CATHOLIC MATH

Little David, who was Jewish, was failing math. His parents
tried everything. Tutors, mentors, flash cards, special learning
centers, and nothing helped.

As a last resort, someone told them to try a Catholic school. "Those nuns are tough" their friends said.

David was soon enrolled at St. Mary's.

After school on the very first day David ran through the door
and straight to his room, without even kissing his mother hello.
He started studying furiously, books and papers spread out all over
his room.

Right after dinner he ran upstairs without mentioning TV,
and hit the books harder than before. His parents were amazed.

This behavior continued for weeks, until report card day arrived.

David quietly laid the envelope on the table, and went to his
room.

With great trepidation, his mother opened the report.
David had gotten an A in math!

She ran up to his room, threw her arms around him and asked, "David honey, how did this happen?

"Was it the nuns?"

"It sure was....!", said David.

"On the first day of school when I saw that guy nailed to the plus sign, I knew they weren't fooling around!"

New study report on Marijuana

In a recent meta-analysis of 35 longitudinal and population-based studies, the researchers found that marijuana use is associated with about a 40 percent increase in the risk of psychosis and the risk increases with more frequent use.

The researchers found that the risk of psychosis was higher in people who used cannabis compared to those who had never used it and the risk increased with increasing frequency of cannabis use.

There was no clear correlation from this analysis on the effect of cannabis use on depression, suicidal thoughts, and anxiety.

The public perception that cannabis has been considered a more or less harmless drug compared with alcohol, central stimulants, and opioids is just not the case. A very high percentage of drug users will state they started with marijuana and progressed to more addictive substances.

The potential long-term hazardous effects of cannabis with regard to psychosis need to be emphasized and the dangers passed on to the public sector.

Many people do not admit to using this drug even when asked about illegal drug uses. It is minimized and thought of by many as a non-drug.

CT scans in kids

There are new recommendations released by the American Academy of Pediatrics related to the use of computed tomographic (CT) scans in children.

The report is intended to aid in decision making and discussions with the healthcare team, patients, and families.

X-ray studies that use ionizing radiation are an essential tool for the evaluation of many disorders of childhood and CT scans seem so easy and accessible that many families push for them even when not necessary.

CT scans are of particular interest because of its relatively high radiation dose and wide use.

In terms of radiation dose, a head CT is equivalent to 200 chest x-rays, a chest CT to 150 chest x-rays, and an abdominal CT to 250 chest x-rays.

The consensus statements published reveal that even low-level radiation may have a small risk of causing cancer.

By only using CT scanning when necessary we will decrease radiation exposure and decrease any risk associated.

Healthcare providers in pediatrics play important roles in deciding when CT scanning is indicated and in discussing the associated risks with patients, parents, and insurance companies.

Radiologists are also a wonderful resource in deciding what types of studies may be the most beneficial with the least amount of risk.

Families and patients need to be educated on the potential risks and discouraged from requesting procedures just because they are available.

Literature review suggests widely differing opinions regarding the cancer risk associated with radiation from these types of studies and most reports conclude the benefits outweigh the risks.

The American Academy of Pediatrics offers the following specific information as a basis to underlie discussions of CT examinations and risks:

• Radiation is a necessary component of a CT examination.
• CT scanning is associated with low-level radiation exposure.
• The cause-and-effect relationship between low-level radiation, such as that associated with CT scanning and cancer is still unclear. Expert consensus panels that have reviewed this issue have suggested that there is a small risk for cancer that increases with increasing radiation exposure.
• Because no direct connection between CT scanning and subsequent development of cancer has yet been shown, the risks from CT scans must be estimated. These estimates vary according to the information underlying them.
• The amount of radiation exposure associated with a CT examination depends on the protocols and equipment settings used, as well as on other factors.
• As an overall rule, CT examinations performed properly in children should expose a child to a much lower radiation dose than that for the same procedure performed on an adult.
• There is clinically recognized and documented potential benefit from an indicated CT examination, which greatly exceeds the potential cancer risk.

