Category Archives: Health

The dangerous bacteria Clostridium

C. difficile is a deadly diarrheal infection that poses a significant threat to U.S. health care patients,” Ileana Arias, principal deputy director at the U.S. Centers for Disease Control and Prevention, said during a morning news conference. “C. difficile is causing many Americans to suffer and die.”

The germ is linked to about 14,000 deaths in the United States every year. People most at risk from C. difficile are those who take antibiotics and also receive care in any medical facility.

“This failure is more difficult to accept because these are treatable, often preventable deaths,” Arias said. “We know what can be done to do a better job of protecting our patients.”

Much of the growth of this bacterial epidemic has been due to the overuse of antibiotics, the CDC noted in its March 6 report. Unlike healthy people, people in poor health are at high risk for C. difficile infection.

Almost 50 percent of infections are among people under 65, but more than 90 percent of deaths are among those aged 65 and older, according to the report.

Previous estimates found that about 337,000 people are hospitalized each year because of C. difficile infections. Those are historically high levels and add at least $1 billion in extra costs to the health care system, the CDC said.

However, these estimates might not completely reflect C. difficile’s overall impact.

According to the new report, 94 percent of C. difficile infections are related to medical care, with 25 percent among hospital patients and 75 percent among nursing home patients or people recently seen in doctors’ offices and clinics.

Although the proportion of infection is lowest in hospitals, they are at the core of prevention because many infected patients are transferred to hospitals for care, raising the risk of spreading the infection there, the CDC said.

Half of those with C. difficile infections were already infected when they were admitted to the hospital, often after getting care at another facility, the agency noted.

The other 50 percent of infections were related to care at the hospital where the infection was diagnosed.

The CDC said that these infections could be reduced if health care workers follow simple infection control precautions, such as prescribing fewer antibiotics, washing their hands more often and isolating infected patients.

These and other measures have reduced C. difficile infections by 20 percent in hospitals in Illinois, Massachusetts and New York, the CDC said.

In England, infections have been cut 50 percent in three years, the agency said.

Patients get C. difficile infections mostly after taking antibiotics, which can diminish the body’s “good” bacteria for several months.

Helps Heart and Brain

Regular aerobic exercise such as walking may protect the memory center in the brain, while stretching exercise may cause the center — called the hippocampus — to shrink, researchers reported.

In a randomized study involving men and women in their mid-60s, walking three times a week for a year led to increases in the volume of the hippocampus, which plays an important role in memory, according to Dr. Arthur Kramer, of the University of Illinois Urbana-Champaign in Urbana, Ill., and colleagues.

On the other hand, control participants who took stretching classes saw drops in the volume of the hippocampus, Kramer and colleagues reported online in the Proceedings of the National Academy of Sciences.

The findings suggest that it’s possible to overcome the age-related decline in hippocampal volume with only moderate exercise, Kramer told MedPage Today, leading to better fitness and perhaps to better spatial memory. “I don’t see a down side to it,” he said.

The volume of the hippocampus is known to fall with age by between 1 percent and 2 percent a year, the researchers noted, leading to impaired memory and increased risk for dementia.

But animal research suggests that exercise reduces the loss of volume and preserves memory, they added.

To test the effect on humans, they enrolled 120 men and women in their mid-sixties and randomly assigned 60 of them to a program of aerobic walking three times a week for a year. The remaining 60 were given stretch classes three times a week and served as a control group.

Their fitness and memory were tested before the intervention, again after six months, and for a last time after a year. Magnetic resonance images of their brains were taken at the same times in order to measure the effect on the hippocampal volume.

The study showed that overall the walkers had a 2 percent increase in the volume of the hippocampus, compared with an average loss of about 1.4% in the control participants.

The researchers also found, improvements in fitness, measured by exercise testing on a treadmill, were significantly associated with increases in the volume of the hippocampus.

On the other hand, the study fell short of demonstrating a group effect on memory – both groups showed significant improvements both in accuracy and speed on a standard test. The apparent lack of effect, Kramer told MedPage Today, is probably a statistical artifact that results from large individual differences within the groups.

Analyses showed that that higher aerobic fitness levels at baseline and after the one-year intervention were associated with better spatial memory performance, the researchers reported.

