Florida Health News - September 2009 issue by Global Health Tribune

No. 6 • September • 2009

'Organic'

THE BEST INFORMATION IN YOUR HANDS SERVING PALM BEACH COUNTY AND SURROUNDING AREAS

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May Not Mean Healthier

Let us meet your diagnostic needs at our State of the Art Facility located at The Palomino Park Professional Park 3347 State Rd 441 in Wellington.

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According to a British review of studies done over the past 50 years, organic and conventionally produced foods have about the same nutrient content, suggesting that neither is better in terms of health benefits. PAGE 8

• MRA

• Ultrasound

Please call 561.795.5558 to schedule an appointment or speak to one of our associates

Analysis: Health care debate a long-running story. PAGE 8

Wish Fulfillment? No. But Dreams (and Sleep) Have Meaning. PAGE 13

Tips to protect your pet from summer heat. PAGE 15

Also in this issue

Selff inflicted abuse ................................................................................2 Foods that burns calories! ......................................................................3 More Kids Becoming Severely Obese ....................................................4 5 tips to keep your home safe in an emergency ....................................5 'Organic' May Not Mean Healthier ..........................................................6 Many Cancer Survivors Don't Adopt Healthy Lifestyle............................7 A Visit To The Doctor ..............................................................................8 iMedX Announces Acquisition of Medware Inc. ....................................11 House health plan to boost taxes on rich..............................................12 5 Neat and easy ways to burn calories all day, every day! ..................13 For Macho Men, Doctor Visits Are Less Likely ....................................14 Tips to protect your pet from summer heat ..........................................15 FLORIDA HEALTH NEWS P.O. Box 542527 Lake Worth, FL 33454-2527

...and announcing "The Women's Center at Independent Imaging/Advanced Diagnostic Solutions" offering Digital Mammography,DEXA Bone Density, Breast MRI, and Obstetric and Breast Ultrasound in a private and relaxed setting...

Many Cancer Survivors Don't Adopt Healthy Lifestyle. PAGE 7

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Self Inflicted Abuse

2 SEPTEMBER • 2009

old on to your health like dear life!! Good health precedes long life. Let us start with drugs,medicines and the like, some of which can be actually deleterious to one’s health when abused as well as have harmful side effects.

Now, talking about drug abuse and dying from overdosing is a known age old fact. Targeting illegal drug peddlers and illegal manufacturers is one way to curtail the flow of illegal drugs. Another possibly more effective way would be to target, apprehend, and arrest the users and abusers. Why are the lawmakers not making the abuse of illegal drugs unlawful? In my opinion if a person’s blood sample is tested positive for a street drug why should not this person be arrested? Ironically if this same individual fails an alcohol breathalyzer test, he/she immediately goes to jail.

When patients get admitted to a hospital with drug overdose taken recreationally, and found to have cocaine, cannabinoids (marijuana), barbiturates etc, they are treated and discharged home. There is no law that requires the hospital or the doctors to report this to the law enforcement. Why not? After all, if the same patients were seen carrying the same illegal drugs they would be arrested by law enforcement officers.

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By Leah James

In most cases, as long as the person abusing street drugs is proven to be 'sane' then that person should definitely be targeted by law enforcement. This measure will in turn stem the sale/flow of illegal drugs from outside sources that prey on the drug users as customers for their gainful business.

So, STOP the user from using illegal drugs by combining the efforts of doctors, hospitals and law enforcement officers. This will definitely stem the flow of illegal drugs into the United States.

Building walls physically on our borders, employing more border patrol and spending more on high tech equipment is only going to increase the costs for the tax payer. These barriers are not going to eradicate illegal drug abuse. As Americans we have to first learn to be responsible for our actions and quit blaming everyone else.

We all knew that robbing a bank is illegal. If we just use this same simple, logical reasoning for illegal drug abuse we will all go a long way in improving are society. If there are as many bank robbers as there are illegal drug users, I think our financial system would take another beating!!!

ADVERTISING SALES Sergio Aguilar Phone: (561) 716-5054 sales@floridahealthnews-online.com PUBLIC RELATIONS Ranjita Shar ma Phone: (561) 267-5232 CONTACT US P.O. Box 542527 Lake Worth, FL 33454-2527 Phone: 561-716-5054 info@floridahealthnews-online.com WEB SITE www.floridahealthnews-online.com CONTRIBUTING ARTICLES U.S. Department of Health and Human Services, Contexto Latino, ARA Content, Hispanic PR Wire, Centers for Disease Control and Prevention, METRO Editorial Services, Family Features,

Florida Health News is a newspaper published every month in Broward, Palm Beach, and surrounding areas. Copyright 2009, all rights reserved by SEA Publications, Inc. Contents may not be reproduced in any form without the written consent of the publisher. The publisher reserves the right to refuse advertising. The publisher accepts not responsibility for advertisement error beyond the cost of the portion of the advertisement

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The President and Congress Need to Address Defensive Medicine

resident Obama has said that the health care system is broken, and that we must find insurance for 47 million uninsured Americans. Helping uninsured Americans is about obtaining affordable health insurance. Obtaining affordable health insurance is about reducing costs. President Obama has agreed one way to reduce costs is to eliminate waste and inefficiencies. The single most easily reducible cost is that associated with malpractice awards. That is why the AMA has set limiting malpractice awards as it's highest legislative priority.

There are two costs associated with malpractice awards. One is the direct cost of malpracitce premiums. As bad as that is, the more wasteful and inefficient cost is that of defensive medicine. Defensive

medicine is the practice of ordering tests and procedures that aren't needed to protect a doctor from a lawsuit and has greatly increased in recent years. Defensive medicine is notoriously hard to quantify, but some estimates published in the Wall Street Journal place the annual cost at $100 billion. Defensive medicine is the one part of the broken health care system that is the easiest to correct. Limits to malpractice awards and replacing the jury malpractice system with a system of expert health courts can save the $100 billion wasted on defensive medicine.

So what is congress going to do about reducing the wasteful, foolish expense of defensive medicine? So far, nothing. None of the bills before congress address the astonishing waste of defensive medicine. Congressional

leaders will not even consider expert health courts. And what is Obama going to do about it? The answer is in his recent speech to the AMA on June 16 2009. The President acknowledged that excessive defensive medicine is a real issue that leads to more treatment rather than better care.

Then he clearly said he opposes limits to malpractice awards. He said the way to reduce defensive spending is to "explore a range of ideas". He got boos from the doctors and probably a sigh of relief from trial laywers. The phrase "a range of ideas" is political double talk which means nothing at all.

The reason for the reluctance of Obama and the Democratic controlled congress to ignore the benefits of reducing defensive medicine is clear: Trial

By Mark Schor MD FACP

lawyers are a major contributer to the democratic party.

Eliminating the need for defensive medicine will help to save enough money for America to afford universal health coverage. As the nation debates health-care reform, failure to address defensive medicine is a willful refusal by Obama and Congress to deal with one of the causes of uninsured Americans. It's not health care that is broken, rather it is the President and Congress that are broken, because they answer to the trial lawyers instead of the needs of the uninsured.

Mark Schor is board certified in Internal Medicine and is one of the partners in U.S. Hospitalists. He sees patients at Palms West Hospital, Wellington Regional Medical Center and JFK Medical Center.

SEPTEMBER â&#x20AC;˘ 2009

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Fish Oils May Prevent and Treat Heart Disease

A new review shows that the omega-3 fatty acids found in certain fish not only prevent cardiovascular disease, but may even help treat it.

A lot of people know that omega-3 fatty acids are a good thing, but have thought of them in the area of nutritional or health foods," said study author Dr. Carl J. Lavie, medical director of cardiac rehabilitation and prevention at the Ochsner Clinic in New Orleans. "They don't realize there is so much data, a lot of data from big studies, that they are not only preventive but also help in therapy for a number of conditions, such as atrial fibrillation, heart attack, atherosclerosis and heart failure." The report in the Aug. 11 issue of the Journal of the American College of Cardiology cites four trials with almost 40,000 participants that show benefits of omega-3 fatty acids in primary prevention of cardiovascular disease, in treatment after heart attack and, most recently, in heart failure patients. The benefits of omega-3 fatty acids are such an old story that such studies can go unnoticed, Lavie said. "If you polled cardiologists about whether this is a good thing or a bad thing, I don't know if they would recognize how much has been done in this area," he noted. As far back as 2002, the American Heart Association issued a scientific statement endorsing omega-3 fatty acid intake, from fish or supplements. It recommended specific amounts of omega-3 fatty acids each day for people in general, with greater intake recommended for people with heart disease. "For the general population, it should be 500 milligrams a day," Lavie said. "If you have heart disease, it should be 800 or 1,000 milligrams a day." Lavie includes himself in the second category, because "I have a family history of heart disease. I eat a lot of fish and take a supplement just to be sure." It's got to be the right kind of fish, the oily species that have a lot of omega-3 fatty acids, Lavie added. "Redfish, trout, salmon," he said. "Salmon is my favorite." Not much effort is needed for most people to achieve the recommended intake, Lavie said. "Five hundred milligrams a day is two fatty fish meals per week," he added.

But too many people eat non-oily fish such as catfish, Lavie noted. "And they have it fried, which reduces its health benefits," he added. Set against that one trial are the many larger studies cited by Lavie, and epidemiological evidence showing that populations such as Asians and Alaskan Eskimos, whose diets are rich in fish oil, have a low incidence of cardiovascular disease. The picture is not complete, the new report noted. Studies still must be done to determine the relative benefits of DHA and EPA, the long-chain fatty acids in the omega-3 family. And the American Heart Association says that Omega-3 supplements should be taken only after consulting with a doctor, because too much can cause excessive bleeding in some people.

Celery and cabbage have long been touted as "calorie burning" foods, simply because the energy used to digest these foods is greater than the energy, or calories, ingested by eating the foods. An added benefit of these foods is that they are fibrous and filling, which means you will feel satisfied faster and on many fewer calories that other food choices.

