TissuGlu, measles, and herbs: Cool stuff I read this week

Source. I came across a bunch of interesting articles and bits of news this week, and I thought I’d share them with you. Spend your lazy Sunday catching up on current events.

  • A father asks a California school district to require unvaccinated children to stay home in hopes that his son, whose leukemia is in remission and who cannot be vaccinated, will not be exposed to measles.
  • The names, addresses, social security numbers, and other personal information for up to 80 million Anthem health insurance customers has been accessed by hackers.
  • Prader-Willi Syndrome, one of the only known genetic causes of obesity, causes significant health problems. This piece in the New York Times Magazine highlights Rachelle, a young woman seeking treatment for the syndrome.
  • The BBC published a series of maps illustrating the growth of the Ebola outbreak within Africa and the presence of Ebola on other continents.
  • It’s about time the Americans with Disabilities Act is applied to websites.
  • The FDA has approved a new internal tissue adhesive called TissuGlu (what a creepy name) for use in surgeries removing excess fat or skin and for repairing separated abdominal muscles.
  • Lots and lots of Chinese kids wear glasses.
  • In store-brand herbal supplements, 4 out of 5 contained fillers like powdered rice and asparagus rather than the herbs named on the packaging.

Read up!

Friday Five: Cigarettes, taxes, cancelled insurance, krokodil, pre-term births

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. This time, it's Bloomberg-heavy!  

New Yorkers have to be 21 to buy cigarettes

In what may be his last public health move before leaving office, New York City mayor Michael Bloomberg is set to sign a bill that will raise the purchasing age of nicotine products to 21. The bill covers cigarettes, e-cigarettes, cigars, and cigarillos. About 90% of adult smokers become smokers before age 20, so I understand the public health rationale. However, I question whether it is ethical to make a product illegal for some adults to purchase based simply on the person’s age. The fallout from this soon-to-be law will help frame tobacco laws around the country, and I’m eager to see what happens next.

 

Mexico creates a junk food tax

Mexico has one of the highest rates of overweight and obese citizens—higher than even the United States. This week, the Mexican Congress approved a bill adding an 8% tax to all “high-calorie” foods like potato chips and sweets and a one peso/liter (about $0.08) tax to all soft drinks. The tax initiative was funded in part by Michael Bloomberg’s foundation. It is resolutely opposed by Femsa, the Mexican manufacturer and distributor of Coca-Cola, and Bimbo, which owns Sara Lee, Entenmann’s, and other processed food companies. Hopefully, when the costs inevitably are passed along to consumers, consumption of these items will fall and the population move toward a healthier weight.

 

Some health insurance plans have been cancelled due to the ACA

Before the implementation of the ACA, about 5% of Americans purchased health insurance individually. Many of these plans are now being cancelled because they do not fit the requirements all plans must meet under the new law. There’s lots of outrage, particularly at President Obama, because people feel misled. It’s pretty clear what’s happening: there’s a combination of insurance companies ended “grandfathered” plans early (which is their decision, not mandated by the ACA) and plans being cancelled because they were purchased after the “grandfathering” date and therefore are not legal. For an excellent flowchart showing how and why this is happening, Jon Lovett made an intricate one.

 

Pre-term birth rates fall again

The US pre-term birth rate fell to a 15 year low of 11.5%, or 1 in 9, in 2012. Although we still have the worst pre-term birth rate of all the industrialized nations, this is a positive development. This is the sixth year in which the rates declined, but the reasons why are not clear. Pre-term, low birth weight, and very low birth weight babies can have developmental delays, need more care, and cost more—on average, about $51,600. For more detailed information, see the March of Dimes 2013 Premature Birth Report Card.

 

Appearance of krokodil may be a false alarm in the US

(Warning: DO NOT Google image search for krokodil. Trust me.)

