Tuesday, February 28, 2012
Family tree may clarify death risk for inherited heart rhythm disorders
American Heart Association Comment: FDA announces safety changes on labeling for some statins
Monday, February 27, 2012
What Are Your Stomach Pain Symptoms Trying to Tell You?
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FacebookTwitterIf you are suffering from stomach pain, you need to find the cause before you can start a treatment. Here are a few of the conditions that can cause stomach pain.
Heartburn Related Resources:
Meal Planning Tips for Preventing Heartburn Dining Out Without Heartburn Foods with Little Risk of Causing Heartburn Preventing Nighttime HeartburnPeptic Ulcer Related Resources
Surgery for Peptic Ulcers Complications of Peptic Ulcers Peptic Ulcer Warning Signs Peptic Ulcers in ChildrenGallstone Related Resources:
What is the Gallbladder? What are Gallstones? What Increases the Risk of Developing Gallstones Diagnosing GallstonesComments (0)See All PostsSharePrevNextCommentsNo comments yet. Leave a CommentLeave a CommentNameRecent Study Highlights Risk of Haloperidol (Haldol) for Persons with Dementia
A recent study published in the online journal BMJ outlines research on antipsychotic medications and their use in people with Alzheimer's and other dementias.
Antipsychotics are a specific type of psychotropic medication that are often used to help control some of the challenging behaviors that people with dementia experience. The initial approach to behaviors should always be to use behavior modification strategies and attempt to determine the causes behind the behaviors, since we know that most behavior has meaning. However, medications are also prescribed when these non-drug approaches are ineffective.
This recent study reviewed more than 75,000 people in the United States who had been prescribed antipsychotic medications in nursing homes from 2001-2005. (Data from people in nursing homes is fairly easy to collect; nursing homes are required to report data regularly since they receive funding from Medicare and Medicaid.) Researchers tracked the doses and the type of antipsychotic medication, as well as the mortality rates of those receiving the medications.
The results show that those receiving a specific type of antipsychotic medication called Haldol (haloperidol) have a significantly increased risk of death, especially shortly after treatment is started, compared to other types of antipsychotic medications.
Haldol is a typical antipsychotic, which places it in a classification of an older medication that often has more risks. Several of the other antipsychotic medications they reviewed were of the atypical class, which is a newer kind of antipsychotic medication that usually has less side effects than the typical ones.
A couple of thoughts about this study:
Having been in the nursing home industry for several years, I can say with confidence that good facilities monitor the use of antipsychotics very closely. These medications have to be periodically reduced, and should not be used without trying non-drug interventions first.When research shows a clear risk, as it does here, it highlights your role as an advocate for a family member or friend with dementia. If your loved one is on an antipsychotic, particularly haloperidol, you might consider asking questions about why that drug was chosen, if another medication could be used instead, or if the medication can be decreased or stopped.
Living Well with GERD: Watch What You Eat
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FacebookTwitterOne of the leading triggers of heartburn is the food we eat. Since we all have to eat, we need ways to prevent food from causing heartburn. This involves making wise food choices.
There are foods you should avoid if you suffer from heartburn. Along with avoiding certain foods if they trigger your heartburn, there are some meal planning tips to have you avoid heartburn.
Everyone is different; what may be a heartburn trigger for someone else may be safe for you to eat, and what others can eat with no problems will cause you a lot of discomfort. For this reason it is important that you keep a food diary to determine which foods are problematic for you.
Related resources:
Foods with little risk of causing heartburn Heartburn friendly recipes Dining out without heartburn Heartburn-free picnics Heartburn-free school lunches Comments (0)See All PostsSharePrevNextCommentsNo comments yet. Leave a CommentLeave a CommentNameGetting Quick Heartburn Relief
Follow me on:
FacebookTwitterWhether you suffer from heartburn once a month or once a week, there are times when you want quick relief from that burning sensation. Here are a few quick relief options:
Chew gumBaking sodaApple cider vinegarAntacidsComments (2)See All PostsSharePrevNextLeave a CommentCommentsMarch 16, 2011 at 12:18 am(1) Gert says:I personally chew sugarless gum and take Maalox Advanced maximum strength. Four teaspoonsful work like a charm.
I chew fruit sensational gum.
Sincerely.
