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    Monday, October 26, 2009

    Post-cholecystectomy cystic duct stump leak: a preventable morbidity

    Irshad Ahammed et al writes that “While major bile duct injury is the most serious complication following laparoscopic cholecystectomy, bile leak from the cystic duct stump remains the commonest morbidity.” This is a retrospective assessment of all patients who had a cholecystectomy over a 5-year period from April 2003 to March 2008.

    Data related to bile leakage were obtained from the Unisoft endoscopic retrograde cholangio-pancreatography (ERCP) database.

    Overall 2011 cholecystectomies were performed, of which 488 were done as emergency procedures. Thirteen patients had significant bile leakage, three of which were from accessory ducts, in one the source could not be identified and nine had a cystic duct stump leak (CDSL), which formed the basis of this study. Emergency cholecystectomies seem to have a higher incidence of CDSL Eight of the nine CDSL patients had successful ERCP and stenting. One had a percutaneous trans-hepatic cholangiography and stenting. CDSL following emergency laparoscopic cholecystectomy was up to threefold higher than after elective procedures.

    CONCLUSION: The CDSL of 0.44% was comparable to the reported incidence in the literature. Endoscopic management remains the treatment of choice.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    *Tune in later for STROKES.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Friday, October 23, 2009

    COLLISIONS BETWEEN MEDICAL HUMANISM AND EVIDENCE-BASED GUIDELINES FOR STANDARDIZED MEDICAL CARE

    Outright collisions between medical humanism and evidence-based guidelines for standardized care can be avoided as long as clinical guidelines (beyond safety measures) remain recommendations rather than mandates. Hartzman and Groopman believe it is essential to respect the ethical principle that any choice of treatment must ultimately be made by the patient who will benefit or suffer from it. Many patients have become aware of the scientific limitations of guidelines through reports in the media about recent reversals of expert advice on hormone-replacement therapy for postmenopausal women, low-fat diets for obesity, the use of erythropoietin for cancer-associated anemia, and tight regulation of glucose levels in various settings. Because guidelines are derived from clinical studies carried out in selected groups of patients and their statistical conclusions are based on study populations, they may not apply to an individual patient, especially if he or she has coexisting conditions. In many instances, the results of larger and better-designed clinical trials have contradicted what appeared to be firm conclusions from earlier research. Furthermore, there are frequently experts who dissent from the majority opinion on which guidelines are based, and their views are not routinely represented in the guidelines.

    What is the remedy ask Hartzband and Groopman writing in the NEJM?
    They suggest that shared decision making be central to any changes resulting from current health care reform initiatives. All national guidelines should acknowledge the dissenting opinions of experts. Furthermore, these guidelines should indicate which specific populations were studied and which important coexisting conditions constituted criteria for exclusion from the trials, so that physicians can judge whether and how the guidelines apply to an individual patient. Currently, some guideline committees receive financial support from pharmaceutical and device companies, and there are indications that such support has influenced the recommendations.4,5 In order to assure the public that there is no potential for a conflict of interest that would taint the guidelines, an independent government body should be established to develop guidelines without industry support — analogous to the role of the Food and Drug Administration as an unbiased party for the approval of treatments. Funding could come instead from the federal monies already designated for comparative-effectiveness research.

    *Tune in later for Post-cholecystectomy cystic duct stump leak.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Tuesday, October 20, 2009

    CHILDHOOD POISONINGS RESULT IN 71,224 EMERGENCY DEPARTMENT VISITS NATIONWIDE EVERY YEAR

    Children are twice as likely to be poisoned by the medicine cabinet than by cleaning products or other household substances, researchers found.

    Emergency department visits for unintentional poisoning involved prescription or over-the-counter medication in 68.9% of pediatric cases, according to Daniel S. Budnitz, MD, of the Centers for Disease Control in Atlanta, and colleagues.

    Children taking medications without supervision caused 10 times as many poisonings as overdose errors by a parent or other caregiver in the national study of emergency department surveillance, the authors reported online ahead of print in the AMERICAN JOURNAL OF PREVENTIVE MEDICINE.

    The findings held few surprises but emphasize the need for prevention, particularly with toddlers, commented Carl Baum, MD, of the Center for Children's Environmental Toxicology at Yale-New Haven Children's Hospital, who was not involved in the study.

