardiogram, a heart ultrasound to measure heart size and an electrocardiogram, or EKG, to assess the heart's electrical rhythms.

Researchers tested the athletes, who were at state track and field championships last year, with the two screening tools and found no life threatening problems, but did find abnormalities in 36 kids. The majority of those were picked up using both screening tools.

 "What is the price for a single life?" said Dr. Theodore Abraham in a news release. "We're counting the costs upfront. We're not counting the savings on the downstream end."

AP photo

Posted by Kelly Brewington at 7:24 AM | Permalink | Comments (0)
Categories: Pediatrics
        

For years, we've been hearing that more children are suffering from food allergies. Some estimates say allergy to peanuts in particular have as much as doubled or tripled in the past decade. 

A new study from federal researchers offers the latest, albeit lower, estimate. Food allergy among children increased 19 percent between 1997 and 2007, they found. In 2007, about 4 percent of all children had a food or digestive allergy.

Between 1993 and 2007, the number of visits to clinicians for allergies tripled. Hospitalizations increased, too. In the period between 1998 and 2000 and 2004 and 2006, hospitalizations rose from an average of 2,600 to 9,500.

The research, published in the new issue of the journal Pediatrics, is based on a review of several federal surveys, such as hospital discharge data and interviews with parents of children with allergies. Researchers with the CDC's National Center for Health Statistics also looked at estimates of child food allergies by race and gender. They found that black children were twice as likely as whites to have peanut allergy and nearly twice as likely to be allergic to milk.

The study examines levels of a particular antibody, known as immunoglobulin E, or IgE. Children with higher IgE levels appeared more susceptible to allergies. Some 9 percent of children had detectable levels of IgE to peanuts, the study found.

The bottom line: food allergies are increasing for boys, girls and children of all ages and ethnicities. But how much of this is a real increase and how much is due to closer detection and increased awareness remains murky.

As parents and doctors grow more worried about child allergies, are they becoming more likely to detect them? For example, hospitals are getting better at keeping records of food allergy diagnoses, the study points out.

Regardless, the study's authors suggest that since the increases wer found across genders and races and detected in numerous surveys, the rise in allergies is likely real.  

AP photo

Posted by Kelly Brewington at 7:02 AM | Permalink | Comments (2)
Categories: Pediatrics
        

As the nation's baby boomers age, their health needs grow in volume and complexity. The extent of those needs and their possible impact on the nation's health care system are constantly being assessed by researchers. The latest: aging baby boomers are more likely to have disabilities, according to a new study by UCLA researchers.  

The study, to be published in the American Journal of Public Health, examined data from the National Health and Nutrition Examination Surveys for 1988-1994 and 1999 to 2004.

Researchers looked at three age groups 60-69, 70-79 and 80 and older, analyzing such mobility issues as walking from room to room, getting out of bed and doing chores around the house. They found increases in disabilities for all groups, except for those 80 and up.

Disabilities among people in their 60s increased between 40 and 70 percent in all the areas studied, regardless of socioeconomic status, health and weight. Racial minorities and overweight people had even higher increases. Researchers think the nation's changing demographics may have something to do with the trend. Blacks and Hispanics, whose populations are expected to grow the most, are more likely to be poor and obese -- factors that increase the risk of disabilities, the study states. 

"Increases in disability in that group are concerning because it's a big group," said Teresa a UCLA professor of medicine and the study's lead author. "We are not sure why the disabilities are going up. But if this trend continues, it could have a major impact on us, due to the resources that will have to be devoted to those people."

Those functional limitations and disabilities are likely to add to the nation's health care costs and have important ramifications for proposals to reform the health care delivery system, the authors write.

More study is needed on why disabilities are on the rise and how much the increase could cost, researchers said.

Baltimore Sun photo

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Categories: General Health
        

A new dairy industry ad campaign extolling the virtues of chocolate milk is drawing the ire of some educators and healthy eating activists.

The "Raise your hand for chocolate milk" campaign, which starts Monday, comes with a website that asks supporters to sign a petition showing their support for chocolate milk in schools. (Get a glimpse of the campaign with this video) 

Really? And here I thought school lunches were getting healthier. The Institute of Medicine said just last month that schools needed to strip the fat and salt from their lunches and offer fat free milk -- not chocolate.