Gert McMillian
October 30, 2011 at 6:45 pm(2) Rory says:Soda just make it worst
I use to drink milk
Saturday, February 25, 2012
What to do for stings
For Stings
Signs & Symptoms
Quick, sharp pain.
Swelling, itching, and redness at the sting site. These can occur beyond the sting site.
Raised bump (with or without pus).
Signs of a severe allergic reaction.
Causes
Insect stings.
Marine animals that sting include jellyfish, Portuguese Man-of-War, and sea nettles.
Treatment
Self-care treats mild reactions to stings. A severe allergic reaction needs immediate care. Symptoms of a severe allergic reaction usually happen soon after or within an hour of the sting. Persons with a severe allergic reaction to a sting in the past should carry an emergency kit, prescribed by a doctor. A medical alert tag should be worn to let others know of the allergy. Persons who have had severe reactions to bee or wasp stings should ask their doctors about allergy shots.
What to do for bites
Bites
For Bites
Signs & Symptoms
Swelling. Redness. Pain. Itching.
Bleeding.
Tissue loss, if the wound is severe.
Skin rash. With Lyme disease, a red bull's eye rash with a white center around the bite occurs. Fatigue, fever, and joint pain may also occur.
Lockjaw. This is a painful, persistent stiffness of the jaw due to a toxin. Tetanus shots can prevent this. (See Immunization Schedule.)
Allergic reaction, such as with insect bites. (See Signs & Symptoms of Allergies.)
Causes
Dog, cat, and human bites are the most common animal bites in the U.S.
Black widow and brown recluse spider bites can cause severe reactions.
Deer tick bites can cause Lyme disease, a bacterial infection.
Less common, but more dangerous, are bites from skunks, raccoons, bats, and other animals that live in the wild. These animals can have rabies. This is a serious viral infection. It can be fatal. Most house pets are vaccinated for rabies. It's unlikely they carry the virus.
Deer tick on scalp.
Mosquito bites can cause West Nile virus if the mosquito is infected with it.
Snake bites can be fatal if the bite is from a poisonous snake (e.g., rattlesnakes, cotton mouths, copperheads, and coral snakes).
Shark bites are a potential problem when swimming in shark-infested waters.
Treatment
Self-care can be used for dog and cat bites that cause scratches on the skin and for insect bites that do not cause a severe allergic reaction. All human bites that break the skin should be checked by a doctor due to the high risk for infection. A series of rabies shots can prevent the spread of rabies to humans. The shots should begin soon after a bite from an infected animal. Antivenom can be given for poisonous snake bites at
Wednesday, February 22, 2012
New Guidelines Seek to Prevent Sudden Death in Young Athletes
WEDNESDAY, Feb. 22 (HealthDay News) --New guidelines outlining the causes and prevention of sudden death among athletes were released this week by the National Athletic Trainer's Association (NATA) in the United States.
"These guidelines were developed for any level of sports participation, and to truly help save a life," NATA President Marjorie Albohm said in an association news release. "It is also critical that a school, team or league's medical professionals have an emergency action plan in place. In the event that an injury occurs, every minute counts when it comes to appropriate care and transport of the athlete."
"While collegiate and professional teams have athletic trainers on staff to prevent and treat injuries, only 42 percent of high schools have access to our members," Albohm noted. "Legislation is improving, though, with 35 states and Washington, D.C., having passed youth sports safety laws. And the NFL just mandated new guidelines requiring athletic trainers in booths during games to watch for hard hits and concussions."
The new position statement includes many recommendations for preventing sudden death among athletes. Here are some of the highlights:
An athlete's chances of survival are much greater if there is an established, site-specific emergency plan.Recognition of the type of problem is key to treatment. Sudden cardiac arrest should be suspected in any athlete who has collapsed and is unresponsive.Public access to early defibrillation is critical. The time between when an athlete collapses and receives the first shock from an automated external defibrillator should be less than three to five minutes.If a serious brain injury is suspected in an unresponsive athlete, medical staff must be prepared to transport the athlete to a health-care facility, while ensuring adequate ventilation and elevating the head to help decrease intracranial pressure.In cases of suspected heatstroke, the athlete's core temperature must be determined soon after collapse to ensure accurate and immediate assessment.Ensure athletes with asthma are properly educated about their condition and how to recognize good or bad breathing days. A structured warm-up program may decrease their risk of an asthma attack or their reliance on asthma medications.The position statement appears in the February issue of the Journal of Athletic Training.
