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Monthly Archives: December 2016

Imported Jewelry Can Pose Danger

A 1-year-old boy living in New York City had a rapid increase in blood lead levels, and the likely source of the exposure was traced to a Cambodian amulet made from knotted string and metallic beads, according to researchers from the NYC Department of Health and Mental Hygiene and the CDC.

Testing revealed that the beads contained 45 percent lead, the researchers reported in Jan. 28 issue of Morbidity and Mortality Weekly Report.

The boy had worn the amulet — “something to protect him,” his father said — since he was 3 months old, and had been seen putting it in his mouth.

“Healthcare providers and public health workers should consider traditional customs when seeking sources of lead exposure in Southeast Asian populations,” the authors wrote.

Healthcare professionals should ask parents — particularly from Southeast Asian families — about the use of amulets, they added, noting that educational efforts about the risk of lead poisoning from jewelry are needed for immigrant families.

An accompanying editorial note pointed out that the CDC recommends blood lead testing for internationally adopted and refugee children and that the New York City health department recommends testing all children with recent travel to foreign countries.

Although the most common source of lead exposure in young children is paint, other sources have been increasingly identified.

That is particularly true in immigrant communities because of the use of lead-containing products from their country of origin, such as spices, food, candy, cosmetics, health remedies, ceramics or pottery, and jewelry.

For the case of the 1-year-old boy, routine lead testing showed an elevated blood lead level of 10 micrograms/dL.

According to the National Institutes of Health lead concentrations in blood should be less than 10 micrograms/dL in children and less than 20 micrograms/dL in adults.

Because he lived in a household with a cousin who had had lead poisoning, he had also been tested at 6 months. His blood lead level was just 1 microgram/dL then.

A risk assessor from the Environmental Protection Agency visited the home to look for potential sources of the lead exposure. The boy’s father denied using any imported products, and the assessor failed to find any potential sources of exposure.

Three months later, the boy’s blood level doubled to 20 micrograms/dL.

The boy’s father again denied that the child wore jewelry or charms, but eventually admitted that the child had worn an amulet acquired at a Cambodian market since he was 3 months old.

A second home inspection identified one area of paint with an elevated lead level, as well as imported spices and rice. Testing revealed that the food products did not have elevated lead content.

Within eight days of the amulet being removed from the home, the boy’s blood lead level decreased to 14 micrograms/dL.

About five weeks later — after the lead paint was reported to be removed — the boy’s blood lead level was 10 micrograms/dL, and five months after the amulet was removed, the level was down to 5 micrograms/dL.

“Although other factors might have contributed to the child’s overall lead burden,” the researchers wrote, “the most likely source identified was the amulet, based on its high lead content, statements that the child had been observed mouthing it, and the rapid decrease in the child’s blood lead level after its removal.”

Federal Judge Strikes

A federal judge ruled Monday that the new U.S. health-care reform law is unconstitutional, saying the federal government has no authority to require citizens to buy health insurance.

That provision is a cornerstone of the new legislation, signed into law in March by President Barack Obama.

The judge’s decision was not unexpected, and both supports and opponents of the legislation anticipate the validity of the new health law ultimately will be decided by the U.S. Supreme Court.

The ruling was handed down by U.S. District Judge Henry E. Hudson, a Republican appointed by President George W. Bush who had seemed sympathetic to the state of Virginia’s case when oral arguments were heard in October, the Associated Press reported.

Last week, White House officials said a negative ruling would not affect the implementation of the law because its major provisions don’t take effect until 2014, the AP reported.

Virginia Attorney General Kenneth Cuccinelli, a Republican, had filed a lawsuit in defense of a new Virginia law barring the federal government from requiring state residents to buy health insurance. He argued that it is unconstitutional for the federal law to force citizens to buy health insurance and to assess a penalty if they don’t.

The U.S. Justice Department said the insurance mandate falls within the scope of the federal government’s authority under the Commerce Clause. But Cuccinelli said deciding not to buy insurance is an economic matter outside the government’s domain.

By 2019, the law will expand health insurance access to 94 percent of non-elderly Americans. Advocates say that between now and then, it will also provide Americans with many new rights and protections.

Key provisions include:

  • Health plans may no longer deny coverage to people based on pre-existing health conditions.
  • Health plans that cover dependents must permit children to stay on a parent’s family policy until age 26.
  • Insurers may no longer place lifetime dollar limits on essential benefits.
  • New health plans must offer preventive services such as mammogramsand colon cancer screenings without charging a deductible, co-payment or coinsurance. (This provision does not apply to existing plans that are “grandfathered.”)

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Dangerous Bacteria Outside Hospitals

The dangerous bacteria Clostridium difficile spreads not only in hospitals but also in other health-care settings, causing infections and death rates to hit “historic highs,” U.S. health officials reported Tuesday.

C. difficile is a deadly diarrheal infection that poses a significant threat to U.S. health care patients,” Ileana Arias, principal deputy director at the U.S. Centers for Disease Control and Prevention, said during a morning news conference. “C. difficile is causing many Americans to suffer and die.”

The germ is linked to about 14,000 deaths in the United States every year. People most at risk from C. difficile are those who take antibiotics and also receive care in any medical facility.

“This failure is more difficult to accept because these are treatable, often preventable deaths,” Arias said. “We know what can be done to do a better job of protecting our patients.”

