- Created on 29 October 2012
8:58 a.m. CDT, October 29, 2012
State health officials knew six clinics in Indiana had received a recalled back pain medication linked to an outbreak of fungal meningitis a week before they notified the public, according to documents obtained by The Associated Press.
A series of emails obtained Friday through an AP public records request indicate officials at the Indiana State Department of Health were racing to keep up with an evolving picture as the disease rapidly spread.
"A lot of new information was coming in regularly over the weekend of Sept. 29 and 30 from the Centers for Disease Control and Prevention as the situation began to take shape," Amy Reel, a spokeswoman for the state health agency, told The Associated Press.
"This is a fast breaking and fluid situation," Randy Snyder, acute care director for the agency, told other state health officials in an Oct. 3 email.
The emails indicate the CDC informed officials at the Indiana health agency on the night of Sept. 28 it was investigating a cluster of fungal meningitis cases in Tennessee and North Carolina that it suspected were connected with injections of a contaminated steroid. An email attachment identified the six Indiana health facilities that were known to have received the suspected medication from a specialty pharmacy in Massachusetts.
The CDC email urged state health agencies to contact clinics that received the tainted steroid and monitor their patients for signs of meningitis symptoms. The Indiana clinics that received the medication were located in Elkhart, Evansville, Fort Wayne, South Bend, Terre Haute and Columbus.
Snyder told officials in an email Sept. 29 that he had received no reports of meningitis cases. That morning, a Saturday, state epidemiologist Pam Pontones sent an email to CDC intelligence officer Rachel Smith saying, "We'll focus on contacting the facilities on the list first."
"We'll contact the patients," Kristi Williams, pharmacy director at Union Hospital in Terre Haute, told state health officials in an email the following Monday. That same day, Oct. 1, Snyder said in an email that the state health department had contacted by phone and email all six of the health facilities that received the tainted lots of medication. The agency also distributed a "script" for the clinics to read from when notifying patients who may have been exposed.
Reel said Indiana and other states didn't receive data defining how to recognize cases that would be considered part of the outbreak from the CDC until Oct. 2, and the state agency immediately alerted physicians.
"It's critical physicians are made aware of signs and symptoms prior to any public announcement so they can be prepared to discuss those signs and symptoms and appropriately treat patients," Reel said.
As of 6:30 a.m. Oct. 4, health officials weren't aware of any meningitis cases in Indiana, according to the documents. But by shortly after noon, they knew that one case had been confirmed and two more were suspected.
"One case has been identified in Indiana, and we probably have at least two more," Pontones said in an email.
That same day, the state health agency informed the clinics that the state epidemiologist would be contacting them for a list of the patients who had received the tainted injections, and to find out how many patients the clinics had already contacted.
In the same email, Snyder told the clinics that the agency intended to announce the outbreak to the public and planned to identify the facilities that had received the contaminated steroid.
Reel said the state health agencies coordinated the release of information with a CDC press conference on Oct. 4, the same day the first Indiana case was confirmed.
As of Sunday, the CDC meningitis website was reporting 44 cases and three deaths connected with Indiana.
The tainted steroids have been traced to the New England Compounding Center of Framingham, Mass., which has since recalled the contaminated lots and suspended production.
- Created on 27 October 2012
As this domestic violence awareness month comes to a close, consider the following disturbing statistics:
- Every 9 seconds in the US a woman is assaulted or beaten.
- Around the world, at least one in every three women has been beaten, coerced into sex or otherwise abused during her lifetime. Most often, the abuser is a member of her own family.
- Domestic violence is the leading cause of injury to women—more than car accidents, muggings, and rapes combined.
- Studies suggest that up to 10 million children witness some form of domestic violence annually.
- Nearly 1 in 5 teenage girls who have been in a relationship said a boyfriend threatened violence or self-harm if presented with a breakup.
- Everyday in the US, more than three women are murdered by their husbands or boyfriends.
- Ninety-two percent of women surveyed listed reducing domestic violence and sexual assault as their top concern.
- Domestic violence victims lose nearly 8 million days of paid work per year in the US alone—the equivalent of 32,000 full-time jobs.
- Based on reports from 10 countries, between 55 percent and 95 percent of women who had been physically abused by their partners had never contacted non-governmental organizations, shelters, or the police for help.
- The costs of intimate partner violence in the US alone exceed $5.8 billion per year: $4.1 billion are for direct medical and health care services, while productivity losses account for nearly $1.8 billion.
- Men who as children witnessed their parents' domestic violence were twice as likely to abuse their own wives than sons of nonviolent parents.
There are several city, state and federal resources, as well as organizations committed to helping victims and attackers in domestic violence situations. Check resources in your area for more information.
- Created on 25 October 2012
People in wealthier white or integrated neighborhoods are more likely to try to save a cardiac arrest victim using CPR than people in other neighborhoods, according to a large U.S. study funded by the Centers for Disease Control and Prevention.