The dairy folks insist that their hope is to get children to drink milk. Without chocolate milk, they may not drink milk at all, they claim. In addition, they say they hope to draw a distinction between chocolate milk and soda, the milk lobby told the AP. Chocolate milk actually has some nutrients -- when compared to soda, they say.

Um, OK. Well, lots of folks aren't buying their claims. With child obesity levels soaring, schools shouldn't be in the business of giving kids chocolate milk-- which has more calories and sugar than the plain variety, opponents say.

Others see more sinister motives. The campaign -- costing between $500,000 and $1 million -- is supported by a group that has been fighting efforts to get chocolate milk out of schools. With millions of dollars in sales to schools at stake, this campaign is all about money, argues the Marion Nestle at the Food Politics blog.

What do you think?

AP photo

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (14)
Categories: Pediatrics
        

Workers exposed to high levels of the chemical BPA were more likely to have erectile dysfunction and other sexual problems than men not exposed to the chemical, a new study has found.

The research, appearing in the latest issue of the journal Human Reproduction, studied 634 Chinese factory workers over five years, comparing men whose workplaces had high levels of BPA to those who had none. Workers in the factories with BPA had four times the risk of erectile dysfunction and seven times more risk of ejaculation problems, researchers from Kaiser Permanente found.

While other studies have linked high BPA levels to sexual dysfunction in animals, the authors say this study is the first in humans to study BPA's impact on men's reproductive system.

BPA, or bisphenol-A, use is widespread and the chemical is present in the urine of some 92 percent of Americans, the study states. Manufacturers use BPA to make the linings of food and beverage bottles and cans because it's durable, makes plastics harder and can withstand high temperatures.

Whether it's safe remains controversial. The government has been debating BPA, while consumer groups push hard for bans of the chemical. The Food and Drug Administration is expected to release findings from a long study on the issue later this month. Meanwhile, studies continue to question the safety of BPA. Last week, we told you about a Consumer Union report that found measurable levels of the chemical in canned foods.

In the study on sexual problems linked to BPA, the authors acknowledge more study is needed on the topic. For starters, men in the study were exposed to BPA levels 50 times higher than what the average man faces in the States. But for now, they say, given the widespread use of BPA their finding should be considered as the debate continues over its safety.

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

With flu shots in hot demand, everyone wants to know where they can find a vaccine near them -- fast.

Well, Google maps says it has an answer for you. The new flu shot finder (google.com/flushot) is just kicking off, so there are a few kinks, the folks at Consumerist tell us (many locations are showing up that they're out of stock).

But eventually, the tool aims to provide users with the most up-to-date locations where they can find both seasonal and H1N1 vaccines.

Google's been working with the CDC and the Department of Health and Human Services on the project and apparently the tool will be available soon on the government's flu site: www.flu.gov.

And if you're local, don't forget The Sun's swine flu webpage has information on local vaccine clinics. You can find that here.

Posted by Kelly Brewington at 3:31 PM | Permalink | Comments (0)
Categories: Swine flu/H1N1
        

Even amid the current shortage of swine flu vaccine, government officials, infectious disease experts and public health experts everywhere have touted the vaccine as the best way to protect against the H1N1 virus.

But what if they're all wrong?

That's the premise of this provocative piece in his month's Atlantic titled "Does the Vaccine Matter?" Some flu researchers are expressing caution about both the vaccine's abilities as well as the use of antivirals to treat the swine flu. The article states:

But what if everything we think we know about fighting influenza is wrong? What if flu vaccines do not protect people from dying—particularly the elderly, who account for 90 percent of deaths from seasonal flu? And what if the expensive antiviral drugs that the government has stockpiled over the past few years also have little, if any, power to reduce the number of people who die or are hospitalized?

Some medical experts argue that people who need protection from the flu the most are not getting it from the vaccine and the drugs out to treat it. Flu vaccines and antivirals don't offer as much protection as they experts tout, say some experts quoted in the story. So, if a severe pandemic strikes, we may not be prepared, the authors write.

Controversial indeed. The article has received heaps of criticism from science blogs and not everyone is convinced of the story's premise and many are coming out to show evidence that flu vaccines do work and that the H1N1 vaccine should work just as well.

The article, written by Shannon Brownlee, author of the book Overtreated, and medical reporter Jeanne Lenzer, notes that so much about the flu -- and how to fight it effectively -- is unknown. The article includes voices from experts who doubt the prevailing scientific wisdom that flu shots significantly reduce the risk of death and are calling for more studies of whether they are effective.