    Children 5 and under accounted for 81.3% of pediatric accidental poisonings in the study, which Baum chalked up to their inventiveness in bypassing adult measures to prevent access. "You have to be careful because toddlers are often one step ahead of adults," he asserted.

    Budnitz' group analyzed data from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS), which receives reports from a random sample of adult and pediatric hospitals across the country.

    The database included 3,034 emergency department visits or hospital admissions of patients under 19 during 2004-2005 for a condition the treating physician attributed to a medication overdose (more than the intended dose or inadvertent exposure), or to poisoning from a nonpharmaceutical consumer product.

    Cases included ingestion and skin or eye exposures but excluded illicit substances, alcohol, tobacco, bee stings, and lead.
    The population rate of emergency care for medication overdoses was significantly higher than those for nonpharmaceutical products at 9.2 visits per 10,000 individuals per year (95% CI 7.3 to 11.0) compared with 4.2 (95% CI 3.3 to 5.0).
    Commonly available over-the-counter medications accounted for 33.9% of cases overall. The most commonly implicated drugs were:
    • Acetaminophen (9.3%).
    • Cough and cold medications (7.3%).
    • Antidepressants (6.1%).
    • Nonsteroidal anti-inflammatory drugs (NSAIDs, 5.3%).

    Inclusion of cough and cold medicines on this list highlights the risks emphasized recently by both the FDA and trade groups representing the manufacturers.

    (See Pediatric OTC Cough and Cold Remedies Should be Shunned in Toddlers and FDA Repeats Warning on Cough and Cold Medicines and Hopes That Parents Get the Message )
    Cough and cold medicines "do a very poor job of treating symptoms that are usually self-limiting" and are potentially dangerous for children, Baum noted.

    Medication overdose rates peaked at age 2 years (54.7 per 10,000 individuals per year) and fell with age until adolescence, when rates again rose (1.8 per 10,000 per year at ages 12 to 14 versus 3.3 at ages 15 to 18).

    "The fact that, annually, one of every 180 children age 2 years is treated in an emergency department for a medication overdose, despite current prevention efforts, underscores the size of this public health issue," Budnitz's group concluded.
    If anything, the results probably underestimate the scope of childhood poisonings, since poison control centers receive many more calls about pediatric poisonings, they noted. However, only a quarter of those result in direct treatment by a healthcare professional, they noted.Since unsupervised ingestion of medications by children 5 and under accounted for more than 75% of childhood poisonings, prevention efforts should concentrate on this problem, the investigators recommended.

    Child-resistant bottles, blister packs, and other packaging have been effective against childhood medication overdoses, Baum noted, though these can be defeated by failure to use them properly, such as cross-threading a lid. Further efforts are recommended to focus on improving packaging for the drugs most commonly implicated in poisonings, such as bottles that release only a single dose at a time or restrict the amount that can be ingested by an unsupervised child, the researchers said.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

    *Tune in later for COLLISIONS BETWEEN MEDICAL HUMANISM AND EVIDENCE-BASED GUIDELINES FOR STANDARDIZED MEDICAL CARE.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Saturday, October 17, 2009

    REVIEW SUGGESTS H1N1 FLU DRUGS SHOULD NOT BE USED FOR CHILDREN UNDER 12.

    A review of research published in the British Medical Journal found that children "under the age of 12 shouldn't be given the common antivirals Tamiflu [oseltamivir] or Relenza [zanamivir] to treat suspected A/H1N1 swine flu." Dr. Matthew Thomson, one of the report's authors, "said giving Tamiflu or Relenza to children under 12 reduces the length of the illness by an average of one day, which he described as a 'short effect for an illness that lasts about a week.'" Dr. Thomson also said that antivirals "could do more harm than good."

    The Oxford University researchers "also concluded that giving the drugs to children after they have been exposed to the flu virus -- post-exposure prophylaxis -- reduces transmission by only eight percent. The researchers "studied four separate randomized trials (two with Tamiflu and two with Relenza) that treated 1,766 children with the flu and three trials of post-exposure prophylaxis involving 863 children." They "concluded that, despite shortening the duration of infection, the drugs did not reduce the normal complications of flu, including asthma flareups, ear infections, sinusitis, bronchitis, and convulsions from fever."


