Adolescents and Vaccinations
Posted by on August 30, 2012 - 2:05pm

The Centers for Disease Control and Prevention recommends pre-teens ages 11 to 12 to get the following vaccines: one dose of tetanus, diphtheria and pertussis vaccine, two doses of meningococcal conjugate vaccine, three doses of human papillomavirus vaccine and a yearly influenza vaccine.  With the school year approaching, this may be the ideal time to go as many teens will require physicals.

Pre-teens may also need to catch up on missed vaccines or vaccines that require multiple dosages.  The Advisory Committee on Immunization Practices (ACIP) recommendation for preteens can be found  at Vaccines.gov.

The HPV vaccine prevents many kinds of cancer.  HPV infection can result in cervical cancer for women, penile cancer in man, anal or throat cancers in both genders.  The vaccine Gardasil can also protect against genital warts caused by sexual or skin on skin contact.  The vaccine has proven safe and effective for both sexes from ages 9-26. The ACIP suggests that adolescents start these vaccinations (one of three) at age 11 or 12, but older adolescents who missed the vaccinations can still catch up as long as they begin as soon as possible.  However, females should not get the vaccines past age 26 and males should not get the vaccines past age 21.  It is recommended that males who have sex with other males receive the vaccines until age 26.

While eleven and twelve may seem young to receive this vaccine, it is required so that all three doses are complete before any sexual activity occurs.  More antibodies against HPV are produced when vaccinated at a younger age.

Anyone under the age of 18 who are registered in new group or individual private health plans are able to receive certain vaccinations without any cost-sharing requirements-when provided by an in-network provider.  These vaccinations include Tetanus, Diptheria, Pertussis, Haemophilus Influenza Type B, Hepatitis A, Hepatitis B, Human Papillomavirus, Inactivated Poliovirus, Measles, Mumps, Rubella, Meningococcal, Rotavirus, and Varicella.

For additional information see: http://www.hhs.gov/ash/oah/news/e-updates/july-2012.html

Sources:

Office of Adolescent Health at the U.S. Department of Health and Human Services: http://www.hhs.gov/ash/oah/news/e-updates/july-2012.html

Centers for Disease Control and Prevention: http://www.cdc.gov/vaccines/who/teens/downloads/parent-version-schedule-7-18yrs.pdf

Advisory Committee on Immunization Practices: www.vaccines.gov

 

Who exactly is voting on women's health?
Posted by on August 28, 2012 - 2:23pm

Although only 3/4 's through 2012, this year has already seen a remarkable number of political men make public assumptions, gaffes and decisions surrounding women’s health that are, politely speaking, just embarrassing.

Granted, not all gaffes and misinformation have been as bad as the Tom Akin statement about “legitimate rape”, but with each day it appears that another piece of the Affordable Care Act comes under scrutiny or another state finds that its budget isn’t balancing and cuts have to be made somewhere. While women elected to hold office have to make these same tough decisions, an analysis of the current Congressional makeup might give a little insight, albeit a sad one, as to why so many ridiculous things are happening in 2012 regarding women’s health.

So who exactly is making decisions about women’s health in Washington, DC? Easy answer: older, mainly white men. Out of 541 Congressional seats, there are exactly 93 filled by women, or 17.2 percent of the members. Here is a current breakdown of your 112th Congress:

House of Representatives (441)

-Republicans: 240

-Democrats: 197

-Vacancies: 4

-Number of Women: 76

-Average Age: 57

-Average Time In Office: 10 years (5 terms)

Senate (100)

-Republicans: 47

-Democrats: 51

-Independents: 2 (Caucus with Democrats)

-Number of Women: 17

-Average Age: 62

-Average Time In Office: 11.5 years (2 terms)

For more information and a further breakdown of the current Congress, visit the House of Representatives website, the Senate website, or read the latest report from the Congressional Research Service.