A month or two ago, the internet was abuzz with reports of people losing body parts to a new drug, krokodil. This homemade heroin substitute popular in rural Russia causes horrible sores that lead to severe disfigurement. A few cases popped up in a number of states earlier this year, but now the DEA suggests these were heroin use-related problems, like staph or MRSA infections at the users’ injection sites. Compounding the skepticism is the fact that in some places, a dose of heroin costs only $5 (!!!), virtually eliminating the need for even the most desperate user to knowingly inject his or herself with krokodil. Here’s to hoping that it really hasn’t shown up here, and that this interest we now have leads to getting actual krokodil users help.

Friday Five: 9/11, tobacco in India, painkiller labels, Chobani recall, child abuse & neglect

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week.  

9/11 responders are suffering from cancer

While we remember the 12th anniversary of the attacks on the World Trade Center, another attack is being waged upon the responders: cancer. So far, 1,140 people have been certified by NIOSH to have 9/11-related cancer. The types of cancer are varied—from non-melanoma skin cancer to non-Hodgkins lymphoma to colon cancer—and thankfully, the September 11th Victim Compensation Fund will cover all related medical and mental health expenses. However, an important deadline approaches: if a person knew of their related medical condition before October 2011, he or she must sign up with the Fund before October 3, 2013 in order to have their treatment covered. If you know anyone who may be eligible for this benefit, please (1) thank them for their selflessness and (2) tell them to sign up ASAP.

 

Tobacco + India = Bad News

Approximately 275 million people out of India’s 1.2 billion population use smokeless tobacco or cigarettes. According to a report from the International Tobacco Control Project, the country could see 1.5 million deaths annually if the number of tobacco users is not reduced by 2020. What’s even more alarming is that 94% of tobacco users surveyed said they had no plans to quit, despite government efforts to curb consumption and self-reported regret for beginning the habit. Citizens groups also advocate for tobacco-free living. This ad from Cancer Patients Aid Association is an example of the kinds of messaging Indians receive.

 

Source

 

New labels for some, but not all, narcotic painkillers

The FDA has announced updates to the labels for extended release narcotic painkillers to remove the idea that the painkillers should be prescribed for “moderate-to-severe pain.” Instead, opiates like OxyContin (oxycodone) and MS Contin (morphine sulfate) should be prescribed only when a patient’s pain cannot be controlled by other methods. These changes do not apply to fast-acting painkillers like Percocet (acetaminophen and oxycodone) or Vicodin (acetaminophen and hydrocodone) because the FDA sees that class of opioids to be less susceptible to abuse and overdose. Hopefully the new label will encourage doctors to think carefully about which painkillers they prescribe. The misuse of these drugs is out of control, and as doctors are the gatekeepers of prescriptions, their cooperation is essential to reducing addiction and unintentional deaths.

 

Chobani yogurt is moldy

Beloved and wildly popular Chobani brand Greek yogurt has been recalled. The problem of bloated, exploding containers is said to be due to contamination by the mold Mucor circinelloides. Although this kind of mold is not known to cause gastrointestinal problems, 89 people have reported nausea and vomiting after eating the recalled yogurt. That said, if your breakfast is fizzing through the lid, please don’t eat it. Let’s have some common sense, okay?

 

New child abuse and neglect report demands changes to the system

A report released this week from the Institute of Medicine described the fractured, underfunded, and unevaluated way the US researches and addresses child abuse and neglect. There are more than three million reports of abuse each year, involving at least six million children. The most common form of mistreatment is neglect, or when a caregiver fails to provide food, supervision, protection, medical care, education, or nurturing and affection. The full report gives a sense of how poorly the US manages child abuse and neglect, and this infographic also gives the basics. Children who are victims of abuse or neglect are far more likely to have serious health problems, including mental health issues, so eliminating violence against children should be at the forefront of public health efforts.

 

This week’s Friday Five is extra-depressing, so I’m going to leave you with a bonus uplifting story:

Wearing a sandwich board may help you find a kidney donor

Larry Swilling of South Carolina has been walking around wearing a sandwich board asking for a kidney donor for his wife Jimmie Sue. A complete stranger, a woman named Kelly Weaverling from Virginia Beach, decided to get tested and was found to be a match. The transplant happened on Wednesday and both Jimmie Sue and Kelly are doing well. Bonus: Larry’s efforts have led to 125 new registered kidney donors in South Carolina.