    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    *Tune in later for CHILDHOOD POISONINGS RESULT IN 71,224 EMERGENCY DEPARTMENT VISITS NATIONWIDE EVERY YEAR.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Wednesday, October 14, 2009

    Patients Spend $34 Billion on Alternative Medicines

    ‘Patients in the U.S. spent about $34 billion on complementary and alternative medicine in 2007, according to a government report,” says Kristina Fiore of MedPage Today, commenting on Nahin RL, et al "Costs of complementary and alternative medicine and frequency of visits to CAM practitioners: United States, 2007" National Health Statistics Report 2009; 18.

    About two-thirds of those out-of-pocket expenditures went to self-care items, including yoga classes and "natural" products, Richard L. Nahin, PhD, MPH, of the National Institutes of Health, and colleagues said. Complimentary and alternative medicine, otherwise known as CAM, "includes medical practices and products...which are not part of conventional medicine. These therapies are sought by Americans mainly "for pain relief and to contribute to their health and well-being

    The findings, reported in a National Center for Health Statistics brief, are consistent with other evidence that the use of self-care therapies has increased, while fewer Americans are going to complementary and alternative medicine professionals.

    The researchers said that the 354 million visits to complementary medicine practitioners in 2007 -- the latest year for which figures are available -- marked a drop of about 50% over 1997 numbers.

    The biggest decrease came among visits to practitioners of energy-healing therapies and relaxation techniques, the researchers said.
    Visits to acupuncturists, however, increased over the 10-year period, likely because more states now license the practice.
    "Natural products" not including vitamins or minerals accounted for the biggest chunk of self-care spending at $14.8 billion (44%) of total complementary medicine out-of-pocket expenditures.

    Practitioners of complementary medicine took in a total of $11.9 billion and $7.2 billion was spent for classes, homeopathic medicines, and relaxation techniques.
    The $34 billion spent on complementary and alternatives medicines is a small slice of the total $2.2 trillion spent on healthcare in 2007, and accounts for 11.2% of total out-of pocket spending.

    A total of $49.6 billion out-of-pocket was spent on physician visits and $47.6 billion went to prescription drugs.
    The findings were based on the 2007 National Health Interview Survey (NHIS), which included questions on 36 types of complementary medicine therapies. The researchers said the study may have been limited by potential recall bias because of patient self-report.

    Josephine P. Briggs, MD, director of the National Center for Complementary and Alternative Medicine, said the findings "underscore the importance of conducting rigorous research and providing evidence-based information on complementary and alternative medicines so that healthcare providers and the public can make informed decisions."

    REPORT INDICATES AMERICANS SPEND ABOUT $34 BILLION ANNUALLY ON CAM.

    USA Today (7/31, Szabo) reports that, according to a study conducted by researchers at the Centers for Disease Control and Prevention and the National Institutes of Health, "while Americans may complain about the high cost of healthcare, they're still willing to shell out roughly $34 billion a year out-of-pocket on alternative therapies that aren't covered by insurance." Josephine Briggs, of the NIH, said that "the results...show why it's important for researchers to conduct rigorous scientific studies of alternative therapies."

    The AP (7/31, Marchione, Stobbe) reports, "The data, gathered in 2007 mostly before the recession was evident, don't clearly reflect whether the economy played a role in spending on these therapies." But, Briggs pointed out that "there has been 'speculation that as the number of uninsured grows, there may be increased utilization of some of these approaches, which tend to be relatively inexpensive.'" The findings are "based on a...survey by the [CDC] of more than 23,000 adults nationwide." While the current report does not cover "vitamins and minerals," they "will be addressed in a future one."

    Complimentary and alternative medicine, otherwise known as CAM, "includes medical practices and products...which are not part of conventional medicine. These therapies are sought by Americans mainly "for pain relief and to contribute to their health and well-being.

    She added that researchers aimed to "find out which areas of CAM warrant research by the [NIH]," and that Americans were surveyed "without regard as to whether any of these alternative or complementary approaches actually work."

    In the Los Angeles Times (7/30) Booster Shots blog, Shari Roan noted that "about 38 percent of the adults surveyed said they had used some form of CAM for preventative health purposes or to treat a disease or condition." Of total expenditures, "about $22 billion of that was for products, including classes, materials and non-vitamin, non-mineral natural products such as fish oil, glucosamine and Echinacea," Rob Stein wrote in the Washington Post (7/30) Checkup blog. Of that amount "$14.8 billion...was for the supplements," while "$11.9 billion was for an estimated 354.2 million visits to acupuncturists, chiropractors, massage therapists and other CAM practitioners."