Chewing Tobacco No Safer Than Smoking Tobacco users who think it's safer to dip snuff or chew tobacco than smoke are dead wrong, researchers say. A study has found that taking one pinch of smokeless tobacco delivers the same amount of polycyclic aromatic hydrocarbons (PAHs) as smoking five cigarettes. PAHs are common environmental contaminants that are formed as a result of incomplete burning of wood, coal, fatty meat or organic matter, according to information in a news release from the American Chemical Society. For instance, PAHs form during the grilling of meats. Some are known carcinogens. The research on PAHs in smokeless tobacco was scheduled to be reported this week at the annual meeting of the American Chemical Society, held in Washington, D.C. It adds to existing evidence that smokeless tobacco contains two dozen other carcinogens that cause oral and pancreatic cancers, scientists say. "This study once again clearly shows us that smokeless tobacco is not safe," said Irina Stepanov, who led the research team. "Our finding places snuff on the same list of major sources of exposure to polycyclic aromatic hydrocarbons as smoking cigarettes," she

Foods That Burn Calories! Eat Foods High in Fiber

She is a leader of the trial, which is now recruiting 10,000 men aged 60 and older and 10,000 women aged 65 and older. The researchers will test not only the effect of omega-3 fatty acids but also of vitamin D. Both are "very promising nutrients in prevention of cardiovascular disease, cancer and other chronic diseases," Manson said. In the five-year trial, a quarter of the participants will take both vitamin D and omega3 fatty acids, a quarter will take the vitamin, a quarter will take the fatty acids and a quarter will take a placebo. Enthusiasts shouldn't anticipate the results of the trial and start taking large doses of omega-3 fatty acids, Manson warned. "It's too early to jump on the bandwagon and take megadoses, but moderate doses seem reasonable," she said.

stated in the news release. Experts hope this evidence helps to end the idea that because it doesn't burn, smokeless tobacco is safer. The marketing and consumption of smokeless tobacco is on the increase, and some estimates suggest that sales of moist snuff in America have doubled since the 1980s. "The feeling of safety among some smokeless users is wrong," said Stepanov, a chemist at the University of Minnesota Masonic Cancer Center in Minneapolis. "A total of 28 carcinogens were identified in smokeless tobacco even before our study. Continued exposure to these over a period of time can lead to cancer. Now we have found even more carcinogens in snuff." Until recently, scientists wrongly believed that, because the tobacco was not burned when used, only trace amounts of PAH existed in snuff, Stepanov noted.

Keep in mind, however, that you don't want your caloric intake to be too low to cause a drop in metabolism. When your metabolism drops, you will retain more weight as the body responds to what it thinks is a period of malnutrition.

By Jennifer Nichol

Eat Low-Fat Dairy Products

Recent studies have been pointing to the fact that dieters who eat at least two to three servings of low-fat dairy products a day, like cottage cheese and yogurt, lose weight faster, keep it off longer, and lose more weight in the belly area than dieters who don't include dairy products in their diets.

Easy lunch additions include single-serving sizes of low-fat string cheese, individually wrapped low-fat cheese wedges, milk cartons (not just for elementary school cafeterias anymore) and even fat-free sour cream in place of other condiments.

Choose Foods Rich in B12

Vitamin C is also believed to be a calorie burner and a weight loss booster. Foods that are high in Vitamin C and also high in fiber and low in calories include oranges, tangerines (fresh, not canned), grapefruit (which are 90 percent water!), limes and lemons.

Eggs, milk, low-fat cheese and cereals that have been vitamin-enriched are all good sources of vitamin B12. Some sources state that B12 increases the body's fat-burning ability. Every gram of fat equals 9 calories, so when you burn fat, you burn calories, too. Vitamin B12 is also known to fight fatigue and speed up the metabolism, which are benefits that can give a boost to any dieter.

inge drinking isn't just a problem of young people, researchers say. In a nationwide survey of people 50 to 64 years old, nearly a quarter of the men and nine percent of the women told Duke University researchers they had engaged in binge drinking in the previous 30 days. Defined as five or more alcoholic drinks in a short time, binge drinking is considered extremely risky behavior, and its dangers increase with age. The survey also found that 14 percent of men and three percent of women 65 and older reported binge drinking in the previous month. The survey results were published online Aug. 17 in the American Journal of Psychiatry. "We feel that our findings are important to the public health of middle-aged and elderly persons as they point to a potentially unrecognized problem that often flies beneath the typical screen for alcohol problems in psychiatry practices," Dr. Dan G. Blazer of Duke, a study co-author, said in a news release. "Clinicians who work with this age group would be well advised to ask specifically about binge drinking." The researchers examined data on the drinking habits of nearly 11,000 middle-age and

older adults from the 2005 and 2006 National Survey on Drug Use and Health. They found that older binge drinkers were more likely to use tobacco or illicit drugs than those reporting no alcohol use. Male binge drinkers tended to be unmarried and have higher income than non-drinkers. Women binge drinkers reported higher nonmedical use of prescription drugs. Binge drinking, also called extreme drinking, has gained notoriety in recent years as experts have decried the drinking habits of college students and young people. In one study, nearly 50 percent of college students reported consuming excessive alcohol in a short time. Binge drinking at any age can lead to alcohol poisoning, liver disease, neurological damage, injuries and violent crimes.

Survey Finds Binge Drinking Among Older People, Too

4 SEPTEMBER â&#x20AC;˘ 2009

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More Kids Becoming Severely Obese

In the last 25 years, rates of severe childhood obesity in the United States have tripled, putting increasing numbers of children at risk for diabetes and heart disease, says a new study.

esearchers looked at National Health and Nutrition Survey data on 12,384 youths, ages 2 to 19 years, and found that the prevalence of severe obesity increased from 0.8 percent in the period from 1976 to 1980 to 3.8 percent in 1999 to 2004. Severe obesity correlates to a body mass index that's equal to or greater than the 99th percentile for age and gender. The finding could mean that 2.7 million children in the United States are severely obese, the researchers said. Black and Mexican-American children had the largest increases in severe obesity, along

Vitamin D Deficiency Linked to Heart Risk Factors in Kids

Low Birth Weight Might Raise Adult Kidney Disease Risk

ow birth weight babies have a much greater risk of developing kidney disease later in life, according to researchers who reviewed 32 observational studies.

The meta-analysis found that people who were less than 5.5 pounds at birth were 70 percent more likely to develop chronic kidney disease than those with normal birth weight. The findings appear in the August issue of the American Journal of Kidney Diseases. "Experimental studies suggest that restricted growth of a fetus in the womb can interfere with normal kidney development and result in fewer and smaller filtering units, or nephrons, at birth," lead author Sarah L. White, of the George Institute and the University of Sydney in Australia, said in a news release from the U.S. National Kidney Foundation.

"Those with low birth weight may therefore be vulnerable to accelerated loss of kidney function later on as a result of any additional injuries to the kidney caused, for example, by accidents, infections or the presence of other risk

with children in families below the poverty level. For example, the percentage of severely obese Mexican-American children rose from 0.9 percent to 5.2 percent. The researchers also found that a third of severely obese children had metabolic syndrome, a group of risk factors for diabetes, stroke and heart attack. The risk factors include high blood pressure, cholesterol and insulin levels. "Children are not only becoming obese but becoming severely obese, which impacts their overall health," Dr. Joseph Skelton, an obesity expert at Brenner Children's Hospital, part of Wake Forest University Baptist Medical Center in Winston-Salem, N.C., and lead author of the study, said in a news release from the center. "These findings reinforce the fact that medically based programs to treat obesity are needed throughout the United States, and insurance companies should be encouraged to cover this care," Skelton said.

factors such as diabetes," she explained. White and colleagues identified significant associations between low birth weight and both of the principal markers of chronic kidney disease -- protein in the urine (albuminuria) and low estimated glomerular filtration rate (poor kidney function). The researchers also identified an association between low birth weight and subsequent development of kidney failure.

"Despite the association between low birth weight and risk of chronic kidney disease in later life, early detection and management of chronic kidney disease and its risk factors are highly effective in preventing adverse outcomes," White said. "People who were very small at birth should avoid obesity that could lead to diabetes, maintain regular physical activity, avoid medications that could be toxic for the kidneys and see their doctors for simple assessment of chronic kidney disease including blood pressure measurement, a dipstick test for urinary protein and a blood test of serum creatinine level," she advised.

ost American youngsters aren't getting enough vitamin D, and that deficiency is associated with an increased incidence of risk factors for cardiovascular problems such as heart attack and stroke, two new studies find. Simultaneous publication of both papers in the Aug. 3 online edition of Pediatrics is coincidental, the lead authors of the reports said. Both used U.S. data from the 20012004 National Health and Nutrition Examination Survey, and both were initiated because of a lack of information about the possible effects of low vitamin D levels on cardiovascular risk in young people. While studies have linked vitamin D deficiency to increased risk in American adults, "few studies have looked at whether vitamin D can be associated with increased cardiovascular disease in children," said Jared P. Reis, who began his study while at Johns Hopkins University. He is now an epidemiologist in the division of cardiovascular sciences of the U.S. National Heart, Lung, and Blood Institute. "Nobody questions that vitamin D deficiency causes rickets," said Dr. Michal L. Melamed, an assistant professor of medicine and epidemiology at Albert Einstein College of Medicine in the Bronx, who led the other study. "We wanted to explore other health outcomes and noticed that nobody had described this outcome." The study she led looked at the overall incidence of low blood levels of vitamin D among young Americans aged 1 to 21 in the survey. There is no formal definition of vitamin D deficiency, Reis said, but many experts believe that a level of 30 nanograms per milliliter of blood is desirable. The Melamed study found that 9 percent of young Americans -- 7.6 million -- were vitamin D-deficient, with blood levels under 15 nanograms per milliliter, and that 61 percent -- 50.8 million -- were vitamin D-insufficient, with levels between 15 nanograms and 29 nanograms per milliliter. The high incidence of vitamin D deficiency was so surprising that "we sat on our data for six months," Melamed said. "We didn't publish until it was confirmed by other people that we had the right numbers." Children with the lowest vitamin D levels were more likely to have higher blood pressure, high blood sugar levels and low blood levels of HDL ("good") cholesterol, the study found.

It's not entirely certain that low levels of vitamin D early in life will translate into health problems in the adult years, Melamed said. "But if you have hypertension [high blood pressure] at age 20, you have 60 more years of dealing with the consequences," she noted. The study led by Reis was a detailed crosssectional analysis of data on 3,577 adolescents. It found an average vitamin D blood level of 24.8 nanograms per milliliter. The average level was 15.5 nanograms per milliliter in blacks, 21.5 in Mexican Americans and 28 in whites. There was a clear association with cardiovascular risk factors. The 25 percent of youngsters with the lowest levels of vitamin D were 2.36 times more likely to have high blood pressure, 54 percent more likely to have low HDL cholesterol levels, 2.54 times more likely to have elevated blood sugar levels and 3.88 times more likely to have metabolic syndrome, a constellation of risk factors including obesity, high blood fats and high blood pressure. But the results should not panic parents, Reis said. "I believe we need additional research," he said. "Our study is observational, and we need additional studies to confirm it." Specifically, parents need not turn to supplements to provide the recommended intake of vitamin D, currently set at 200 International Units a day for everyone up to age 50, Reis said. Adequate vitamin D intake can be achieved with 15 minutes a day of exposure to sunlight or consuming fortified milk, bread and other wheat products, among other foods, he said. "Parents should focus on modifiable risk factors," Melamed said. "Children should not always be on the computer or watching television. They can drink more milk, rather than using supplements."

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5 tips to keep your home safe in an emergency

ver the years, Americans have endured many different types of tragedies and crises -- from Hurricane Katrina and Sept. 11 to countless tornadoes, earthquakes and other natural disasters. During these hardships, we have learned to expect the unexpected and to be ready for anything.

