SALUD (78)
HOUSTON
It is important for parents to remember the basics about prevention and management of allergies, said a pediatrician from Baylor College of Medicine. Dr. Armando Correa, an assistant professor of pediatrics at BCM and a pediatrician at Texas Children’s Hospital, offered the following tips:
-Seek immediate medical attention for difficulty breathing, swelling of the face, tongue or other extremities.
-Consider short-term medication for symptoms such a runny nose, itchy eyes or sneezing.
-If symptoms persist, contact your pediatrician.
-For children under the age of 2 experiencing allergies, always seek medical attention.
-Help manage environmental allergies by avoiding places that have just been cleaned or places where pets frequent.
Correa also offered tips on food allergies:
-If your child has multiple or severe allergies, they should always carry an injectable medication.
-Always read the food labels and be aware of where foods are manufactured.
-Consider allergy testing for children with severe or multiple allergies.
Always consult a pediatrician on questions related to allergy prevention and management.
HOUSTON
If running is turning into a pain in the knees, it might actually be the hips that need your attention, according to an expert at Baylor College of Medicine. When runners have knee pain, it’s usually related to foot or hip problems, according to Dr. Joseph Chorley, associate professor of pediatrics – adolescent and sports medicine at BCM and Texas Children’s Hospital. If a runner is not in control at the foot, ankle or hip, the knee is what gets twisted, has to overwork and develops irritation.
Chorley makes the following suggestions:
-Stretch properly before running
-Don’t increase mileage by more than 10 to 15 percent per week -Walk when knee pain begins
-Replace shoes every six to nine months or every 500 miles
-Know what your foot type is and be sure you have proper cushioning
-Consider cross-training and strengthening exercises to help strengthen the core, glutes or hamstrings
-Multi-vitamins are helpful for all runners and fish oil is good for long distance runners
However, there are some symptoms that may indicate a more severe problem that should be seen by a sports medicine physician:
-Fluid accumulating in the knee
-Painful popping or a mechanical sensation
-Someone who had a previous structural injury such as torn ACL or PCL that’s now experiencing pain
HOUSTON
While there are several factors that can cause anxiety in older adults, it can be difficult to identify because they express anxiety in unique ways, according to an expert at Baylor College of Medicine.
According to Dr. Melinda Stanley, professor in the Menninger Department of Psychiatry and Behavioral Sciences at BCM, common types of anxiety disorders in adults include:
-Generalized anxiety
-Specific fears and phobias
-Social phobias
-Post-traumatic stress disorder
Anxiety symptoms that older adults and their family members should watch for include:
-Shortness of breath
-Increased heart rate
-Dizziness
-Difficulty sleeping
- Muscle aches and pains
Anxiety is not a normal part of aging and can be treated. The first important step is to have a physical exam. Cognitive behavioral therapy is a treatment option that teaches learning skills to manage anxiety. Skills that can help reduce anxiety include relaxation, changing thoughts, facing fears, learning how to solve problems and learning behaviors to improve sleep.
MIKE STOBBE,AP Medical Writer
NEW YORK (AP)
They sweep. They swab. They sterilize. And still the germs persist.
In U.S. hospitals, an estimated 1 in 20 patients pick up infections they didn't have when they arrived, some caused by dangerous 'superbugs' that are hard to treat.
The rise of these superbugs, along with increased pressure from the government and insurers, is driving hospitals to try all sorts of new approaches to stop their spread:
Machines that resemble "Star Wars" robots and emit ultraviolet light or hydrogen peroxide vapors. Germ-resistant copper bed rails, call buttons and IV poles. Antimicrobial linens, curtains and wall paint.
While these products can help get a room clean, their true impact is still debatable. There is no widely-accepted evidence that these inventions have prevented infections or deaths.
Meanwhile, insurers are pushing hospitals to do a better job and the government's Medicare program has moved to stop paying bills for certain infections caught in the hospital.
"We're seeing a culture change" in hospitals, said Jennie Mayfield, who tracks infections at Barnes-Jewish Hospital in St. Louis.