Guest Author:   Nicole Fisher

 

Women underuse aspirin to prevent heart disease
Posted by on August 26, 2012 - 8:41am

For years we criticized heart researchers for not including women in the early studies that recommended aspirin to prevent heart disease.  We asked:  How can you recommend aspirin in women when all the studies took place in males!  In 2007, after additional studies that included females, the American Heart Association released guidelines for the CVD preventive care in women including aspirin. Their recommendations:

  • Primary prevention (other at-risk or healthy women):   Consider aspirin therapy in women >65 years if blood pressure is well-controlled and benefit for ischemic stroke and myocardial infarction prevention is likely to outweigh the risk of gastrointestinal bleeding and hemorrhagic stroke.
  • Secondary prevention (high risk):  Aspirin therapy should be used in high-risk women (established coronary heart disease, cerebrovascular disease, peripheral arterial disease, abdominal aortic aneurysm, end-stage or chronic renal disease, diabetes, and 10-year Framingham risk>20%) unless contraindicated.

A recent study, using a web-based risk assessment tool found that the majority of women for whom aspirin is recommended were not following national guidelines.  The authors led by Cathleen Rivera, MD at Scott and White Healthcare in Texas concluded that there is a need for more education about aspirin among clinicians and women for increased prevention of heart disease.  Given the rising direct and indirect costs of cardiovascular disease, it makes sense that health care providers take a closer, serious look at the increased use of low cost aspirin in lieu of designer heart meds.!

Source:  Rivera C, Song J, Copeland L et al.  Journal of Women's Health, Vol. 21, 2012.

Health Reform across the Border
Posted by on August 24, 2012 - 7:40am

The U.S. can learn from Mexico's recent efforts at health reform, especially as it relates to transferring care from specialists back to primary care physicians, researchers said.

Mexico created its national health insurance program, called the Seguro Popular in 2003, and achieved universal coverage for its 100 million citizens earlier this year, Felicia Knaul, PhD, of Harvard Medical School and colleagues wrote in the Aug. 16, 2012 edition of The Lancet.    The program now provides coverage to 52 million previously uninsured Mexicans, they noted.

Its list of essential covered services grew from 91 in 2004 to 284 in 2012 -- covering treatment for more than 95% of conditions in ambulatory units and hospitals, Knaul and colleagues wrote.  Meanwhile, Mexico also built 15 high-specialty centers, more than 200 hospitals, and almost 2,000 ambulatory clinics.

As the country slowly expanded coverage, its state-run specialty care centers became overcrowded with patients. To avoid facing a similar problem, the U.S. could learn to strengthen primary care's ability to provide follow-up treatment to patients recovering from catastrophic illnesses such as cancer, Knaul said in an interview with MedPage Today.

"That's not what primary care has been able to do well," she said.

The real challenge for the medical community will be how to train primary care doctors to handle that, Knaul said. It's not good for patients to continue to seek treatment at the specialty level, but it can be complex to link that follow-up care back to primary care doctors.

Regardless of how that's done, Mexican reform has shown it's possible to build financially responsible ways to treat chronic diseases alongside prevention, Knaul and colleagues wrote.

"Part of the global community has been convinced that middle-income and especially low-income countries should limit their activities to prevention in the case of chronic and noncommunicable diseases," the paper stated. That line of thinking is wrong and would conflict with the point of health reform, which is to provide affordable healthcare to all citizens, Knaul said.

For example, although treating a chronic illness like childhood asthma isn't expensive from month to month, Knaul pointed out that it adds up over time and can be financially burdensome.

Knaul knows of Mexican families living in the U.S. that have developed serious medical conditions, lost their jobs and their work visas as a result, and have returned to Mexico because they can be treated there. "Hopefully, this will change as a result of reform in the United States," she said.

Health reform in Mexico has spurred economic growth while improving health, Knaul noted. The infant mortality rate dropped from from 18.2 to 14.1 per 1,000 live births from 2000 to 2010. The percentage of deaths from communicable diseases also fell -- from 15.4% to 10.8% -- during the same period.

Meanwhile, the gross domestic product per capita in Mexico increased from $11,852.70 in 2000 to $12,440.90 in 2010.

Massage as a Compliment to Physical Therapy
Posted by on August 22, 2012 - 7:45am

Those with chronic or acute injury may not be confined to rehabilitation.  Massage therapy may be beneficial as well for those suffering from chronic or acute injuries.  Benefits include decreased pain and anxiety, increased endorphins, decreased insomnia, less muscle spasms, decreased tension headaches, and an increased sense of well-being and relaxation.