With this in mind, the U.S. Department of Homeland Security has declared September National Preparedness Month in an effort to educate people about natural and national disaster preparedness and to motivate families to plan ahead. In support of this year’s "Ready Campaign," First Alert and The Lehigh Group, makers of home safety and security products, offer some simple tips for preparing your home and family to face unexpected emergencies. 1. Create a preparedness kit When preparing for an emergency or potential disaster, basic survival items like fresh water and non-perishable foods are often at the top of the list. Just as important are necessities like blankets, a first aid kit, transistor radio, flashlights, batteries, cell phone with charger, prescription medications, cash or traveler’s checks and even a can opener.

2. Set alarms Carbon monoxide (CO) poisoning incidents escalate during hurricane season and heavy wind storms due to more frequent power outages when homeowners turn to fuelburning generators or other fuel sources to cook, light, cool or heat their homes. To protect your family from this "silent killer,"

SEPTEMBER • 2009

Plastic Surgeons Stay Busy in Recession

Earlier this year, Janice Axelrod, an insurance broker in Chicago, visited a plastic surgeon for a "makeover" -- a chemical peel and injections of abdominal fat under her eyes, around her lips and at the corners of her mouth.

5. Secure outdoor items High winds can take a toll on the outside of a home. At the first sign of danger, secure outdoor items using rope or other cordage products to tie down outdoor furniture, plants, decorative items and more. A new rope innovation called Cordzilla offers bungee-style stretch with vinyl-coated hooks that help securely tie down items without scratching their surfaces.

xelrod's decision was not motivated by concern she might lose her competitive edge in a tightening job market. "I would have done it recession or no recession," she said. "It was about my confidence and how I felt seeing clients." But many other women see such cosmetic procedures as "employment insurance" in these tough times. The American Society of Plastic Surgeons reported that nearly 3.5 million women in the workforce (3 percent) have already undergone a cosmetic procedure as an investment in their careers. "Many people are going out on the job market and want touch-ups," confirmed Dr. Seth Thaller, professor and chief of plastic surgery at the University of Miami Miller School of Medicine in Florida. "I have a patient coming in next week who works. Her competition is younger, and she's getting plastic surgery to be more competitive in the market." According to the ASPS, Botox procedures, which are used to treat moderate to severe frown lines, were up 8 percent in 2008 versus 2007; use of hyaluronic acid fillers for wrinkles and folds increased 6 percent, and chemical peels were up 2 percent. Total cosmetic procedures and minimally invasive cosmetic procedures have increased since 2007 (3 percent and 5 percent, respectively), while more involved surgical cosmetic procedures, such as breast augmentation and tummy tucks, are down 9 percent overall. A standard Botox procedure involving the upper face averages $800, said Dr. Loren Schechter, who performed Axelrod's procedures for about $5,000. Two vials of Restylane, a filler commonly used around the nose and lower face, can cost $1,200, added Schechter, who is an assistant professor of surgery and chief of

plastic surgery at Chicago Medical School and an ASPS spokesperson. Other than cost-savings, a major reason women opt for more minor procedures is not wanting to take time out from a job or a job hunt. "A lot of people don't want to be away from work," said ASPS president Dr. John Canady, professor of plastic surgery at the University of Iowa in Iowa City. "Without a doubt, people are looking for quicker recovery time. That's why Botox and fillers are so popular: The downtime is minimal to none," agreed Thaller. Axelrod, who took less than a week off work, said her face was swollen for about two weeks. While three-quarters of practitioners from a recent ASPS poll reported an "increased or stable" demand for these types of minor procedures, many individual surgeons say they feel the pinch of the recession. "Across the country, there's not a place that hasn't felt the economic impact," Canady said. Some filler companies are giving discounts for their products, Thaller said. And while some patients still will fork over $1,000 or more to boost their employment prospects, others are opting out of the plastic surgery market completely. Some people just don't show up for appointments, Thaller said. Others are simply cutting back. "People who used to do two or three areas [with Botox] might do one area now, or they're not coming every three to four months. They're coming every six to 12 months," Thaller said. "They're looking for deals. They don't want to spend $200 or $400, when before they would spend $1,000 or $1,200 without batting an eyelash."

not know as much as I did." Women within the highest 25 percent of optimism scores had a 9 percent lower chance of developing heart disease and a 14 percent lower chance of dying of any cause. Women with the highest degree of cynical hostility were 16 percent more likely to die than those with the most trust in their fellow humans. The results most likely apply to men as well

as women, Tindle said, citing several previous studies, such as a 2004 Dutch report that men who were more optimistic died less often of cardiovascular disease. There are several possible explanations for the new finding, Tindle said. Money might well be involved, since "optimism is associated with higher income and education," she said. But curiously, "the level of socioeconomic status when a woman was young was better associated with outcome than current status," Tindle said. Beyond that, there are "three broad categories of possibilities," she said. One is related to lifestyle factors. "Optimistic women had more stable risk profiles, with less high blood pressure and diabetes," Tindle said. "They didn't smoke as much and tended to exercise more. So their lower risk might just be associated with living healthier." It's also possible that optimists are more likely to follow their doctors advice more faithfully. "Previous studies have shown that optimists tend to follow the diet they are told to follow," Tindle noted. Or a woman's outlook on life might affect

how she responds to stress, theb researcher said. Pessimism and cynical hostility might lead to higher blood pressure, higher heart rate and other physical risk factors, she said. Tindle said she would like to test all of those possibilities in a controlled trial. "We would recruit individuals who are pessimistic, and try to alter their outlook and see if it affects their health," she said. The answer probably would be "yes," Tindle said. "Even the most cynical, hostile individual can change, given the right stimulus, and I see this every day," she said. The report was cheering news for Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City. "It turns out that being optimistic is an important part of maintaining health," Steinbaum said. The study shows that "one's view of the world and your perspective can play an important role in your health," she said. "This study demonstrates the role and significance of the connection between the mind and the body. Its just another reason to try to look at the bright side of life."

CO alarms should be installed throughout the home, including one on each level and outside every sleeping area.

3. Store valuables in a "safe" place Even if you live in the safest town in America, having a safe at home can prove a wise investment when it comes to natural disasters. Through fire or flood, a safe can help protect important documents, family photos and sentimental keepsakes, as well as jewelry and other valuables. Look for a safe that is both fire resistant and waterproof, not just water resistant.

4. Keep security front and center Doors and windows are particularly vulnerable spots in a home during a major storm or national disaster. Proper storm doors can protect exposed areas of the home from wind, precipitation and debris. For homes and businesses, vertical window guards like those offered by Leslie Locke help to keep flying debris from breaking glass and exposing a home’s interior to outside elements. Security screen doors and window guards also can help keep homes safe from unwanted intrusion.

Optimism Good for Heart and Longevity

omen who take a darker view of life are more likely to develop heart trouble than those with a cheerful, trusting outlook, a new study indicates. The finding comes from the Women's Health Initiative, which has tracked more than 97,000 postmenopausal American women for more than eight years. "In addition to looking at hormones and their effect on heart disease and cancer, the study also examined psychosocial and social factors and how they affected the health of postmenopausal women," said Dr. Hilary A. Tindle, an assistant professor of medicine at the University of Pittsburgh, and lead author of a report in the Aug. 10 issue of Circulation. "Fortunately, we have this wealth of information on the psychological profile at the time they joined the study." Optimism was measured by a questionnaire on whether a woman agreed with such statements as "In unclear times, I usually expect the best." The questions measuring cynicism asked about agreement with such statements as "It is safer to trust no one" and "I have often had to take orders from people who did

6 SEPTEMBER â&#x20AC;˘ 2009

FLORIDAHEALTHNEWS-ONLINE.COM

'Organic' May Not Mean Healthier

Food that beckons from the organic aisles of grocery stores may not be any better for you than what lines the rest of supermarket shelves.

ccording to a British review of studies done over the past 50 years, organic and conventionally produced foods have about the same nutrient content, suggesting that neither is better in terms of health benefits. "We did not find any important differences in nutrient content between organically and conventionally produced foods," said study author Alan Dangour, a registered public health nutritionist with the London School of Hygiene and Tropical Medicine. Nonetheless, the researchers noted, organic foods continue to grow in popularity. In the United Kingdom, the market share for organic foods increased 22 percent from 2005 to 2007, they said. Likewise, the market for organic foods in the United States has grown at about a 20 percent rate each year since 1990, reaching $13.8 billion in consumer sales in 2005, according to the Organic Trade Association. That represents 2.5 percent of total food sales in the country, the trade group noted. "As a registered dietitian, it is good to see that a systematic review of the literature supports what has long been believed -- that the nutritional content of traditionally grown foods and organic foods are comparable," said Connie Diekman, director of university nutrition at Washington University in St. Louis and past president of the American Dietetic Association. "This report provides

Stress,

Bad Bedtime Habits Cause Insomnia

Bad bedtime habits can keep you up at night and cause problems during the day, says the head of a Texas sleep study facility. Stress, worry, caffeine, alcohol and watching TV in bed -- factors known as "poor sleep hygiene" -- are the major reasons why people can't shut down their bodies when it's time for sleep, explained Dr. Sunil Mathews, medical director of the Sleep Center at Baylor Medical Center at Irving, Texas. Poor sleep hygiene can also lead to taking sleep-aid medications that could interfere with alertness the next day, he said. A recent National Sleep Foundation poll found that 47 percent of people with sleep problems were likely to use caffeinated beverages to compensate for their daytime sleepiness, but these stimulants contribute to more difficulties sleeping. "Insomnia can turn into a vicious cycle," he said in a news release from the medical center. To develop good sleep hygiene, Mathews recommends the following: Develop a calming bedtime routine. Relax body and mind through yoga, biofeedback and meditation, or take a cup of warm milk with nutmeg. Avoid workouts within four hours of bedtime. While regular exercise relieves stress, it also raises core body temperature, which can make falling asleep more difficult. Avoid caffeine, alcohol or sugary items within eight hours of bedtime. Keep your bedroom dark, cool, quiet and comfortable.

confirmation for consumers that if they choose conventionally grown foods or organic foods they will be meeting their nutritional needs." The review zeroed in on 162 studies that dealt with the nutrient content of foods. Only 55 were of what the researchers considered to be "satisfactory quality" -- a strong indicator that, overall, the science on the subject is not up to snuff. They found no noted differences between conventional and organic crops with regard to vitamin C, magnesium, calcium, potassium, zinc and copper content. Organic crops did have higher levels of phosphorus, and conventionally produced crops had higher levels of nitrogen. No differences in nutrient content were in-

dicated in the livestock studies, according to the review. The Oregon-based Organic Center, which promotes organic food, conducted a similar review of the literature, said Charles Benbrook, chief scientist for the Center. That study yielded results similar to those in the British study, but it also found higher levels of healthy antioxidants and polyphenols in organic foods. "Given that some of the most significant differences favoring organic foods were for key antioxidant nutrients that most Americans do not get enough of on most days, we concluded that the consumption of organic fruits and vegetables, in particular, offered significant health benefits, roughly equivalent to an additional serving of a moderately nutrient dense fruit or vegetable on an aver-

age day," Benbrook said. And there's another aspect to the organic vs. conventional food debate, said Sheah Rarback, director of nutrition at the Mailman Center for Child Development at the University of Miami Miller School of Medicine. "You have to also look at what you're not getting" with organic foods, she said. "Maybe it's not a big difference nutritionally, but conventional products may have more pesticides." And that's a particularly important issue for children, she said. "We know that young children are getting the nutrition, whatever choice they make, but we also have to look at the pesticide issue," Rarback said. "A study published in Environmental Health Perspectives found that children eating conventionally grown fruit had pesticide residue in their urine, which decreased after just five days on an organic diet." The production of organic food is subject to a variety of regulations, including those that govern the use of pesticides and other chemicals in fruits and vegetables and the use of medicines in animals, the authors of the review noted in their study, which will be published in the September issue of the American Journal of Clinical Nutrition. Rarback indicated that the ability to get solid research on organic versus conventionally produced products is hampered by variations in the production process. "There are so many variables," she said. "Where is something grown? Where is it shipped from? How long was it on the truck? There are going to be variables in terms of nutrition just from production methods."