Lice treatment

Each year millions of children are infested with head lice and it is responsible for tens of millions of lost school days.

Over the years, head lice have become more resistant to many of the currently used pediculicides and they are becoming harder to treat.

There are over the counter medications and prescription treatments for lice and all are somewhat effective but one common prescription medication has been taken off the market.

New methods are always being sought and in a recent article in the Pediatrics journal, a hot-air device was very effective.

This study showed a custom-built machine called the LouseBuster, resulted in nearly 100% mortality of eggs and 80% mortality of hatched lice, even when operated at a comfortable temperature (slightly cooler than a standard blow-dryer).



Virtually all subjects were cured of head lice when examined 1 week after treatment with the LouseBuster, and no adverse effects were observed.

The findings demonstrate that one 30-minute application of hot air has the potential to eradicate head lice infestations and hot air is an effective, safe treatment and one to which lice are unlikely to evolve resistance.

The LouseBuster could be an institutionally based machine operated by healthcare providers, school administrators, or trained parents or other volunteers and could help eliminate missed school days.

Improving absences means more money from the State and it could easily pay for itself with just a few treatments.

Economic Credentialing

Modern Healthcare recently reported on what may be a test case within our legal system. Two groups of physician-investors have sued Memorial Hermann Healthcare System for allegedly orchestrating an insurance boycott that financially drained the 99-bed Physician-owned Houston Town & Country Hospital.

In 2003, a group of 109 physician-investors formed a limited partnership called Stealth, and each doctor invested between $25,000 and $150,000 to build the $65 million hospital and medical office building.

Town & Country Hospital then opened in November 2005 as a general acute-care hospital located on a 26-acre campus in west Houston.

According to the lawsuits filed in Harris County District Court, Memorial Hermann—an eight-hospital not-for-profit system that is the largest in Houston with a 25% market share—began a concerted effort to pressure insurance companies to avoid contracting with Town & Country and by the summer of 2006, with only a handful of insurance contracts, Town & Country faced financial disaster and required additional capital to stay open.

Allegedly Memorial Hermann told insurers, including Aetna, Cigna Corp., Humana and UnitedHealth Group that they would terminate their contracts or demand 25% rate increases if they contracted with Town & Country.

They allegedly also had as their strategy to deny managed-care contracts, lobby the state of Texas to require certificate of need to build, and punish doctors who invest.

All physician hospitals that don’t have the protection of a big entity (large healthcare system) are being subjected to this kind of pressure from hospitals like Memorial.

Meanwhile, on June 8, Memorial Hermann filed a federal lawsuit against Stealth asking the court to rule that the hospital system acted appropriately.

Specifically, Memorial Hermann is asking the court to find it is free to enter into exclusive or semi exclusive contracts with insurers “even if the effect of such contracts is to exclude Stealth from contracting with one or more insurers.”

The Texas attorney general’s antitrust department is also now investigating Memorial Hermann
The physicians also claim Memorial Hermann removed some of them from committees and staff positions, terminated certain privileges of their practice at the hospital and threatened to terminate medical staff credentials at system hospitals.

This is what is referred to as economic credentialing which is being challenged in many other states.

This is a simple story. A bunch of doctors wanted to create their own hospital or healthcare facility that competed with the established system. Once opened, the Goliath, Memorial, did everything it could to drive them out of business and hurt the doctors. This is similar to what Microsoft has done in the tech industry.

Legal and healthcare experts nationally are waiting to hear what the court says about Memorial Hermann’s actions.

Can Memorial Hermann and other systems engage in this kind of activity?

This is a battleground and a test case that will need to look at many different issues.

If Memorial can do this, it sends a message to other doctors that if you try and go against us, we will squish you like a bug.

Physicians have no problems with competition as long as there is fairness in the playing field.



