World's richest man leads coaltion that aims to outpace emerging health crises by developing new vaccines in less than a year
From: http://www.cbsnews.com/news/davos-world-economic-forum-bill-gates-outsmart-global-epidemics-cepi-coalition-for-epidemic-preparedness/
Wednesday, January 18, 2017
Too Much Sitting Ages You Faster
Cells of elderly sedentary women look much older than their actual age, study finds
From: http://www.webmd.com/healthy-aging/news/20170118/too-much-sitting-ages-you-faster?src=RSS_PUBLIC
Next-gen medicine: Robotic "sleeve" to keep flabby hearts pumping
Scientists are developing a "soft robotic” device that mimics the heart's natural movements; has been tested in animals
From: http://www.cbsnews.com/news/flabby-heart-keeps-pumping-with-squeeze-from-robotic-sleeve/
From: http://www.cbsnews.com/news/flabby-heart-keeps-pumping-with-squeeze-from-robotic-sleeve/
Insurance equality? States push for cost-free vasectomies
The procedure, which is not covered under current health care law, is increasingly being included in state measures that would require insurers to provide cost-free birth control coverage
From: http://www.cbsnews.com/news/insurance-equality-states-push-for-cost-free-vasectomies/
From: http://www.cbsnews.com/news/insurance-equality-states-push-for-cost-free-vasectomies/
FDA: New Fish Guidelines for Kids, Pregnant Women
Agency recommends 2-3 servings of 'best choices' weekly
From: http://www.webmd.com/food-recipes/news/20170118/fda-offers-guidance-on-fish-intake-for-kids-pregnant-women?src=RSS_PUBLIC
Short Exercise Sessions May Decrease Inflammation
20 minutes on a treadmill linked to drop in immune cells tied to inflammation, study finds
From: http://www.webmd.com/fitness-exercise/news/20170118/short-stretches-of-exercise-may-have-anti-inflammatory-effect?src=RSS_PUBLIC
Understanding head injuries
Ski season is here, and I am reminded of the story of Natasha Richardson (Liam Neeson’s wife), who tragically died of a head injury while skiing without a helmet in 2007. Here in the emergency department, we see many patients with concern for head injuries. We factor what may have caused the injury, your age, what we find when we examine you, the timing of the incident, the medicines you take, as well as some other factors, when deciding whether to do a CT scan or admit you to the hospital.
When a head injury causes bleeding in the brain
Ms. Richardson died of an epidural hematoma, one of several types of brain bleeding, but arguably one of the most severe.
Bleeding inside the skull can occur in several different areas. The brain is covered by three layers of tissue called the meninges. If bleeding occurs between the skull and the outermost brain tissue layer (the dura), it is called an epidural hematoma. These usually occur from high-pressure bleeding from an artery and can rapidly expand, putting pressure on the brain tissue and leading to death within hours. These types of bleeds are almost always treated surgically. Epidural hematomas usually result from high impact mechanisms, and trauma to the sides of the head, near where the larger arteries lie.
Bleeding underneath the dural layer of tissue, outside the brain tissue, is usually from a subdural bleed. This is generally a low-pressure bleed from a vein. When found, they may be monitored or treated surgically, depending on the size of the bleed as well as many other factors. This type of bleeding is more common after age 60, as the veins in the brain become slightly more taut due to natural shrinking of the brain tissue. These tight “bridging veins” are more easily sheared with a fairly low impact.
Bleeding inside the brain can be divided into subarachnoid or intraparenchymal, depending on the exact location. These bleeds, when caused by trauma, are generally treated without surgery unless they are very large.
Blood thinners such as Coumadin, Xarelto, Eliquis, Lovenox, or even Plavix put you at higher risk for dangerous bleeding after an injury. There are reversal agents for some of these medicines, but not all.
One thing to note is that while all of these types of bleeding can be seen on CT scanning, occasionally very small bleeds can be missed. Additionally, sometimes bleeding occurs several hours to days after the initial injury (delayed bleeding). Routine admission is not recommended, but if symptoms are suddenly worsening after being discharged from a hospital, please return to the emergency department for a repeat evaluation.
Concussions
Many people are worried about concussions, in part because there has been much press about them in football players and children. I see many people come into the ED, requesting a CT scan to see if they have a concussion. Unfortunately, we can’t see a concussion on a CT scan. A concussion is defined by a constellation of symptoms, generally: headache, dizziness, nausea, difficulty focusing, light sensitivity, and problems with balance and coordination. Symptoms usually last a few days, but can sometimes last weeks or even months. The most important factor that we know of right now to prevent long term problems, is to rest your brain after a concussion, to allow it to heal, and to avoid another injury on an already bruised brain. It’s okay to sleep, and frequent awakenings are no longer routinely recommended.