Happiness Keeps Growing

who feel trapped in distressing situations and those with forms of dementia, Charles said. "We know that older adults who are dealing with chronic stressors, such as caregiving, report high rates of physical symptoms and emotional distress," she added.

he longer you live, the happier you're likely to be, a growing body of research shows.

Researchers who spoke at the recently concluded annual convention of the American Psychological Association in Toronto said that mental health generally improves with age. Given that the world population of people over 65 is expected to nearly triple by 2050, according to U.S. officials, this should come as good news.

In separate reports, Charles and Laura Carstensen, a psychology professor at Stanford University, also noted that social relationships -- or lack of them -- influence how older people respond to stress. Carstensen cited a Swedish study that concluded that people with strong social connections were less likely to suffer cognitive impairment than others. It seems social relationships influence the way that the brain processes information, she said. "These changes have a profound impact on health outcomes," Carstensen said.

Reporting on several studies of aging and mental health, Susan Turk Charles, a professor at the University of California, Irvine, said the findings indicate that happiness and emotional well-being improve with time.

Older adults exert greater emotional control, said Charles. Studies show they learn to avoid or limit stressful situations and are less likely than younger adults to let negative comments or criticism bother them.

Charles added that "we know that older people are increasingly aware that the time they have left in life is growing shorter. They want to make the best of it so they avoid engaging in situations that will make them unhappy. They have also had more time to learn and understand the intentions of others, which helps them to avoid these stressful situations."

Another study conducted over a 23-year period examined three groups of people at three different life stages and concluded that emotional happiness grew with age, she said. These findings may not apply to older adults

To make the most of the coming years, Carstensen offered these tips: Think of ways to enjoy the time ahead and try to imagine living 100, healthy, happy years.

Provide daily routines that reinforce your goals, both in your home and in your social life.

Develop new activities and relationships, and don't invest all of your emotional energy in a job or a single relationship.

SEPTEMBER â&#x20AC;˘ 2009

FLORIDAHEALTHNEWS-ONLINE.COM

Overburdened doctors are shunning all types of insurance

tients have "unfettered" access to him whenever they need him for a fee of between $50 to $150 a month. The model has enabled Blanchard to "cut down on everything by about 25%," including his patient caseloads and time spent on filing insurance claims. One industry report cited that processing claims is the secondbiggest area of wasteful expenditure in the health care system, costing as much as $210 billion annually.

Like a lot of their patients, doctors are sick of long waits in the waiting room and dealing with insurance companies. hat's why a growing number of primary care physicians are adopting a direct fee-for-service or "retainer-based" model of care that minimizes acceptance of insurance. Except for lab tests and other special services, your insurance plan is no good with them.

In a retainer practice, doctors charge patients an annual fee ranging from $1,500 to as high as over $10,000 for round-the-clock access to physicians, sometimes including house calls. Other services included in the membership are annual physicals, preventive care programs and hospital visits.

Doctors argue that this model cuts down their patient load, allows them to spend more time per patient and help save the system money. However, some industry groups caution that these emerging trends are a consequence of a health care system badly in need of reform. "I had to change the model": Dr. John Kihm, 51, an internist based in Durham, N.C., converted his solo private practice to a retainerbased model in May. Until then, his daily schedule was jam-packed. "I was seeing patients every 15 minutes," said Kihm.

He was seeing about 80 patients a week, "many were very sick with multiple systems and complications," he said. "After 20 years, I realized that this was not doable, not sustainable."

His goal is to continue medicine for another 20 years, "but I want to practice it the right way," Kihm said. That means spending more than 15 minutes per patients and doing house calls. "I had to change the model," he said, as he adopted the retainer-based structure. He now spends 30 minutes on average per patient. He didn't disclose his annual fees but said his fees are "less that what it could cost to smoke a pack of cigarettes a day." His fees covers annual exams, wellness programs and other types of preventative care typically not covered by insurance. If his patients do have insurance, it would pay for things like lab tests. "My income is about the same as before, but I have less overhead costs from half as many patients and half the amount of supplies that I need," he said. Michigan-based family doctor Dr. John Blanchard has been practicing the retainerbased care for eight years. He said his pa-

Prevention better than cure: MDVIP, based in Boca Raton, Fla., is one of the largest organizations of primary care physicians, numbering about 326 nationwide, that practice retainer-based medicine. "We call it preventive, personalized health care," said Darin Engelhardt, president of MDVIP. "Our premise is if we reconstruct primary care, what would it look like?'" According to the MDVIP formula, it means limiting its affiliated practices to no more than 600 patients. For an annual fee of between $1,500 and $1,800, its members receive full health assessment, 24/7 access to their doctor, including via a doctor's cell phone or e-mail and a personal Web page on which they can access their medical records.

MDVIP-affiliated practices do take insurance, including Medicare, for other medical services such as lab tests and sick visits. Engelhardt said MDVIP has about 110,000 members nationwide, half of whom are over the age of 65.

ure, may experience a "silent stroke" and won't even know it, Australian researchers say.

"These strokes are not truly silent, because they have been linked to memory and thinking problems and are a possible cause of a type of dementia," study author Dr. Perminder Sachdev, a neuropsychiatry professor at the University of New South Wales in Sidney, said in a news release from the American Academy of Neurology. The study, published in the July 28 issue of the journal Neurology, followed 477 people aged 60 to 64 for four years. The researchers found that 7.8 percent of the group had evidence of strokes that do not cause any noticeable symptoms -- known as silent lacunar infarctions -- in which blood flow is blocked in one of the arteries leading to areas deep within the brain. An additional 1.6 percent of the study group had experienced silent strokes by the end of the study period.

"This is a variation of the traditional model," he said. "We believe it enhances the physician-doctor relationship as well as reduces costs by stressing prevention."

Many Cancer Survivors Don't Adopt Healthy Lifestyle

Most older, long-term cancer survivors struggle with good health habits, such as regular exercise and a proper diet, a new study shows.

Those with high blood pressure had a 60 percent greater chance of having a silent stroke than those with normal blood pressure. Also, study participants with a condition called white matter hyperintensities were almost five times more likely to have a silent stroke than those without this small type of brain damage, the researchers found. Although relatively symptom-free, silent strokes are a major health problem among the elderly, according to the American Academy of Neurology. People who have had a silent stroke are at higher risk for subsequent strokes and for an accelerated loss of mental skills. In addition to high blood pressure, risk factors include diabetes, heart disease, smoking and older age.

hose who did exercise and eat well after their treatment, however, tended to have more vitality and a better quality of life, the study also

found. "Our findings point to the potential negative impact of obesity and the positive effect of regular exercise and a healthy diet on physical quality of life outcomes among older, long-term cancer survivors," Catherine Mosher, a postdoctoral fellow in psychiatry and behavioral sciences at Sloan-Kettering, said in a news release from the American Cancer Society. Mosher and her colleagues examined data from more than 750 people who had survived breast, prostate or colorectal cancer for five years or more. All were 65 or older. Most people expressed interest in pursuing healthy habits, but only 7 percent actually met national guidelines for exercise and diet. The majority reported exercising an average of 10 minutes a week -- far short of the recommended 150 minutes of exercise a week, the study said. Obese survivors had

worse physical quality of life. People aged 65 and older make up more than half of the estimated 11 million cancer survivors in the United States, according to the American Cancer Society. Numerous studies have linked healthy

lifestyle choices with better outcomes after a cancer diagnosis. In one recent study, people who had head and neck cancer appeared to have better survival if they exercised, improved their diet and avoided smoking and heavy alcohol consumption.

In the event that a person is experiencing any symptoms of stroke, call emergency medical services immediately, the academy states. Common signs of stroke are: Sudden weakness or numbness of the arms, legs or face, especially on one side Quick onset of blurred vision in one or both eyes Difficulty walking, dizziness, or loss of balance or coordination

Sudden confusion or trouble speaking Sudden severe headache with no known cause.

8 SEPTEMBER • 2009

A Visit To The Doctor

Shekhar V. Sharma M.D. Board Certified in Internal Medicine

am writing this article to give readers an understanding of patient doctor interactions within an examination room. Many a time a patient walks into my office (an unscheduled walk in) with chest pains. In the exam room the patient states that he is “doing fine”. This patient is a cigarette smoker and has had a past history of non compliance with his medicines. Apparently, he did not like to “see doctors”, eats unhealthily, starts telling me what kind of tests he wants and also that he is an avid “Google medical search” user. He states he will settle for an EKG (electro cardiogram) and blood tests and nothing further, except an examination. Further, he also wants me to take care of all his other problems in this visit. For a brief moment I think: “Should I tackle all this patient’s problems in this visit” or should I just do what the patient actually came into my office for: which is chest-pains. I soon come to a decision in a split second (which I am used to) and opted for the latter. The EKG turned out normal, the examination was normal too but the patient had all the signs and symptoms of angina or impaired blood flow to the heart that causes chest pain. The patient at this time is disbelieving stating “I have no chest pains now, so I

should be fine!”. After much explaining I convinced the patient to get a stress test done. My staff has to call his insurance company to get an approval for various tests to be done as well as a referral to another specialist /imaging center ASAP. I then have to think of other dangerous health issues in the patient that could have caused the chest pain. Could this patient have had a clot in the lungs? If so, does this patient have clots in the legs? Is this pain related to a gastric issue? In the meantime, my staff is put on hold by the insurance company that denies the stress test for reasons unknown and later I find out that this insurance company sends a letter to the patient that the physician did not supply enough information to get the stress test approved. For most insurance companies it has always been a matter of saving money and appeasing the patient

by blaming ‘The Doctor’. The patient now walks out of our office blaming our staff for something the insurance company should be held responsible. The next day the patient had another episode of chest pains and goes to the emergency room. The ER admits the patient and the cost incurred by the insurance company for this hospital visit amounts to ten times more than an outpatient office work up.