Will this story add more fuel to anti-vaccine fire? Your thoughts?

AP photo

Posted by Kelly Brewington at 12:31 PM | Permalink | Comments (4)
        

Breast cancer patients often struggle with persistent pain long after their treatments are completed, according to new research published in the latest Journal of the American Medical Association.

Nearly half of patients surveyed said they had lingering pain two to three years after their cancer treatment, according to the study by Danish researchers. The pain can be severe to mild, and for some women it doesn't simply come and go -- it endures. Of the 13 percent of women who reported severe pain, 77 percent said they experienced it every day.

The study, which examined chronic pain in 3,754 women ages 18 to 70, found women younger than 40 were more likely to suffer from it. Of women who had breast-conserving surgery, the highest risk of pain was in young women 18 to 39 -- much higher than those in their 60s.

The pain was due to surgery and subsequent nerve damage, as well as chemotherapy and radiation treatments. Women felt pain in their breasts, but also under their arms and on the sides of their body.

The issue demands more attention, according to an accompanying editorial, from doctors from the Lee Moffitt Cancer Center in Tampa, Fla. ...

Some people are starting to take notice. My colleague Jill Rosen explored the arduous journey  breast cancer survivors face after treatment, from fatigue and depression to cardiac issues and joint pain. While a medical movement is underway to confront the hardships that women face, being a survivor can be difficult.

As breast cancer survivor Ellen Currotto (pictured right) says in the story: "I don't think it ever really is done. Survivorship is still a challenge."

Baltimore Sun photo

Posted by Kelly Brewington at 7:04 AM | Permalink | Comments (5)
Categories: Cancer
        

Long waits in the nation's emergency rooms are nothing new. But research finds they're getting worse.

One in four emergency room patients in 2006 waited longer to be seen than recommended -- an increase of one in five from less than a decade earlier in 1997, according to a new study in the Archives of Internal Medicine.

With more people using emergency rooms for non-life threatening medical problems, the rates of ER usage have soared. In 1994, there were 93 million visits to the nation's ERs. In 2006 that figure spiked to 119 million visits, according to the study. And it's worst in urban areas. Three quarters of emergency departments in urban areas are at or above capacity, which means longer waits, people being diverted to other hospitals or people choosing to leave without getting care.

Overcrowding means not just unhappy patients, but can cause serious delays in treatment of conditions such as pneumonia, cardiac symptoms and abdominal pain, the authors write.

Researchers analyzed data from the National Hospital Ambulatory and Medical Care Survey to examine wait times. When a patient enters the ER, they are triaged -- processed and prioritized according to how severe their illness -- and given a recommended time by which a clinician should see them.

But no matter how patients were classified -- urgent patients were recommended to see a clinician within 14 minutes, while non urgent ones could be seen in up to 24 hours, for example -- patients in all categories saw their wait times increase.

The problem is not just with the ER, but it represents a "system-wide failure," says an accompanying editorial by Dr. Renee Y. Hsia and Dr. Jeffrey A. Tabas of the University of California, San Francisco. Hospitals need to reduce crowding, reduce stays and limit wait times, not only through the use of electronic medical records and quicker lab results, but with better access to care in other arenas, including more urgent care clinics and primary care offices, they write.

While health care reform offers some hope for improvement -- by expanding health insurance coverage to people who use the ER as their safety net --it's unrealistic to expect it to fix the problem, the authors write.

AP photo

Posted by Kelly Brewington at 7:02 AM | Permalink | Comments (0)
Categories: General Health
        

Stroller company Maclaren USA announced a huge stroller recall this morning affecting more than 1 million strollers after a dozen reports of children's fingertips being amputated when they put their hands into a side hinge. 

Our colleagues at the Consuming Interests blog give us the full details.

The recalled strollers include 11 different models, details of which can be found at the company website www.maclaren.us/recall or by calling (877) 688-2326. The products were sold from 1999 through November 2009 at stores like BabysRUs for $100 to $360.

photo courtesy of AP

Posted by Kelly Brewington at 12:20 PM | Permalink | Comments (5)
Categories: Pediatrics
        

Swine flu's so-called remedies are everywhere, from potions claiming to cure the ill to cleaning products touting they can kill flu germs.

As far as flu cures are concerned, we've shared with you how to detect the real from the bogus. But what about cleaning supplies? Do disinfectants that claim to battle the flu really work?