More information
Washington University has more on preventing sudden death in young athletes.
Support for Tougher Liquor Laws Rises When Booze, Crime Linked
WEDNESDAY, Feb. 22 (HealthDay News) -- News coverage of alcohol's role in violent crime and fatal accidents may persuade the public to give stronger support to alcohol-control laws, new research suggests.
It is estimated that drinking is involved in nearly one-third of deaths from accidents and violent crime. Most news reports of such cases, however, make no mention of alcohol, according to the authors of the study, published in the March issue of the Journal of Studies on Alcohol and Drugs.
"People have some awareness of the social cost that alcohol can have," study author Michael D. Slater, of Ohio State University, in Columbus, said in a journal news release. "But only a small fraction of news stories on violent crime and nonmotor-vehicle accidents acknowledge the contributing role of alcohol."
This means that many people don't realize how often alcohol plays a role in violence and accidents that don't occur on the roads. This lack of awareness may dampen public support for alcohol-control laws such as strict enforcement of underage drinking rules or bans on serving alcohol to drunk customers, Slater said.
In the study, Slater and his colleagues surveyed 789 adults and found that they were more likely to support alcohol-control laws after they read media stories about violent crime, vehicle crashes and other accidents involving alcohol.
"I think this buttresses the idea that media coverage does matter," Slater said. "Alcohol, as a public-health issue, is not as front and center as it might be if there were more news coverage."
In areas that already have alcohol-control laws, public support is still important because local resources are needed to enforce those laws, he noted. Local authorities should mention any role of alcohol when giving details about crimes and accidents to the media, Slater added.
More information
The U.S. Centers for Disease Control and Prevention offers an overview of alcohol and public health.
American Heart Association launches free-access online journal
Raw Milk Causes Most Illness From Dairy Products: CDC
TUESDAY, Feb. 21 (HealthDay News) -- Raw, or unpasteurized, milk causes 150 times more dairy product-related disease outbreaks than pasteurized milk. And states where the sale of raw milk is legal have twice as many outbreaks as states where it is illegal, according to a new U.S. Centers for Disease Control and Prevention study.
"This study shows an association between state laws and the number of outbreaks and illnesses from raw milk products," Dr. Robert Tauxe, deputy director of CDC's division of foodborne, waterborne and environmental diseases, said in an agency news release.
The 13-year review looked at more than 120 dairy product-related outbreaks that occurred in 30 states between 1993 and 2006. The outbreaks caused more than 4,400 illnesses, 239 hospitalizations and three deaths.
Raw milk products -- including cheese and yogurt -- caused 73 of the outbreaks (60 percent) and most of the 239 hospitalizations.
Some people mistakenly believe that raw milk is a healthier alternative to pasteurized milk, according to the U.S. Food and Drug Administration. Its website debunks the notion that raw milk is less likely than pasteurized milk to cause lactose intolerance, an inability to digest milk products.
Unless milk is pasteurized -- heated to kill harmful bacteria -- bacteria can accumulate in collected milk, multiply and cause illness, the researchers said.
The study found that 13 percent of patients in raw milk outbreaks were hospitalized, compared with 1 percent of those made ill by pasteurized milk products. This may be because raw milk outbreaks were all caused by bacteria, such as E. coli O157, that tend to provoke more severe illness, according to the study.
On the other hand, pasteurized milk and cheese outbreaks were often caused by milder infections, such as norovirus and Staphylococcus aureus.
Fifty-five of the outbreaks reviewed occurred in the 21 states where it was legal to sell raw milk at the time, the CDC found.
Young people were much more likely to get sick from raw milk products than pasteurized items. Where ages were available, people younger than age 20 accounted for 60 percent of patients in raw milk outbreaks, compared with 23 percent of patients in pasteurized milk outbreaks.
During the study period, about 2.7 trillion pounds of milk was produced in the United States. By comparing that amount to the estimated 27 billion pounds (1 percent) consumed raw, the study authors determined that raw milk products cause 150 times more outbreaks than pasteurized milk.
The study appears Feb. 21 in the journal Emerging Infectious Diseases, published by the CDC.
It's impossible for consumers to tell if raw milk is safe to drink by looking at, smelling, or tasting it, the CDC said.
