Wednesday, December 1, 2010

Health : Health Buzz: Dosing for Children's Medicines Confusing, Study Shows

Health : Health Buzz: Dosing for Children's Medicines Confusing, Study Shows

Health Buzz: Dosing for Children's Medicines Confusing, Study Shows

Posted: 01 Dec 2010 01:59 PM PST

Study: Children's Medications Contain Inconsistencies Between Instructions, Measuring Devices

Over-the-counter liquid children's medicines like pain relievers and stomach aids may be dangerous, and it's not because of the drugs themselves, but because of their oft-confusing instructions and measuring devices. According to a new study in the Journal of the American Medical Association, 98.6 percent of 200 popular children's liquid medicines examined contained dosing directions that didn't match up with the markings on the measuring cup or syringe provided. About 25 percent had devices that lacked the necessary markings, and 81 percent of the devices had markings that weren't among the label's recommended doses. The study's authors suggest requiring that all manufacturers use a standard unit for measuring, like milliliters, rather than teaspoons and tablespoons. That could take government action to bring about.

From: To Use OTC Children's Medications Safely, Parents Need to Take Charge

In the meantime, we've got kids to take care of, U.S. News contributor Nancy Shute writes. Darren DeWalt, an assistant professor of medicine at the University of North Carolina School of Medicine, spoke with U.S. News about what parents can do to protect their children from dosing errors while the industry gets its act together. DeWalt studies how well people understand medical information and wrote an editorial in JAMA calling for not just better packaging, but more help for parents. Here's his advice:

1. Don't grab a spoon from the silverware drawer for dosing medicine. "We know those are inaccurate," DeWalt says. But parents often choose them because those plastic cups that come with many children's medications are "unintelligible," he says.

2. If you're using medicine that comes with a cup or a syringe, take it to the pharmacist and ask her to put a mark on it. Say: "My kid weighs 40 pounds. Can you mark the right dosage?" DeWalt says that's the easiest way to reduce the risk of mistakes that can lead to dangerous drug overdoses.

3. Realize that doling out the correct dose is difficult in the best of circumstances, and give extra attention to the process if you're up in the middle of the night with a sick child. Says DeWalt: "One thing we know for sure is that it's easy to make mistakes."

Other research has found that droppers are more accurate than are the oft-provided plastic measuring cups, but the U.S. Food and Drug Administration has been urging parents to use the measuring devices packaged with the medicine, even if they aren't droppers. Confusing enough? Once again, more clarity and guidance is desperately needed.

The bottom line: We parents need to come up with a system for our families that will be as accurate as possible, given the crummy tools we've got to work with. You can be sure that the next time I buy over-the-counter meds for my child, I'll march right up to the pharmacist's counter, Sharpie in hand, and say: "Can you mark this for me?"

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Smile to Improve Your Mood

Posted: 01 Dec 2010 09:17 AM PST

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10 HIV/AIDS Beliefs—Which Ones Are True?

Posted: 01 Dec 2010 08:55 AM PST

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New Food Safety Regulations? It's About Time

Posted: 01 Dec 2010 08:21 AM PST

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Health Buzz: Finger Length Linked to Prostate Cancer Risk

Posted: 01 Dec 2010 07:53 AM PST

Finger Length Could Predict Prostate Cancer Risk

The key to predicting a man's risk of prostate cancer could lie in—his pointer finger? That's what a new study published today in the British Journal of Cancer suggests. Researchers compared the hands of 1,500 prostate cancer patients and 3,000 healthy men, and found that those whose index fingers were longer than their ring fingers were 33 percent less likely to develop the disease. The study authors said that's probably because longer index fingers indicate less testosterone, a hormone that's associated with the cancer. Previous studies have found that men with naturally high testosterone levels have a heightened risk of prostate cancer. "This exciting finding means that finger pattern could potentially be used to select at-risk men for ongoing screening, perhaps in combination with other factors such as family history or genetic testing," study author Ros Eeles told BBC News.