This hospital by filing its own lawsuit appears to be admitting they are using a monopoly type of transaction to eliminate the competition.

The court will have to decide.

Can't get up, Can't get out

An elderly gentlemen went to the local drug store and asked the pharmacist for the little blue Viagra pill.

The pharmacist asked how many?

The man replied, just a few, maybe a half dozen, I cut one into four pieces.

The pharmacist said; that’s too small a dose. That won’t even get you through intimacy.

The old fellow said, Oh, I’m past seventy years old and I don’t even think about intimacy anymore.

I just want it to stick out far enough so I don’t pee on my new golf shoes!

Alcohol-It's what ales you

I get asked all the time about what role alcohol plays in a person’s health. Some seem to believe it is beneficial while others believe it harmful.

A recent study found the following:

• Consumption of 1 drink daily in women and 1 to 2 drinks daily in men has been demonstrated to reduce rates of total mortality by 18% vs. abstinence, although the risk for mortality rises with heavy use of alcohol.
• Light to moderate drinking also reduces the risk for CHD events by 30% to 35% vs. abstinence and this is considered 1-2 oz of alcohol a day.
• Alcohol use seems effective in reducing cardiovascular outcomes regardless of sex or age. Even among men with a healthy lifestyle, alcohol can reduce the risk for myocardial infarction by up to 50%.
• Light to moderate alcohol consumption seems to be beneficial among patients with hypertension, although alcohol can increase blood pressure in a dose-dependent fashion.
• Alcohol also seems to reduce the risk for CHD among patients with diabetes but can cause blood sugar control to be more difficult.
• Alcohol use is also helpful in regard to the risk for stroke and dementia in the same manner as above.
• Alcohol consumption has been associated with a reduced risk for peripheral arterial disease.
• It seems that the ethanol itself, rather than the type of drink consumed, is the component most responsible for the health benefits of alcoholic beverages. Red wine got the original fame because of the studies done years ago through the VA system.
• Despite the benefits of light to moderate alcohol consumption, binge drinking is associated with a 2-fold increase in the risk for myocardial infarction and mortality vs. with abstinence from alcohol.
• Therefore, the most cardiovascular protection seems to be derived from 1 drink per day among women and 1 to 2 drinks per day among men.
• The authors of the study note that alcohol abuse is the third leading cause of preventable death in the United States and that encouraging regular use of alcohol may contribute more cases to this already significant problem.
• Alcohol can improve cardiovascular outcomes primarily by increasing HDL cholesterol.

So the bottom line is; based on the current review, it suggests that light to moderate use of alcohol can help improve rates of total mortality, myocardial infarction, stroke, and peripheral arterial disease.

However, because of the high rate of preventable deaths associated with alcohol use, the study authors recommend against the universal prescription of alcohol consumption.

Coffee now under attack

Well, is coffee the next target?

In a recent Finish study, and using questionnaires with 24,000 patients and observing them prospectively for 13.2 years, investigators determined daily coffee consumption increased their risk of having to use medication for blood pressure.

The study showed at baseline subjects were aged 25 to 64 years and had no history of antihypertensive drug treatment, coronary heart disease, or stroke. Multivariate adjustments were then made for age, sex, study year, education, leisure-time physical activity, smoking status, body mass index (BMI), high total cholesterol level, history of diabetes, and consumption of alcohol, tea, fruit, vegetable, sausage, and bread.

The investigators stated the results indicated that coffee drinking seems to increase the risk of antihypertensive drug treatment, and this risk was higher in subjects with low-to-moderate coffee intakes; however, there was no significantly increased trend in drinkers of ~ 1 cup or ≥ 8 cups/day.

The increased risk showed no dose-response relation, but a threshold was observed between those who drank > 1 cup/day and those who drank only 0-1 cups/d.

In my opinion, this study was limited by self-reported data on coffee intake, potential bias from a possible change in coffee consumption during follow-up, lack of data on consumption of cola beverages and chocolate, but most importantly, they do not mention doing multivariate adjustments for family history.