But change in aerobic fitness was not related to improvements in memory for either the entire sample or either group separately, they found.

On the other hand, larger hippocampi at baseline and after the intervention were associated with better memory performance, they reported.

The results “clearly indicate that aerobic exercise is neuroprotective and that starting an exercise regimen later in life is not futile for either enhancing cognition or augmenting brain volume,” the researchers argued.

The study was supported by the National Institute on Aging, the Pittsburgh Claude D. Pepper Older Americans Independence Center, and the University of Pittsburgh Alzheimer’s Disease Research Center. The authors said they had no conflicts.

Healthcare Reform Law

A federal judge in Florida has ruled that the healthcare reform law is unconstitutional, siding with the 26 states that sued to block enforcement of the law.

The lawsuit, filed by 26 states that sued to block the Affordable Care Act (ACA), is considered likely to go all the way to the Supreme Court.

Judge Roger Vinson, of the U.S. District Court in Pensacola, Fla., stopped short of directing the federal government to stop implementing the law. Still, the ruling is the harshest legal action yet against the ACA.

Unlike a ruling last month by a judge in Richmond, Va., stating that the individual mandate portion of the ACA violates the Constitution, Vinson ruled the entire law “void” because the individual mandate provision can’t be separated out from the rest of the law.

Congress “exceeded the bounds of its authority in passing the Act with the individual mandate,” Vinson wrote in his 78-page ruling, which was released Monday afternoon. The mandate requires all citizens to have health insurance by 2014 or else pay a penalty.

“Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void,” he concluded.

He did contend that Congress has the power to address the “problems and inequities in our health care system,” but that Congress overstepped its power in passing the ACA.

“There is widespread sentiment for positive improvements that will reduce costs, improve the quality of care, and expand availability in a way that the nation can afford,” Vinson wrote. “This is obviously a very difficult task. Regardless of how laudable its attempts may have been to accomplish these goals in passing the Act, Congress must operate within the bounds established by the Constitution.”

While it was widely expected that Vinson would side with the states, it comes as somewhat of a surprise that he declared the entire law “void.”

The original lawsuit — which filed just hours after Obama signed the ACA into law on March 23, 2010 — alleged that the “individual mandate” in the law exceeded Congress’ authority under the Commerce Clause of the Constitution, but didn’t argue that the whole of the law is unconstitutional. The Commerce Clause permits the federal government to regulate interstate commerce.

In October, when Vinson ruled the case could proceed, he said the states “had a plausible claim” in their argument that the law’s individual mandate violated the Commerce Clause.

The states argued that the government cannot force individuals to participate in the stream of commerce — in this case, the health insurance market.

The federal government responded that at some point, every U.S. citizen will seek medical care, and if that person chooses to not have insurance, the cost of his or her medical care is passed on to those with insurance. Thus, a choice to not participate in the commerce of healthcare doesn’t actually exist.

Two other judges have rejected challenges to the law, ruling that the ACA’s individual mandate provision is constitutional.

Other states that have joined the lawsuit are: Alabama, Alaska, Arizona, Colorado, Georgia, Indiana, Idaho, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin and Wyoming.

Common Among NFL Players

Retired National Football League players who abused opioid painkillers while active were most likely to use and abuse the same drugs after leaving the sport, the results of a telephone survey and analysis found.

The survey found more than half of the retired NFL players interviewed used opioid painkillers during their career. Of those, 71 percent reported misusing the drugs while playing, and 15 percent said they still abuse the prescription medication, Dr. Linda B. Cottler, of Washington University School of Medicine, and colleagues reported online in Drug and Alcohol Dependence.

The former broadcaster and NY Giants great, Frank Gifford, said, “pro football is like nuclear warfare. There are no winners, only survivors.”

The findings from Cottler’s survey support Gifford’s assessment.

An analysis of survey data showed the rate of opioid misuse while the retired players were active in the NFL was roughly three times greater than the lifetime rate of nonmedical use of opioids in the general population of approximately the same age.

Misuse in the past 30 days in retired players was seven percent, versus less than two percent in adults 26 and older in the general population. Looking only at men in the general population, the abuse rate is about two and half percent.