Much of the growth of this bacterial epidemic has been due to the overuse of antibiotics, the CDC noted in its March 6 report. Unlike healthy people, people in poor health are at high risk for C. difficile infection.

Almost 50 percent of infections are among people under 65, but more than 90 percent of deaths are among those aged 65 and older, according to the report.

Previous estimates found that about 337,000 people are hospitalized each year because of C. difficile infections. Those are historically high levels and add at least $1 billion in extra costs to the health care system, the CDC said.

However, these estimates might not completely reflect C. difficile’s overall impact.

According to the new report, 94 percent of C. difficile infections are related to medical care, with 25 percent among hospital patients and 75 percent among nursing home patients or people recently seen in doctors’ offices and clinics.

Although the proportion of infection is lowest in hospitals, they are at the core of prevention because many infected patients are transferred to hospitals for care, raising the risk of spreading the infection there, the CDC said.

Half of those with C. difficile infections were already infected when they were admitted to the hospital, often after getting care at another facility, the agency noted.

The other 50 percent of infections were related to care at the hospital where the infection was diagnosed.

The CDC said that these infections could be reduced if health care workers follow simple infection control precautions, such as prescribing fewer antibiotics, washing their hands more often and isolating infected patients.

These and other measures have reduced C. difficile infections by 20 percent in hospitals in Illinois, Massachusetts and New York, the CDC said.

In England, infections have been cut 50 percent in three years, the agency said.

Patients get C. difficile infections mostly after taking antibiotics, which can diminish the body’s “good” bacteria for several months.

That’s when patients can get sick from C. difficile, which can be picked up from contaminated surfaces or spread by health care providers.

The predominant sign of C. difficile infection is diarrhea, which can cause dehydration. If serious, the infection can become deadly. Other symptoms include fever, nausea and loss of appetite.

The CDC advises that if diarrhea occurs after a patient starts antibiotics, C. difficileshould be suspected and treatment continued with another antibiotic.

Commenting on the report, infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University, said, “All these recommendations are fine; the problem is they are not going to work, you can’t stop these practices. This bug exists in a climate of overuse of antibiotics.”

It is hard to eradicate C. difficile because it buries itself in the colon, then recurs and testing isn’t always accurate, Siegel said. “It’s a pervasive problem in hospitals, and even in communities,” he said.

Tips to Good Personal Hygiene

Mom was right: Good personal hygiene is essential to promoting good health.

Personal hygiene habits such as washing your hands and brushing and flossing your teeth will help keep bacteria, viruses, and illnesses at bay. And there are mental as well as physical benefits. “Practicing good body hygiene helps you feel good about yourself, which is important for your mental health,” notes Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. People who have poor hygiene — disheveled hair and clothes, body odor, bad breath, missing teeth, and the like — often are seen as unhealthy and may face discrimination.

Personal Hygiene: Healthy Habits Include Good Grooming

If you want to minimize your risk of infection and also enhance your overall health, follow these basic personal hygiene habits:

  • Bathe regularly. Wash your body and your hair often. “I’m not saying that you need to shower or bathe every day,” remarks Dr. Novey. “But you should clean your body and shampoo your hair at regular intervals that work for you.” Your body is constantly shedding skin. Novey explains, “That skin needs to come off. Otherwise, it will cake up and can cause illnesses.”
  • Trim your nails. Keeping your finger and toenails trimmed and in good shape will prevent problems such as hang nails and infected nail beds. Feet that are clean and dry are less likely to contract athlete’s foot, Novey says.
  • Brush and floss. Ideally, you should brush your teeth after every meal. At the very least, brush your teeth twice a day and floss daily. Brushing minimizes the accumulation of bacteria in your mouth, which can cause tooth decay and gum disease, Novey says. Flossing, too, helps maintain strong, healthy gums. “The bacteria that builds up and causes gum diseasecan go straight to the heart and cause very serious valve problems,” Novey explains. Unhealthy gums also can cause your teeth to loosen, which makes it difficult to chew and to eat properly, he adds. To maintain a healthy smile, visit the dentist at six-month intervals for checkups and cleanings.
  • Wash your hands. Washing your hands before preparing or eating food, after going to the bathroom, after coughing or sneezing, and after handling garbage, goes a long way toward preventing the spread of bacteria and viruses. Keep a hygiene product, like an alcohol-based sanitizing gel, handy for when soap and water isn’t available.
  • Sleep tight. Get plenty of rest — 8 to 10 hours a night — so that you are refreshed and are ready to take on the day every morning. Lack of sleepcan leave you feeling run down and can compromise your body’s natural defenses, your immune system, Novey says.

Personal Hygiene: Poor Hygiene Hints at Other Issues

If someone you know hasn’t bathed or appears unkempt, it could be a sign that he or she is depressed. “When people are sad or depressed, they neglect themselves,” Novey says. Talking about the importance of proper personal hygiene for preventing illnesses and providing personal hygiene items may help some people. Be candid but sensitive and understanding in your discussions, Novey says. Despite your best efforts, your friend or loved one may need professional help. You should encourage them to see a counselor or doctor if their personal hygiene doesn’t improve.

Personal Hygiene: Good Habits Help Keep You Healthy

For most people, good hygiene is so much a part of their daily routines that they think little about it. They bathe, they brush their teeth, visit the dentist and doctor for regular checkups, and wash their hands when preparing or eating food and handling unsanitary items. To keep those you care about healthy and safe, help them learn, and be sure that they are practicing, good personal hygiene.