We typically tell patients that 90% of Hypertension is genetic and hereditary and therefore, not including this in the study is a major flaw reducing the believability.

Don’t eliminate your coffee, but moderation continues to be the prevailing thought.

Editorial

Here is a thought provoking editorial by Thomas Sowell that I thought was interesting related to our current health care situation

No "Health Insurance"?
September 03, 2007 02:00 PM EST

During the first 30 years of my life, I had no health insurance. Neither did a lot of other people, back in those days.

During those 30 years, I had a broken arm, a broken jaw, a badly injured shoulder, and miscellaneous other medical problems. To say that my income was below average during those years would be a euphemism.

How did I manage? The same way everybody else managed: I went to doctors and I paid them directly, instead of paying indirectly through taxes.

This was all before politicians gave us the idea that the things we could not afford individually we could somehow afford collectively through the magic of government.

When my jaw was broken, I was treated in an emergency room and was given a bill for $50 -- which was like a king's ransom to me at the time, 1949. But I paid it off in installments over a period of months.

Like most young people, I was lucky enough not to have any heavy-duty medical expenses that would have required major operations or a long hospital stay.

That is still true for most young people today, which is why many people in their twenties do not choose to pay for medical insurance, even when they can afford it.

They know that, in an emergency, they can always go to an emergency room. And today the idea that you ought to pay for that out of your own pocket is considered almost quaint in some quarters.

It is not uncommon -- especially in California, with its large illegal immigrant population -- for hospitals to have to shut down because so few people pay for the emergency room care they receive.

There are, of course, people with huge medical bills that they cannot possibly pay. Believe it or not, that also happened back before the modern welfare state.

Some hospitals -- whether public or private -- could absorb such costs, with the help of donors. There were people with polio living in iron lungs, which is why rich and poor alike gave money to the March of Dimes.

But that is very different from hospitals being stiffed every day by emergency room users whose only emergency is that they want to keep their money to spend on fun, instead of on doctors.

The biggest of the big lies in the "health care" hype is that a lack of insurance means a lack of medical care. The second biggest lie is that health care and medical care are the same thing.

Doctors cannot stop you from ruining your health in a hundred different ways, so statistics on everything from infant mortality to AIDS are not proof of a need for government to take over medical treatment.

Few people show the slightest interest in what has actually happened in countries with government-controlled medical care.

We are apparently supposed to follow those countries' example without asking about the months that people in those countries spend on waiting lists for medical treatments that Americans get just by picking up a phone and making an appointment.

It is amazing how many people seem uninterested in such things as why so many doctors in Britain are from Third World countries with lower medical standards -- or why people from Canada come to the United States for medical treatment that they could get cheaper at home.

Government price controls on pharmaceutical drugs are more of the same illusion of something for nothing.

People who are urging us to follow other countries that control the prices of medications seem uninterested in the fact that those countries depend on the United States to create new drugs, after they destroyed incentives to do so in their own countries.

Since it takes more than a decade to create a new drug, a politician can be elected president by hyping price controls on drugs, spend eight years in the White House, and be living in retirement before people start to notice that we no longer get the kinds of new medications that successively conquered deadly diseases in the past.

The Art of Medicine

Based on the recent report in Ann Behav Med 2007;33:262-268, not all patients want to take an active role in their health care and medical decision-making.

There are many patients who strongly believe it's the physician's job to make decisions and they really take no active role in their healthcare decisions.

This study tried to examine "the similarity of the attitudes held by patients and their physicians (symmetry) about the patient role in health care delivery and its relationship to patient outcomes."

They surveyed 16 primary care physicians at the University Of Iowa Carver College Of Medicine in Iowa City, and 146 of their patients.

Patients were asked, among other things, to rate their satisfaction with their present physician and their healthcare, as well as their adherence to medical recommendations.