The final sample included 644 former players listed in the 2009 Retired NFL Football Players Association Directory who had retired from 1979 to 2006 and had at least one phone number listed.

They completed a phone interview that discussed general demographic data, health status, pain, impairment, alcohol use, prescription opioid use, and illicit drug use. Prescription opioid use was measured for while a player was active as well as over the past 30 days. Participants were categorized into users and nonusers. Users were subcategorized as having used the drugs as prescribed, or having misused them.

Misuse was defined as taking more of the drug than prescribed, using it in a way other than prescribed, using it after a prescription ended, using it for a different reason, or using it without a prescription.

When compared against players prescribed opioids while in the NFL and with those who were non-users during their NFL careers, 17 percent of those who misused while playing used as prescribed in the past 30 days, 15 percent misused in the past 30 days, and 68 percent reported no use.

In a multivariate analysis, moderate to severe pain, undiagnosed concussions, and drinking 20 or more alcoholic drinks a week were the strongest predictors of misuse. Undiagnosed concussions were reported by 81 percent of misusers.

“This association might have been due to the fact that those who choose not to report concussions are the same players who choose not to reveal their pain to a physician, thus managing their pain on their own,” the researchers wrote. “They may believe that if they report a concussion, they will be pulled from active play.”

The researchers noted the study may have been limited by lack of detailed pain information from while a player was active, a small sample size, a more inclusive definition of misuse that included abuse of opioids a player was prescribed, and a sample that included potentially more-healthy-than-average retired footballers — the researchers noted interviews with former players not in the Retired Players Association uncovered “multiple examples of serious and heavy opioid abuse.”

They added that future research could measure number of alcoholic drinks and level of pain while active in the NFL against opioid use and abuse.

New Dietary Guidelines

The federal government has issued the first update in five years of its “Dietary Guidelines for Americans” — but despite broad recognition of the U.S. obesity crisis, the update left the major cornerstones of the guidelines largely intact.

The recommendations for salt intake are likely to be among the most controversial elements in the 2010 edition, but it’s the absence of change that will be driving this controversy since the sodium recommendations hardly vary from the 2005 Dietary Guidelines for Americans.

The sole difference is that the 1,500-mg/day sodium limit for individuals with hypertension or its risk factors was a “suggestion” in 2005 — but has now been promoted to a full-fledged recommendation that the document notes “applies to about half of the U.S. population, including children, and the majority of adults.”

Earlier this month, the American Heart Association called for an across-the-board, 1,500-mg/day limit for everyone — including people without risk factors for hypertension.

Other groups and individual researchers have also argued that the government’s 2,300-mg/day sodium target for the general population was too high.

The revision, a joint effort of the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS), was released today — although it carries a 2010 date.

Basic recommendations for maximum intake of fats and cholesterol, sodium, potassium, and fiber remain unchanged from the last edition.

Instead, the “Dietary Guidelines for Americans 2010” focused mainly on wording tweaks — reorganizing how some of the recommendations are presented.

For example, the recommendation to reduce calories from added sugar now gets separate emphasis. In the 2005 edition of the dietary guidelines, added sugar was lumped with other suggestions in a large section on carbohydrates.

The new edition of the dietary guidelines sets the following daily limits or targets:

  • Fat intake: 20 percent to 35 percent of total calories
  • Saturated fat: less than 10 percent of total calories (mono- and polyunsaturated fats may be substituted)
  • Trans-fats: less than 1percent of calories
  • Cholesterol: less than 300 mg
  • Fiber: 14 g per 1,000 calories
  • Potassium: 4,700 mg
  • Sodium: less than 1,500 mg for all African-Americans and those with hypertension, diabetes, and chronic kidney disease (including children), as well as persons older than 51; everyone else is advised to consume under 2,300 mg of sodium a day
  • Fruits and vegetables: at least 2.5 cups
  • Refined grains: less than 3 oz

Although most of these basic numeric targets are the same as before, the 2010 revision expands on them in new ways. For example, the new guidelines make numerous references to “solid fats” as an unhealthy food to be avoided. It also recommends substituting mono- and polyunsaturated fats and oils for solid and animal fats when possible.

The new edition also makes more suggestions of alternatives to refined grains and sugars and high-fat meats.