Those hospital infections are tied to an estimated 100,000 deaths each year and add as much as $30 billion a year in medical costs, according to the Centers for Disease Control and Prevention. The agency last month sounded an alarm about a "nightmare bacteria" resistant to one class of antibiotics. That kind is still rare but it showed up last year in at least 200 hospitals.
Hospitals started paying attention to infection control in the late 1880s, when mounting evidence showed unsanitary conditions were hurting patients. Hospital hygiene has been a concern ever since, with a renewed emphasis triggered by the emergence a decade ago of a nasty strain of intestinal bug called Clostridium difficile, or C-diff.
The diarrhea-causing C-diff is now linked to 14,000 U.S. deaths annually. That's been the catalyst for the growing focus on infection control, said Mayfield, who is also president-elect of the Association for Professionals in Infection Control and Epidemiology.
C-diff is easier to treat than some other hospital superbugs, like methicillin-resistant staph, or MRSA, but it's particularly difficult to clean away. Alcohol-based hand sanitizers don't work and C-diff can persist on hospital room surfaces for days. The CDC recommends hospital staff clean their hands rigorously with soap and water — or better yet, wear gloves. And rooms should be cleaned intensively with bleach, the CDC says.
Michael Claes developed a bad case of C-diff while he was a kidney patient last fall at New York City's Lenox Hill Hospital. He and his doctor believe he caught it at the hospital. Claes praised his overall care, but felt the hospital's room cleaning and infection control was less than perfect.
"I would use the word 'perfunctory,'" he said.
Lenox Hill spokeswoman Ann Silverman disputed that characterization, noting hospital workers are making efforts that patients often can't see, like using hand cleansers dispensers in hallways. She ticked off a list of measure used to prevent the spread of germs, ranging from educating patients' family members to isolation and other protective steps with each C-diff patient.
The hospital's C-diff infection rate is lower than the state average, she said.
Westchester Medical Center, a 643-bed hospital in the suburbs of New York City has also been hit by cases of C-diff and the other superbugs.
Complicating matters is the fact that larger proportions of hospital patients today are sicker and more susceptible to the ravages of infections, said Dr. Marisa Montecalvo, a contagious diseases specialist at Westchester.
There's a growing recognition that it's not only surgical knives and operating rooms that need a thorough cleaning but also spots like bed rails and even television remote controls, she said. Now there's more attention to making sure "that all the nooks and crannies are clean, and that it's done in as perfect a manner as can be done," Montecalvo said.
Enter companies like Xenex Healthcare Services, a San Antonio company that makes a portable, $125,000 machine that's rolled into rooms to zap C-diff and other bacteria and viruses dead with ultraviolet light. Xenex has sold or leased devices to more than 100 U.S. hospitals, including Westchester Medical Center.
The market niche is expected to grow from $30 million to $80 million in the next three years, according to Frost & Sullivan, a market research firm.
Mark Stibich, Xenex's chief scientific officer, said client hospitals sometimes call them robots and report improved satisfaction scores from patients who seem impressed that the medical center is trotting out that kind of technology.
At Westchester, workers still clean rooms, but the staff appreciates the high-tech backup, said housekeeping manager Carolyn Bevans.
"We all like it," she said of the Xenex.
At Cooley Dickinson Hospital, a 140-bed facility in Northampton, Mass., the staff calls their machines Thing One, Thing Two, Thing Three and Thing Four, borrowing from the children's book "The Cat in the Hat."
But while the things in the Dr. Seuss tale were house-wrecking imps, Cooley Dickinson officials said the ultraviolet has done a terrific job at cleaning their hospital of the difficult C-diff.
"We did all the recommended things. We used bleach. We monitored the quality of cleaning," but C-diff rates wouldn't budge, said nurse Linda Riley, who's in charge of infection prevention at Cooley Dickinson.
A small observational study at the hospital showed C-diff infection rates fell by half and C-diff deaths fell from 14 to 2 during the last two years, compared to the two years before the machines.
Some experts say there's not enough evidence to show the machines are worth it. No national study has shown that these products have led to reduced deaths or infection rates, noted Dr. L. Clifford McDonald of the Centers for Disease Control and Prevention.