FLORIDAHEALTHNEWS-ONLINE.COM

In the next examination room is seated another patient who has come in with severe fatigue that she has had for a certain period of time. Fatigue is a symptom that should be taken seriously and not be simply brushed aside. I immediately have to think of all the various causes for this symptom. I wind up doing labs and an EKG. The EKG is to rule out cardiac arrhythmia. Labs are done to rule out anemia, hypothyroidism, diabetes mellitus etc. At this time, I have to use my clinical chess mind to make the right moves to come to a diagnosis. Patients often tell the staff that their problem can be analyzed in ten minutes. How can a good doctor examine a patient, do the necessary tests, make the required referrals, prescribe the right medications, check the patient’s allergies, medications all in ten minutes. That is an impossible feat. In the meantime, other patients have to wait. They may have simple issues or complex issues and I will never know that till I see them in the examination room. The entire day goes on in this manner where some patients have to wait longer due to the complexity of the problems that arise in the examination room. Physician patient encounters are not like appointments you may have with an attorney or your beautician. The encounters are complex in nature and time cannot be an issue. As an experienced physician I have to reiterate that practicing good medicine is like a game of chess, and then thinking through a complex maze and finally hitting the mark is not as easy as it may sometimes seem. To all my patients out there who have come to me with complex issues to solve, I appreciate your patience and understanding. Dr. Sharma is Board Certified in Internal Medicine and his office is located in the Palomino Park Medical Center at 3347 State Rd. 7 (2 miles south of the Wellington Green Mall) in Suite 200. He is available 5 days a week from 9 a.m. to 5 p.m. For an appointment please call his office at 561-795-9087. Medicare and most major insurances are accepted.

Ask Dr. Sharma:

: I am a 65 year old female with low back pain for about 2 years and I am right now being treated for arthiritis of the lower back of my spine. What do you think? Stephanie from Wellington

: Considering your age and your symptoms of lower back pain, I have to consider the possibility of you having an abdominal aortic aneurysm which can cause lower back pain. If this is left undiagnosed it can be fatal. I would recommend that you get an ultrasound of the abdominal aorta and see your primary care physician immediately who will guide you in the right direction.

: I have a headache for the past few weeks when I get up in the morning. This tends to go away during the day. What is wrong with me doctor? Jeremiah from West Palm Beach.

: Jeremiah, you have not mentioned your age in this question. However there are various causes of headaches. Since I do not have your age and medical history at hand, I would consider the possibility of you having uncontrolled hypertension or otherwise called high blood pressure. Please call your primary care physician for a check up. Questions to Dr. Sharma can be mailed to P.O. Box 542527 Lake Worth, FL 33454-2527

or by email: info@floridahealthnews-online.com

Analysis: Health care debate a long-running story

resident Barack Obama's campaign for a health care overhaul is an intense installment in a long-running story, dating to Theodore Roosevelt in 1912.

It did not go well nearly a century ago. Roosevelt made national health insurance an issue in his last, losing campaign for the White House, and successive efforts to get it enacted have lost, too.

The basic issue, affordable health care for all Americans, has not changed. But possible solutions have not evolved either, in part because new proposals seldom build on old ones. Obama's broad, leave-thedetails-to-Congress proposal has little in common with the 1,300-page measure President Bill Clinton couldn't even get to a vote in a Democratic Senate in 1993.

The Obama strategy was designed to avoid mistakes Clinton made in confronting Congress with a massive bill written in the White House under the management of Hillary Rodham Clinton and essentially telling the House and Senate to take it or leave it. Clinton threatened to veto any bill

coverage. The multimillion-dollar ad buy would be one of the largest so far critical of Obama's effort; opponents this year have been heavily outspent by supporters of Obama's plan.

that did not deliver universal health care. He got nothing to veto.

The Obama team missed part of the lesson when the president pressed for passage of House and Senate bills before Congress took its summer vacation so that they could negotiate a final version when they reconvene in September. What he got was narrow committee approval in the House, a preface to debate and action after Labor Day. In the Senate, the Finance Committee was trying to meet a Sept. 15 deadline to deliver its bill. Obama's push for action before the summer recess created a goal the Democrats couldn't meet and a psychological setback he didn't need to risk. He now says that it was no big deal and that what he wants is a reform law by the end of the year, to get all Americans insured and curb medical costs.

That is a big deal, underscored by his aggressive television and traveling campaign to try to build public support and pressure in Congress to enact health care overhaul this time. "Now is the hard part because the history is clear every time we come close to passing

Short of enacting an overhaul plan, Obama and the Democrats could have a major political burden going into the 2010 congressional elections, just as Clinton did when Democrats lost the 1994 elections after his health care failure.

health insurance reform, the special interests fight back with everything they've got," Obama told a town hall in Portsmouth, N.H., on Tuesday. "They use their influence. They use their political allies to scare and mislead the American people. They start running ads. This is what they always do."

Within hours of Obama's comments, the U.S. Chamber of Commerce said it will begin airing 30-second ads in about 20 states Wednesday criticizing the Democratic proposal to offer optional government health

An issue that affects all Americans, their doctors, insurers and employers is bound to carry political risk. Franklin D. Roosevelt wanted national health insurance but, even with his power in the New Deal Congress, he did not dare to tie it to Social Security in 1935 lest he lose the whole program. Harry S. Truman pushed it on a Congress that wouldn't buy it. While Dwight D. Eisenhower balked at national insurance, he tried to get Congress to support a reinsurance program to buttress private insurers and gain coverage for highrisk patients and the needy.

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10 SEPTEMBER â&#x20AC;˘ 2009

FLORIDAHEALTHNEWS-ONLINE.COM

For Short Kids, No Lack of Self-Esteem

For parents who worry that their short child will be psychologically damaged from merciless teasing, a new study provides reassurance that there will likely be no lasting effects from any exposure to short jokes.

he study, which appears in the September issue of Pediatrics, found that short children reported being teased only slightly more than their peers, but such teasing didn't appear to affect their popularity or relationships with other children. And, short children were no more likely than their peers to have symptoms of depression. "The gist of our study is that parents and pediatricians should be reassured by this," said study author Dr. Joyce Lee, an assistant professor in pediatric endocrinology at the University of Michigan in Ann Arbor. "For kids below the 10th percentile [on standardized growth charts], there didn't seem to be any significant outcomes in terms of popularity or in peer victimization reported by the teachers." Lee and her colleagues undertook this study because many parents are concerned when their children fail to grow at a similar pace to their peers. Once medical conditions have been ruled out, parents often worry that being significantly shorter than other children the same age will have lasting social or psychological effects on their youngsters, according to the study. This concern may prompt parents to ask that their children be given growth hormones, even when not medically indicated. Lee's study included 712 sixth-graders who were part of the National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development. The data included information from both teachers' and children's perceptions of peer victimization or teasing. It also included measures of depression, optimism, popularity and social support from peers. According to Lee, the researchers found there were really no differences between short children and taller ones. The one factor where shorter children scored slightly higher was in the self-report of peer victimization. However, the teachers indicated no difference in peer victimization. Lee said that teachers might miss out on

some of the teasing, or that children might focus more on teasing. Also, short children may feel as if they're being picked on solely because of their height. The good news, however, is that even with slightly higher levels of reported teasing, the shorter kids were still just as popular and had support from their peers, and didn't appear depressed or less optimistic due to taunts. As children get older, say in seventh or eighth grade, young teens may have a harder time if they're smaller, Lee said. "Adolescence is a particular time when you have a lot of differences in growth, and one might predict it would be a little more difficult time if you're of short stature," she noted. Dr. Jennifer Helmcamp, a pediatrician at Scott & White Healthcare in Temple, Texas, said she thought the new study "is a very helpful article for parents. It shows that even when teased, all children pretty much come out the same for levels of popularity, acceptance by peers and behavioral problems." Helmcamp explained that there are three types of short stature: familial, constitutional and systemic. Familial is the height passed down by your parents. If both parents are short, then it's likely the child will be too. Constitutional is when kids are latebloomers, and they may not get a significant growth spurt until the end of high school. Systemic is when there are medical reasons for short stature, and these often can be treated, she said. "If you've got familial or constitutional short stature, you can be reassured that social outcomes will be on par," Helmcamp said. If you're at all concerned about your child's height, Helmcamp said you should discuss it with your child's pediatrician, who can let you know whether or not your child needs further evaluation.

Talk to Your Kids about Tobacco, Alcohol, and Drugs

Talk to your child about the dangers of tobacco, alcohol, and drugs. Explaining the facts will help your child make healthy choices.

Kids who don't use alcohol or drugs are less likely to: Have serious trouble in school Get hurt in car accidents Be victims of crime. Research shows that kids do listen to their

parents. Children who learn about drug risks from their parents are less likely to start using drugs. If you say nothing, your child may think it's okay to use alcohol and other drugs. Start early. By preschool, most children have seen adults smoking cigarettes or drinking alcohol, either in real life or on TV.

Many kids start using tobacco by age 11 and are addicted by age 14. Between ages 9 and 13, kids begin to think that using alcohol is okay. Some children are already abusing drugs at age 12 or 13. Explain the facts about tobacco, alcohol, and drugs. Tell your child that you expect him or her not to use alcohol and other drugs. Teach your child how to say â&#x20AC;&#x153;noâ&#x20AC;? to drugs.

SEPTEMBER • 2009

FLORIDAHEALTHNEWS-ONLINE.COM

Eat this fish to protect your iMedX Announces Acquisition of Medware Inc. skin from sun damage

s a kid I used to spend my summer vacation at the beach soaking up the sun. These days, not so much—I’m way too worried about keeping my skin wrinkle-free. But my fiancé Andy’s job keeps him outside in the sun all day long. Not just in the summer, but all year round. Although he wears sunscreen, he’s kind of given up on trying to ward off wrinkles, but skin cancer? That’s scary stuff—and sunscreen can only do so much.

So to help protect our skin we’re adding more salmon and tuna to our diet. (Find delicious salmon recipes here.) The omega3 fatty acids in oily fish like salmon and tuna can boost your skin’s defenses against UV damage, according to a recent study in the American Journal of Clinical Nutrition.

Researchers found that study participants who ate a little more than 5 ounces of omega-3-rich fish each week decreased the development of precancerous skin lesions by almost 30 percent. Scientists think the omega-3s act as a shield, protecting cell walls from free-radical damage.

So next time you head to the beach or spend the day in the garden remember your sunscreen and hat, and cook up one of these

Will create one of the industry's largest transcription service providers and offer new opportunities to deliver leading Internet-based technologies to combined customer-base.

omega-3-rich recipes for dinner: Find more tuna recipes here.