Some academic physicians contacted by MedPage Today and ABC News were skeptical about the guidelines’ ability to change the average American’s eating habits.

Dr. Goutham Rao, of Children’s Hospital of Pittsburgh, stated his view of the likely impact in a single word: “Negligible.”

Basics of Bell Palsy

Imagine waking up in the morning, looking in the mirror and realizing that one side of your face is sagging, your eyelid is drooping, and you are drooling out the side of your mouth. If you have ever had this experience, you were probably experiencing Bell’s palsy.

Bell’s palsy is the most common cause of facial paralysis. Although Bell’s palsy duration is usually limited to a few months, the symptoms can certainly be disturbing.

What Causes Bell’s Palsy?

Bell’s palsy can occur at any age but is most common at around age 40. Men and women are affected equally. Every year about 15 to 30 people out of 100,000 get Bell’s palsy. The cause of Bell’s palsy is not completely understood but is believed to be caused by a viral infection that causes swelling of the facial nerve.

A Sneak Peek Inside the Human Body

The two facial nerves are large nerves that branch out across the face and carry electrical impulses to the facial muscles. Each nerve contains 7,000 nerve fibers. When the nerve swells in response to an infection, the electrical impulses get weak and the facial muscles lose their movement. Branches of the facial nerve are also important for tear and saliva production, and they transmit some taste sensations from the tongue.

Although the exact cause of Bell’s palsy is not always clear, certain risk factors are known to increase the chances of getting Bell’s palsy. Risk factors include:

  • Being exposed to herpes simplex virus type 1
  • Having diabetes
  • Being pregnant
  • Having had a previous episode of Bell’s palsy

Bell’s Palsy Symptoms

Bell’s palsy usually only affects one side of the face. Bell’s palsy symptoms usually start suddenly and reach their peak in 48 hours. Symptoms can range from partial to total paralysis. Common symptoms include:

  • Weakness of the facial muscles causing loss of facial expression
  • Twitching of the facial muscles
  • Drooping of the eyelid with inability to close the eye
  • Dryness of the eye and mouth
  • Loss of taste
  • Drooling from the corner of the mouth
  • Difficulty speaking clearly

Diagnosis and Treatment of Bell’s Palsy

The typical symptoms and sudden onset of one-sided facial weakness are sufficient to make a diagnosis of Bell’s palsy. Other types of diagnostic tests are not usually needed. If Bell’s palsy does not seem to be getting better over time, a referral to a neurologist or an ear, nose, and throat doctor may be needed to rule out other causes of facial paralysis such as tumors, Lyme disease, or multiple sclerosis.

9 Surprising Things That Can Make You Sick

Even without treatment, more than 80 percent of people with Bell’s palsy start to get better within three weeks. An early sign of improvement is often the return of taste. Bell’s palsy duration is rarely longer than six months. Some studies show that treatment can shorten Bell’s palsy duration and improve symptoms. Bell’s palsy treatment includes:

  • Steroids. The anti-inflammatory drug prednisone may be used to reduce swelling of the facial nerve. Prednisone may be started as soon as the diagnosis is made and tapered off over 10 days.
  • Antiviral drugs. Oral acyclovir (Zovirax) or valacyclovir (Valtrex) may be started within three days of Bell’s palsy symptoms and continued for seven days.
  • Eye care. Taping the eye closed, using an eye patch, and using artificial tears are helpful treatments to prevent eye irritation from excessive dryness.
  • Physical therapy. Messaging the face, exercising facial muscles, and applying gentle heat may help recovery.

Health and Medical Care News

Since the earthquake struck on Jan. 12, many non-profit organizations have been providing search and rescue aid, medical care, shelter, food, and other essential services in Haiti. All need additional funds to continue their work in the coming weeks and months.

Health and Medical Care

Doctors Without Borders (Médecins Sans Frontières)

An international humanitarian organization created by doctors and journalists that provides medical and health services, often in emergency situations.

Direct Relief International

Provides medical care to people harmed by poverty, natural disasters, and civil unrest.

Partners in Health

An organization that provides medical care and advocacy in Haiti and nine other countries.