"Restricting the sale of raw milk products is likely to reduce the number of outbreaks and can help keep people healthier. The states that allow sale of raw milk will probably continue to see outbreaks in the future," Tauxe said.
Study co-author Barbara Mahon, deputy chief of the CDC's Enteric Diseases Epidemiology Branch, said in the news release: "While some people think that raw milk has more health benefits than pasteurized milk, this study shows that raw milk has great risks, especially for children, who experience more severe illnesses if they get sick.
"Parents who have lived through the experience of watching their child fight for their life after drinking raw milk now say that it's just not worth the risk," she added.
More information
The U.S. Food and Drug Administration has more about raw milk.
Monday, February 20, 2012
Some states denying immunity for the community
While we at ACSH have long been working to promote increased immunization rates, lawmakers in many states are contemplating a move in the opposite direction. Seven states are currently considering bills that would make it easier for parents to have their kids skip important childhood vaccinations.
Currently, all states except for West Virginia, Mississippi, and Washington D.C. allow parents to exempt their children from vaccines that are required by schools due to religious beliefs. Additionally, 19 states allow “philosophical exemptions” for required childhood vaccinations. Now, West Virginia and Mississippi, in addition to five more states, are considering joining the ranks of those that permit such philosophical exemptions.
As Diane Peterson, associate director at the Immunization Action Coalition, says, “That’s not a move in the right direction.” ACSH's Dr. Elizabeth Whelan wholeheartedly agrees. “If these bills pass, parents will keep their kids from getting vaccinated for whatever reasons they choose,” she says. “This will put not only their own children, but also the rest of the school population, at risk of diseases that are entirely preventable and that can be dangerous for young people. There need to be consequences for people who refuse to be vaccinated.”
Organically confused
When many people see a label that says “organic,” they tend to interpret this as a clear sign that the food is both safer and more nutritious than a conventional product. But an organic label doesn’t guarantee safety or greater nutritional value, as the results of a new Dartmouth study emphasize. The study focused on organic brown rice syrup — a sweetener found in some foods, including certain infant formulas, cereal and energy bars, and high-energy foods consumed by athletes.
The researchers purchased these food products — some of which contained organic brown rice syrup — and analyzed them for levels of arsenic. The results, published in the journal Environmental Health Perspectives, may come as a surprise to those who consider “organic” to be superior products: The foods that contained organic brown rice syrup actually had significantly higher levels of arsenic than those that did not use the syrup. In fact, the two infant formulas that listed organic brown rice syrup as the primary ingredient contained levels of arsenic over 20 times higher than the other infant formulas.
Brown rice syrup may be particularly susceptible to arsenic contamination since rice easily absorbs this chemical, which can be found in groundwater. Yet ACSH's Dr. Elizabeth Whelan points out that even the levels found in the samples tested in this study should not concern the average consumer.
ACSH's Dr. Josh Bloom remarks that the irony of this story is “the hypocrisy of the organic food industry. They add a sweetener that sounds healthy because it’s ‘organic,’ but in reality it contains more arsenic than regular sugar does.”
“People keep forgetting that organic labeling has nothing at all to do with nutritional value or safety,” ACSH's Dr. Ruth Kava points out. “Yet consumers continue to think that if it’s organic, there can’t be anything wrong with it.”
Don’t accept any counterfeit pills
It seems like a problem that would exist only in the developing world — counterfeit drugs making it into the mainstream market. But American consumers are becoming increasingly concerned about counterfeit medications ending up in their own pharmacies: The FDA has confirmed that a fake version of the cancer drug Avastin was sold to at least 19 doctors and clinics. Fortunately, although the counterfeit drug did not contain any actual Avastin, there have been no reports of harm. But in the wake of several other counterfeiting incidents in the U.S., including the weight-loss drug Alli and the cholesterol-lowering Lipitor, it appears that fake drugs are indeed a reality even in our country.
“We have no way of knowing what counterfeit medicines contain, or whether they were produced in carefully controlled conditions,” says ACSH’s Dr. Ruth Kava. “In addition to having no efficacy, they could also contain contaminants.”
ACSH’s Dr. Josh Bloom says that the biggest concern is with IV drugs. “If these contain any contaminants, such as bacteria or particulate matter, they will go straight into the bloodstream, which could do a lot of harm,” he notes. “Although counterfeit pills can be dangerous, the potential for harm is greater with injectables.”