His point: It only takes a minute for a nurse or visitor with dirty hands to walk into a room, touch a vulnerable patient with germy hands, and undo the benefits of a recent space-age cleaning.
"Environments get dirty again," McDonald said, and thorough cleaning with conventional disinfectants ought to do the job.
Beyond products to disinfect a room, there are tools to make sure doctors, nurses and other hospital staff are properly cleaning their hands when they come into a patient's room. Among them are scanners that monitor how many times a health care worker uses a sink or hand sanitizer dispenser.
Still, "technology only takes us so far," said Christian Lillis, who runs a small foundation named after his mother who died from a C-diff infection.
Lillis said the hospitals he is most impressed with include Swedish Covenant Hospital in Chicago, where thorough cleanings are confirmed with spot checks. Fluorescent powder is dabbed around a room before it's cleaned and a special light shows if the powder was removed. That strategy was followed by a 28 percent decline in C-diff, he said.
He also cites Advocate Christ Medical Center in Oak Lawn, Ill., where the focus is on elbow grease and bleach wipes. What's different, he said, is the merger of the housekeeping and infection prevention staff. That emphasizes that cleaning is less about being a maid's service than about saving patients from superbugs.
"If your hospital's not clean, you're creating more problems than you're solving," Lillis said.a
Oncologist Offers 7 Tips for Increasing Awareness
Not too long ago – just after World War II – few people in the United States brushed their teeth with any regularity. Now, the mere thought of going an entire day or night without brushing one’s teeth is simply out of the question for most. Hopefully, someday in the near future, a similar attitude will prevail regarding mental well-being, says Dr. Matt Mumber, an oncologist and author of “Sustainable Wellness: An Integrative Approach to Transform Your Mind, Body, and Spirit,” (www.sustainablewellnessonline.com), coauthored by Yoga therapist Heather Reed. “Human happiness and well-being are rudderless without awareness, which I define as the quality of paying attention to what’s going on in the present moment from an inquisitive, nonjudgmental and focused perspective,” he says. An easy way to think of optimal wellbeing might be to envision a three-legged stool, says Reed. “The three legs include physical activity, nutrition and that underappreciated component missing from too many Americans’ lives – stress management, or a healthy mental state,” she says. After checking off a healthy diet and exercise from the list, how does one go about ensuring a healthy mind? Mumber and Reed say the key is mindfulness, which they define as paying attention on purpose, non-judgmentally and as though your life depended on it. Framed another way, mindfulness means focusing on something without trying to change it, like the sky holding passing clouds without clinging to them.
They describe the states necessary for attaining mindfulness:
• Beginner’s mind is the ability to see things with new eyes. The Bible warns against putting new wine in old wine skins – doing so risks tainting the new stock. A beginner’s mind opens people to the world of possibilities that exist in the present moment. That does not mean throwing away good ideas from the past; rather, it means to entertain new ideas with a truly open sensibility.
• Trust: Believe in your authority to know your own body, thoughts and feelings. We need to have the confidence necessary to trust that our thoughts and feelings at any given moment have value.
• Non-judging is the ability to see things for what they are, to hold an open and neutral place for whatever comes up within and around you, without thinking of anything as categorically better or worse than anything else.
• Patience is a willingness to continue with the process of paying attention on purpose even when it appears that no progress is being made. Learning and growing through mindful practice happens with time, and we can’t force the outcome.
• Acceptance refers to allowing whatever comes up in the moment to be held in our field of awareness. This is not the same as giving up or being passive; acceptance is merely acknowledgement.
• Letting go is refusing to attach to specific thoughts, feelings or behaviors. This can feel like losing something, but every time we let go, we open ourselves to something new and, potentially, deeper.
• Non-striving: In our goal-oriented society, this may seem counterintuitive. However, non-striving refers only to practicing mindfulness without expectation of some future goal or dream, which helps us better live in the now.
“By having our three-legged stool firmly planted in awareness, we can drop into what we typically call a sense of spiritual wellbeing,’ says Mumber.