U.S. Dietary Guidelines About to Change—Get Ready for a Serious Food Fight

A few more than the usual number of New Year's pledges to eat better, exercise diligently, and shed flab just might be kept in 2011, pending the federal government's about-to-be-unveiled revamping of the 2005 Dietary Guidelines for Americans. Updated by law every five years by the Department of Agriculture and Department of Health and Human Services, the guidelines direct federal nutritional policy from the contents of an 8-year-old's cafeteria tray to the numbers displayed on the nutritional label of a can of tomato soup. Few Americans are left untouched by their recommendations, U.S. News reports.

The thrust and details of the 2010 guidelines won't be known until they are released, a change from before, when the government simply adopted the recommendations of an advisory panel. This time DOA and HHS are hammering out the final version behind the curtains, with a 13-member advisory panel providing input rather than dictating the content. But the report and recommendations released by the panel in June are bound to carry heavy weight. If the panel's input foreshadows the shape and scope of the guidelines the government will issue, the public will see a thorough overhaul, and one that reflects a sense of urgency.

The report marks the first time proposed guidelines have confronted obesity directly. It notes that nearly three-fourths of women and two-thirds of men are now considered overweight or obese, and it calls for quick and far-reaching changes—not only in personal diet and lifestyle but also in the marketplace, to reverse the trend. "The obesity epidemic has only gotten worse since 2005," says Linda Van Horn, chair of the advisory committee and professor of preventive medicine at Northwestern University. [Read more: U.S. Dietary Guidelines About to Change—Get Ready for a Serious Food Fight.]

10 Ways U.S. Dietary Guidelines Should Change

The 13-member advisory committee that in June handed the federal government its recommendations for new dietary guidelines wants to wage all-out war on obesity—not simply suggest, as earlier guidelines have, that Americans eat more of this (veggies and whole grains) and less of that (salt and fat). Here are 10 of the key recommendations from the panel's report:

Think total diet. A concrete but flexible diet is more likely than one that is vague and rigid to succeed over time, U.S. News reports. Rather than saying that less than 10 percent of calories should come from saturated fat, for example, the panel's guidelines promote nutrient-dense foods that are also low in saturated fat, such as whole-grain bread, produce, skim milk, and poultry, and discourage but never impose a total ban on foods like full-fat cheese, pizza, french fries, ice cream, and bacon. "A healthful total diet is not a rigid prescription, but rather is a flexible approach that incorporates a wide range of individual tastes and preferences," the panel wrote.

Salt is out, potassium in. To bring down the 70 percent of the adult population with hypertension, or high blood pressure, the recommended daily maximum for salt should be slashed to 1,500 milligrams from the current 2,300 mg. Hypertension raises the risk of heart attacks, stroke, and other cardiovascular problems. The lower number already is the suggested ceiling for Americans who are middle-aged or older or African-American, or who already have been diagnosed with high blood pressure. Raising the blood level of potassium is another way to lower blood pressure, and many Americans don't get enough from foods like raisins, figs, and bananas; the panel recommends more than doubling the currently suggested 2,000 mg. a day to 4,700 mg. [Read more: 10 Ways U.S. Dietary Guidelines Should Change.]

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Health Buzz: Most Get the Calcium, Vitamin D They Need

Posted: 30 Nov 2010 02:53 PM PST

Yes, Vitamin D and Calcium Are Important, but Don't Go Overboard

Most people get enough calcium and vitamin D to keep their bones healthy and strong,­ according to a report released Tuesday by the Institute of Medicine. Eating calcium-rich foods and, in the case of vitamin D, soaking up sunlight are helping people get enough of the nutrients. Still, Tuesday's report proposes new guidelines on how much of each nutrient is ideal. Those younger than 71 need no more than 600 international units of vitamin D each day, the IOM says. And people should aim for getting between 700 and 1,300 milligrams of calcium daily, depending on their age, USA Today reports. While those benchmarks are higher than they were a decade ago, some experts believe the IOM's vitamin D recommendation is too low, given that research has recently linked low levels of the nutrient to cancer, diabetes, and bone problems. The IOM says getting more—up to 4,000 IUs—is safe for those 9 and older, but is not advised, since excessive vitamin D is associated with heart and kidney damage. What's more, researchers haven't proven that increasing vitamin D levels has conclusive health benefits, committee members told USA Today.