    WebMD (7/30, Boyles) reported, however, that "newly published survey was so different from" data published in 1997 "that researchers were hesitant to compare them." Still, "the data suggest that adults in the US made half as many visits to CAM practitioners in 2007 as they did in 1997, a decline from roughly three visits for every 1,000 adults to 1.5 visits." But, "visits to acupuncturists increased from 27 visits per 1,000 adults in 1997 to 79 visits per 1,000 adults in 2007." The report stated that this increase "may be in part due to the greater number of states that license this practice and a corresponding increase in the number of licensed practitioners in 2007...as well as increased coverage for these therapies." The Wall Street Journal (7/30) Health Blog, the Baltimore Sun (7/31, Brewington) Picture of Health blog, and Reuters (7/31) also covered the story.

    Research article
    Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn's Disease
    Jochen Klaus , Ulrike Spaniol , Guido Adler , Richard A Mason , Max Reinshagen and Christian von Tirpitz C
    BMC Gastroenterology 2009, 9:61doi:10.1186/1471-230X-9-61


    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

    *Tune in later for REVIEW SUGGESTS H1N1 FLU DRUGS SHOULD NOT BE USED FOR CHILDREN UNDER 12.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Monday, October 12, 2009

    NEW LAW SEEN AS ADDING MORE RESTRICTIONS TO ENSURE PRESCRIPTION DATA PRIVACY.

    The New York Times (8/9, BU1, Freudenheim) reported on the front of its Sunday Business section about how people believe their prescription drug information is "private. But in fact, prescriptions, and all the information on them -- including not only the name and dosage of the drug and the name and address of the doctor, but also the patient's address and Social Security number -- are a commodity bought and sold in a murky marketplace." However, this "may change if some little-noted protections from the Obama administration are strictly enforced.

    The federal stimulus law enacted in February prohibits in most cases the sale of personal health information, with a few exceptions for research and public health measures like tracking flu epidemics." Still, the "law won't shut down the medical data mining industry, but there will be more restrictions on using private information without patients' consent and penalties for civil violations will be increased." Dr. David Blumenthal, the national coordinator for health IT, said, "We can't afford to go forward with our plans unless we have assured the American public that the privacy of their information is assured."


    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

    *Tune in later for Patients Spend $34 Billion on Alternative Medicines.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Friday, October 9, 2009

    HOW MUCH EVIDENCE DO WE NEED TO CHANGE PRACTICES IN WHICH WE FIRMLY BELIEVE?

    Enough already! Randomized trials show that tight glucose control in patients with long-standing type 2 diabetes isn't beneficial,” says Richard Saitz, MD, MPH, FACP, FASAM; Published in Journal Watch General Medicine

    Should the glycosylated hemoglobin (HbA1c) level goal in patients with long-standing type 2 diabetes be 7%? 6.5%? Lower? Although many clinicians believe in tight control for patients with type 2 diabetes, recent studies suggest that this practice is not beneficial. Several recently published commentaries cite evidence that challenges current beliefs and practices.

    In the first major trial (done in the 1960s) of tight glucose control in patients with type 2 diabetes, oral glucose-lowering agents were associated with higher cardiovascular mortality and no differences in microvascular complications compared with placebo.1 Insulin also was not associated with clinical benefit.

    In three recent large randomized trials (ACCORD,2 ADVANCE,3 and VADT4), tight control in patients with long-standing type 2 diabetes did not lower overall mortality, cardiovascular-related mortality, stroke, amputations, or even clinical (as opposed to surrogate) microvascular endpoints. Differences in specific outcomes in these trials might be related to different treatments or to duration of diabetes in participants. In some studies, fewer intensively treated patients reached composite outcomes (such as "any diabetes complications"), but the bulk of improvement was in nonclinical outcomes (e.g., incident albuminuria). Tight control was associated with severe hypoglycemia and weight gain. In the UKPDS study,5 published a decade ago, nonobese intensively treated participants with newly diagnosed type 2 diabetes were less likely to reach microvascular endpoints (including "need for photocoagulation," but not visual loss) but showed no difference in mortality (cardiovascular, diabetes-related, or all-cause) compared with nonobese control patients. Among obese participants, metformin alone lowered long-term mortality and myocardial infarction rate, but sulfonylureas and insulin did not; tight control did not lessen risk for microvascular complications. Metformin and sulfonylureas in combination were associated with excess diabetes-related deaths and all-cause mortality.