The researchers then categorized patient-physician dyads into three groups: asymmetrical dyads in which patients were less patient-centered than their physicians, asymmetrical dyads in which patients were more patient-centered than their physicians, and symmetrical dyads.

When patients did not want an active role, but their physician wanted to involve patients more and to share decision-making, patients were significantly less adherent and less satisfied, the report indicates.

In contrast, patients who were more patient-centered did not differ significantly in terms of adherence or satisfaction, compared with patients in symmetrical dyads.

This also showed that patients who are motivated to take responsibility for their own health will find ways to do so "even when confronted with a provider who is reluctant to share control,"

On the other hand, one of the researchers stated, "A more passive patient who wants the doctor to take the reins is probably not as adaptable to an unwelcome role."

In that case, he added, "the physician could end up putting too much responsibility on the patient's shoulders and not giving them enough direction. So they leave the appointment feeling confused about what they're supposed to do, or with information overload."

This study once again highlights the fact that the practice of medicine is not a cookbook approach as many insurance companies want everyone to believe. One treatment protocol will not work with every patient and one single approach is not satisfactory to every patient.

This continues to emphasize the fact there is an art of medicine along with the practice and science of medicine!

More on Global Warning Concerns

Methane is a greenhouse gas that is 20 times as harmful as carbon dioxide.

Sixteen percent of worldwide emissions of methane come from belching and farting farm animals.

A single cow can pass up to 130 gallons of methane a day surely contributing to the “Global Warming”.

Scientists at the University of Wales are looking for ways to help curb the global warming problem and have found that adding garlic to an artificial cow stomach reduces gas emissions by almost 50 percent.

They are currently unsure what garlic will do to the taste of the milk and meat.

What would Al Gore’s solution be? Eliminate all the farm animals and especially the cows?
Wipe that smirk off your face Al!



Forbes Magazine recently published a quote from physician/author Michael Crichton in which he said; "Nobody believes a weather prediction 12 hours ahead. Now we're being asked to believe a prediction that goes out 100 years into the future? And make financial investments based on that prediction? Has everybody lost their minds? "





For more info on recent challenges, see the following site:

http://www.oism.org/pproject/

http://www.earthtimes.org/articles/show/news_press_release,176495.shtml

The Great Hoax

How many Global Warming proponents know that in August of this year, NASA scientists had corrected an error that resulted in 1934 replacing 1998 as the warmest year on record in the U.S.?

Questions are being raised about whether 2007 is going to be the demise of this anxiety provoking issue. Some recent excerpts from various sources include:

Comments from astronomer Dr. Ian Wilson after reviewing a new study that has been accepted for publication in the Journal of Geophysical Research, “Anthropogenic (man-made) global warming bites the dust,”

And a former Harvard physicist, Dr. Lubos Motl, said this new study has reduced global warming fear-mongers to “playing the children’s game to scare each other.” The newest research is showing that the Earth’s climate is only about one-third as sensitive to carbon dioxide which is far different than a series of reports by the UN’s Intergovernmental Panel on Climate Change. Many are dismissing the IPCC reports as many believe they are deliberate distortions of data that amount to propaganda.

Paleoclimate scientist, Bob Carter, after testifying before the U.S. Senate Committee on Environment & Public Works, noted in a June 18, 2007 that global warming has stopped. There has been little, if any, global warming since 1979, a period over which atmospheric CO2 has increased by 17 percent. Thus, the connection between CO2 and “global warming”, the key to the claims that it is occurring and will increase has been proven wrong.

Dr. Roy Spencer, another critic of the global warming hoax, has noted that “At least 80 percent of the Earth’s natural greenhouse effect is due to water vapor and clouds, and those are largely under the control of precipitation systems.” The computer models used by advocates of global warming have been able to include the actions and impact of clouds, thus rendering them seriously flawed.