Friday Five: sterilization, pain robot, brains, surgeons, Sharknado

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Rural women are more likely to be sterilized

Tubal ligation, also known as sterilization or “getting your tubes tied,” is far more common among rural women as compared to urban women. Of rural women, 23% said they had been sterilized; urban women, 13%. There is only speculation about why this difference exists. Some of the theories floating around are: less access to other forms of birth control; piggybacking tubal ligation onto post-partum Medicaid coverage; lower educational level. Importantly, 39% of those rural women regret their decision. We should be asking why they didn’t choose a long-term, reversible birth control such as an IUD or an implant (like Implanon) instead.

Somewhat cute robot helps reduce kids’ pain and suffering during injections

As a needle phobic myself, I was very excited to learn that there’s an innovation in helping kids’ distress during shots. The robot not only talks to the child in order to distract him or her from the scary needle, but encourages exhalation during the injection to help with muscle relaxation (video here). There are two reasons why reducing pain and anxiety for children receiving immunizations is important: excessive worry can make other parts of the exam difficult, and in the future, an adult who had a bad medical experience as a child may be more likely to avoid care. These both have significant health implications. If this robot can help, I say let’s get one in every pediatrician’s office—and maybe in internist’s offices too, for ‘fraidy cats like me.

Brain pathways involved with learning and changing behavior charted

This week the NIH published a study identifying neural pathways associated with learning and changing behavior in mice. The nerves associated with the switch from moderate to compulsive drinking were found to also have a role in learning and decision making. Researchers hope that their insights will be helpful in understanding alcoholism and addiction. Learning more about why some people can use substances in moderation while others become addicted is crucial to improving mental and physical health. Hopefully, these findings will also apply for humans.

Surgery residents operate less often under new rules

Medical residents (doctors who are done with medical school and are completing their practical training) work notoriously long shifts and even longer workweeks. Restrictions created in 2011 limited shifts to 16 hours for first-year residents and 28 hours for the more advanced doctors and everyone’s week is limited to 80 hours. Surgical residents have in turn participated in fewer hours of surgery because of the limits on working hours. Many doctors are concerned that this will put the budding surgeons at risk for not gaining enough experience. There has to be a balance between allowing doctors to get enough rest while also learning enough to practice on one’s own—the question is, how

Kathleen Sebelius may in fact have a sense of humor

Twitter blew up last night with references to Sharknado, a horribly wonderful movie about a tornado that blew sharks into a city. (I don’t know how that works, I didn’t watch it!) Buzzfeed immediately wrote an article claiming “There is no Obamacare coverage for pre-existing Sharknado injuries.” Kathleen Sebelius replied: https://twitter.com/Sebelius/status/355766513334108160 Hey, an ACA joke!

I leave you this weekend with an excellent infographic explaining pretty much everything you need to know about gender, sexual orientation, and the like…The Genderbread Person!

Genderbread-Person

Friday Five: violence, HPV, obesity, smog, Obamacare

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Global rates of violence against women are alarmingly high

This week, the WHO released a study showing that more than 30% of women around the world have been victims of physical or sexual violence, particularly from their spouse or partner. The report also outlines the health issues associated with violence against women: death, depression, alcohol use, STIs, unwanted pregnancies and abortions, low birth weight babies. The WHO recommends that health care providers take violence more seriously. These findings remind us that violence is not a far away issue that impacts other people—all of the WHO regions have violence rates hovering between 23-38% (map). Whether we realize it or not, we all know women who have experienced violence against them, and we are all responsible for ensuring women have the education and mobility they need to keep themselves safe.

 

HPV rates are lower in teen girls thanks to vaccine

And now for some good news: the prevalence (number of cases currently in the population) of vaccine preventable HPV in teen girls has dropped 56% since the introduction of the vaccine. The ultimate goal is to have 80% of American children vaccinated in order to create herd immunity, meaning that enough people are vaccinated so the virus has nowhere to go. However, only about half of teen girls have gotten the necessary three doses of Gardasil or Cervarix. It’s time to stop stalling. Vaccinate kids and help prevent them from developing cervical, anal, or—as Michael Douglas reminded us—throat cancer.

