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Thursday, April 7, 2011

CDC Sees EHRs As Public Health 'Game Changer' -- InformationWeek

Sometimes forgotten in the rush to install electronic health records (EHRs) is that improving population and public health is a major goal of the federal meaningful use EHR incentive program. But many in the public health community are counting on greater EHR adoption and interoperability among physicians and hospitals to help identify and respond to future disease outbreaks, according to a top government health IT official.
"Public health agencies, from local to state to federal, have been building information technology for years, but because we don't have a lot of connections to y'all, we don't have a lot of information to share," Dr. Seth Foldy, director of the public health informatics and technology program office at the Centers for Disease Control and Prevention (CDC), said Tuesday. "In the future, we assume that most of our public health allies will be perched in front of their EHRs."

via informationweek.com

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Friday, March 11, 2011

Joseph Nowinski, Ph.D.: Rethinking Societal Attitudes About People Who Get Cancer

In her 1978 book, "Illness as Metaphor," Susan Sontag argued that societal myths and metaphors surrounding disease can kill. How? By instilling shame and guilt in the sick. Sontag was the first writer to point out the basically accusatory tone of the metaphors we use to describe illness and its causes, as well as the essence of its cure. Examples she cited included tuberculosis, which was once popularly thought of as an illness that afflicted only individuals with delicate temperaments. Because they were supposedly constitutionally weak, these individuals were prone to wasting away. Accordingly, the "cure" for tuberculosis involved "rest" -- a prolonged stay in a sanatorium.

Sontag applied the same reasoning to debunk what she thought were myths surrounding cancer: It is not a curse or punishment, she argued. Our personality does not make us more or less likely to get cancer, and its successful treatment is not essentially a matter of our outlook. We do not get cancer because we are angry, or because we are lacking in some spiritual quality. To quote Sontag, "Theories that diseases are caused by mental states and can be cured by will power are always an index of how much is not understood about a disease." That was true for tuberculosis in the 20th century, and it is true today for cancer. Despite that truth, some cancer patients -- and in particular those who have been diagnosed with metastatic breast cancer that has spread to other organs -- continue to experience what amounts to a societal stigma. Consider the following correspondence between me and Ellen, who has metastatic breast cancer:

via huffingtonpost.com

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Prevalence and Correlates of Eating Disorders in Adolescents: Results From the National Comorbidity Survey Replication Adolescent Supplement, March 7, 2011, Swanson et al. 0 (2011): archgenpsychiatry.2011.22v1

Lifetime prevalence estimates of anorexia nervosa,bulimia nervosa, and binge-eating disorder were 0.3%, 0.9%,and 1.6%, respectively. Important differences were observedbetween eating disorder subtypes concerning sociodemographiccorrelates, psychiatric comorbidity, role impairment, and suicidality.Although the majority of adolescents with an eating disordersought some form of treatment, only a minority received treatmentspecifically for their eating or weight problems. Analyses of2 related subthreshold conditions suggest that these conditionsare often clinically significant.

via archpsyc.ama-assn.org

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Friday, February 18, 2011

C. Difficile Spreads from Hospital to Community, ACG from MedPage Today

Clostridium difficile infection has spread from the hospital to the community but has proved manageable thus far, according to data reported here.

From 1991 to 2005, the incidence of community-acquired C. difficile in Olmsted County, Minn., quadrupled but still remained less common than the hospital-acquired gastrointestinal infection, Sahil Khanna, MD, of the Mayo Clinic in Rochester, Minn., said at the American College of Gastroenterology meeting.

"Patients with community-acquired C. difficile infection were younger, more likely to be female, and less likely to have severe infections," Khanna observed.

Epidemiologic studies have shown an increasing incidence of both nosocomial and community-acquired infections. However, few studies have looked at the incidence of community-acquired C. difficile, said Khanna.

via medpagetoday.com

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Sick doctors who work are doing more harm to their patients than good

Doctors: if you’re sick, don’t go to work.
The stereotype of doctors is that they go to work, despite whatever symptoms ail them. Calling in sick places strain on colleagues. Especially in residency, where team members are expected to pick up the slack.
In a recent column, the New York Times’ Pauline Chen discusses the image of self-sacrifice that a sick doctor going to work portrays:
Hacking, febrile or racked with the sequelae of chronic illnesses, doctors who are sick have continued for generations to see their patients. Although published reports for over a decade have linked patient illnesses like the flu, whooping cough and resistant bacterial infections to sick health care workers, as many as 80 percent of physicians continue to work through their own ailments, even though they would have excused patients in the same condition.
In today’s age of H1N1 influenza and other assorted public health worries, presenteeism is being looked at. Interestingly,
researchers in the business world have begun to question this assumption. Instead of focusing on problems incurred by absenteeism, these researchers have analyzed the impact of what’s been called presenteeism, or working despite being ill. And it turns out, at least in early studies, that those employees who choose to go to work sick are expensive. Presenteeism costs companies more than $150 billion a year in lost worker productivity.

via kevinmd.com

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Tuesday, January 18, 2011

Medical News: Cut Daily Salt Intake to 1,500 Mg, AHA Says - in Cardiovascular, Hypertension from MedPage Today