Mediterranean Tuna Antipasto Salad – Also packed with protein and fiber, this tuna and bean salad is ready in a flash. Serve with warm, crusty bread or pack it in a pita for a sandwich.

Salmon Burgers with Green Goddess Sauce – The key to perfect salmon burgers is to handle the fish delicately: don’t overseason, overhandle or overcook it. Serve over a bed of salad greens with the Green Goddess Sauce dolloped on top or as a traditional burger using the sauce as a spread for the bun.

HELTON, Conn., - iMedX Inc., a leading healthcare software and services company, announced today that it has acquired Medware Inc. With this acquisition, iMedX expands its reach into the hospital market and emerges as one of the largest medical transcription companies in the United States.

combined companies. Medware will operate as a division of iMedX, with Medware's experienced production and operational team joining iMedX to create a stronger combined customer-facing organization. "This acquisition offers significant advantages to iMedX in terms of strengthening revenue and operational efficiencies and by gaining new opportunities to deliver leading-edge Internet-based technology and services to our combined customer base," said Mr. Sharma. "Our customers will benefit because all of our solutions are designed to improve their efficiency, accuracy and ultimately, the quality of care in the dynamic healthcare industry."

About iMedX iMedX is a leading US-based outsource provider of healthcare software and services to hospitals and medical practices throughout the U.S. iMedX's innovative Internetbased transcription delivery platform, TurboScribe(R) is used by thousands of providers across the United States. High quality transcription services are provided through delivery centers in the U.S. and India. iMedX's new TurboRecord(R) electronic medical record service and an e-Prescription platform TurboRx(R) allows doctors to comply with HIPAA guidelines and minimize costs. iMedX is headquarVenkat Sharma, iMedX's President and tered in Shelton, Connecticut. CEO, along with the current iMedX man- For more information please visit: agement team, will continue to lead the www.imedx.com. Based just outside of Orlando, Florida, Medware currently serves over sixty health systems across the country, utilizing a labor force of over 350 US-based medical language specialists. As a result of this significant acquisition iMedX will benefit from greater penetration into the large health system market. Medware's fifteen-years of experience providing high quality transcription services to leading hospitals and clinics will augment iMedX's reputation as a quality leader in technology-enabled medical documentation services.

Wellington Regional Medical Center Hosts Residency Graduation Dinner

ellington Regional Medical Center held its Annual Residency Graduation Dinner celebration on June 10, 2009 at the hospital’s new Conference Center. In celebration, graduating residents and interns along with family members and guests enjoyed a beautiful catered dinner.

The evening began with welcoming remarks and congratulations by Director of Medical Education, Jeffrey Bishop, D.O. There were four Family Practice Resident graduates: Danielle Manolakos, D.O., Daniel Dodson, D.O. Nikerson Geneve, D.O. and Carmen Marrero, D.O. Family Practice Residency Director, Dr. Robert Campitelli, presented diplomas and words of congratulations, along with Dr. Joanna Widdows, Internal Medicine Residency Director.

Diplomas were presented to graduating Dermatology Residents, Marianne Carroll, D.O. and Patricia Klem, D.O. by Dermatology Residency Director, Dr. Brad Glick. There were four graduating interns: Jennifer Berger, D.O. who accepted a Pediatric Residency at Miami Children’s Hospital; Brad Troxler, D.O., going on to a Residency program in Physical and Rehab Medicine at Boston University Medical Center; Greg Polar, D.O., who as accepted a Pathology Residency at Baystate Medical Center, Stacy Rosenblum, D.O. who will be doing research and Brad Goldstein, D.O., pursuing an Internal Medicine. There were special awards presented to: - Greg Polar, D.O., Most Valuable Intern - Geeta Malhotra, D.O., Most Valuable Resident

Back row, from l-r: Kevin DiLallo, Chief Executive Officer; Dan Dodson, D.O.; Nikerson Geneve, D.O.; Mohammad Yaqub, M.D., Attending, Internal Medicine. Middle row, from 1-r: Jeffrey Bishop, D.O., Director of Medical Education and Chief Medical Officer; Geeta Malhotra, D.O., Danielle Manolakos, D.O.; James Landero, D.O.; Carmen Marrero, D.O.; Iris Saleh, D.O.; Joanna Widdows, D.O., Internal Medicine Residency Director. Front row, from l-r: Brad Troxler, D.O.; Stacey Rosenblum, D.O.; Brad Goldstein, D.O.; Greg Polar, D.O. Missing from the group: Jennifer Berger, D.O.

Special recognition was given to the following physician mentors for their dedication to the Residency Programs: - Mauricio Melhado, Golden Apple Award

- Joanna Widdows, D.O., Resident Choice Award

The Medical Education Program at Wellington Regional Medical Center, that

graduated its first group of residents in 1990, is accredited by the American Osteopathic Association and is affiliated with the Lake Erie College of Osteopathic Medicine.

The program provides a comprehensive postgraduate medical education curriculum offering resident maximum exposure to all areas of osteopathic medicine through a se-

ries of service rotations. Specialty residency programs are offered in Family Practice, Internal Medicine, Dermatology and later this year, Emergency Medicine.

“We are very proud of our exceptional physician graduates, “said Dr. Jeffrey Bishop. “They leave our program well prepared for independent practice with strong foundations in osteopathic medicine.”

House health plan to boost taxes on rich

12 SEPTEMBER • 2009

WASHINGTON – House Democrats rolled out a far-reaching $1.5 trillion plan that for the first time would make health care a right and a responsibility for all Americans, with medical providers, employers and the wealthiest picking up most of the tab.

he federal government would be responsible for ensuring that every person, regardless of income or the state of their health, has access to an affordable insurance plan. Individuals and employers would have new obligations to get coverage, or face hefty penalties. Health care overhaul is President Barack Obama's top domestic priority, and his goal is to slow rising costs and provide coverage to nearly 50 million uninsured Americans. Democratic leaders said they would push the measure through committee and toward a vote in the full House by month's end, while the pace of activity quickened on the other side of the Capitol. Senate Majority Leader Harry Reid said he wanted floor debate to begin a week from Monday. Other officials said that timetable was likely to slip. Even so, it underscored a renewed sense of urgency. The House legislation unveiled by Speaker Nancy Pelosi and other Democrats would slow the growth of Medicare and Medicaid payments to medical providers. From big hospitals to solo physician practices, providers also would be held to account for quality care, not just ordering up tests and procedures. Insurance companies would be prohibited from denying coverage to the sick. The industry also would face stiff competition from a new government plan designed along the lines of Medicare. The liberal-leaning plan lacked figures on total costs, but a House Democratic aide said the total bill would add up to about $1.5 trillion over 10 years. The aide spoke on condition of anonymity to discuss the private calculations. Most of the bill's costs come in the last five years after the 2012 presidential election. The legislation calls for a 5.4 percent tax increase on individuals making more than $1 million a year, with a gradual tax beginning at $280,000 for individuals. Employers who don't provide coverage would be hit with a penalty equal to 8 percent of workers' wages with an exemption for small businesses. Individuals who decline an offer of affordable coverage would pay 2.5 percent of their incomes as a penalty, up to the average cost of a health insurance plan. With Obama pressing Congress to act on health care this summer, House leaders want to move their bill quickly through three committees and to a floor vote before the August congressional recess. But a group of moderate and conservative Democrats has withheld support, and no Republican votes are expected. The House bill seemed unlikely to win broad backing in the Senate, where the Senate Health, Education, Labor and Pensions Committee was expected to finish its version of the legislation in what was looking to be a party-line vote. Another panel, the Senate Finance Committee, was striving to unveil a bill by the end of the week. Standing before a banner that read "Quality Affordable Care for the Middle Class," Pelosi, D-Calif., called the moment "his-

toric and transformative." The bill would provide "stability and peace of mind" by braking costs and guaranteeing coverage, she said. "We are going to accomplish what many people felt wouldn't happen in our lifetime," said House Energy and Commerce Committee Chairman Henry Waxman, DCalif., one of the main sponsors. Obama, who issued a statement hailing the measure, plans to keep up the pressure on Congress by delivering remarks in the Rose Garden on Wednesday. Speaking in Warren, Mich., where he was promoting new spending for community colleges, Obama anticipated a congressional confrontation over health care. "There's going to be a major debate over the next three weeks," he said, deviating from his prepared text. "And don't be fooled by folks trying to scare you saying we can't change the health care system.We have no choice but to change the health care system because right now it's broken for too many Americans."

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decisions on benefits, as called for in the legislation. Thirty-one organizations signed the letter, including the U.S. Chamber of Commerce, the Business Roundtable representing top corporate CEOs and the National Retail Federation. The House bill would change the way individuals and many employers get health insurance. It would set up a new national purchasing pool, called an exchange. The exchange would offer a menu of plans, with different levels of coverage. A government plan would be among the options, and the exchange would eventually be open to most employers. Insurers say that combination would drive many of them out of business since the public plan would be able to offer lower premiums to virtually all Americans. But backers of a public plan — including Obama — say it would provide healthy competition for the insurance industry. Under the House bill, the government would provide subsidies to make coverage more affordable for households with in-

How Health Insurance Reform will Benefit Florida

Ending the Hidden Tax – Saving You Money: Right now, providers in Florida lose over $3.4 billion in bad debt which often gets passed along to families in the form of a hidden premium “tax”. Health insurance reform will tackle this financial burden by improving our health care system and covering the uninsured, allowing the 200 hospitals and the 58,565 physicians in Florida to better care for their patients. Health Insurance Premium Relief: Premiums for residents of Florida have risen 88% since 2000 Through health insurance reform, 3,233,600 to 3,741,500 middle class Florida residents will be eligible for premium credits to ease the burden of these high costs.5 Strengthening Small Businesses: 298,566 employers in Florida are small businesses.6 With tax credits and a health insurance exchange where they can shop for health plans, insurance coverage will become more affordable for them.