If you unfortunately need to be seen in an emergency department after an accident, know that we have guidelines (such as the Canadian CT head rule) that help us determine who needs CT scanning. We factor the risks of radiation against the likelihood of an injury, and so please do not take personally when we decide that you do or do not need to have an imaging test.
Please wear a helmet when you’re out on those slopes. Stay safe!
The post Understanding head injuries appeared first on Harvard Health Blog.
From: Jonathan Nadler, MD http://www.health.harvard.edu/blog/understanding-head-injuries-2017011810987
USDA Announces $8.8 Million Available to Support Agriculture Programs at Hispanic Serving Institutions
WASHINGTON, Jan. 18, 2017 - The U.S. Department of Agriculture’s (USDA) National Institute of Food and Agriculture today announced availability of $8.8 million in funding to support agricultural science education at Hispanic-Serving Institutions (HSIs).
From: /wps/portal/usda/usdahome?contentid=2017/01/0009.xml&contentidonly=true
From: /wps/portal/usda/usdahome?contentid=2017/01/0009.xml&contentidonly=true
Plastic surgeons often miss patients' mental disorders
Nearly 10 percent of people seeking facial procedures have a condition that distorts their perception of physical defects, new research suggests
From: http://www.cbsnews.com/news/plastic-surgeons-often-miss-patients-mental-disorders/
From: http://www.cbsnews.com/news/plastic-surgeons-often-miss-patients-mental-disorders/
These groups less likely to get high blood pressure treatment, study finds
A new study finds racial disparities in treatment of high blood pressure, a risk factor for cardiovascular disease, stroke, and heart attack
From: http://www.cbsnews.com/news/hispanics-blacks-less-likely-to-get-high-blood-pressure-treatment/
From: http://www.cbsnews.com/news/hispanics-blacks-less-likely-to-get-high-blood-pressure-treatment/
Ticks carrying Lyme disease confirmed in 9 national parks
U.S. National Park Service and CDC advise using insect repellents on clothes and skin
From: http://www.cbsnews.com/news/ticks-carrying-lyme-disease-confirmed-in-eastern-national-parks/
From: http://www.cbsnews.com/news/ticks-carrying-lyme-disease-confirmed-in-eastern-national-parks/
Hot Chili Peppers May Extend Life
Hot Chili Peppers May Extend Life: Study
From: http://www.webmd.com/food-recipes/news/20170118/hot-peppers-extend-life?src=RSS_PUBLIC
Ticks Carrying Lyme Disease in Some National Parks
U.S. National Park Service and CDC advise using insect repellents on clothes and skin
From: http://www.webmd.com/news/20170117/ticks-carrying-lyme-disease-confirmed-in-eastern-national-parks?src=RSS_PUBLIC
Working Out? Don't Bring Your Cellphone
Researchers say talking and texting makes workout less efficient and throws you off-balance
From: http://www.webmd.com/fitness-exercise/news/20170117/working-out--dont-bring-your-cellphone?src=RSS_PUBLIC
Steep Rise in Births to U.S. Women Using Opioids
Few treatment programs deal with substance abuse in expectant moms, federal report says
From: http://www.webmd.com/mental-health/addiction/news/20170117/steep-rise-in-births-to-us-women-using-opioids?src=RSS_PUBLIC
Bills Surprise Patients Who Go 'Out-of-Network'
For example, anesthesiologists charge nearly 6 times the Medicare rate, study finds
From: http://www.webmd.com/health-insurance/20170117/steep-bills-surprise-patients-who-go-out-of-network?src=RSS_PUBLIC
USDA Announces $18.9 Million Available to Support Agricultural Education at 1890s Land-grant Institutions
WASHINGTON, Jan. 18, 2017 – The U.S. Department of Agriculture’s (USDA) National Institute of Food and Agriculture (NIFA) today announced $18.9 million in funding for eligible 1890 land-grant colleges and universities to obtain or improve agricultural and food sciences facilities and equipment.
From: /wps/portal/usda/usdahome?contentid=2017/01/0008.xml&contentidonly=true
From: /wps/portal/usda/usdahome?contentid=2017/01/0008.xml&contentidonly=true
Senator helps New Jersey woman get kidney from mom abroad
A New Jersey woman finally has a new kidney, more than a year after a life-saving transplant fell through at the last minute. After complications with the first donor's organs, Nina Saria found a match in her mother -- who lived half a world away in the country of Georgia. Jamie Wax has the heartwarming story.