While some counterfeit drugs are infiltrating the American market, the developing world is certainly harder hit than developed regions; in Asia and Latin America, up to 30 percent of medications sold are fake, as opposed to just 1 percent in the U.S. and other developed countries. Indeed, out of the 1,700 counterfeiting incidents reported by pharmaceutical companies last year, only 6 percent occurred in the U.S.
Overall, ACSH's Dr. Elizabeth Whelan would like to reassure the public that counterfeit drugs are extremely rare in the U.S. “You should by no means be afraid to go to the pharmacy and pick up a prescription,” she says. To read more about this problem and what can be done to help prevent the spread of potentially dangerous fakes, check out ACSH’s 2009 publication, Counterfeit Drugs: Coming to a Pharmacy Near You.
Lack of sex disparity in cardiovascular testing after coronary computerized tomographic angiography.
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Sunday, February 19, 2012
Post-stroke language impairment adds thousands to medical costs
Peripheral artery disease undertreated, understudied in women
All Americans Will Bear the Pain of Prevention Fund Cut, Says Nancy Brown, American Heart Association CEO
Good Football Helmet Fit Key to Preventing Brain Injuries
FRIDAY, Feb. 17 (HealthDay News) -- While football helmets don't prevent concussions, good helmet fit might help reduce loss of consciousness that can follow a blow to the head, a new study finds.
Expensive, high-tech helmets with air-lining systems aren't much better than vintage "leatherheads" for preventing concussions, the researchers said.
"The occurrence of concussion has been constant for the past 30 years: whether it was a leather helmet, whether it was a plastic helmet with web suspension, whether it was a plastic helmet with foam, or one with the new combination air cells and padding," said study author Dr. Joseph Torg, an adjunct professor of orthopedic surgery at Temple University in Philadelphia.
The researchers looked at data from the U.S. National High School Sports-Related Injury Surveillance System from 2005 to 2009. Of the nearly 1,400 kids who sustained a concussion, 44 lost consciousness and 267 experienced amnesia.
Injury reports addressed helmet fit, type of inner-helmet padding and whether the helmet was new or reconditioned.
"Youngsters who had a concussion, if the helmet fit, they had 82 percent less chance of loss of consciousness," Torg said. "Helmets -- and advanced helmet technology -- do not prevent against concussions or the severe intracranial injuries of hemorrhage
How useful are the Heart Foundation risk criteria for assessment of emergency department patients with chest pain?
Objective: To investigate the prognostic utility of Heart Foundation (Australia) risk stratification table in an ED chest pain population.
Methods: A planned sub‐study of a prospective observational study of adult patients with potentially cardiac chest pain who underwent evaluation for acute coronary syndrome (ACS) was conducted. Data collected included demographical, clinical, ECG, biomarker and outcome data. Outcome of interest was diagnostic utility of the classification system for ACS or myocardial infarction (MI) at index presentation and major adverse cardiac events (MACE) within 7 and 30 days. MACE included death, cardiac arrest, revascularization, cardiogenic shock, arrhythmia and prevalent (cause of presentation) and incident (occurring within the follow‐up period) MI. Analysis was by descriptive and receiver–operator curve analyses.
Results: Seven hundred and sixty‐eight patients were studied; 109 had MI (14.2%, 95% confidence interval
Fatal disconnection of a ventricular assist device in an out-of-hospital setting
Body temperature of trauma patients on admission to hospital: a comparison of anaesthetised and non-anaesthetised patients
Interhospital variation in the RATPAC Trial (Randomised Assessment of Treatment using Panel Assay of Cardiac markers)
Saturday, February 18, 2012
Antibiotics for most sinus infections are anti-effective
Sinus infections are miserable. Anyone suffering from one wants relief as soon as possible. The tricky thing is, the overwhelming majority of such infections are caused by viruses; only about 2 percent of sinus infections are bacterial. Since viral infections do not respond to antibiotics, having your doctor prescribe an antibiotic is unlikely to help. And a new study just published in the Journal of the American Medical Association confirms this: Sinus infection patients treated with the antibiotic amoxicillin were no better off than those given a placebo pill.
You’ve got to: Move it
The basic idea is conventional wisdom: Children who spend more time physically active than their sedentary peers will generally be healthier. Now a new study in the current Journal of the American Medical Association has refined this common understanding, looking specifically at the amount of time spent physically active and sedentary as it relates to certain risk factors in otherwise healthy children. The findings suggest that the length of time a child spends being physically active, regardless of sedentary time, is key to improved heart and metabolic health.