Prior to and during 2007, one research study after another revealed that the central premise of “global warming” lacks any scientific merit. One by Dr. Tim Patterson concluded that, “The earth temperature does respond to the solar cycle as confirmed by numerous studies.” The solar cycle is known to be about eleven years in length and reflects increased or decreased sunspot (magnetic storms) activity. It is the Sun that largely determines the Earth’s temperature, which is never the same throughout the planet, given seasonal and solar changes.

In 2007, meteorologist Anthony Watts who led a team of researchers revealed that, “The U.S. National Climate Data Center is in the middle of a scandal. Their global observing network, the heart and soul of surface weather measurement, is a disaster.” It had been discovered that many of the measuring stations were placed in locations such as on hot black asphalt, next to trash burn barrels, beside heat exhaust vents, and even attached to hot chimneys and above outdoor grills!

Determining the Earth’s temperature, says Bjarne Andresen, a professor at The Niels Borh Institute, University of Copenhagen, collaborated with two other professors to write an article in Science Daily, saying, “It is impossible to talk about a single temperature for something as complicated as the climate of the Earth.” Indeed, “differences in temperature drive the processes and create the storms, sea currents, thunder, etc. which make up the climate.”

In May 2007, Dr. Reid Bryson, the founding chairman of the Department of Meteorology at the University of Wisconsin dismissed fears of increased man-made CO2 in the atmosphere. He called the “global warming” argument “absurd.” As to any increase in the Earth’s temperature, he said, “Of course it’s going up. It has gone up since the early 1800s, before the industrial Revolution, because we’re coming out of the Little Ice Age, not because we’re putting carbon dioxide in the air.”

On August 15, 2007, meteorologist Joseph D’Aleo, the first Director of Meteorology at The Weather Channel and former chairman of the American Meteorological Society’s Committee on Weather Analysis and Forecasting, said, “If the atmosphere was a 100 story building, our annual anthropogenic (man-made) CO2 contribution today would be equivalent to the linoleum on the first floor.”

Whether these comments questioning Global warming or studies in support of Global Warming are accurate is still in question.

It reminds me of the many medical studies that claim certainty this year only to refute it next year.

Conservation is important and remembering my Scout Leader’s instruction “always try to leave the place better than how you found it” seems to be very practical advice.

Medical School broken down

As my number two son started medical school a few weeks in INDY, I thought I’d write this to remind him and all his classmates who chose the medical field what the first several years are like.

Once you begin your Junior year and continuing through your residency which can last from 3 to 7 years, your average work week will be 80 hours.

This is twice what a regular “full time” job requires and this is considered by some to still be “too lenient”. Breaking it down further:

• There are 168 hours in a week.
• 80 hours is 47.6% of 168. You’re working for nearly half of the week.
• If you are on a rare rotation where you actually get one day off in seven, you need to get your 80 hours in six days.
• This means you’ll average 13.3 hours per day for 6 days a week.
• A first-year resident makes about $30,000 - $35,000. Let’s use $35,000.
• With days off, a resident will work in the ballpark of 4150 hours per year.
• With a salary of $35,000 per year, this is equivalent to $8.43 per hour - before taxes and will last for the 3-7 years of residency training without much change
• The federal minimum wage is $5.85 per hour.
• The average citizen in the US sleeps 6.9 hours per night.
• After sleep and a regular work day, you’ll have exactly 3.8 hours per day to spend with your family, eat, shower, drive to and from work, buy groceries, pay bills, wash clothes, go to the bathroom, have sex, watch the news, read, study, cook, and live.

Even knowing this, most physicians love what they do and I personally would do it again without question.

The relationships with patients and families are extremely rewarding and worth every hour spent during training.

Good luck to the Medical School class of 2011!

Physician Communication

Questions arise from the beginning of Medical School through physician’s years in practice on what is the best way to address patients.

According to a survey reported in the June 11 issue of Archives of Internal Medicine, most patients prefer their physicians to greet them with a handshake and to introduce themselves using their first and last name.