Well, some do and some don't, according to Polly Ristaino, associate director of hospital epidemiology and infection control for Johns Hopkins. The most important thing to look for in a product is an Environmental Protection Agency label that bares the claim. These products have had extensive testing to meet standards by the EPA, which regulates disinfectants, she said. Manufacturers who tout that their potions kill flu germs without the EPA stamp are false, she said.

Another caveat: there are no EPA-approved products yet that claim to kill the H1N1 virus, but there are tons that say they fight influenza-A, or the seasonal flu. So far, experts believe these seasonal flu fighters can disinfect against the swine flu, since the viruses are similar. The EPA also makes a list of some 500 products on the market that are approved to fight seasonal flu germs and you can find those here.

Cleaning is important, but Ristaino reminds us, you don't need fancy products. "Regular soap and water is just fine," she said. Still, people are taking disinfecting seriously these days. Fears of the virus have even helped propel a 23 percent increase in first quarter sales for Clorox products.

But more important than cleaning the environment is practicing good hand hygiene, said Ristaino. And you all know what that means -- wash your hands frequently and sneeze and cough into your elbow, as public health officials have been drilling into our heads for months.

That's because, the flu -- both seasonal and H1N1 varieties -- is spread through droplets in the air. But those germs can only survive on surfaces anywhere from two to 8 hours, according to the CDC.

If you are convinced you must disinfect every surface to keep yourself healthy (hey, cleaning is never a bad thing, go for it) Ristaino suggests following product instructions carefully. Often, labels specify that you leave the substance on a surface for 15 minutes or more before wiping down. 

Here are some more tips on disinfecting your home.

photo courtesy of the CDC

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Swine flu/H1N1
        

MC Kelly Kel on the mic: Check one two, wash your hands to protect from the swine flu. Sorry, that was awful. But I'm OK with that. I am not a rapper; I'm a reporter. I can play my position.

Doctors are not rappers either, and yet, some physicians unfortunately have turned to hip hop to spread the message of swine flu prevention. Take Dr. Mache Seibel, a.k.a. DocRock, who has teamed up with insurance carrier Cigna for a rap public service announcement to teach children how to ward of the H1N1 virus. No comment is necessary, I will let the video speak for itself:

Still cringing? Me too. Good intentions aside, it's hard for us old peeps to stay young and hip. So after watching DocRock, I said to myself, why bother risking such embarrassment?

But then I stumbled upon another rapping doc -- who has skills. Seriously. Check out Dr. John Clarke, a Long Island, NY doctor whose freestyle was so good he was named as one of 10 finalists in a U.S. Department of Health and Human Services search for a swine flu PSA. Then tell me which one you think is better.

Posted by Kelly Brewington at 7:23 AM | Permalink | Comments (0)
Categories: Swine flu/H1N1
        

Our colleague Jill Rosen over a the Unleashed blog gives us the scoop on the Iowa cat who came down with, yes, you guessed it, the swine flu.

The cat recovered and officials believed the pet contracted the virus from someone in the household who was already sick from it. The H1N1 virus has been found in pigs, birds and ferrets too.

The American Veterinary Medical Association and the American Association of Feline Practitioners are reminding pet owners that some viruses can pass from people to animals, so this wasn't unexpected. Note to cats and dogs: stay away from your sneezing owners. 

Looking for more info on protecting your pets against the virus? Check out this piece by the NYT.  

AP photo

Posted by Kelly Brewington at 4:18 PM | Permalink | Comments (1)
Categories: Swine flu/H1N1
        

Hospital food. Yuck, right? Ranks right up there with bland school lunches and nuked airline "meals," goes the stereotype. Well, not all hospital food is lousy, according to the folks at Chowhound, a great site for restaurant reviews, recipes and good foodie tips.

There's an amusing post on a Chowhound message board asking about the quality of food in hospitals around the country. People have chimed in with tales of unclassifiable "meat covered in sauce" and "gummy oatmeal" to tasty Asian stir fry and enchiladas so scrumptious one patient didn't want to go home. The details are great. Hilarious stuff.

Some folks said the food was so bad they lost weight in the hospital and others said they were so hungry from their medical problems any old crumb was delicious. And still other raved about the selection of fresh veggies and inventive meals. Who knew?