Reforms that Reduce Your Costs: Under health insurance reform, insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive. Insurance companies will also have to abide by yearly limits on how much they can charge for out-of-pocket expenses, helping 79,800 households in Florida struggling under the burden of high health care expenses.7

Separately, Obama spoke by telephone with Sen. Charles Grassley, the Iowa Republican viewed as critical to the fate of bipartisan negotiations in the Senate. House Democrats said the income tax increase in their bill would apply only to the top 1.2 percent of households, those who earn about one-quarter of all income. The wealthiest 4 percent of small business owners would be among them. The tax would start at 1 percent for couples making $350,000 and individuals earning $280,000, ramp up to 1.5 percent above $500,000 of income, and jump to 5.4 percent for those earning above $1 million. The tax would raise an estimated $544 billion over 10 years. Business groups and the insurance industry immediately assailed the legislation. In a letter to lawmakers, major business organizations branded the 1,000-page bill a jobkiller. Its coverage mandate would automatically raise the cost of hiring a new worker, they said. "Exempting some micro-businesses will not prevent this provision from killing many jobs," the letter said. "Congress should allow market forces and employer autonomy to determine what benefits employers provide, rather than deciding by fiat." The business groups also warned that the U.S. health care system could be damaged by adding a government-run insurance plan and a federal council that would make some

comes up to four times the federal poverty level, or $88,000 for a family of four and $43,000 for an individual. Medicaid — the federal-state health program for the poor — would be expanded to individuals and families up to 133 percent of the poverty line. About 17 million people would remain uninsured — about 6 percent of the population — and half of them would be illegal immigrants. The legislation also would improve the Medicare prescription drug benefit by gradually reducing a coverage gap known as the 'doughnut hole.' The individual and employer coverage requirements would raise about $192 billion over 10 years, the Congressional Budget Office said. Even before the bill was unveiled, the House Ways and Means Committee announced it would vote on the proposal. The panel is one of three that must act before the bill can go to the full House, probably later in the month. Some House Democrats privately have expressed concern that they will be required to vote on higher taxes, only to learn later that the Senate does not intend to follow through with legislation of its own. That would leave rank-and-file House Democrats up for re-election next year in the uncomfortable position of having to explain their vote on a costly bill that never reached Obama's desk or became law.

INCREASE YOUR CHOICES: PROTECTING WHAT WORKS AND FIXING WHAT'S BROKEN Insurance Stability and Security: Health insurance reform will strengthen our system of employer-based health insurance, with an additional 165,600 people in Florida potentially getting insurance through their work. Health insurance reform will also ensure that you will always have guaranteed choices of quality, affordable health insurance if you lose your job, switch jobs, move or get sick. Eliminating Discrimination for Pre-Existing Conditions, Health Status or Gender: 10% of people in Florida have diabetes9, and 28% have high blood pressure – two conditions that insurance companies could use as a reason to deny you health insurance. Health insurance reform will prevent insurance companies from denying coverage based on your health, and it will end discrimination that charges you more if you’re sick or a woman. One-Stop Shopping – Putting Families in Charge: With the new health insurance exchange, you can easily and simply compare insurance prices and health plans and decide which quality affordable option is right for you and your family. These proposals will help the 373,8200 residents of Florida who currently do not have health insurance to obtain needed coverage, and it will also help the 950,800 Florida residents who currently purchase insurance in the individual insurance market.11

Guaranteeing Choices: The largest health insurer in Florida holds 24% of the market, which limits the choices that you have for finding coverage.12 With a competitive public insurance option, you will have more choices and increased competition that holds insurance companies accountable.

SEPTEMBER • 2009

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ou know that friend, the one who is always tapping her leg, getting up to straighten the bookshelf, the one who generally just can’t sit still? She’s likely burning an extra 200 to 300 calories a day on top of any workouts she does or the amount of calories she burns just being alive. This process is neatly called NEAT, which stands for “NonExercise Activity Thermogenesis” (say that 5 times fast!), and it’s essential for successful weight loss. Basically, it’s the extra stuff you do, physically, all day long that adds up. Make a point to add more “neat” into your day and you can zap another 500 calories! Here are a few ideas:

Laugh: Watch something that’s con-

by Liz Vaccariello

sistently funny (like 30 Rock) and you could burn about 40 calories if you guffaw for 10 to 15 minutes straight.

Walk, pace, jog down the hall: In other words, MOVE! Doing lit-

tle bits of activity all day—taking the stairs to use the restroom on another floor at work, doing an extra lap around the grocery store—can help you burn an additional 375 calories a day!

Do crunches in bed: You could

burn about 20 calories in under 5 minutes just by drawing your knees to your chest 25 to 50 times, plus it strengthens your abs and gets your blood pumping.

upbeat music on your iPod (if you can) while doing all your morning rituals—an hour of hip shakin’ can burn about 55 calories.

Stand up! Don’t sit when you can be

on your feet—you’ll burn about 40% more calories. So just take a stand—when you’re on the phone, watching kids at the playground, making small talk at a party.

Md. Doctor: Kidney Transplant Record Achieved

Dr. Robert Montgomery, chief transplant surgeon at Johns Hopkins Hospital, and doctors at four hospitals in four states transplanted eight kidneys over three weeks in what he called the largest chain of donations in history. "We finally beat the 'Grey's Anatomy' record for domino transplants," Montgomery joked at a news conference hours after the last in a series of surgeries was completed Monday night. "We hope this creates a movement that encourages other transplant centers to adopt the model we used." The donor pool in the United States could facilitate 1,500 transplants per year if transplant centers nationwide participated in

Transplant surgeon Dr. Robert Montgomery fields questions during a news conference, at Johns Hopkins Hospital in Baltimore.

Wish Fulfillment? No. But Dreams (and Sleep) Have Meaning

reams may not be the secret window into the frustrated desires of the unconscious that Sigmund Freud first posited in 1899, but growing evidence suggests that dreams - and, more so, sleep - are powerfully connected to the processing of human emotions.

According to new research presented last week at the annual meeting of the Associated Professional Sleep Societies in Seattle, adequate sleep may underpin our ability to understand complex emotions properly in waking life. "Sleep essentially is resetting the magnetic north of your emotional compass," says Matthew Walker, director of the Sleep and Neuroimaging Lab at the University of California, Berkeley.

Dance around while getting dressed: Turn up the radio or listen to

transplant surgeon who completed an unprecedented eightway kidney swap this week said Tuesday he believes such intricate, multistate exchanges can drastically reduce the number of patients waiting for eligible donors.

computer modeling that matches donors with recipients, Montgomery said.

Multiple-kidney transplants occur when several people who need transplants have friends or relatives who are willing to donate kidneys but aren't compatible. A chain of surgeries is arranged in which each donor is matched with a transplant candidate who they don't know but is compatible with the kidney being given up. The chain of transplants typically also involve a so-called altruistic donor, who's willing to give a kidney to anyone and is located through a database.

Ten doctors performed 16 surgeries on the eight donors and eight recipients at Hopkins, Barnes-Jewish Hospital in St. Louis, INTEGRIS Baptist Memorial Center in Oklahoma City and Henry Ford Hospital in Detroit. Recipients and donors were equally delighted to be part of unique procedure. "My kidney lives and pees in St. Louis right now," said a teary Pamela Paulk, a 55-yearold donor and a vice president of human resources at Johns Hopkins. Paulk joined the group because a co-worker of hers needed a kidney but wasn't compatible with hers. Kidneys given by living donors are estimated to have double the longevity of kidneys taken from cadavers, Montgomery said. Surgeons at Johns Hopkins transplanted six kidneys simultaneously in April 2008 and performed a quintuple transplant in 2006. They have also completed several triple transplants.

A recent study by Walker and his colleagues examined how rest - specifically, rapid eye movement (REM) sleep - influences our ability to read emotions in other people's faces. In the small analysis of 36 adults, volunteers were asked to interpret the facial expressions of people in photographs, following either a 60- or 90-minute nap during the day or with no nap. Participants who had reached REM sleep (when dreaming most frequently occurs) during their nap were better able to identify expressions of positive emotions like happiness in other people, compared with participants who did not achieve REM sleep or did not nap at all. Those volunteers were more sensitive to negative expressions, including anger and fear.

Past research by Walker and colleagues at Harvard Medical School, which was published in the journal Current Biology, found that in people who were sleep deprived, activity in the prefrontal lobe - a region of the brain involved in controlling emotion - was significantly diminished. He suggests that a similar response may be occurring in the nap-deprived volunteers, albeit to a lesser extent, and that it may have its roots in evolution. "If you're walking through the jungle and you're tired, it might benefit you more to be hypersensitive to negative things," he says. The idea is that with little mental energy to spare, you're emotionally more attuned to things that are likely to be the most threatening in the immediate moment. Inversely, when you're well rested, you may be more sensitive to positive emotions, which could benefit long-term survival, he suggests: "If it's getting food, if it's getting some kind of reward, finding

a wife - those things are pretty good to pick up on." Our daily existence is largely influenced by our ability "to understand our societal interactions, to understand someone else's emotional state of mind, to understand the expression on their face," says Ninad Gujar, a senior research scientist at Walker's lab and lead author of the study, which was recently submitted for publication. "These are the most fundamental processes guiding our personal and professional lives." REM sleep appears to not only improve our ability to identify positive emotions in others; it may also round out the sharp angles of our own emotional experiences. Walker suggests that one function of REM sleep - dreaming, in particular - is to allow the brain to sift through that day's events, process any negative emotion attached to them, then strip it away from the memories. He likens the process to applying a "nocturnal soothing balm." REM sleep, he says, "tries to ameliorate the sharp emotional chips and dents that life gives you along the way."

"It's not that you've forgotten. You haven't," he says. "It's a memory of an emotional episode, but it's no longer emotional itself." That palliative safety-valve quality of sleep may be hampered when we fail to reach REM sleep or when REM sleep is disrupted, Walker says. "If you don't let go of the emotion, what results is a constant state of anxiety," he says. The theory is consistent with new research conducted by Rebecca Bernert, a doctoral candidate in clinical psychology at Florida State University who specializes in the relationship between sleep and suicidal thoughts and behaviors, and who also presented her work at the sleep conference.

In her study of 82 men and women between the ages of 18 and 66 who were admitted into a mental-health hospital for emergency psychiatric evaluation, Bernert discovered that the presence of severe and frequent nightmares or insomnia was a strong predictor of suicidal thoughts and behaviors. More than half of the study participants had attempted suicide at least once in the past, and the 17% of the study group who had made an attempt within the previous month had dramatically higher scores in nightmare frequency and intensity than the rest. Bernert found that the relationship between nightmares or insomnia and suicide persisted, even when researchers controlled for other factors like depression.

14 SEPTEMBER • 2009

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For Macho Men, Doctor Visits Are Less Likely

It's no secret that men don't like to go to the doctor, but new research finds they're especially likely to stay home if they're big on being macho.

iddle-aged men who are most devoted to traditional beliefs about masculinity are half as likely as other men to get routine medical care, researchers report.

It's not clear whether feelings about masculinity directly make men avoid doctor visits; the study only indicates that a causeand-effect link might exist. Nor do researchers know what this might mean for men's health.

Still, the findings suggest that "we could help men's health if we could dismantle this idea that manhood and masculinity is about being invulnerable, not needing help and not showing pain," said study author Kristen W. Springer, an assistant professor of sociology at Rutgers, the State University of New Jersey.

"This shows that the heart can indeed repair itself if given the opportunity," said Dr. Douglas Zipes, a past president of the American College of Cardiology. Zipes was not linked to Clark's treatment or to the Lancet paper. "The heart apparently has major regenerative powers, and it is now key to find out how they work." In 1994, when Clark was eight months old, she developed severe heart failure and doctors put her on a waiting list to get a new heart. But Clark's heart difficulties caused problems with her lungs, meaning she also needed a lung transplant.