Emergency Services and Logistical Support

American Red Cross

The U.S. branch of the International Red Cross, which assists people whose lives have been disrupted by natural disasters, humanitarian crises, and health emergencies.

Clinton Bush Haiti Fund

A fundraising group started by Presidents Bill Clinton and George W. Bush at the request of President Barack Obama to support immediate relief efforts such as the provision of food, water, shelter, and medical care, and to work on long-term recovery plans.

The International Rescue Committee

A group of volunteer first responders, humanitarian relief workers, healthcare providers, educators, and other volunteers who provide emergency relief services.

Mercy Corps

A volunteer group of professional engineers, financial analysts, public health experts, and others who help out in times of humanitarian emergencies.

Assistance for Children and Families

CARE

A humanitarian organization that fights poverty by working with poor women to help their families and communities.

Save the Children

Provides prenatal care, immunizations, educational help, and other services to children in need and their families.

Stillerstrong

An organization founded by the actor Ben Stiller to build schools and provide education programs for the children of Haiti.

UNICEF

The United Nations agency that provides health care, clean water, nutrition, education, and emergency relief services for children and families.

Yele Haiti

A group founded by musician Wyclef Jean to support health, education, environmental change, and community development in Haiti.

Food Aid

World Food Program

A United Nations agency that provides food assistance in developing nations around the world.

Medical Identity Theft

What is medical identity theft? In this serious and growing problem, someone else uses your personal information to obtain medical goods or services. Medical identity theft affects consumers, health care providers, and insurance organization. According to the Federal Trade Commission (FTC), medical identity theft accounts for about 3 percent of all identity theft, and the World Privacy Forum claims it’s the most difficult form of identity theft to correct.

When you are the victim of medical identity theft, incorrect information about diagnoses and treatments may appear on your medical records, potentially affecting your health care providers’ decisions about your care and treatment. Also, in addition to paying for treatment you didn’t receive, in some cases you might be denied treatment or coverage because of fraudulent medical or insurance information.

But there is some good news: HIPAA (the Health Insurance Portability and Accountability Act) regulations and the Identity Theft Protection Act, already in place, give you many of the tools you need to get errors corrected at your doctor’s office and with your insurance provider. Of course, like any crime, you’re better off preventing it from happening in the first place.

Spotting Medical Identity Theft

Among other signs, the FTC states that you may be a target of a potential medical identity theft or fraud if you are charged for medical services you didn’t receive. Keep a calendar to track your appointments, treatment dates, and any hospital admission and discharge dates. If the explanation of benefits from your insurance provider or Medicare isn’t exactly right, clear up the error as soon as possible.

Medical receipts, prescription drug information, health insurance forms, and any documents bearing your health care providers’ names might be all a clever thief needs to begin off-loading other medical claims to you. If you don’t need to keep medical documents, shred or burn them, and peel off labels from your prescription medications before recycling the containers.

Legal Protection to Combat Medical Identity Theft

The Identity Theft Protection Act of 2005 requires any commercial, charitable, educational, or non-profit organization that acquires or uses sensitive personal data to provide significant administrative, technical, and physical safeguards to prevent that data from being mishandled.

The same act that allows consumers to place a freeze on their credit reports also requires any covered entity to investigate suspected misappropriation of personal medical data and to do everything possible to correct resulting inaccurate medical information and billing problems.

Tips to Prevent Medical Identity Theft

  • Take your photo ID to all doctor appointments. Bring an ID along with your insurance information and any other documents, such as a Medicare card, so you can provide it. An FTC law known as the “red flags rule” encourages doctors and other health care providers to require proof of identity before providing services. You can write “See ID” on the signature line of your Medicare card, just as you can on a credit card, so your health care provider will be prompted to verify your identity. Also, when you’re asked to sign any paper at your doctor’s office, review the document first and be sure any erroneous information is corrected immediately.
  • Don’t divulge medical or insurance information too freely. Sometimes you’re smart to be suspicious, especially of someone contacting you by phone. If you get a caller asking you to take a health care survey and requesting your health care provider’s name or your insurance information, hang up, and then call to alert your insurance provider. Also, be suspicious of health care providers and equipment suppliers who use telemarketing or door-to-door sales tactics, put the wrong diagnosis on a claim “so Medicare will pay,” or advertise free medical consultations for people with Medicare.
  • Report any ID card loss immediately. If you lose your Medicare card or suspect it may have been stolen, call Social Security to get a replacement. Likewise, if you lose your insurance card, let your provider know right away.
  • Review all of your insurance documents. Insurance information and statements of benefits can be confusing, and medical identity thieves know that many people don’t read them carefully. However, these documents are one of the first alerts that you may be a victim of medical identity theft. Read your statements and if they don’t seem right, call your insurer’s office. Before you call, verify that the phone number on the documents you have matches the one on your insurance card.