Friday, February 17, 2012
Just when you thought the flu season flew by
Though we’re already halfway through February, this year’s influenza season is just starting to pick up steam. According to data from the Centers for Disease Control and Prevention (CDC), this is the slowest start to the flu season in almost thirty years. Normally the virus prevails in January, though it can hit as early as October and can continue as late as May.
Areas in the central and northwestern U.S. are only now reporting an uptick in flu-like illnesses, while California is already experiencing widespread flu activity. As Dr. Richard Zimmerman, a professor of family medicine at the University of Pittsburgh School of Medicine, explains, “It’s fairly common for the west to precede the east” as far as the spread of the virus is concerned. Dr. Zimmerman also reminds everyone that “this is really the last chance to get vaccinated,” since it takes about one to two weeks for the vaccine to be effective.
ACSH seconds Dr. Zimmerman’s recommendation and encourages folks to visit their local pharmacy or healthcare professional to get immunized while it’s not too late!
Toothbrush Can Chip Teeth and Cause Choking
Thursday, February 16, 2012
Diagnostic accuracy of nitroglycerine as a 'test of treatment' for cardiac chest pain: a systematic review
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Wednesday, February 15, 2012
Quality control for biosimilars
Biosimilars — the generic versions of biological drugs — are considerably more difficult to produce than regular drugs. Now, a new draft guidance issued last week by the FDA aims to more precisely define the steps biopharmaceutical companies must follow to navigate the approval process and to delineate the quality standards for reproducing such medications. Although the Affordable Care Act specified that the FDA must issue such a guidance, no company has yet applied for approval.
While standard drugs are generally small molecules that can be uniformly reproduced by any given manufacturer, biosimilar drugs cannot be so exactly replicated. These drugs are usually larger, more complex compounds that must undergo an extensive manufacturing process — one that will undoubtedly create some variation among the final products.
That biological drugs are so susceptible to variation makes it especially important to ensure that generic companies are making a version of the drug that is sufficiently similar to the approved brand-name product. ACSH's Dr. Josh Bloom explains: “Conventional drugs, like Lipitor, are single compounds that are generally easy to manufacture, purify, and analyze. Using sound manufacturing practices, a generic will be much the same as the brand name version. But biological drugs are complex mixtures that require a recipe-like manufacturing process. There is batch-to-batch variability even within the same company — but when someone else tries the recipe, the product can turn out quite differently. And purification and analysis of these drugs are much harder. In the absence of tight controls, substandard biosimilars could do considerable damage.”
Monday, February 13, 2012
Home Oxygen Could Raise Burn Risk: Experts
MONDAY, Feb. 13 (HealthDay News) -- Use of home oxygen in the United States has risen over the past decade, which has led to an increase in the number of patients with medical oxygen-related burn injuries, according to experts at the Burn Center at Wake Forest Baptist Medical Center.
"Medical oxygen is 100 percent oxygen. This can raise the oxygen levels inside a structure causing many items that would not normally burn to more easily ignite and burn hotter and faster," Donna Joyner, a registered nurse in Trauma/Burn Outreach, said in a medical center news release.
"Burns resulting from the misuse of home oxygen can be life threatening; however, they are preventable," she added.
Joyner and the U.S. Fire Administration offer the following safety tips for the use of home oxygen:
Never smoke in a home where medical oxygen is in use. "No smoking" signs should be posted inside and outside the home.All ignition sources -- matches, lighters, candles, gas stoves, appliances, electric razors and hair dryers -- should be kept at least 10 feet away from the point where the oxygen comes out.Do not wear oxygen while cooking. Oils, grease and petroleum products can spontaneously ignite when exposed to high levels of oxygen. Also, do not use oil-based lotions, lip balm or aerosol sprays.Homes with medical oxygen must have working smoke alarms that are tested monthly.Keep a fire extinguisher within reach. If a fire occurs, turn off the oxygen and leave the home.Develop a fire escape plan that includes two ways out of every room and an outside meeting place. Practice the escape plan at least twice a year.More information
The MedlinePlus Medical Encyclopedia has more about medical oxygen safety.