HOUSTON
Dr. Anthony Maresso, assistant professor of molecular virology and microbiology at Baylor College of Medicine in Houston, answers questions on ricin:
Q: What is ricin?
Ricin is a protein toxin. It is not an infectious agent, so it is not believed to be able to spread from person to person. If it enters your body, it can enter into your cells and when it does so, it can prevent proteins that your body wants to make from being made, which is very toxic.
Q: How are you exposed to ricin?
There are a number of ways you can be exposed to ricin. One way is through inhalation, meaning that you breathe it in. Eating or ingesting the toxin would be gastrointestinal exposure and then there’s the direct injection into your body. The concern with what has happened in Washington, D.C. would be inhalation exposure to ricin protein toxin being sent via the mail.
Q: Where is ricin found?
Ricin comes from the castor bean plant. It’s possible to obtain the beans and isolate the toxin and use that for harmful purposes. However, this is a very crude way to isolate the toxin and I suspect that what’s happened in Washington, D.C. is very crude.
Q: Is this similar to the anthrax scare?
This is very different from the anthrax scare in 2001 where the spores of the bacterium B. anthracis, which causes anthrax and are infectious, were made to be distributed and more easily aerosolized. It’s much harder to get ricin intoxication through a letter than it is to get an anthrax infection through inhalation of spores, which is a bacterial infection. That’s not to diminish the concerns for safety and the impact of this event, just that it is more difficult to be intoxicated with crude ricin than it is a specially formulated spore of anthrax.
Q: Is it always toxic?
It’s thought that enough ricin of the size say of a few salt grains is enough to kill an adult human being. Relative to botulinum toxin, it is less toxic but it is much more toxic than many other proteins or protein toxins.
Q: What are the symptoms if you are exposed to ricin?
Inhalation symptoms manifest three to six hours after breathing it in (and you have to breathe in a significant amount), include:
-Shortness of breath
-Pain or tightness in the chest
-Cough
-Nausea or vomiting (especially if ingested)
-Fever If untreated, a person can succumb or die from ricin intoxication in about three to five days.
Q: What is the treatment?
The treatment for ricin exposure is supportive, meaning that the symptoms you are experiencing are treated. This can include intravenous fluids or pumping of the stomach (if ingested). There is no known vaccine or antidote that is readily available to the public.
Q: Can it spread from person to person?
If you are exposed to ricin and it’s in your clothing or hair, it’s very low probability (not likely) that it can be transferred from one person to another. If you are experiencing symptoms of exposure to ricin, you cannot transmit to another person.
Q: How do you detect ricin?
There are measures in place that the government uses to screen for this, but those are not available to the general public. However, it’s important to avoid all suspicious powder-like material, regardless of its color or texture.
Q: What should you do if you think you are exposed to ricin?
If you know you’re exposed via aerosol, immediately leave the area and get fresh air as soon as possible. If you believe it’s on your clothing the general recommendation is to remove the clothing, preferably by cutting the clothing off rather than pulling it over your head. Take a shower and thoroughly rub your body with soap for 10 to 15 minutes and wash your hair as well. Immediately contact emergency personnel. Don’t manipulate, handle or touch any suspicious packages or letters that you do not recognize.
Q: If it’s detected in an area, or there is a suspicion of ricin, who needs to evacuate?
Do not manipulate, handle, or touch any suspicious packages, letters, or material suspected of containing ricin or powder-like material. Contact emergency personnel immediately. If exposure is in a single room, other parts of the building may be contaminated, and the entire room or building should be evacuated.
Q: Any additional information you would like to add?
The Center for Disease Control and Prevention (www.cdc.gov) is a good resource to learn more about ricin. Relative to some other toxins, the amount of ricin needed for death is much higher and exposures of this sort are usually with a crude preparation, which in and of itself is not usually very potent. However, all the normal procedures for handling or staying away from suspicious packages and letters should be applied.