Communication skills are very important, but there is little evidence regarding what constitutes an appropriate greeting.

This survey was to provide some guidance for medical students, residents, and practicing physicians by defining patient expectations for physician behaviors during the greeting stage of medical visits. It primarily focused on patients that were new or that the physician had no long-term relationship.

The survey was done using a computer-assisted telephone survey of adults in the 48 contiguous United States. The investigators asked closed-ended questions about preferences for shaking hands, use of patient names, and use of physician names and in order to characterize patterns of greeting behavior in everyday clinical practice, they also analyzed an existing sample of 123 videotaped new patient visits.

Although patient expectations varied somewhat with patient sex, age, and race, most (78.1%) of the 415 survey respondents reported that they wanted the physician to shake their hand, 50.4% wanted their first name to be used when physicians greeted them, and 56.4% wanted physicians to introduce themselves using their first and last names.

More women than men and African Americans than whites preferred that the physicians use both first and last names when introducing him or herself.

Other physician characteristics of value to patients interviewed by telephone included smiling, being friendly, being warm and respectful, and being attentive and calm.

Videotapes showed that physicians and patients shook hands in 82.9% of visits but, in 50.4% of the initial encounters, physicians did not mention the patient's name at all. However, physicians tended to use their first and last names when introducing themselves.

The recommendations were that physicians should be encouraged to shake hands with patients but remain sensitive to nonverbal cues that might indicate whether patients are open to this behavior.

The medical interview is one of the most important tools for any physician and greetings create a first impression that may extend far beyond what is conventionally seen as 'bedside manner.'"

How do you like your physician to greet you?

Benefits of Fish

It seems the media can spin things to a point that is unhealthy. Over the past few years, we have read about the potential health hazards of eating fish.

There have been highly publicized stories about the association of certain species of fish containing methylmercury, dioxins, and polychlorinated biphenyls (PCBs).

The cancer risk from consuming PCBs or dioxins in fish appears to be negligible, especially when stacked up against the likely cardiovascular protection offered by the consumption of fish. The mercury levels are very low and probably negligible for most individuals. The theoretical risk was extrapolated from animal data.

According to an article in JAMA , a review of the literature on the health effects of dietary fish or fish-oil intake has a reassuring message for seafood lovers, anyone eating fish for health reasons, and perhaps most everyone else.

The main message is really that everybody should be eating one or two servings of fish or seafood per week for their health.

The main results of the review showed that regular modest intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and the 2 long-chain n-3 polyunsaturated fatty acids (PUFAs) abundant in finfish and shellfish is associated with a 36% drop in coronary disease mortality (P < .001) and a 17% decrease in total mortality (P = .046). The n-3 PUFAs also appear to be important to early brain development.

The report did specify that pregnant women should avoid shark, swordfish, golden bass, and king mackerel, and restrict intake of albacore tuna to 6 oz per week to limit exposure to methylmercury and the concern over the developing child.

For the general population a weekly target of 1500 to 2000 mg of EPA and DHA is "reasonable" and could be met by one 6 oz serving per week of "wild salmon or similar oily fish, or more frequent intake of smaller or less n-3 PUFA-rich servings."

If you live in an area where higher levels of toxins are known to be a problem, then buying fish from other sources would be prudent as well as varying the types of fish being eaten.

For now, enjoy the fish and help your heart!

Newest Denial Process

I thought a little satire today might be in order. This comes after a week of ongoing denials for many of the things I ordered on patients from drugs to x-rays.

LOUISVILLE, KY--Harmona Healthcare, one of the nation's largest managed care insurance payors, has announced plans to introduce "Pre-Denial" of claims to all of its members beginning in the first quarter of 2008.

According to Harmona spokesperson Richard Leikie, "Pre-Denial" will eliminate 80% of claims processing delays, and is expected to galvanize sagging profits at the HMO, which also operates clinics throughout the southeastern U.S. and nationally.