Heart failure patients have new hope
Most Teens Who Self-Harm Are Not Evaluated for Mental Health in ER
FRIDAY, Feb. 10 (HealthDay News) -- Most children and teens who deliberately injure themselves are discharged from emergency rooms without an evaluation of their mental health, a new study shows.
The findings are worrisome since risk for suicide is greatest right after an episode of deliberate self-harm, according to researchers at Nationwide Children's Hospital in Columbus, Ohio.
The researchers also found the majority of these kids do not receive any follow-up care with a mental health professional up to one month after their ER visit.
"Emergency department personnel can play a unique role in suicide prevention by assessing the mental health of patients after deliberate self-harm and providing potentially lifesaving referrals for outpatient mental health care," said lead study author Jeff Bridge, principal investigator at the hospital's Center for Innovation in Pediatric Practice, in a news release. "However, the coordination between emergency services for patients who deliberately harm themselves and linkage with outpatient mental health treatment is often inadequate."
For the study in the Journal of the American Academy of Child & Adolescent Psychiatry, researchers examined Medicaid data for adolescents aged 10 to 19 years. Only 39 percent of the patients discharged after trying to harm themselves received a mental health assessment in the emergency department.
Only about half of the children who had visited the ER for a mental health-related reason within the previous 60 days received a mental health evaluation during their visit to the ER for self-harm.
Up to 90 percent of young people who deliberately harm themselves meet criteria for at least one psychiatric disorder, particularly mood disorders, the researchers said.
The U.K.'s National Institute for Health and Clinical Excellence recommends that people who show up in an emergency room for self-harm should receive a mental health evaluation before being released from the hospital.
"This study highlights the need for strategies to promote emergency department mental health assessments, strengthening the training of physicians in pediatric mental health and adolescent suicide prevention and timely transitions to outpatient mental health care," Bridge said.
More information
The American Academy of Child & Adolescent Psychiatry has more about self-injury among teens.
Study Weighs Pros, Cons of Home or Hospital Birth
FRIDAY, Feb. 10 (HealthDay News) -- Babies whose mothers choose to deliver at home are at higher risk of complications after birth, including low Apgar scores and seizures, a new study finds.
However, if the home birth was attended by a certified nurse midwife, some of the added risk disappeared.
But only about 26 percent of home births were attended by a certified nurse midwife, according to a new study to be presented Friday at the Maternal-Fetal Medicine Society's annual meeting in Dallas.
"We observed a higher risk of lower Apgar scores and incidence of neonatal seizures in women who had home births," said study author Dr. Yvonne Cheng, an obstetrician/gynecologist at the University of California, San Francisco. "These adverse findings are particularly present when the birth attendant is not a certified nurse midwife."
She added: "The location of birth is important, but who is present at the delivery is more important."
Cheng and her colleagues analyzed birth certificate data on nearly 2.3 million singleton births in 2008 in the United States. About 10,700 women, or less than 1 percent (0.47 percent), delivered in a birthing center, usually a standalone facility staffed by a midwife and in close proximity to a hospital in case of emergency.
About 12,400 women (0.54 percent) gave birth at home intentionally.
The birth certificates included whether it was a doctor, a certified nurse midwife, an "other midwife" or someone else who assisted with the delivery.
There was little difference in outcomes for babies if they were born in a hospital or a birthing center.
The study did find that babies born at home or a birthing center were much less likely to be delivered via Cesarean section; however, researchers said their data are likely not reliable. The reason is that if a mother intended to give birth at home or in a birthing center but ended up being taken to the hospital for a C-section because of complications, the birth certificate would have recorded an in-hospital birth.
Babies born at home were more than twice as likely to have an Apgar score of under 7 as children born in a hospital or at a birthing center, and also had double the chances of having a seizure.
The Apgar score is a test used to measure a child's skin color, pulse and overall vigor in the moments after birth.
The overall number of kids who had seizures was low -- less than 1 percent at any location.
Prior research has shown that babies with lower Apgar scores are more likely to have complications after birth, such as needing breathing assistance, going to the ICU, having seizures or having developmental issues, Cheng said.
Although the numbers are still small, a growing number of women are choosing to give birth outside of hospitals, Cheng said, with the numbers rising about 20 percent between 2004 and 2008.
Those women often want to give birth without painkillers such as epidurals. They want to have "more control" over the birth experience; may feel more comfortable in their own surroundings; or may want to have multiple people in the room when they deliver, something many hospitals limit, added Dr. Mary Norton, director of perinatal research at Stanford University Medical Center.