To avoid doing a risky heart and lung transplant, doctors decided to try something completely different. Sir Magdi Yacoub of Imperial College London, one of the world's top heart surgeons, said that if Clark's heart was given a time-out, it might be able to recover on its own. So in 1995 Yacoub and others grafted a donor heart from a 5-month-old directly onto Clark's own heart. After four and a half years, both hearts were working fine, so Yacoub and colleagues decided not to take out the extra heart. The powerful drugs Clark was taking to prevent her from rejecting the donor heart then caused cancer, which led to chemotherapy. Even when doctors lowered the doses of drugs to suppress Clark's immune system, the cancer spread, and Clark's body eventually rejected the donor heart.

The findings were to be presented Monday at the American Sociological Association annual meeting in San Francisco.

Springer said she defines masculinity as a "stereotypical, old-school, John Wayne- and Sylvester Stallone-style" approach to life.

The researchers examined the results of surveys taken in 2004 by 1,000 white, middle-aged men in Wisconsin. The men answered questions about their beliefs regarding masculinity and disclosed whether they'd gotten recommended annual physicals, prostate checks and flu shots.

After adjusting the results to reduce the chance they would be thrown off by such things as a high number of married participants, researchers found that men who were the highest believers in masculine

ONDON — British doctors designed a radical solution to save a girl with major heart problems in 1995: They implanted a donor heart directly onto her own failing heart.

After 10 years with two blood pumping organs, Hannah Clark's faulty one did what many experts had thought impossible: it healed itself enough so that doctors could remove the donated heart. But she also had a price to pay: The drugs Clark took to prevent her body from rejecting the donated heart led to malignant cancer that required chemotherapy. Details of Clark's revolutionary transplant and follow-up care were published online in the medical journal Lancet.

The study has limitations. All participants were white, and all had completed high school. And Springer said unanswered questions remain, such as whether spouses play a role through "support or nagging."

Springer and a colleague launched their study to determine the role that ideas about masculinity play in the decisions men make about their health care.

British Girl's Heart Heals Itself After Transplant

There was one exception to the rule: Bluecolor workers who had a high attachment to masculinity were more likely to get the recommended health care.

Previous research has suggested that "men are less likely to go to the doctor than women, across the board," Springer said -a notion she finds surprising because men are wealthier overall, potentially giving them better access to medical care.

Doctors grafted a donor heart onto Hannah Clark's own ailing heart. This gave the sick heart a chance to heal itself.

Luckily, by that time, Clark's own heart seemed to have fully recovered. In February 2006, Dr. Victor Tsang of Great Ormond Street Hospital in London, Yacoub and other doctors removed Clark's donor heart. Since then, Clark — now 16 years old — has started playing sports, gotten a parttime job, and plans to go back to school in September. "Thanks to this operation, I've now got a normal life just like all of my friends," said Clark, who lives near Cardiff.

Her parents marveled at her recovery, and said that at one point during Clark's illness, they were told she would be dead within 12 hours. Miguel Uva, chairman of the European Society of Cardiology's group on cardiovascular surgery, called Clark's case "a miracle," adding that it was rare for patients' hearts to simply get better on their own. Still, transplants like Clark's won't be widely available to others due to a shortage of donor hearts and because the necessary surgeries are very complicated. In the last few years, artificial hearts also have been developed that can buy patients the time needed to get a transplant or even for their own heart to recover. Zipes said if doctors can figure out how Clark's heart healed itself and develop a treatment from that mechanism, many other cardiac patients could benefit.

At the moment, doctors aren't sure how that regeneration happens. Some think there are a small number of stem cells in the heart, which may somehow be triggered in crisis situations to heal damaged tissue. Experts said Clark's example is encouraging both to doctors and patients.

standards were 50 percent less likely to get the recommended care than other men.

Springer was unable to provide statistics about the percentage of men in each group who got the recommended care. Overall, though, fewer than half of all men did, according to the study.

Howard S. Friedman, a professor of psychology at the University of California at Riverside, said his research has found that less masculine men live longer than masculine men. But the new study doesn't show anything like that because it doesn't examine long-term effects on health, he said.

As for the gap between men and women when it comes to living longer, he said, "it would be a stretch, going beyond the data, to link it closely to men's increased mortality risk as compared to women."

Antioxidants Abound in Cereals, Popcorn, Whole-Grain Snacks

ating a bowl of your favorite cereal every day is a great source of natural antioxidants, new research shows. Joe Vinson, a professor of chemistry at the University of Scranton, in Pennsylvania, and his team have found that nearly all whole-grain breakfast cereals and many common, grain-based snacks contain substantial amounts of polyphenols, a form of antioxidants that is thought to have major health benefits. Vinson was scheduled to present his findings Tuesday at the American Chemical Society annual meeting, held in Washington, D.C. "Cereals have a plethora of [good things]," said Vinson, who tested more than 30 brands and types of breakfast cereals found in supermarkets. "They all have polyphenols." Whole grains are the main source of polyphenols in breakfast cereals, and since nearly all cereals contain at least some whole grains, it stands to reason that consumers should consider making cereals a regular part of their diet, said Vinson, adding that he received no food industry funding for his study. "Early researchers thought the fiber was the active ingredient for these benefits in whole grains -- the reason why they may reduce the risk of cancer and coronary heart disease," Vinson noted. "But recently, polyphenols emerged as potentially more important. Breakfast cereals, pasta, crackers and salty snacks constitute over 66 percent of whole grain intake in the U.S. diet," he added. "We found that, in fact, whole-grain products have comparable antioxidants per gram to fruits and vegetables," Vinson said. "This is the first study to examine total phenol antioxidants in breakfast cereals and snacks, whereas previous studies have measured free antioxidants in the products." Polyphenols occur naturally in plants and

are the most abundant antioxidant. They have anti-inflammatory properties, and scientists believe they may reduce the risk of cardiovascular disease, cancer and other illnesses. Nutritionists have recommended regular consumption of green tea, red wine, fruits, nuts and a few other food categories for their antioxidant content. Raisin bran had the most polyphenols -- 3 percent by weight; however, Vinson attributed the concentration to the raisins -- like other dried fruits, a known rich source of antioxidants. Another high-ranking cereal was a wheatbased blend containing the polyphenol-rich spice cinnamon. Vinson declined to name the brands he tested, but he encouraged people to add nuts, raisins and various spices like cinnamon to their cereal to boost their polyphenol content. As for snacks, Vinson found that popcorn had the most polyphenols (2.6 percent), followed by whole-grain crackers (0.45 percent). Sadly, most processed tortilla chips - Vinson's favorite -- contained negligible amounts of polyphenols. Registered dietician and nutritionist Eva To, who practices in White Plains, N.Y., said she found the study fascinating, but she had some concerns. "Whole-grain cereal is a great replacement for high-fat breakfast food or as a replacement for no breakfast at all, since breakfast is the most important meal of the day," said To, who specializes in obesity and diabetes management. "But moderation is the key. Many cereals contain ingredients that may not be very good for you, such as excessive sugar." Also, she added, "cereals are easy to binge on. It is very important to follow the serving size suggestions."

SEPTEMBER • 2009

FLORIDAHEALTHNEWS-ONLINE.COM

Tips to protect your pet from summer heat

With summer upon us, warmer weather beckons everyone outdoors to enjoy the sunshine. When family and friends gather for backyard barbecues and outings in the park, it is natural to want to include the pets. It is wise, though, to consider the health and safety of pets before taking them out into the heat for prolonged periods.

ets cannot tolerate heat the same way as people. One big reason is that dogs don't sweat, thereby lacking a natural way to cool down. To help ensure your pets don't suffer from the heat, veterinarian Tracy Chase-Thompson, department chair of the veterinary technology program at Brown Mackie College in Michigan City, Ind., offers advice. "Heat exhaustion is one of the big things that can occur," she says. "It happens more with dogs than cats, but it can occur with both." Heat exhaustion is a dangerous condition in animals that occurs due to lack of protection from hot weather and humidity. "It doesn't take much time for heat exhaustion to develop," says Chase-Thompson. "A dog can overheat in a hot vehicle in just 10 minutes." Symptoms of heat exhaustion include heavy panting, drooling and labored breathing. "Gum color is another indicator. If gums appear red instead of pink, that's a sign of an animal in distress."

Normal body temperature for a dog is between 101 F and 102 F. "A temperature higher than 105 F signals heat exhaustion," says Chase-Thompson. In this case, the dog would require veterinarian care with IV fluids for hydration, and close monitoring of body temperature. Pet owners can take a number of precautions to prevent heat stress and exhaustion in pets. If your dog will spend any amount of time outside, Chase-Thompson advises providing a shelter so that the dog can access shade at all times, and walking your

dog before 10 a.m. or after 4 p.m. when sunlight and humidity are less powerful. "It is safer to leave your pet at home on hot or humid days rather than in the car, even with the windows cracked. If you must take your pet, park in the shade, open the window, and don't leave for more than 10 minutes," she adds.

Another concern among pet owners is how to protect a pet that is afraid of the noise from fireworks and thunderstorms. "Some pets have a fear of noise at a young age. Others are fine when they're young, yet become bothered by loud sounds as they grow older," says Chase-Thompson. "It's impossible to make the noise go away, but there are ways to minimize or disguise the noise.

"If you leave the dog alone, it could help to leave music playing. Turn on the radio or TV, or even a loud fan or air conditioner," she advises. "If the animal's reaction is really bad, I recommend staying with your pet to provide reassurance. There are antianxiety medications that a veterinarian can prescribe." Chase-Thompson advises discussing with your veterinarian whether your pet is a good candidate. "Medications can help, but they don't always work. It is important to lessen your pet's fear with other types of comfort," she says.

Can your dog save the planet? We all think our dogs are super, but could your dog help save the planet by reducing landfill waste? How you train your dog has a big impact on the environment and on your wallet.

Housebreaking a puppy or dog is never fun, but it’s a necessary part of adding a new member to the family. There will be unpleasant messes to clean up, but you’ll need to teach the dog the right and wrong places to go. So, where does saving the environment come into play?

Many people use training pads (essentially big, flat disposable diapers) for housetraining the dog, or to use as a "dog bathroom" indoors. Unfortunately they are dirty, dogs can drag them around the house and they are definitely not eco-friendly.

Using an indoor dog potty can make housetraining much easier. Here are a few other tips to help you and your four-legged friend through the process:

* Take your puppy or dog to his bathroom area immediately in the morning.

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* Take him to his area immediately after each meal.

* Give him lots of cheerful praise when he goes in the appropriate place.

* Never punish a dog for a housetraining mistake; he won’t understand why he’s in trouble. If you catch him in the act, tell him "no" firmly and move him to the appropriate area immediately.

Once your canine friend gets the hang of it, having a dog toilet in the house will prevent him having to "hold it" all day and you’ll appreciate not having to clean up messes when you get home.

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