From: http://www.cbsnews.com/videos/senator-helps-new-jersey-woman-get-kidney-from-mom-abroad/
From: http://www.cbsnews.com/videos/senator-helps-new-jersey-woman-get-kidney-from-mom-abroad/
New guidelines for preventing peanut allergy in babies
Follow me on Twitter @drClaire
In 2015, a study showed that giving peanut products to babies could help prevent peanut allergy. This was exciting news, given that 1-2% of children suffer from peanut allergy, an allergy that can not only be life-threatening but last a lifetime, unlike other food allergies that often improve as children get older.
This is a change for pediatricians and parents, who traditionally have thought that peanut products shouldn’t be given until children are a bit older. It’s also tricky in that babies can choke on peanuts and peanut butter. And to make it even trickier, the study cautioned that some babies at higher risk of peanut allergy might need testing before trying out peanut products. So it is great news that the American Academy of Pediatrics has come out with a guideline that gives specific guidance to pediatricians on how to implement the findings of the study.
The guideline divides babies into three groups:
- babies with severe eczema (persistent or recurrent eczema with a frequent need for prescription creams) and/or egg allergy
- babies with mild to moderate eczema
- babies without eczema or food allergy.
Testing for peanut allergy is recommended for the first group. Skin prick testing is best, but a blood test can be done also. If the testing shows allergy, the baby should see a specialist to discuss giving peanut products. Most babies can get them, but it needs to be done carefully and in small amounts. The first time should be in a doctor’s office, in case a severe allergic reaction occurs. It’s important to do this testing early, as the recommendation is that these babies should get peanut products between 4 and 6 months, once they have tried some solid foods and shown that they are ready.
The second group, those with mild to moderate eczema, don’t need to get testing — although parents should talk to their doctors about their particular situation and see if testing might be a good idea. Those babies should get peanut products at around 6 months of age, once (like the babies in the first group) they can handle solid foods.
As for babies without eczema or food allergy, the guideline says that parents should introduce peanut products “freely” into the diet along with other foods, based on their own family preferences and cultural practices. For these babies, it’s less important that peanut products be in the diet early, although it’s fine if they are.
Notice that I am saying “peanut products” and not “peanuts.” Whole peanuts, or chunks of peanuts, should never be given to babies because they can choke on them. A spoonful of peanut butter, even creamy peanut butter (never give chunky to babies!) can also be hard for babies to manage. A little bit of peanut butter (just enough to lick off a spoon) is a bit more manageable — and the AAP suggests mixing it into purees. Families can also give snacks or foods made with peanut butter. In the original study, researchers used an Israeli snack called Bamba.
At the 2- or 4-month checkup, parents should talk to their doctor about what group their baby falls into, and about any other factors — like a family history of peanut or other food allergy — that might be important. That gives them and their doctor time to figure out if testing is needed, and talk about the best plan for preventing food allergy in their baby.
The post New guidelines for preventing peanut allergy in babies appeared first on Harvard Health Blog.
From: Claire McCarthy, MD http://www.health.harvard.edu/blog/new-guidelines-preventing-peanut-allergy-babies-2017011711049
Your Rights, One Voice: Sarah’s Story
You see, Sarah has been living with type 1 diabetes since she was 5 years old. Although she manages the disease well and does not let it slow her down, her mother recognizes the importance of having a school nurse around at all times. During the school day, on the bus and at other extracurricular activities such as chorus, the nurse helps Sarah calculate insulin dosages, monitor her blood glucose and treat hyperglycemia and hypoglycemia (episodes of high and low blood glucose). Why was this after-school activity any different?
Heather reached out to the school principal and the county’s support services staff, but they insisted that Science Explorers did not qualify as a “school-sponsored program” since it is not facilitated by school staff and outside students are allowed to attend. They claimed they were not responsible for providing medical care at the club’s weekly activities, despite Sarah’s existing Individualized Education Program (IEP). Heather was told she would need to accompany her daughter to the club each week.
Frustrated, Heather contacted the American Diabetes Association® for help. One of our legal advocate staff attorneys assisted Heather in defining and evaluating the factors that qualify an extracurricular activity as “school-sponsored.” The legal advocate helped Heather make the argument the Science Explorers club was, in fact, school-sponsored because it is held at and publicized by the school, and registration is open to its students. As a result, all medical protections that Sarah receives during the school day need to be offered at Science Explorers.