Looking for hospital food that isn't crummy? There are quite a few corners of the Internet devoted to the search for tasty hospital cuisine. Hospital Food, encourages people to post photos of their meals and even includes a link to a popular Facebook group devoted to hospital eats.

Hospitals have been working to step it up lately with tastier, healthier meals, after enduring the  reputation of doling out processed foods with zero flavor. Organic produce, hormone-free meats and local ingredients have been making their way to hospital kitchens. Some hospital cafeterias have gotten downright glitzy, with low-fat high-flavor buffets. And local hospitals such as Johns Hopkins and the University of Maryland Medical Center even sponsor farmer's markets.

So, is it all bad? Tell us your hospital food experiences.

AP photo.

Posted by Kelly Brewington at 7:33 AM | Permalink | Comments (9)
Categories: General Health
        

We know many people are having trouble finding swine flu vaccines. But perhaps relief is on the way. We're hearing reports of flu clinics opening up in unexpected places.

Baltimore's public library system is teaming up with the city health department to offer free seasonal and H1N1 vaccines. 

The clinics begin this Friday at the central library at 400 Cathedral Street from 10 a.m. to 2 p.m. for seasonal flu shots only. H1N1 vaccines will be available Friday Dec. 11 and Friday Jan. 8 at the same times and location. Flu experts will also be on hand to answer questions. For more info, visit the library's website at www.prattlibrary.org.

Additional H1N1 clinics are coming up this week at the city health department -- including by appointment for pregnant women. You can find out about those at the department's website: www.baltimorehealth.org.

In addition, our friends at the Consuming Interests blog tell us both seasonal and H1N1 vaccines will be available at the BWI airport. Check out the details here. Apparently, BWI has been providing flu shots for the last couple of years. It's called AeroClinic and the vaccines don't come cheap-- seasonal flu shots are $40 and the H1N1 vaccine - when it's available - will go for $22.

Hear of any other clinics? Let us know.

Posted by Kelly Brewington at 1:44 PM | Permalink | Comments (1)
Categories: Swine flu/H1N1
        

University of Maryland School of Public Health is getting a boost from an old football playing alum to launch a center devoted to local and global health issues.

Madieu Williams, a 2003 Maryland grad and Minnesota Vikings free safety, made an endowment to the school of public health to launch the Center for Global Public Health Initiatives.

The center brings together efforts near and far -- from Williams' own Prince George's County to the Embassy of Sierra Leone. The center will focus on local, state and global public health initiatives in Prince George's County and Freetown, Sierra Leone.

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

A new study finds that a range of common canned goods contain measurable levels of the chemical additive BPA -- even in products whose labels assured they were "organic" or "BPA- free."

The study by Consumer Union, the nonprofit that publishes Consumer Reports, included a wide range of canned goods and showed elevated levels of BPA, known as Bisphenol A. Top among the list included such products as Campbell's Chicken Noodle Soup and Del Monte Fresh Cut Green Beans. You can read the full list of products tested here.

Children who eat numerous servings a day of the products with the highest BPA levels could ingest levels shown to cause adverse affects in animal studies, the report said.

BPA is a used to make the linings of food and beverage bottles and cans. Manufacturers use it because it's durable, makes plastics harder and can withstand high temperatures. 

Public health advocates have been pushing to get the FDA to ban BPAs in can linings and baby bottles, pointing to studies that link the chemical to reproductive problems and cancer. Consumer Union sent a letter to the FDA noting the latest research as further support for such a ban. Meanwhile, manufacturers and industry groups say their products don't expose people to unsafe levels of the chemical.

The FDA is studying data on the issue and is expected to make a decision later this month.

Posted by Kelly Brewington at 7:12 AM | Permalink | Comments (0)
Categories: General Health
        

People can struggle for years to quit smoking and the magnitude of advice and remedies about how to do so effectively can be overwhelming. 

So, which method works best?

New research examining five treatments finds that the nicotine patch plus a nicotine lozenge does the trick.

The study, appearing in the November issue of the Archives of General Psychiatry, enrolled 1,504 adult smokers -- all of whom were were motivated to quit -- to try one of six smoking cessation methods: nicotine lozenge alone, nicotine patch alone, bupropion (the drug Wellbutrin) alone, patch and nicotine lozenge, bupropion and nicotine lozenge or lastly, a placebo.