At rare, extremely high blood glucose levels (1024 mg/dL and above), the FreeStyle lnsuLinx Blood Glucose Meter may provide an inaccurate reading
April
Abbott announced it is initiating a voluntary recall of FreeStyle lnsulinx® Blood Glucose Meters in the United States. The company has determined that at extremely high blood glucose levels of 1024 mg/dL and above, the FreeStyle lnsulinx Meter will display and store in memory an incorrect test result that is 1024 mg/dL below the measured result. For example, at a blood glucose value of 1066 mg/dL, the meter will display and store a value of 42 mg/dL (1066 mg/dL - 1024 mg/dL = 42 mg/dL). No other Abbott blood glucose meters are impacted by this issue. Blood glucose levels at 1024 mg/dL and above are very rare. However, if high blood glucose levels of 1024 mg/dL and above do occur, they are a serious health risk and require immediate medical attention. As the FreeStyle lnsulinx Meter can display an inaccurate low result at a blood glucose level above 1024 mg/dL, there may be a delay in the identification and treatment of severe hyperglycemia, or incorrect treatment may be given.
This could lead to serious injury or death. Customers who are using the FreeStyle lnsulinx Meter should immediately take one of the following actions to address this issue with their meter:
• Customers can access a software update to resolve the issue at www.freestyleinsulinx.com/swupdate. The software update will allow customers to maintain settings and historical data on their meter.
• Customers can contact Abbott Diabetes Care Customer Service at 1-866-723- 2697 to expedite return and replacement of their FreeStyle lnsulinx meter at no charge. Replacements are available, and Abbott will send meters to customers immediately upon request. Until customers are able to update the meter software or until a requested replacement meter arrives, the current FreeStyle lnsulinx meter may be used; however, if patients experience symptoms that are not consistent with their readings, they should contact their healthcare professional and follow his or her treatment advice. "Our first priority is to safeguard the health and safety of patients," said Heather Mason, Senior Vice President, Diabetes Care, Abbott. "We are committed to ensuring that our customers are able to continue to test their blood glucose with confidence, and we initiated this voluntary recall to ensure our products continue to meet the highest standards of quality and safety. We regret any inconvenience this action may cause." The company is notifying all registered users, healthcare professionals, pharmacies and distributors where the FreeStyle lnsulinx Meter is sold. Abbott estimates that there are approximately 50,000 active FreeStyle lnsulinx Meter users in the United States. Upon identifying the issue, Abbott promptly developed and implemented an update to the meter.
(StatePoint)
Eating right is essential to keeping your body running at its best. But nutrition advice doesn’t always account for people’s varied lifestyles, health needs and tastes. Take some time to review your diet and make positive, sustainable changes. So what’s the “right” way to eat for you? Experts say it’s not as restrictive as you may think. “There’s sometimes a misperception that eating properly means giving up favorite foods,” says registered dietitian and President of the Academy of Nutrition and Dietetics, Ethan A. Bergman. “But including foods you love in your diet can help you stick to your goals.”
As part of the “Eat Right, Your Way, Every Day” campaign, Bergman suggests that those looking to eat a healthy diet, tailor food choices to meet lifestyle, needs and preferences:
• Business People: Busy work days can lead to on-the-fly meals. For desktop dining, keep single-serve packages of crackers, fruit, peanut butter, low-sodium soup or canned tuna in your desk. Always on the go? Tuck portable, nonperishable foods in your bag for meals on the run. Try granola bars, peanut butter and crackers, fresh fruit, trail mix or single-serve packages of whole-grain cereal or crackers.
• Athletes: Whether you’re a competitive athlete or just enjoy working out, what you eat affects your performance. Eat a light meal or snack before exercising, such as low-fat yogurt, a banana or cereal with low-fat milk. Before, during and after exercise, drink plenty of water or a sports drink, if you prefer.
• Students: For nutritional, budget-friendly snacking, combine protein and carbohydrates, such as apples and peanut butter, low-fat cheese and whole-grain crackers or hardboiled eggs and fruit. These also double as quick grab-and-go breakfasts. At the cafeteria, salad bars are a great choice -- just go easy on the high-calorie add-ons.