Finding an experienced clinical massage therapist (or rehabilitation massage therapist) is vital, as opposed to a massage therapist.  The massage will be a site-specific treatment with a defined goal or outcome that treats a particular problem area.

Compared to a traditional relaxation massage, a clinical massage will have a therapist with the same basic skills and knowledge as a relaxation therapist, but with specialized experience working with people with injuries or complaints.  Many clinical massage therapists continue their education with the hundreds of available diverse courses.  Many take classes that will shape their practice, such as classes for Rotator Cuff injuries, IT Band Syndrome, common orthopedic injuries, Neuro-fascial Integration and positional release.  The classes are advanced and hands on.  Clinical massage therapists usually work within a medical setting with chiropractors, physical therapists, athletic trainers and doctors at their disposal.

Before the first massage, the therapist will discuss patient history and what they wish to get out of it, whether it is to be pain free or to run better.  A multitude of questions are asked in hopes of knowing all there is to know about the patient and to create a plan of treatment.  The therapist may recommend how frequently the patient should be treated, what the patient can do to further their treatment on their own and may refer the patient for further treatment if necessary.

However, there are disadvantages. Treatments can be pricy potentially reaching $200 an hour and insurance policies may not cover therapeutic massage.  Also, they can be time consuming ranging from 60 to 90 minutes without the ability to multi-task during the treatment.  For busy people this may be an issue.  Massage therapy is an intimate treatment sometimes requiring partial nudity, an issue for some as well.  No matter how skilled a therapist, there is still the risk of accidental injury including bruising, soreness and potentially nerve damage with deep muscle massage.  In some very rare cases, massage therapy has set off nerve related illnesses like shingles and neuropathies.

Overall, the benefits may outweigh the disadvantages.  While some injuries may require both, some may only need massage therapy or rehabilitation.  Your doctor or therapist can prescribe the course of treatment and decide what is best for the injury.  For more information or to find a clinical massage therapist visit the first link below.

Sources:

Athletico: http://www.athletico.com/blog/index.php/2012/07/03/massage-therapy-to-enhance-your-rehabilitation/

Livestrong- Disadvantages to Clinical Massage Therapy: http://www.livestrong.com/article/129614-disadvantages-massage-therapy/

Beaumont-Benefits of CMT: http://www.beaumont.edu/integrative-medicine-massage

Should hospitals lock up baby formula to urge new mothers to breastfeed?
Posted by on August 20, 2012 - 6:57am

A clear majority of MedPage Today readers do not want hospitals to lock up infant formula as a way to encourage new moms to breastfeed.

The 1,600-plus vote tally was 72% against and 28% for hospitals keeping infant formula out of sight. The prompt for their survey was a story about some 27 New York City hospitals that plan to stow away the formula in an effort to promote breastfeeding.    The voluntary program was launched by the city's Department of Health and Mental Hygiene.

These hospitals might be acting in good faith, but whether they are going about it in the right way is up for debate, according to reader comments.   "There is a HUGE difference between educating as to the benefits of breastfeeding versus creating a negative barrier to access. One way promotes choice and the other looks like tyranny," said one commenter.

However, another reader said the lock-up requirement is "perfectly reasonable."   She went on to say that it's "sad that it is necessary," but by doing so perhaps nurses would think twice before going for the formula.

Many readers agreed that breastfeeding is best for babies and that new mothers should be taught breastfeeding in the hospital. But many also drew the line at the suggestion of locking up the formula.

What do you think?   After all, baby formula is not a controlled substance....hmmm.

 

Meditation, exercise and acute repiratory infections
Posted by on August 17, 2012 - 6:56am

According to a recent study, exercising or practicing meditation may be effective in reducing acute respiratory infections. Acute respiratory infections, which are caused by influenza and other viruses, are very common illnesses and account for millions of doctor visits and lost school and work days each year. Previous research has suggested that enhancing general physical and mental health may offer protection against these illnesses. Findings from this NCCAM-funded study were published in the journal Annals of Family Medicine.