Daily intake of salt should be limited to 1,500 mg for all Americans, according to an advisory statement from the American Heart Association (AHA).
"The 2020 goal of the American Heart Association is to improve the cardiovascular health of all Americans by 20% while continuing to reduce deaths from [cardiovascular disease] and stroke by 20%," Lawrence J. Appel, MD, of Johns Hopkins, and colleagues wrote online in Circulation.
Two key components of improving cardiovascular health are population-wide lowering of blood pressure below 120/80 and reducing sodium chloride intake below 1,500 mg per day, observed AHA president Appel.
Action Points --->
Note that the American Heart Association states that two of the key metrics for ideal cardiovascular health are a blood pressure of 120/80 mm Hg and sodium consumption of 1500 mg/day.
Note further that in this advisory, the AHA reviews the evidence for the benefits of reduced sodium intake and issues a call to action.

The evidence linking salt intake with blood pressure -- and the major adverse outcomes of heart disease, stroke, and kidney disease -- is "impressive," wrote the authors of the advisory.

That evidence includes more than 50 trials assessing the blood pressure effects of salt, as well as a meta-analysis showing that cutting salt intake by about 1,800 mg per day lowered blood pressure by 5 mm Hg systolic and 2.7 mm Hg diastolic.

Various studies also have compared the benefits and outcomes of a number of different sodium reduction goals. Notably, reducing salt consumption also can help prevent the blood pressure increases that come with age, ultimately affecting 90% of adults.

via medpagetoday.com

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Monday, November 22, 2010

Myths Fuel Dangerous Decisions to Not Vaccinate Children | Vaccination Decline | Bacterial Meningitis & Vaccine Myths | LiveScience

Over the course of one summer vacation, Tyler Ludlum went from being a healthy 10-year-old, looking forward to the pool, to an emotionally and physically traumatized preteen who'd traded both of his feet, and half the fingers on his right hand, for his life.

It could have been prevented if he – or those around him – had been vaccinated.

Tyler had contracted meningococcal meningitis, a swelling of membranes around the brain and spinal cord that's caused by bacteria passed by nasal or oral droplets. Tyler was likely in the vicinity of a perhaps asymptomatic carrier of the disease, when this person coughed or sneezed.

But his story is more than a case of being in the wrong place at the wrong time: A vaccine that's at least 85 percent effective at preventing meningococcal meningitis is widely available and strongly recommended by health officials. Too young to have received the vaccination as part of a routine visit, Tyler was dependent on those around him to be immunized.

via livescience.com

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Wednesday, November 17, 2010

FDA expected to ban alcoholic energy drinks - Health - Addictions - msnbc.com

WASHINGTON — The Food and Drug Administration is poised to announce a virtual ban of alcoholic energy drinks on Wednesday, even as a leading manufacturer is pulling its products off the market.

The FDA is expected to say that caffeine is an unsafe food additive to alcoholic drinks, a move that would effectively ban them from sale. College students have been hospitalized after drinking the beverages, including the popular Four Loko, and four states have banned the drinks.

Phusion Projects, which manufactures Four Loko, announced late Tuesday that it would reformulate its drinks, removing caffeine. While there is little known medical evidence that the drinks are less safe than other alcoholic drinks, public health advocates say they can make people feel more alert and able to handle risky tasks like driving.

The company's statement said it was removing caffeine from the drinks after unsuccessfully trying to deal with "a difficult and politically-charged regulatory environment at both the state and federal levels."

"We have repeatedly contended — and still believe, as do many people throughout the country — that the combination of alcohol and caffeine is safe," said Chris Hunter, Jeff Wright and Jaisen Freeman, who identify themselves as Phusion's three co-founders and current managing partners.

The statement did not mention several recent incidents in which college students were hospitalized after drinking the beverage. In response to such incidents, four states — Washington, Michigan, Utah and Oklahoma — have banned the beverages. Other states are considering similar action.

Four Loko comes in several varieties, including fruit punch and blue raspberry. A 23.5-ounce can sells for about $2.50 and has an alcohol content of 12 percent, comparable to four beers, according to the company's website.

via msnbc.msn.com

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Thursday, April 7, 2011

CDC Sees EHRs As Public Health 'Game Changer' -- InformationWeek

Friday, March 11, 2011

Joseph Nowinski, Ph.D.: Rethinking Societal Attitudes About People Who Get Cancer

Prevalence and Correlates of Eating Disorders in Adolescents: Results From the National Comorbidity Survey Replication Adolescent Supplement, March 7, 2011, Swanson et al. 0 (2011): archgenpsychiatry.2011.22v1

Friday, February 18, 2011

C. Difficile Spreads from Hospital to Community, ACG from MedPage Today

Sick doctors who work are doing more harm to their patients than good

Tuesday, January 18, 2011

Medical News: Cut Daily Salt Intake to 1,500 Mg, AHA Says - in Cardiovascular, Hypertension from MedPage Today

Monday, November 22, 2010

Myths Fuel Dangerous Decisions to Not Vaccinate Children | Vaccination Decline | Bacterial Meningitis & Vaccine Myths | LiveScience

Wednesday, November 17, 2010

FDA expected to ban alcoholic energy drinks - Health - Addictions - msnbc.com

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