The legal advocate sent Heather sample language to provide the school, as well as general information regarding the rights of students with diabetes and a fact sheet about field trips and extracurricular activities. Heather called the school with this information, and the administrators agreed to have a nurse available for Sarah at Science Explorers.
All was well until a few months later when the school’s staff changed and they again refused to provide a nurse—this time for an extracurricular art club. Once again, Heather reached out to the American Diabetes Association, and we suggested that her IEP be updated to include an accommodation for extracurricular activities. Verbal confirmation was not enough to guarantee Sarah’s safety. With support from the legal advocate, Heather successfully revised Sarah’s IEP to state that a nurse would accompany her to ALL extracurricular activities sponsored by the school.
Now Sarah can participate in the same extracurricular activities as her classmates without having to worry about her safety. Although Heather is relieved for her daughter, she says, “I just wish that we parents did not have to go through this.”
Today Heather advocates for our Safe at School® program to ensure that other children with diabetes receive the resources, support and care they need.
The American Diabetes Association leads the effort to prevent and eliminate discrimination against people with diabetes at school, at work and in other parts of daily life. If you need help, call 1-800-DIABETES (800-342-2383) or visit diabetes.org/gethelp.
Through our nationwide Safe at School program, the Association is dedicated to making sure that all children with diabetes are medically safe at school and have the same educational opportunities as their peers. Visit our Safe at School website for information and resources.
Give the gift of fairness—donate now to help people with diabetes facing discrimination, just like Sarah.
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From: American Diabetes Association http://diabetesstopshere.org/2017/01/18/your-rights-one-voice-sarahs-story/
New guidelines for preventing peanut allergy in babies
Follow me on Twitter @drClaire
In 2015, a study showed that giving peanut products to babies could help prevent peanut allergy. This was exciting news, given that 1-2% of children suffer from peanut allergy, an allergy that can not only be life-threatening but last a lifetime, unlike other food allergies that often improve as children get older.
This is a change for pediatricians and parents, who traditionally have thought that peanut products shouldn’t be given until children are a bit older. It’s also tricky in that babies can choke on peanuts and peanut butter. And to make it even trickier, the study cautioned that some babies at higher risk of peanut allergy might need testing before trying out peanut products. So it is great news that the American Academy of Pediatrics has come out with a guideline that gives specific guidance to pediatricians on how to implement the findings of the study.
The guideline divides babies into three groups:
- babies with severe eczema (persistent or recurrent eczema with a frequent need for prescription creams) and/or egg allergy
- babies with mild to moderate eczema
- babies without eczema or food allergy.
Testing for peanut allergy is recommended for the first group. Skin prick testing is best, but a blood test can be done also. If the testing shows allergy, the baby should see a specialist to discuss giving peanut products. Most babies can get them, but it needs to be done carefully and in small amounts. The first time should be in a doctor’s office, in case a severe allergic reaction occurs. It’s important to do this testing early, as the recommendation is that these babies should get peanut products between 4 and 6 months, once they have tried some solid foods and shown that they are ready.
The second group, those with mild to moderate eczema, don’t need to get testing — although parents should talk to their doctors about their particular situation and see if testing might be a good idea. Those babies should get peanut products at around 6 months of age, once (like the babies in the first group) they can handle solid foods.
As for babies without eczema or food allergy, the guideline says that parents should introduce peanut products “freely” into the diet along with other foods, based on their own family preferences and cultural practices. For these babies, it’s less important that peanut products be in the diet early, although it’s fine if they are.
Notice that I am saying “peanut products” and not “peanuts.” Whole peanuts, or chunks of peanuts, should never be given to babies because they can choke on them. A spoonful of peanut butter, even creamy peanut butter (never give chunky to babies!) can also be hard for babies to manage. A little bit of peanut butter (just enough to lick off a spoon) is a bit more manageable — and the AAP suggests mixing it into purees. Families can also give snacks or foods made with peanut butter. In the original study, researchers used an Israeli snack called Bamba.
At the 2- or 4-month checkup, parents should talk to their doctor about what group their baby falls into, and about any other factors — like a family history of peanut or other food allergy — that might be important. That gives them and their doctor time to figure out if testing is needed, and talk about the best plan for preventing food allergy in their baby.
The post New guidelines for preventing peanut allergy in babies appeared first on Harvard Health Blog.
From: Claire McCarthy, MD http://www.health.harvard.edu/blog/new-guidelines-preventing-peanut-allergy-babies-2017011711049
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