In addition to taking the specified treatment for eight to 12 weeks after quitting, participants got six one-on-one counseling sessions. People were evaluated after one week, eight weeks and six months after quitting. Nicotine patch plus a lozenge had the strongest support in helping folks take the first steps to quit, researchers found. These participants were more likely to have quit after seven days, and although some relapsed, they had longer periods between quitting and relapse than people in the other groups.

Previous studies have found the patch works well with other nicotine replacement methods from gum to nasal sprays, the authors said. Researchers think the key to making that first successful attempt to quit is using a patch with some other form of treatment.

Posted by Kelly Brewington at 12:05 PM | Permalink | Comments (8)
Categories: General Health
        

The H1N1 vaccine is safe and effective in pregnant women and just one dose appears to offer adequate immunity against the virus, according to preliminary findings from NIH studies of the vaccine.

Pregnant women are among groups at greatest risk of complications from the swine flu and have been placed to the front of the line for vaccination against it. The virus has caused 28 deaths in pregnant women and least 100 hospitalizations, according to the CDC.  

The initial results come from trials that began in September with 120 healthy women ages 18 to 39 in their second and third trimesters. Of 25 women who received one standard 15-microgram dose of the vaccine, 92 percent of them showed an immune response, researchers found. Similar results were found for 25 women who received a 30-microgram dose of the vaccine -- 96 percent showed an immune response. 

Perhaps most important to women eyeing the results, the vaccine is being tolerated well by pregnant women and there have been no safety concerns, so far.

The findings are not unexpected, since the response is similar to what researchers find with seasonal flu shots, which have been found to be safe and effective for pregnant women. A review article in last week's American Journal of Obstetrics and Gynecology found the benefits of getting flu vaccines outweigh any potential risks. Still, with some expectant mothers reluctant to get the H1N1 vaccine, worried it could harm their babies, the news offers a boost to public health officials hoping to convince women otherwise.

Posted by Kelly Brewington at 7:06 AM | Permalink | Comments (1)
Categories: Swine flu/H1N1
        

New York beef manufacturer Fairbanks Farms has issued a voluntary recall of a little more than half a million pounds of ground beef.

The recall, which affects states from Maine to North Carolina -- Maryland included -- comes after one person died in New Hampshire and people were sickened in other states after eating beef thought to be contaminated by the bacteria E.coli. 

The products, which include ground beef, meatloaf and meatball mix, carry sell-by dates from Sept. 19-28 and were sold under such brands as Trader Joe's Butcher Shop Fine Quality Meats, Giant Meatloaf & Meatball Mix and BJ's Lean Ground Beef, Contains 7% Fat. Here are some details from Fairbanks Farms. And here's a list of the products from the USDA.

But the extent of affected meat could be much broader, the USDA warns. The products were distributed to stores in Maryland, Connecticut, New York, Pennsylvania, New Jersey, Massachusetts, North Carolina and Virginia and the recall initially applied to just those states. But because chain stores often redistribute products, Fairbanks Farms has extended the recall to include all states throughout the Northeast and Mid-Atlantic. 

Also confusing matters, the affected meat may carry different labels and sell-by dates than are included in the USDA product list. So bottom line: check the meat in your freezer. If you're concerned, contact the store where the meat was purchased. Or, just toss it in the trash if you're really worried.

Posted by Kelly Brewington at 12:03 PM | Permalink | Comments (2)
Categories: General Health
        

So far, swine flu has been linked to at least 114 child deaths nationwide, according to the CDC. It's a figure that has frustrated and puzzled researchers and infectious disease experts.

While most people -- children and adults alike -- recover from the virus after a week at home, often with no medication, researchers are struggling to make sense out of why this new flu can turn a healthy child severely ill.

My colleague Meredith Cohn offers this great explainer of how the virus behaves in children, particularly how it can attack their lungs, leaving them vulnerable to  pneumonia and other infections. 

Experts think elderly people may have been exposed to some form of the virus in the past, providing them at least some immunity. Children, on the other hand, appear to have none and this might hinder their ability to fight off secondary infections.

But that only explains part of the mystery, the story says.

"It's a harder question about why some kids do fine and some get sicker," said Dr. John, head of the Hospital for Children's pediatric intensive-care unit, who said he's at least 50 percent busier in the pediatric unit because of swine flu. "But most kids are fine in a few days."

AP photo

Posted by Kelly Brewington at 7:09 AM | Permalink | Comments (3)
Categories: Swine flu/H1N1