"The way it works is this," said Leike. "Rather than having a member waste their time filling out a complicated form and sending it to us, only to find out a month later that we denied it, what we're going to do is give our members the option of filling out our new 'Pre-Denial' form, which they'll address and send to themselves instead."

"That way, they'll find out about their claim denial in as few as two to three days on average, though it may be slightly longer during busy mail seasons."

Leike added that members would also be given the option, for a nominal fee, of using USPS Priority Mail, Express Mail, or Federal Express Overnight for considerably faster notification of their claim denial.

Basically, we're putting the control back into the hands of the consumer," continued Leike. "Survey after survey tells us the same thing: no one likes to wait weeks or months for their claim to be processed. Now, if someone says, 'I've gotta know by noon tomorrow,' they just fill out the form, address an envelope to themselves, and drop it all off at Fed Ex before 6PM. You better believe they'll have their answer by morning!"

Reportedly, "Pre-Denial" will be offered to participating Harmona physicians as early as fall 2008, in order to accelerate processing of authorization requests for urgent diagnostic tests and procedures.

Vaccinations and School-Entry

It is becoming increasingly more difficult to keep up with all the recommended and required immunizations for children, but according to the recent report in Morbidity and Mortality Weekly Report the school-entry requirements appear to be somewhat effective in increasing vaccination coverage.

Approximately 75% of states have reached the 2010 objective of at least 95% coverage for all of the vaccines recommended.

The investigators of this report analyzed data from the 2006–2007 information submitted to the CDC by 49 states and the District of Columbia. Up-to-date vaccination coverage was defined according to the vaccines and doses required for school entry in each state. The vaccinations requirements vary state by state. To determine a national estimate of coverage, each state's coverage estimate was weighted based on the size of its kindergarten enrollment.

Nevada was the only state not submitting data but this study was limited by the fact that there was no standard way of reporting data and therefore it could not necessarily be adequately compared state by state.

The bottom line; state laws requiring proof of vaccination at early school entry are key to the U.S. vaccination program and help ensure that no child is unvaccinated.

Higher percentages of children are up to date at kindergarten entry than at younger ages, suggesting that early school-entry laws help maintain high coverage and ensure completion of the vaccine doses recommended for children by ages 4–6 years.

The CDC is continuing to work with state immunization programs to improve certain state survey methods and standardize reporting of data.

Benefits of eating healthy

Another recent study published in the August 15, 2007 issue of the Journal of the American Medical Association once again suggests what many have suspected; our unhealthy American diet affects colon cancer outcomes.

The researchers showed that patients with the highest intake of a Western-pattern diet, characterized by high intakes of red meat, sugar desserts, high fat, and refined grains, have a 3-fold increase in cancer recurrences and mortality.

Previous studies have shown that diet and other lifestyle factors have a significant influence on the risk of developing colon cancer however, the influence of diet and other lifestyle factors on the outcome of patients with established colon cancer is largely unknown.

This study was just an observational study and more work needs to be done, but for now, it appears that changing diet patterns even after the diagnosis does offer real benefits.

It’s never too late to make positive changes

Benefits of eating healthy

Another recent study published in the August 15, 2007 issue of the Journal of the American Medical Association once again suggests what many have suspected; our unhealthy American diet affects colon cancer outcomes.

The researchers showed that patients with the highest intake of a Western-pattern diet, characterized by high intakes of red meat, sugar desserts, high fat, and refined grains, have a 3-fold increase in cancer recurrences and mortality.

Previous studies have shown that diet and other lifestyle factors have a significant influence on the risk of developing colon cancer however, the influence of diet and other lifestyle factors on the outcome of patients with established colon cancer is largely unknown.

This study was just an observational study and more work needs to be done, but for now, it appears that changing diet patterns even after the diagnosis does offer real benefits.

It’s never too late to make positive changes