• Families: Family meals allow parents to be role models to ensure kids eat right. And, just because a meal is made quickly doesn’t mean it can’t be nutritious. Keep things simple. Choose ingredients you can use for more than one meal. For example, cook extra grilled chicken for salad or fajitas the next day. Get the kids involved. They can make the salad, set the table or do other simple tasks.
• Vegetarians: A vegetarian diet can include just as much variety as one including meat. For example, nutrient-rich beans are a great choice. Enjoy vegetarian chili, a hummus-filled pita sandwich or veggie burger. Many popular items are or can be vegetarian -- pasta primavera, veggie pizza and tofu-vegetable stir-fry.
• Meat lovers: Keep your meaty meals heart-healthy by selecting lean cuts and choosing chicken, turkey and fish more often. Avoid deep fried foods. Instead, bake, broil, roast, stew or stir-fry your meals.
Set yourself up for success. Consider working with a registered dietitian to develop a personalized eating plan. More tips can be found at www.EatRight.org. Remember, good nutrition isn’t meant to make you suffer. With exercise and moderation, you can enjoy your favorite foods regularly.
(StatePoint)
Unfortunately, beautiful flowers and warm weather can also mean itchy, watery eyes, sneezing fits and nasal congestion. These days, pollen from plants and flowers typically are released earlier in the year than in the past, causing longer allergy seasons according to the American College of Allergy, Asthma and Immunology, which noted that 2012 was one of the worst such seasons on record. While there is no cure-all for seasonal allergies, popular over-the-counter (OTC) medications can provide relief for the most common symptoms.
These guidelines can help you better manage your seasonal allergies:
Season for Sneezing
Popular OTC antihistamines can provide relief from sneezing, runny noses and irritated, watery eyes by blocking the action of histamine, a chemical in the body that triggers congestion and upper respiratory discomfort.
All Stuffed Up?
Decongestants like pseudoephedrine (PSE) relieve a stuffy nose by actually narrowing the blood vessels in nasal passages so you can breathe more easily. PSEs are now located behind the pharmacy counter because they are an ingredient that can be used to make the illegal drug methamphetamine (meth). Rest assured though, PSE has been safely used for decades. If you’re congested, consider treating your symptoms and doing your part to keep your community safer at the same time. Ask your pharmacist about new Nexafed 30mg pseudoephedrine HCl tablets, the next-generation PSE that provides the same effective relief from nasal congestion as standard PSEs, but with technology that disrupts the extraction and conversion of pseudoephedrine into meth.
Itchy, Watery Eyes
Over-the-counter eye drops that are specifically designed to treat allergy symptoms can be found in any drug store and can be very effective at reliving redness and washing away allergens. Also consider using an air purifier or humidifier in your house to help clear the air of possible irritants.
Eat for Allergy Relief
According to experts, certain foods you may already be enjoying have allergy-fighting properties. For example, quercetin, found in oranges, broccoli and sweet potatoes, can help reduce your body’s reaction to pollen. Or, try loading up on salmon and walnuts, as omega-3 fatty acids are thought to alleviate itchy eyes and a runny nose.
If you have questions or doubts about which medications may be best for you, talk with your pharmacist. And if symptoms worsen or last for more than two weeks, be sure to see your doctor. Rest assured, relief for seasonal allergy symptoms does exist! Visit your local drugstore or the Asthma and Allergy Foundation of America’s website for more information on how to treat seasonal allergies. You can check the daily pollen level in your area at National Allergy Bureau online. There’s no reason to miss out on the warm weather and all fun outdoor activities this time of year has to offer.
(StatePoint)
Prostate cancer, the most common non-skin cancer in America, affects one in six men.
Knowing your risk can help you get diagnosed more quickly:
• Age: Although only one in 10,000 men under 40 will be diagnosed, the rate shoots up to one in 38 for ages 40 to 59, and one in 15 for ages 60 to 69.
• Race: African-American men are the most likely to develop prostate cancer. Asian men living in Asia are the least likely.
• Genetics: Men with a family history of prostate cancer are more likely to develop the disease.
For more information on risk factors and healthy living tips that may help to decrease your chance of developing prostate cancer, please visit www.PCF.org.