Researchers from the University of Wisconsin-Madison randomly assigned 154 people, aged 50 and older, to one of three groups: a mindfulness meditation group, an exercise group, or a wait-list control group. Participants in the meditation group received training in mindfulness-based stress reduction (a type of meditation based on the idea that an increased awareness of physical, emotional, and cognitive manifestations of stress may lead to a healthier mind-body response to stress). Participants in the exercise group received instruction and practiced moderately intensive exercise (using stationary bicycles, treadmills, and other equipment) during group sessions, and walked briskly or jogged for home exercise. Both interventions lasted 8 weeks, consisting of 2.5-hour group sessions each week and 45 minutes of daily at-home practice.

The researchers observed substantial reductions in acute respiratory illness among those in the exercise group, and even greater benefits among those in the meditation group. While not all of the observed benefits were statistically significant, the researchers noted that the magnitude of the observed reductions in illness was clinically significant. They also found that compared to the control group, there were 48 percent fewer days of work missed due to acute respiratory infections in the exercise group, and 76 percent fewer in the meditation group. Researchers stated that these findings are especially noteworthy because apart from hand-washing, no acute respiratory infection prevention strategies have previously been proven. The researchers concluded that future studies are needed to confirm these findings.

The Low-Glycemic Index Diet may be best
Posted by on August 15, 2012 - 8:40am

It is no wonder why the weight-loss industry is a $20 billion per year industry.  Dieters spend money on diet books, diet drugs and weight-loss surgery.  108 million people in the United States are on diets and typically attempt four or five diets a year.  85% of dieters are women.

Some diets preach low-calorie, some are low-carbohydrate.  Some allow for only eating grapefruit or cabbage soup.  Some say it’s only about how much you eat and the amount of time spent exercising, while others say not all calories are created equal and it is about what we eat as well as how much of it.  We are constantly bombarded by different information and different diets.  No wonder we cannot keep the weight off.

A promising study published in the Journal of the American Medical Association may finally set the record straight.  It found that a specific mix of carbohydrate, fat and protein might be ideal.  It also suggested that not all calories are created equal, meaning that calories can have different effects on the body.

The study followed 21 adults ages 18 through 40 for four years to determine the effects of various diets on the ability to burn calories following weight loss. At the start of the study, the participants had a BMI over 27, which is considered overweight or obese.  The participants were originally placed on a diet to lose 10%-15% of their body weight.  After the initial weight loss, researchers placed the participants on three different diets in a random order each for four weeks at a time.  All diets maintained the same total number of calories.  However, they did differ in their carbohydrate, fat and protein content.

The low-fat diet required that 60% of calories came from carbohydrates, 20% from fat and 20% from protein.  The low-glycemic diet required that 40% of calories be derived from carbohydrates, 40% from fat and 20% from protein in order to prevent spikes in blood sugar.  The very low-carbohydrate diet (“Atkins”) required that 10% of calories came from carbohydrate, 60% from fat and 30% from protein.

Researchers measured participants’ energy expenditure as well as other aspects of metabolism and concluded that the total number of calories burned daily differed with each diet.  Researchers also studied hormone levels and metabolic measures concluding that they too varied by diet.

On average the very-low carbohydrate diet burned calories most efficiently with participants burning 3,137 calories daily.  The low-glycemic diet burned 2,937 calories per day, 200 less than the very-low carbohydrate.  The low-fat diet burned 2,812 calories daily.

While researchers did conclude that it improved metabolism the best, don’t switch to the very-low carbohydrate diet just yet.  The participants showed higher levels of risk factors for diabetes and heart disease, including the stress hormone cortisol.

The low-glycemic diet resulted in only a 200 calorie difference and showed similar benefits to the very-low carbohydrate diet, with less negative effects.  A low-glycemic diet consists of less-processed grains, vegetables and legumes.  According to researchers, this may be the best diet for both long-term weight loss and heart disease prevention when coupled with exercise.

A low-glycemic index diet emphasizes foods based on how they affect blood sugar levels.  Foods, specifically carbohydrates since they have the most effect on blood sugar, are given a score between 0 and 100.  High scores of 70 and up include white and brown rice, white bread, white skinless baked potato, boiled red potatoes and watermelon.  Medium scores between 56-69 include sweet corn, bananas, raw pineapple, raisins and some ice creams.  Examples of low scoring foods of 55 and under include raw carrots, peanuts, raw apple, grapefruit, peas, skim milk, kidney beans and lentils.

