HHS Releases Mediocre Report on Hospitals

news you may not know

Not Really Your Best Work, Is It?

"Wow, this is spectacular!" Yes, that would be nice. We'd even settle for, "Gee, this is really helpful." But, when the Department of Health and Human Services (HHS) released its most recent report on hospital quality, the collective response was, "Uhm - so what?"

It's too bad. It appears the intentions are admirable: give the American consumer greater access to data that assesses a hospitals performance in critical care areas. In this case, the focus in on the treatment of heart attacks and heart failure, pneumonia, and the occurrence of surgical infections. This is information we'd like to know.

Unfortunately, the new release does little to inform. The data on heart attacks, for example, provides percentages for patients receiving various treatments: ACE inhibitors administered on admission, aspirin on arrival, and beta blockers upon discharge. However, the minor discrepancies in the percentages, typically just a couple points, do little to inform our health care decisions.

...Little - which is more than nothing. That's why the report receives a "mediocre" rating. It's better than nothing, but not by too much. There is still a long way to go in providing the American health care consumer with useful hospital quality assessments.

In the meantime, you may want to revisit the U.S. News & World Report's "Best Hospitals 2006." Ah... That's the way to assess - and report - hospital quality.

To read more about the release of the recent report, see this from Reuters. To view the actual report, and to find data on hospitals within your region, see this from the Department of Health and Human Services.

Simple Ways to Help Breast Cancer Survivors Want to Exercise

news you may not knowSometimes Simple Is Best...

So, what's the key to motivating breast cancer survivors to "get out there and get healthy"? Well, surely it has something to do with a two-year program with weekly support group meetings, and individual counseling sessions. Or, for cyberspace fans, a virtual program that includes a chat room, an expert facilitator, and online counseling sessions. Or, if these don't fit the bill, maybe it's best to just sign up for the counseling sessions - twice. Or...

Maybe handing the patient a $20 pedometer will do the trick.

This is quite a testimony to the power of personal encouragement. Researchers from the University of Alberta studied the difference in exercise activities among breast cancer survivors. 377 women, divided into three groups, were followed over a 12-week period. All three groups were encouraged to exercise 30 minutes a day, five days per week.

Two groups, however, were given some simple additional encouragement. One group was given a step pedometer - a device that automatically records the number of steps walked. The third group was given both the step pedometer and a physical activity guidebook.

The groups given the pedometers and guidebooks increased their activity levels by an average of 70 to 90 minutes per week - compared to an average of 30 minutes per week for the control group. This is significant. Prior studies have shown that maintaining a healthy weight is a key factor in lowering the risk of both initial and recurring breast cancer.

As an added benefit, the women who exercised more reported less fatigue, greater energy, and an overall improvement in their quality of life.

So, while high tech medical interventions and intensive counseling programs are great, sometimes it's the simpler things that are most effective. You know, things like saying to people, "Come on - you can do this."

To read more about the study, see this from ScienceDaily. To learn more about pedometers, see this from About.com.

Drinking Negates Smoking's Impact on Rheumatoid Arthritis

tidbits that tantalizeMore Good News...

Now, this is truly an odd situation.

Perhaps the two greatest vices known to man - well, certainly two of the top five - seem to have formed a strange partnership. Smoking and drinking have been partners forever, but new research shows one of them isn't pulling its weight.

Scientists at the Karolinska Institute in Sweden have some kind words about alcohol - not so, however, when it comes to tobacco. A recent study reveals that regular consumption of alcohol protects against rheumatoid arthritis. Good news indeed.

The study reports those drinking 3 units of alcohol per week reduced their risk of developing arthritis by 50%. Still thirsty? Those drinking 10 units each week received even greater protection. Now, if we only had a clue as to what a "unit" of alcohol may represent...

Actually, each unit of alcohol is the equivalent of a glass of wine, or a small beer. No definitive guidelines were offered as to units of beer nuts, pretzels, and deep-fried-cheese-based foods.

The positive effect of the alcohol is enough to offset the negative impact of smoking. In addition to multiple other health complications, smoking increases the risk of developing arthritis.

So, as odd as it seems, it appears smokers can now order a beer, and then turn to their friends and say, "I'm doing it for my health."

To read more about the study, see this from Reuters. To read more about smoking's negative impact, and find resources to help you quit, see this from the Centers for Disease Control.

Heart Attack Care is a Race Against the Clock

news you may not knowDoctor Buffy - Balloonologist...

It's called "door-to-balloon" time, and it's often the difference between life and death.