What do you know about medications safety

The U.S. Food and Drug Administration (FDA) judges a drug to be safe enough to approve when the benefits of the medicine outweigh the known risks for the labeled use.

Doctors, physician assistants, nurses, pharmacists, and YOU make up your health care team. To reduce the risks from using medicines and to get the most benefit, you need to be an active member of the team.

To make medicine use SAFER:

  • Speak up
  • Ask questions
  • Find the facts
  • Evaluate your choices
  • Read the label and follow directions

Speak Up

The more information your health care team knows about you, the better the team can plan the care that’s right for you.

The members of your team need to know your medical history, such as illnesses, medical conditions (like high blood pressure or diabetes), and operations you have had.

They also need to know all the medicines and treatments you use, whether all the time or only some of the time. Before you add something new, talk it over with your team. Your team can help you with what mixes well, and what doesn’t.

It helps to give a written list of all your medicines and treatments to all your doctors, pharmacists and other team members. Keep a copy of the list for yourself and give a copy to a loved one.

Be sure to include:

  • prescription medicines, including any samples your doctor may have given you
  • over-the-counter (OTC) medicines, or medicines you can buy without a prescription (such as antacids, laxatives, or pain, fever, and cough/cold medicines)
  • dietary supplements, including vitamins and herbs
  • any other treatments
  • any allergies, and any problems you may have had with a medicine
  • anything that could have an effect on your use of medicine, such as pregnancy, breast feeding, trouble swallowing, trouble remembering, or cost

Good Personal Hygiene Tips

Mom was right: Good personal hygiene is essential to promoting good health.

Personal hygiene habits such as washing your hands and brushing and flossing your teeth will help keep bacteria, viruses, and illnesses at bay. And there are mental as well as physical benefits. “Practicing good body hygiene helps you feel good about yourself, which is important for your mental health,” notes Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. People who have poor hygiene — disheveled hair and clothes, body odor, bad breath, missing teeth, and the like — often are seen as unhealthy and may face discrimination.

Personal Hygiene: Healthy Habits Include Good Grooming
If you want to minimize your risk of infection and also enhance your overall health, follow these basic personal hygiene habits:

  • Bathe regularly. Wash your body and your hair often. “I’m not saying that you need to shower or bathe every day,” remarks Dr. Novey. “But you should clean your body and shampoo your hair at regular intervals that work for you.” Your body is constantly shedding skin. Novey explains, “That skin needs to come off. Otherwise, it will cake up and can cause illnesses.”
  • Trim your nails. Keeping your finger and toenails trimmed and in good shape will prevent problems such as hang nails and infected nail beds. Feet that are clean and dry are less likely to contract athlete’s foot, Novey says.
  • Brush and floss. Ideally, you should brush your teeth after every meal. At the very least, brush your teeth twice a day and floss daily. Brushing minimizes the accumulation of bacteria in your mouth, which can cause tooth decay and gum disease, Novey says. Flossing, too, helps maintain strong, healthy gums. “The bacteria that builds up and causes gum disease can go straight to the heart and cause very serious valve problems,” Novey explains. Unhealthy gums also can cause your teeth to loosen, which makes it difficult to chew and to eat properly, he adds. To maintain a healthy smile, visit the dentist at six-month intervals for checkups and cleanings.
  • Wash your hands. Washing your hands before preparing or eating food, after going to the bathroom, after coughing or sneezing, and after handling garbage, goes a long way toward preventing the spread of bacteria and viruses. Keep a hygiene product, like an alcohol-based sanitizing gel, handy for when soap and water isn’t available.