The diet does not require counting carbs, counting calories or reducing portion sizes.  It only directs dieters to the right kind of carbohydrates in order to keep blood sugar levels balanced.  Specifically, lower glycemic diets are digested less rapidly by the body, which raises the blood sugar in a regulated, balanced way; whereas higher glycemic foods and beverages are digested more rapidly causing a blood sugar spike followed by a drastic decline.  Since low-glycemic index foods are digested more slowly, they remain in the digestive tract longer, potentially controlling appetite and hunger.  This can also reduce the risk of insulin resistance.

The study shows that a low-glycemic diet can work for long-term weight-loss, as it is easily sustainable because whole food groups are not removed.  Furthermore, it may reduce the risk of serious diseases such as diabetes and cardiovascular disease.

Sources:

Weight-Loss Stats: http://abcnews.go.com/Health/100-million-dieters-20-billion-weight-loss-industry/story?id=16297197#.UBBfZo7p7ao

NIH: http://www.nih.gov/researchmatters/july2012/07162012weight.htm

Mayo Clinic on the Low-Glycemic Diet: http://www.mayoclinic.com/health/glycemic-index-diet/MY00770

 

Women who are obese before pregnancy put child at risk
Posted by on August 15, 2012 - 8:35am

Women who are obese before they become pregnant may be putting their child at a disadvantage. New research shows that reading and math scores for kids ages 5 to 7 were lower if the mother was obese before she got pregnant. Obesity can alter how a baby receives nutrients and grows inside the womb.

“Fetal period is known as a critical period of brain development, where any disruption in the development during this sensitive period may cause sustained or permanent changes in structures or functions,"  says Rika Tanda at Ohio State University.

Future moms can give their children the best chance at success by maintaining a healthy weight.

The study in the Maternal and Child Health Journal was supported by the National Institutes of Health.

Cup of Jo for health
Posted by on August 9, 2012 - 10:10am

Coffee has been widely linked to an array of health benefits including: decreased occurrences of type-2 diabetes; lower risks of Parkinson’s disease; lower risk of colorectal cancer; lower mortality rates; decreased skin cancer risk; and decreased rates of heart failure.  Some studies have deemed coffee unhealthy, but according to others, this claim proves inconsistent and improvable.  There are disadvantages to drinking coffee such as irritability and insomnia, but in general, coffee proves beneficial. In honor of National Coffee Month, pour yourself a cup or two and reap the following benefits.

A study in the journal Food Science and Nutrition cited coffee as being associated with a reduced the incidence of both metabolic syndrome and diabetes mellitus.  Researchers believe this is due to coffee’s antioxidants and its ability to enhance insulin sensitivity, which results in decreased glucose storage.  Specifically, caffeine affects glucose metabolism through increased uncoupling protein expression and lipid oxidation.  This causes decreased glucose storage as well, thus reducing the extent of diabetes mellitus. The same study also attributed coffee to lowering the risk of Parkinson’s disease.  Researchers theorize that this lower risk may be due to antioxidants acting on neural pathways that affect one's risk for Parkinson's. However, the study also said that water intake must be included to reap these benefits.

Additional research reveals that coffee may lower the risk for many other conditions. Certain acids and fiber in coffee may protect against colorectal cancer and skin cancer (specifically basil cell carcinoma), and coffee consumption may also decrease the risk for developing heart failure by 11% (compared to the risk for non-coffee drinkers), but that this decreased risk comes with a two eight-ounce cup limit, with protective benefits undermined after 4 cups.

Drinking coffee does not mean that you will not suffer from the aforementioned conditions; researchers show that it only lowers one’s chances.  There are many other factors to consider such as lifestyle, environment, and genetics. Coffee should not be used solely as a preventive measure, nor should it be considered a reliable treatment for any condition. Additionally, results of the myriad coffee studies are conflicting as far as how much is too much or how little is too little to reap the most benefits. Continued study is required to determine the ideal amount and to understand the mechanisms behind any benefits.

In the meantime, enjoy the 'jo. Cheers to good health.

Sources:

Coffee and Mortality

Coffee and Skin Cancer

Coffee and Heart Failure

 

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