 

AMA declares obesity a disease

The American Medical Association (AMA) voted this week to define obesity as a disease, identifying it as a complex issue that requires therapeutic medical treatment. They hope to reduce stigma and understand obesity to be a disease because it impairs some body functions. Critics denounced the decision, saying that because obesity is defined using BMI, it is not a precise diagnosis and that obesity has no specific symptoms of its own, only that it a contributing factor to other diseases. Although obesity is often characterized as a willpower and laziness issue, the resolution, as quoted in the New York Times, says:

The suggestion that obesity is not a disease but rather a consequence of a chosen lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes.

Hopefully, the AMA’s decision will lead to increased insurance reimbursement for obesity treatments, including nutritionists and gym memberships, as well as medical interventions and therapy.

 

Singapore is covered with smog

Fires in Indonesia are causing dangerous smog in the country and Singapore. Though no one has fessed up to starting the fires, they are likely due to illegal land clearing practices in Sumatra, which is west of Singapore. Today, Singapore’s Pollution Standards Index (PSI) hit 401, far higher than the “dangerous” level defined by a PSI of 300, and is considered “life-threatening” to the ill and elderly. Smog is a mixture of accumulated greenhouse gases and smoke, and is made worse by the combination of pollutants, sunlight, and heat that creates ozone. Smog causes serious respiratory, eye, and skin problems, and this smog is so thick visibility is seriously impaired.

 

Dems love the term “Obamacare,” Republicans don’t

The Kaiser Family Foundation June tracking poll shows that when referred to as “Obamacare,” 73% of Democrats responded favorably to the Affordable Care Act (ACA), as compared to 58% when the ACA was called “health reform law.” Republicans, however, saw an increase in unfavorable responses when the ACA was called “Obamacare,” from 76% to 86%. Apparently, the pejorative likely coined by none other than Mitt Romney has been successfully appropriated and turned into a rallying point for Democrats in support of the ACA. Obama is a linguistic master, and this shows he can turn even the most negative epithet into a compliment. Take that, Sarah Palin!

It's the first day of summer! This lion knows how to celebrate:

http://www.youtube.com/watch?v=mV1CVTPVAJg

Friday Five: Oklahoma tornado, MERS, 3D printing, polio, live-tweeting surgery

Each Friday, I use  five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week.  

Tornado in Moore, OK is the latest national disaster

On Monday, a mile wide tornado with 200+ mph winds decimated Moore, OK. Approximately 10,000 people were directly affected, 240 injured, and 24 killed, including nine children. Reports of heroism abound, as do shocking photos. Coming just months after the shooting at Sandy Hook and weeks after the Boston Marathon bombing, the Moore tornado victims may find themselves on the losing end of American disaster fatigue. Hopefully Moore will stay in the forefront of American’s minds and not blend in with other communities rebuilding from natural and human-made tragedies.

 

MERS is on the move

After a slow march toward notoriety, MERS is becoming a real threat. This novel coronavirus dubbed Middle East Respiratory Syndrome has been confirmed in 44 people across multiple countries and caused 22 deaths. In this month alone, two new outbreak clusters surfaced—one in Saudi Arabia infected 22 people and killed 10, the other in France infected two, one of whom contracted MERS from a hospital roommate. However, the exact mode of transmission, incubation period, and reservoir (meaning whether or not the virus lives someplace outside of humans) are unknown and research is stymied due to restrictions placed on the virus by Erasmus Medical Center in the Netherlands. For a virus with a 50% mortality rate so far, this is an egregious example of the problems with commercializing organisms needed for public health research. How many others will fall ill and die because of Erasmus’s patent?