"Where you drop literally can determine your likelihood of having someone stop and do CPR, and it changes from one side of the street to the other," coauthor Dr. Comilla Sasson of the University of Colorado School of Medicine told Reuters Health.
Although the racial makeup of a neighborhood was a factor, "it's probably socioeconomic status that matters more than racial composition," she said.
About 300,000 people collapse from cardiac arrest each year, and other research has suggested that ethnic or socioeconomic conditions influence the chance that a bystander will start CPR.
"We've seen for many years that certain communities have a higher likelihood of a patient getting CPR," Dr. Bryan McNally of Emory University in Atlanta, another coauthor, told Reuters Health. "This is pointing out that within communities there is variation in the local or neighborhood area."
The findings, reported in the New England Journal of Medicine, are based on 14,225 cases of cardiac arrest from 29 non-rural parts of the U.S.
Using Census data, the researchers separated the sites of each collapse into two categories: high income, where the median household income was $40,000 or more, and low income. A neighborhood was given an ethnic classification if that group made up more than 80% of the population.
The overall chance of a cardiac arrest victim getting CPR from a bystander was about 29 percent.
Based on the results, if a bystander is available to help and "a person who falls down in a primarily-white higher-income neighborhood, their chance of getting CPR is 55 percent," said Sasson.
In a high-income integrated neighborhood, the chance was 49 percent, and it was 45 percent in a high-income black neighborhood.
"If that person crosses the street and goes into an African-American poor neighborhood, the percentage goes down to 35 percent," Sasson said.
She said information from focus groups suggests that one reason the rate may be lower in poorer neighborhoods is the cost of CPR training, which can be up to $250 for a class. "If you're making $20,000 a year, that's 15 percent of your monthly income. A lot of folks would love to learn it, but they can't."
"Once the barriers to CPR training and performance are better understood, it may be possible to design more linguistically appropriate and culturally sensitive CPR training programs that can be implemented in neighborhoods with low rates of bystander-initiated CPR," the team said.
The study "may help guide decision making about where to put our resources," McNally said in a telephone interview.
The study did not examine if a neighborhood's characteristics affected a person's chance of surviving cardiac arrest.
In this study, only 8 percent of the patients survived to be discharged from the hospital, and about half of those had some kind of brain damage.
SOURCE: http://bit.ly/XgOe2O New England Journal of Medicine, October 25, 2012.
- Created on 26 October 2012
The Chicago Defender will hold it's annual Living Well Health Fair from 10 am to 2 pm on Saturday, October 27, 2012 at the Charles A. Hayes Center, 4859 South Wabash in Chicago.
This fun-filled day will be full of seminars, live demonstrations and free health screenings. Attendees will learn how to prevent strokes, heart disease and diabetes. These diseases impact African Americans at a higher rate than other ethnic groups.
There will be seminars on heart failure, financial health and breast cancer awareness, as well as the opportunity to participate in Zumba, Jazzercise and Line Dancing. Attendees can also receive free glucose, blood pressure and HIV health screenings.
This health fair will offer all of the events and activities listed and more.
- Created on 18 October 2012
As many as 2.3 million American women have survived breast cancer or are living with breast cancer after surgery or other treatment. Most cancer survivors want to do everything they can to recover from surgery. If you are one of these women, you need to know nutrition and exercise can play a key role in regaining optimum health.
What To Eat To Ease Symptoms
Nausea and vomiting are common after surgery. They are especially common if you've also had chemotherapy or radiation. Other symptoms after surgery include a loss of appetite or desire to eat, and "wasting syndrome" called cachexia. This is a wasting away of muscle, organ tissue, and other lean body mass. It's often accompanied by weight loss and weakness.
Here are some ways to ease symptoms of nausea after breast cancer treatment:
• Eat several smaller meals throughout the day instead of three big meals.
• Try protein shakes, yogurt, and liquid protein drinks when solid foods cause you to feel sick.
• Try simple soups, such as chicken with vegetables and broth, if nausea is an issue.
What To Eat To Aid Healing
Good nutrition is also associated with a better chance of recovery from cancer. After breast cancer surgery, your body needs more than its usual supply of protein. It needs it to repair cells, fight infection, and heal incisions. Right after surgery, boost your protein intake without worrying about calories. It will aid your healing and help you regain your strength. If you need to lose weight, you can focus on that after your post-op recovery.
Here are some ways to increase your protein intake:
• Add protein powder or dry milk to dishes to boost their protein level.
• Add grated cheese to vegetables, potatoes, rice, and salads to increase protein and calories.
• Add high-protein snacks such as almonds, peanuts, and cheese to your diet.
What To Eat To Prevent Recurrence
• Phytochemicals. "Phyto" means plant — are chemicals found in plant foods. Some phytochemicals have been studied for their potential anti-cancer benefits and their ability to prevent recurrence.