    Because trials do not support tight control and because of the cost, burden, and harms associated with tight control, we should be emphasizing cardiovascular risk reduction (particularly control of blood pressure and cholesterol levels) and healthy lifestyles for patients with type 2 diabetes.6 Several groups of editorialists suggest aiming for HbA1c levels of 7.0% or 7.5% in patients in whom this goal is achievable with one medication and adjusting this target for others based on symptoms, side effects, treatment burden, and patient values and preferences.6,7,8 Commentary authors suggest that the HbA1c goals for practice guidelines should not be <7% and that, to encourage individualized treatment, performance measures should set an upper limit (e.g., 9%) rather than a lower limit (e.g., <7%).7

    Randomized trial results often are not available to answer important clinical questions. In this case, they are. We shouldn't ignore them. Many clinical trials are completed that show benefits, and much time passes, before new treatments are adopted; similarly, many trials that show lack of benefit, or even harm, might be required before clinicians abandon ineffective practices that have become routine. Haynes and Haynes ask, "What does it take to put an ugly fact through the heart of a beautiful hypothesis?" and they quote poetry: "The chains of habit are too weak to be felt until they are too strong to be broken."9 Social psychology literature suggests that people cling to belief even in the face of mountains of evidence to the contrary. But, as physicians and scientists, we should embrace change when new evidence consistently contradicts our prior beliefs and clinical practice.


    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

    *Tune in later for NEW LAW SEEN AS ADDING MORE RESTRICTIONS TO ENSURE PRESCRIPTION DATA PRIVACY.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Tuesday, October 6, 2009

    GUIDE TO THE MAIN HEALTHCARE FIGHT POINTS

    KEEP IT OR LOSE IT?
    If you like your doctor, you will be able to keep your doctor? If you like your health care plan, you’ll be able to keep your health care plan? No one will take it away, no matter what?

    These assurances may not be literally true or enforceable. The legislation does not require insurers or employers to continue offering the health benefits they now provide. Current insurance coverage might not be viable for long because insurers could not add benefits or enroll additional people in noncompliant policies. Your health plan may change, and your doctor may no longer accept your insurance.

    SOCIALIZED MEDICINE?

    Whether a public plan would crowd out private insurers depends on details yet to be decided, including its premiums and its payment rates for health care providers.
    The federal government already holds sway over the health care system through Medicare, Medicaid and various insurance programs for children, veterans, military personnel and other federal employees. The federal government will account for 35 percent of the expected $2.5 trillion in health spending this year, and that does not include subsidies built into the tax code.

    INSURERS ARE TO BLAME?
    Democrats have unleashed a blistering attack on private health insurers as they try to convince the vast majority of Americans who already have coverage that the current system is tilted in favor of corporate profits, not patients, and that insurers are a main obstacle to passing legislation.
    Most Americans do not know the full cost of their employer-sponsored insurance. And it is easier for Democrats to paint insurers as greedy than to explain the complex math that shows current health care spending is unsustainable.

    DEFICIT-NEUTRAL?
    The Congressional Budget Office has yet to issue cost estimates for the latest versions of the bill approved by three House committees. But it has warned that the legislation “would probably generate substantial increases in federal budget deficits” beyond 2019, in part because health costs are rising faster than the rate of inflation and proposed new taxes would not keep up.

    EUTHANASIA?
    Critics say the legislation could limit end-of-life care and even encourage euthanasia. Moreover, some assert, it would require people to draw up plans saying how they want to die.
    These concerns appear to be unfounded. AARP, the lobby for older Americans, says, “The rumors out there are flat-out lies.” The House bill would provide Medicare coverage for optional consultations with doctors who advise patients on life-sustaining treatment and “end-of-life services,” including hospice care. The legislation instructs Medicare officials to propose ways to measure the quality of end-of-life care. Doctors would have financial incentives to report data on such care to the government.