 

Child’s life is saved by 3D printed trachea splint

In a groundbreaking and heartwarming use of the new technology of 3D printing, University of Michigan researchers created and implanted a trachea splint in a young child. Kaiba Gionnfrido, who had spent nearly all of his 20-month long life in a hospital on a respirator due to his trachobrochomalacia, or the softening and subsequent collapse of the windpipe. The splint, made to fit Kaiba perfectly, will give structure to his trachea to allow it to grow and is composed of a biopolymer that will be absorbed by his body in about three years. After years of requiring daily resuscitation, the splint allowed Kaiba to come off the respirator three weeks later. We can look forward to the emerging practice of saving lives using 3D printing to create custom-made medical devices.

 

Polio in Kenya and Somalia threatens eradication effort

A four-month old girl developed symptoms of paralysis and two other children tested positive for polio in a Kenyan refugee camp. Just a few weeks ago, Somalia reported its first wild case in five years. Vaccination rates in these areas are low, and nearly 500,000 people travel to and from the Kenyan refugee camp annually, increasing risk for an epidemic. This development complicates the newly adopted six year plan for polio eradication, and mass vaccination campaigns in the area are underway in hopes of containing the virus. Maintaining vaccination in vulnerable areas, even after years pass with no new infections, is crucial to destroying polio forever.

 

Brain surgery documented on Twitter and Vine

In this week’s example of how social media is revolutionizing health care and medicine, UCLA Hospital live tweeted Vine videos of brain surgery. Brad Carter, an actor and musician, underwent awake brain surgery to implant a pacemaker to calm his essential tremors. The Vine videos show distinct improvement in Carter’s guitar playing once the pacemaker was in place. By using Twitter and Vine to document the surgery, UCLA surgeons and Carter do the public a great service—showing exactly how incredible medicine can be. The videos inspire awe while simultaneously taking some of the mystery out of surgery.

 

This week's song to celebrate the end of the week: The Cure's "Friday I'm in Love"

[youtube=http://www.youtube.com/watch?v=b69XWDUtMew]

New meat names help us eat healthier

When I shop for meat, I look for the leanest cuts. I go armed with a list of options so I’m ready to tackle the daunting selection of cuts, sizes, and shapes. Despite my preparation, I sometimes turn to Google to see if the “London Broil” on sale is the same thing as the “extra lean top round” on my list (it is!). Image from sillypants.net

The confusion is about to come to an end. The National Pork Board and the Beef Checkoff Program is rolling out a new consumer-friendly naming system. Now, instead of “pork loin top loin chop,” labels will read “Porterhouse chop.” Rather than “beef shoulder top blade steak, boneless,” we’ll see “flatiron steak.” Retailers can either stick with the old, confusing system or upgrade to the new one. Because uniform names are anticipated to help with meat sales, this system will likely catch on quickly.

The new labels include the simplified name, species, characteristics, and preparation suggestions. (Image from independentmail.com)

Healthy eating advocates* must seize this opportunity. By simplifying the names, the beef and pork industries help nutrition activists clearly communicate which options are best for health. Unambiguous naming across retailers will allow the very lean pork tenderloin to sport the same label in most stores. The fatty New York Strip steak won’t be masquerading as Boneless Top Loin steak. Once shoppers learn the names of the few best options, they’ll be able to trust their knowledge and feel confident they’re choosing the lean cuts.

As soon as the new list is announced, advocates should publicize the names of the leanest options, lobby grocery stores to include the new names on their meat case signs and update their websites and materials to reflect the changes. If we are able to effectively explain that the new labeling system empowers shoppers to make consistent and confident choices each time they approach the meat case, we’ll go a long way to promote lean meat as a good option. Going one step further and ensuring our messaging lines up with the retail names enriches our materials and dietary recommendations.

Food industries don’t often make healthy eating easier. So let’s use this rare opportunity to facilitate sound nutrition communication and encourage wise choices.

*Though balanced vegetarian diets are the gold standard for healthy eating, consuming a light to moderate amount of meat seems to be a decent compromise for those of us who love a good steak now and then.

Updated 4/15/13: This video of Letterman playing a game called "Know Your Cuts of Meat" will be a whole lot easier now!

http://www.youtube.com/watch?v=hB5W61rGQ38