• Soy. Soybeans contain phytoestrogens. These are weak estrogen-like compounds. Soybeans (also called edamame), tofu, soy milk, and miso soup all contain these phytoestrogens. Some researchers think they can help protect against the kind of breast cancer that depends on estrogen for its growth. Experts agree that more research is needed to fully understand the role phytoestrogens might play in preventing breast cancer recurrence. In the meantime, ask your doctor whether eating a moderate amount of soy foods — one to three servings a day — is advised for you. It's possible it may interfere with hormone therapy or some other treatment. There is a link between estrogen levels and breast cancer growth. But how various hormone therapies, surgery, phytoestrogens from foods, and recurrence of cancer are all related is, as yet, far from understood.
• Antioxidants. Many vegetables, fruits, nuts, and other foods contain antioxidants. Examples of specific foods with antioxidants include broccoli, liver, and mangos. Antioxidants protect your cells from damage from "free radicals." These are atoms or groups of atoms thought to trigger cancer growth. Dietitians advise eating a balanced diet with a variety of fresh foods to provide antioxidants. That's better than taking high "megadoses" of vitamin C, vitamin E, or other antioxidants.
• Beta-carotene. Beta-carotene gives carrots, apricots, yams, and other orange-colored vegetables and fruits their color. Results of studies examining the relationship between breast cancer and beta-carotene are inconsistent. But there are some studies that suggest that a diet high in beta-carotene-rich foods may reduce the risk of death from breast cancer.
• Lycopene. Lycopene is what puts the red in tomatoes and the pink in pink grapefruit. It might also help prevent recurrence of breast cancer in some women. Studies haven't shown a consistent benefit, though.
An Anti-Cancer Diet?
Here are some guidelines you can use for planning an anti-cancer diet. You might also want to consider consulting with a registered dietitian. The dietitian can give you more personalized advice on the best diet and nutrition plan for your condition.
• Choose low-fat protein, such as roasted chicken and baked fish, rather than steak, duck, sausages, or other high-fat meats.
• Try to eat five servings of a wide variety of vegetables and fruits each day.
• Avoid or eliminate processed meats linked to cancer. This includes meats such as bacon, bologna, hot dogs, ham, and smoked meats.
• Choose whole-grain products like whole-wheat bread and brown rice, rather than white bread and white rice.
• Cut back or eliminate alcohol. Limit yourself to one to two drinks a day at most.
Exercise After Breast Cancer Surgery
Exercise has long been known to improve self-esteem, elevate mood, and create a sense of personal mastery and well-being. Exercise after breast cancer surgery is no exception. In addition, studies have shown a link between being overweight and breast cancer recurrence. So losing weight through exercise may help you restore your health and improve your outcome.
Fatigue often lingers for some time after surgery. It may even be more pronounced if you've also had chemotherapy and radiation. Still, most experts advise some form of regular exercise, even if you start with short walks around the block. Exercise can actually boost your energy. And recent studies suggest that exercise after breast surgery can lower the risk of cancer recurrence.
Ideal Post-Treatment Exercises
1. Talk with your doctor before starting. For the first days and weeks after breast cancer surgery, focus on protecting your incision. Also focus on protecting any other tender areas from bumping and bruising. Avoid carrying children or heavy groceries. Once your doctor gives you clearance to begin exercising, some precautions may apply. Consider seeing a physical therapist experienced with breast cancer. The therapists can help you improve your range of motion, strength, and flexibility in the affected arm and shoulder after surgery.
If you had a lumpectomy to remove a breast lump, or surgery to remove part of your breast (a segmental mastectomy), exercise precautions are usually minimal.
If you had surgery to remove the lymph nodes under your arm, you're at higher risk of lymphedema (swelling of the arm). This is especially true if you receive radiation. That's because fluids can't drain normally from your affected arm. Lymphedema can occur any time after surgery or radiation. You'll need to protect your arm from injury. You may also need to avoid exercises such as tennis, running, and some styles of yoga that use your arms for some time after surgery.
If you had a mastectomy, you may have more precautions than women who have had a breast-conserving surgery that removes less tissue. Also, if you go on to have breast reconstruction surgery, you may face several surgeries to finish the full reconstruction of your breast and nipple. That may mean you'll be restricted from exercise for a longer period of time.
2. Choose an exercise you enjoy. The best exercise for you is the one you'll stay with and enjoy — and one that's safe, given your type of breast cancer surgery. Start with brisk walking. Or try using a stationary bike so you can sit upright without leaning on your arms. Other exercises that don't require you to put weight on your arms include tai chi, qigong, or gentle yoga. Later, add more vigorous exercise that uses your arms more. For example, you might try running, swimming, cycling, hiking, more vigorous styles of yoga, and other aerobic exercise.
3. Work up to 30 minutes, five days a week. Progress slowly and safely in the months following surgery. Eventually, you may be able to work up to the American Cancer Society's general guidelines for cancer prevention — unless your doctor has advised against it based on your age or medical condition.