    CUTTING MEDICARE?
    To help finance coverage for the uninsured, Congress would squeeze huge savings out of Medicare, the program for older Americans and the disabled. These savings would pay nearly 40 percent of the bills’ cost.The legislation would trim Medicare payments for most services, as an incentive for hospitals and other health care providers to become more efficient. The providers make a plausible case that the cutbacks could inadvertently reduce beneficiaries’ access to some types of care.Indeed some proposals could affect beneficiaries. The major bills in Congress would cut more than $150 billion over 10 years from federal payments to private health plans that care for more than 10 million Medicare beneficiaries.
    From “a primer on the details of health care reform” by R. Pear and d. M. Herszenhorn

    COMMENT:
    To pass his health proposal without busting the budget, especially this year, Obama would first need to violate his word. ... He pledged that 'no one making less than $250,000 a year will see any type of tax increase' -- the most memorable number of the 2008 campaign. Taxing health benefits would certainly cross this very bright line and add to the public stock of cynicism. Second, Obama would need to abandon economic common sense -- adding debt to debt or new taxes to a struggling economy.


    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    *Tune in later for How Much Evidence Do We Need to Change Practices in Which We Firmly Believe?


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Saturday, October 3, 2009

    FOUR LIFESTYLE CHOICES MAY HELP REDUCE RISK OF CHRONIC DISEASE, RESEARCHERS SAY.

    "If people would just do four things -- engage in regular physical activity, eat a healthy diet, not smoke, and avoid becoming obese -- they could slash their risk of diabetes, heart attack, stroke or cancer by 80 percent," CDC researchers found. "But less than 10 percent of the 23,153 people in the multiyear study -- published in the Archives of Internal Medicine -- actually lived their lives this way." The new study, however, may change some minds, because it has "such a simple straightforward focus on making the point that prevention works in preventing serious disease," noted Dr. J. Leonard Lichtenfeld, of the American Cancer Society.

    Delving into the specifics of the study, the CDC investigators, alongside scientists in Germany, "drew on data from a German study conducted between 1994 and 1998" in which participants between 35 and 65 years of age were asked about their "lifestyle characteristics," disease history, and dietary habits. "Adherence to four key lifestyle indicators were tracked: never having smoked; having a body-mass index below 30 (the threshold for obesity); exercising for a minimum of 3.5 hours per week; and eating healthfully, as evidenced by a diet high in fruit and vegetable intake, but low in meat." Although "most study participants engaged in some (one to three), but not all of the ideal behaviors," the team found that "less than four percent met none of the criteria for a healthy lifestyle, while nine percent followed all four."

    As for disease incidence, "3.7 percent of participants developed diabetes, 0.9 percent developed myocardial infarction, 0.8 percent developed stroke, and 3.8 percent developed cancer,"Yet, participants "who followed all four lifestyle factors had a 78 percent lower risk of developing a chronic disease than those with no healthy factors." Specifically, they had a "93 percent lower risk of diabetes, an 81 percent lower risk of myocardial infarction, a 50 percent lower risk of stroke," and a "36 percent lower risk of cancer." And, "reductions in risk were similar for men and women."


    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    *Tune in later for GUIDE TO THE MAIN HEALTH CARE FIGHT POINTS.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Thursday, October 1, 2009

    ACIP Recommends Five Groups as Priority Targets for H1N1 Vaccination

    The CDC's Advisory Committee on Immunization Practices (ACIP) has recommended which U.S. population groups should be targeted to receive H1N1 influenza vaccine when it becomes available. People over 65 have the lowest priority.
    The 15-member ACIP says these five groups should be targeted:
    • pregnant women;
    • household contacts of infants under 6 months;
    • healthcare and emergency-services workers;
    • young people between 6 months and 24 years of age;
    • and nonelderly adults with underlying risk conditions, such as diabetes and chronic lung disease.
    The five groups comprise about 160 million people, about half the U.S. population.
    Dr. Anne Schuchat, who directs the CDC's center for immunization, said at a press conference that people over 65 received ACIP's lowest priority for H1N1 vaccination because the virus "has, to a large extent, spared that population." She emphasized, however, the importance of ensuring that the elderly receive the seasonal flu vaccine.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    *Tune in later for FOUR LIFESTYLE CHOICES MAY HELP REDUCE RISK OF CHRONIC DISEASE, RESEARCHERS SAY.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com