Yet, women who are choosing home birth should recognize there are risks, Norton said.
"Even in a normal-health woman with a normal pregnancy, there will always be unanticipated things that can happen and unanticipated emergencies," she said.
At home, you are further from medical care. Whereas birthing centers often have systems in place to transfer a woman to a hospital in case of emergency, women at home may have to wait longer for an ambulance, or it may be difficult to move a woman who is in labor onto a gurney and transport her to a hospital.
"This data does indicate there is a higher level of risk to the baby when delivering at home. If someone is carefully monitored, is in close proximity to the hospital and willing to go to the hospital if needed, then the risks are lower," she said.
Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.
More information
Nemours has more about birthing centers and hospital births.
Emergency Medical Services Education in Emergency Medicine Residency Programs: A National Survey
Conclusions: There is a wide range in the didactic, online, and in‐field EMS educational experiences provided as part of EM training. Most residents participate in ground ride‐along activities, provide DMO, and have a dedicated EMS rotation. Disaster‐preparedness is the most common desired addition to existing EMS rotations.
ACADEMIC EMERGENCY MEDICINE 2012; 19:1–6 © 2012 by the Society for Academic Emergency Medicine
View Full Article with Supporting Information (HTML) Get PDF (221K)Sunday, February 12, 2012
New anti-clotting drug fails to meet expectations in major trial
Breastfeeding absolutely vital for strengthening the developing lungs of children, research finds
Eating less made easier
Recently, we applauded the New York City Health Department’s latest campaign to warn the public about increasing portion sizes. Now a new study published in the journal Health Affairs has added to the mounting evidence that offering smaller portions at restaurants may be an effective means of reducing caloric intake.
For their study, researchers from Tulane University examined the ordering choices of patrons visiting a Chinese fast food restaurant located on a college campus. In a trio of small studies, the results demonstrated that offering smaller portion sizes more effectively encouraged moderation than the practice of posting calorie counts. In fact, almost one-third of customers opted for the smaller portion sizes — which contained 200 fewer calories — when these portions were offered at a 25-cent discounted rate.
“Hopefully, restaurants will take this study to heart and offer consumers the choice of smaller portions,” says ACSH’s Dr. Ruth Kava. “Such an option could really help people who frequently eat out yet still try to control their calorie intake.”
“This study supports the idea that, even with relatively small incentives,” says ACSH's Dr. Gilbert Ross, “people will accept smaller portion sizes. Given that this strategy appears to be a more effective way to reduce caloric intake, we encourage more restaurants to offer these smaller plate options.”
Some salient facts about salt
What’s the largest source of salt in our diets? Is it potato chips? French fries? Neither of these, says a recent report form the U.S. Centers for Disease Control and Prevention (CDC). Actually, bread and rolls provide us with the greatest amount of salt in our diets.
This answer may come as a surprise to many Americans who are used to being told to avoid snacks like chips and pretzels because of their high sodium content. But these snacks were actually at the bottom of the CDC’s list of the top 10 sources of sodium in the American diet. The top five sources, on the other hand, were bread and rolls, cured meats and cold cuts, pizza, poultry, and soups. The CDC collected this data through surveys of over 7,000 people in 2007 and 2008, including almost 3,000 children. Researchers obtained detailed information about what the participants ate, then categorized these responses and assigned sodium levels to each category.
“This is just another part of nutrition that people need to be aware of,” says ACSH’s Cheryl Martin. “Most of us don’t know how much sodium is in the products we consume on a daily basis.” Indeed, while the CDC does not necessarily recommend that people cut down on bread and rolls, they are advising consumers to be mindful of sodium content and to read labels, since the results of the agency’s study show that the greatest amount of sodium we consume may come from sources we don’t expect.
ACSH's Dr. Ruth Kava comments, “People have been told before that most of their salt does not come from the salt shaker, but that it’s already present in the foods they buy. This report is just further evidence that there are many sources of salt in our diets that may not be obvious.”
But ACSH’s Dr. Elizabeth Whelan reminds us that, while it’s important to be mindful of nutrition labels, “most of us do not need to be concerned with following a very low-sodium diet. This type of diet has not been shown to help many people; in some cases, it can actually be detrimental.”