Yes, you're right - this is not a measure of how quickly Clarence the Clown moves from the front door to the patio, and completes his first five-legged balloon horse. As impressive as that fifth leg is, this is much more serious business.

This particular door-to-balloon time is measured from the ERs front door to the catheterization lab. The cath lab is where they perform angioplasties, a procedure in which a thin wire equipped with a small balloon is threaded through the blocked artery. Once in place, the balloon is inflated, the blood flow returns, and the damage to the heart muscle stops. Thus, the shorter the time between the front door and this critical treatment the better.

Though the recommended time is under 90 minutes, this has been a hard target to reach. But, Indiana Heart Physicians/St. Francis Heart Center (St. Francis) has shown it's possible.

St. Francis established a new procedure for dealing with heart attack patients. The first change was to allow the ER physician to activate the cath lab preparations. Previously, this required the approval of a cardiologist, and cost precious time.

The second, and possibly most significant change, was the development of a special heart attack team: the Emergency Heart Attack Response Team (EHART). This team consists of several specially trained nurses who are in-house 24/7 - no more waiting for specialists to be called in. The EHART team immediately transports the patient to the cath lab and begins preparations for the angioplasty.

The results have been spectacular. The average door-to-balloon time decreased by over 30%, from 113 minutes to 75 minutes. The average length of hospital stay decreased from 5 days to 3 days, and cost per stay is down by an average of $10,000.

But, the best news is that patients go home with less damage to their heart and a better future.

Now, where's that five-legged horse?

To read more about the study, see this from ScienceDaily. To read more about angioplasty, see this from the National Heart Lung and Blood Institute.

Shot of Alcohol Eases Foot Pain

tidbits that tantalizeI Could Use A Shot...

Careful now - yes, researchers in England have discovered that a shot of alcohol eases the pain of Morton's neuroma. This is a common cause of chronic foot pain and is often quite difficult to treat. The pain begins gradually and is intermittent in the early stages. However, over time, the pain intensifies and may last for several days, or even weeks.

The neuroma is a benign growth caused by the thickening of the nerve tissue. This most commonly occurs between the third and fourth toes, and symptoms include numbness, tingling, and a sensation that something is caught inside the ball of the foot. Typical treatments include padding, icing, orthotics, new shoes, and activity restrictions. When all else fails, a trip to the surgeon may be necessary. There is a natural... What's that?

Oh, yes, of course - the shot of alcohol...

Yes, a shot of alcohol appears to be quite effective at relieving the pain. This is quite good news, as it is much less invasive than surgery. It also has the advantage of not causing the permanent sense of numbness that often results form severing the nerves during surgery. But...

Here's the part where you must be careful. Though tempted, do not treat this at home with a "shot of alcohol." Yes, it will provide temporary relief. However, for a permanent fix, you'll need the injectable shot of alcohol only a doctor can provide.

...No details were available as to whether bourbon or gin was more effective over the long term.

To read more about the study, see this from ScienceDaily. To learn more about Morton's neuroma, see this from the American College of Foot and Ankle Surgeons.

Heart Disease Down, Junk Food on the Rise

tidbits that tantalizeNice Job America...

Epidemiologists - very smart people who study the origins, distribution patterns and outcomes of disease - have noted some progress in the battle against heart disease.

Researchers at the University of Liverpool and the Heart of Mersey in England studied health data from 1980 to 2000. They specifically compared coronary heart disease (CHD) deaths in the United States, and assessed the reasons for the decline in the death rate; the number of deaths due to CHD fell by almost 50% during this period.

Why such good news?

Well, it's a combination of medical advances and good old hard work. On the medical side, treatments for chronic heart failure, and emergency treatments for heart attacks and angina, are responsible for about one-half the decrease. But, the best news is...

The other half of the decline is due to healthy lifestyle changes. This is fabulous news indeed.

People have apparently been paying attention to the ceaseless yammering of health professionals about healthy diets and lifestyles. The researchers found significant improvements in major risk factors: smoking rates down, cholesterol levels down, blood pressure down, and - physical activity up. It couldn't get any better. Or...

Maybe it could be a tad better.

The researchers say the results would be a full 15% better if both obesity and diabetes were not on the rise. They say this reflects the ongoing love affair Americans have with junk food.

What's the solution to the junk food problem? Hmm...

How about a new slogan: "Eat less, yammer more!"

To read more about the study, see this from ScienceDaily. To learn more about leading a healthy lifestyle, see this fabulous site from The Heart of Mersey.

The "Eat More - Lose More" Diet

tidbits that tantalize National Headquarters: Low Calorie Density Foods...

This can't be right, can it?

You must've read the headline wrong. It appears to say that one can eat more food and lose weight at the same time. Hmm... Better check the source - surely it's a checkout stand tabloid, with other headlines screaming, "Paris Hilton Wails in Jail," and, "Martians Vacation at Spanish Resort." But...

The actual source of the research is Penn State, hardly a tabloid journalism hotbed. Scientists there report that eating foods low in "calorie density" may be the key to long-term weight loss. This is an important finding, as previous studies have shown that diets typical fail over the long run, with most dieters regaining all previously discarded baggage.

Foods low in calorie density are those with high water content and low fat content - fruits, vegetables, soups, lean meats and low-fat diary foods. These foods allow dieters to eat portions that satisfy their hunger, while providing a natural means of caloric restriction.

The study followed two groups of women over a one-year period. One group was taught how to select low fat foods (LF group), and the other how to select foods both low in fat and high in water (Water group). Both groups showed sustained weight loss at one year, but the Water group lost more during the first six months.

Most significantly, the Water group actually increased their food consumption - by a full 25%, as measured by food weight. As a result, they reported feeling less hungry. Researchers point to this as a key for maintaining healthy eating habits over the long haul.

So, there you have it. When your friends start asking why you look so great, tell them, "I finally started eating enough food to lose weight."

To read more about the study, see this from ScienceDaily. To read more about all aspects of weight loss, see this from About.com.

Avoid Hospitals When Traveling to Europe

news you may not knowChoices, Choices...

Ah, summer is here and that can mean only one thing: Baseball games, hot dogs and beer, swimming pools, and vacations.

...OK. So, that's a few more than "one thing," but let's face it - summertime is great fun and the perfect time for exuberance to be set free. It's also a wonderful time to explore the universe beyond the bounds of the work-a-day world. Where's everyone going this year? Hmm...

Europe is often the destination of choice for American travelers, and rightfully so. There's beer to be drunk in Germany, pizza to be savored in Italy, croissants to be buttered in France, and streusel to be nibbled in Austria. Yes - the sights are rumored to be quite tempting as well.

But...

Please stay healthy when traveling in Europe this summer. The European Centre for Disease Prevention and Control reports that hospitals are not necessarily healthy. In fact, it reports a full 10% of patients admitting to European hospitals acquire a new infection during their stay. The result is over 3 million infections each year - and 50,000 deaths.

The infections, known as Nosocomial infections, are both common and problematic throughout the world. The threat is becoming more difficult to manage, due in part to the widespread use of antibiotics, a practice that promotes the development of treatment resistant strains of bacteria.

So, enjoy the pizza and beer, the streusel and whatever else catches your eye - just don't come home with anything they're giving away willy-nilly at the local hospital.

To read more about the study, see this from Reuters. To read more about staying healthy while traveling abroad, see this from the Mayo Clinic.

New Diabetes Monitoring Device Never Sleeps

news you may not knowWell, Maybe Just A Bite -- Or Five...

Diabetes impacts over 20 million Americans.

Type 1 diabetics depend on insulin injections to maintain appropriate glucose levels. For them, life is a series of measurements and calculations. The measurements are the familiar finger sticks that assess blood sugar levels. The calculations are a bit less formal: "Hmm, can I have a piece of chocolate cake without pushing myself over the edge?"

The issues are, however, much more significant than the temptations of rich and gooey desserts. Patients with too much, or too little, insulin in their body can suffer serious complications. The most serious complication is Insulin Shock - a severe form of hypoglycemia - a condition in which there is an excess of insulin in the body. This causes a rapid lowering of the blood sugar levels, resulting in dizziness, weakness, sweating, rapid pulse and diminished levels of consciousness. This is a true medical emergency that must be resolved quickly, or the patient may die.

But - there is some good news on the measurement front.

The FDA has approved the STS-7 System, manufactured by DexCom Inc. This system continuously monitors a patient's blood sugar levels over a seven-day period. A small wirelike sensor is inserted just beneath the skin and held in place with a bit of tape. The sensor then begins to work its magic.

Every five minutes the sensor reads the patient's blood sugar level. It then transmits the reading, via a wireless signal, to a receiver that stores the data. Most significantly, the sensor allows the patient to set an alarm that will sound if their blood sugar levels are either too high or too low. This can serve as a crucial alert to both patients and family members, allowing them to take action before a true emergency develops.

The system also allows for the collected data to be downloaded to a computer. This allows users to generate reports that show blood glucose level trends for specific days or weeks.

So, if you're going to have the chocolate cake, make sure the alarm volume is turned all the way up...

To read more about the study, see this from ScienceDaily. To read more about the STS-7 System, see this from DexCom Inc.

Does Watching Leno Cause Obesity?

tidbits that tantalizeThat's Great! - Pass The Chips...

In your quest for late night entertainment, do you prefer the guy with the funny teeth, or the guy with the funny chin?

Well, regardless of whether you're a Letterman or a Leno fan, a trip to the bathroom scale may be in order. Researchers at the Smell and Taste Treatment and Research Foundation report that engaging television may add pounds. Boring television, on the other hand, will simply put you to sleep.

The research tested the impact on the consumption of snacks while watching television. The study participants were given five minutes, a bag of potato chips, and then shown monologues from either David Letterman or Jay Leno. The process was repeated several times over a three-week period.

The results? It was Letterman by a chip.

Actually, the researchers found that participants watching either comedian ate over 40% more chips than when they did not watch television. Letterman did edge out Leno, 44% to 42%, in the late night chip-off. Seinfeld reruns were disqualified from the study, after it was discovered Newman had eaten the three-week chip supply in a single setting. "Way to go, Newman..."

The scientists explain that concentrating on the way food tastes sends signals to the brain about fullness. When distracted, the signals are simply ignored, and the snacking continues unabated.

So, now you know: "Caution: Great television shows may be hazardous to your waist."

To read more about the study, see this from Reuters. Or, learn more about the Smell and Taste Treatment and Research Foundation.

Photo is courtesy of Emiliano Spada.

Breast Cancer Treated with Higher Doses, Shorter Length

news you may not knowThis Is Good News...

Women face many difficult decisions in their lives. But, when faced with breast cancer, the treatment choices become especially complex.

How do women weigh the treatment choices with other responsibilities? If they choose breast-conserving surgery, a lumpectomy, they face a long series of radiation treatments. The typical protocol calls for treatment five days per week, for six to seven weeks. How does a workingwoman, including moms who work at raising our next generation, fit that into their schedule?

This is one of the primary factors shaping the choice of many women to opt for a mastectomy. While it may not be their optimal choice, it simplifies the follow-up care tremendously.

But... There is some good news from researchers at the Fox Chase Cancer Center.

They report success in shortening the radiation treatment protocol to only four weeks. They accomplish this by increasing the strength of the daily radiation treatments. By utilizing a highly accurate radiation delivery system known as intensity-modulated radiation therapy (IMRT), they are able to target the breast tissue with an even-dose distribution of radiation. The IMRT system also helps reduce side effects, by lowering the amount of radiation received by vital organs, such as the lungs and heart.

The researchers have called for longer-term follow-up to assess the effectiveness at five years post treatment.

Keep your fingers crossed - anything that can be done to shorten the treatment cycle, and get women back to their normal routines quickly is good news for everyone.

To read more about the study, see this from ScienceDaily. Or, read more about the Fox Chase Cancer Center.

Healthy Living: What We Know & What We Do

tidbits that tantalizeWow - That's A Great Question...

Are these really our best and brightest?

It seems a bit like scientific research based on the Jay Leno "Man in the Street" methodology. The International Food Information Council (IFIC) recently interviewed 1,000 US adults about their dietary habits. The results were less than encouraging and point to a gap in people's knowledge and their actions - it's the age-old, "Do as I say, not as I do" syndrome.

While 90% of those surveyed agreed breakfast is important, only 49% consistently eat this early morning wakeup meal. On the positive side, 84% said they were physically active at least one time per week. On the "I'll never lose these dang love handles" side, only 44% actively balanced diet and physical activity to maintain a healthy weight. (It is believed, however, the other 56% watch additional weight loss television commercials when they are dieting...)

Are we confused about health? Well...

While both polyunsaturated fats (fish and whole grains) and monounsaturated fats (nuts, avocados and vegetable oils) are healthy, roughly 40% of respondents reported trying to cut down on them. Additionally, a meager 11% knew the number of calories they should consume to maintain a healthy weight level. Hmm...

So, there you have it, America. Jay Leno would be proud...

To read more about the study, see this from Reuters. To read more about health and nutrition, see this from IFIC, or this from the American Dietetic Association.

Have 10 Minutes to Spare? Even Minimal Exercise Improves Health

tidbits that tantalizeI Should've Picked Pie...

OK- It's a tough choice. You just chiseled out a spare 10 minutes from your hectic life and you want to use it wisely. So...

You saunter over to the fridge and pop open the freezer door. Hmm... With the microwave, you could have that cherry pie defrosted and, if you kicked it up a bit, even a little on the steamy side. Then, that Premium Double Rich Old Fashioned Vanilla ice cream would melt right over the edges and wow! Your mouth begins to water at the thought. Or...

You could take a quick little jaunt outside, cruise on down the block, and get a little fresh air and sunshine...

It is a tough choice, but...

If health is uppermost in your mind, you'll opt for the walk.

Researchers at Louisiana State University report that even as little as 10 minutes of exercise per day helps improve the health of overweight women. They followed over 400 women, with an average age of 57, with high or borderline high blood pressure. The women were divided into four groups, and assigned weekly exercise amounts of none, 75 minutes, 135 minutes and 190 minutes.

At the end of six months, the women who exercised showed improved oxygen intake during exercise and their waists were smaller.

So, when life is hectic and the choice is pie or pavement - hit the pavement. The pie will keep.

To read more about the study, see this from Reuters. To read more about health and diet, see this from WebMD.

Treadmill Desk Promotes Weight Loss

tidbits that tantalizeHmm... How Do You Drive This Thing?

The "Life is a treadmill" crowd just found a new champion.

Researchers at Mayo Clinic - yes, the world-renowned research and treatment center - have devised a new way to shed pounds. No, it does not involve going outside to exercise, dieting or various forms of oriental arts. They simply want you to go to work and step up to your desk. But, here's where it gets tricky...

They have devised a desk that incorporates a treadmill - seems fitting, doesn't it? - into your everyday routine. So, you "Walk as You Work."

Here's the deal - they studied 15 subjects as they worked on the "Vertical Workstations." The subjects burned an additional 100 calories per hour when strolling through their work at a leisurely one-mile-per-hour pace. (At a rate of two-miles-per-hour the subjects simply cascaded off the device, and fell to the floor where, exhausted, they napped until the end of the workday.)

The device costs about $1,600 and researchers believe it holds the potential to reverse obesity. The questions of increased hunger, leading to excessive snack binging, have yet to be addressed...

To read more about the study, see this from Reuters. To read more about the Treadmill Desk, see this from Treadmill Desk. To read more about health and diet tips, see this from WebMD.

With Appendicitis, Skip the CT Scan - Go Straight to Surgery

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Nobody Knows What It Does??

Quick - What does the appendix do? Come on, you know this one. OK - relax, let your mind become a blank slate - breath deeply and... Still no clue? Welcome to the club.

Ask a physician the role of the appendix and she will give you the same blank stare you have mastered. Depending on your mutual schedules, you could spend several minutes exchanging your lack of knowledge through the non-verbal universal language of cluelessness.

But, enough about the art of communication.

Though its role is unknown, the appendix does occasionally cause problems. And, typically, these need to be dealt with quickly to avoid more serious complications.

Researchers at the University of Wisconsin at Madison report that time is of the essence in treating acute appendicitis. This means the time spent waiting for CT scan results places patients at increased risk. They recommend the scans be skipped in cases that present a straightforward diagnosis and that patients be sent directly to surgery.

The difference in time, and outcome, is significant. The researchers reviewed the records of over 400 appendectomy patients and found twice the rate of complications for patients who underwent a CT scan: 17% of patients receiving the scan experienced a perforation (rupture) of the appendix compared to only 8% of patients who received no scan.

The scientists attribute the difference to the delay in moving to surgery. Patients going directly to surgery do so within an average of 5 hours - those receiving scans take about 8 hours to hit surgery.

How do you know if you're experiencing appendicitis? Look for these classic symptoms:

-pain in the abdomen - beginning near the belly button and moving to the lower right

-nausea

-vomiting

-constipation or diarrhea

-loss of appetite

-inability to pass gas

-low-grade fever developing after other symptoms appear

-abdominal swelling

The pain of appendicitis intensifies rather quickly, and may become quite severe over a 6 to 12 hour period. Those between 10 and 30 years of age are at greatest risk of experiencing appendicitis.

So, now you know. If you're unfortunate enough to experience an appendicitis attack, at least you're prepared. As they wheel you through the doors at the ER, muster your strength and shout, "Take me straight to surgery - the CT scan is a waste of my time!"

To read more about the study, see this from Reuters. To read more about appendicitis, see this from the Mayo Clinic.