Experts have long debated how much vitamin D is optimal, but getting a test to find out your levels might not be necessary.

From: Why You May Not Need That Vitamin D Test After All

Right now, at this very moment, your vitamin D levels are probably at their lowest levels of the year, since your body can't make the nutrient from sunshine during the dark winter months, U.S. News's Deborah Kotz wrote earlier this year. You could be facing an increased risk of heart disease, osteoporosis, dementia, diabetes, and a variety of cancers. Scared yet?

Many people are, especially after having their levels tested and being told that they're deficient. With a spate of recent studies touting the prevalence of D deficiency—half of all Americans—and the disease-prevention benefits of having high vitamin D levels, doctors have rushed to test and treat low levels with supplements. Some experts, though, are starting to sound alarms about the boom in testing, which has been increasing by 80 to 90 percent per year, with several million people expected to be checked in 2010, according to Mayo Clinic pathologist Ravinder Singh. He says he's concerned about the lack of standardization among testing labs after seeing results vary greatly from lab to lab using the same blood sample. (In a separate matter, Quest Diagnostics, the nation's largest medical laboratory, last year revealed that it provided "questionable" vitamin D level results to thousands of patients that may have indicated levels were higher or lower than they actually were.)

The bigger problem, though, is that experts still don't agree on what an "optimal" level of vitamin D might be or whether raising levels actually prevents disease. Vitamin D researcher Robert Heaney, a professor of medicine at Creighton University in Nebraska, says most researchers agree that blood levels should be at least 30 nanograms/milliliter to protect bones, but some scientists think these levels should higher—perhaps 40 ng/ml or more to provide protection against diabetes, heart disease, and cancer. Others, though, question whether it's truly beneficial to drive blood levels into this range using supplements. "I think there's great potential for vitamin D to reduce the burden of chronic disease, but I also think there's reason to be cautiously optimistic," says JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston, who is conducting a large clinical trial of vitamin D supplementation. "Let's not jump on the bandwagon and take megadoses before we have results from research trials." After all, a host of supplement studies—on vitamin C, vitamin E, selenium, beta carotene—found that those who were given supplements fared no better, and sometimes worse, than those who took placebos. This, despite the fact that previous population studies had shown that those with high levels of these particular nutrients had lower rates of heart disease, cancer, and other diseases.

Could the same hold true for vitamin D? Those promising benefits of high vitamin D amounts were demonstrated in studies that simply looked at vitamin D levels in various populations and then correlated them with disease. Only a handful of intervention studies have shown a modest benefit to giving vitamin D supplements—mostly for lowering the risk of bone fractures in elderly nursing home residents when vitamin D is taken along with a calcium supplement. Heaney and his colleagues found in a 2007 study of nearly 1,200 postmenopausal women that those who were randomly assigned to take a vitamin D and calcium supplement for four years had a 60 percent lower risk of developing any kind of cancer than those who were randomly given placebos. But while that finding is intriguing, argues cancer researcher Rowan Chlebowski, a professor of medicine at David Geffen School of Medicine at the University of California–Los Angeles, the study was small and needs to be replicated before it's possible to conclude that raising vitamin D levels prevents cancer. "I think it's reasonable to do further studies," he says. "But people need to realize that high levels of vitamin D in the bloodstream may simply be due to good genes or some other factor beyond sun exposure or dietary intake."

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To Use OTC Children's Medications Safely, Parents Need to Take Charge

Posted: 30 Nov 2010 02:16 PM PST

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Shape Up With a New Video Game Workout

Posted: 30 Nov 2010 11:02 AM PST

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Health Buzz: Weight Watchers Revamps Points System

Posted: 30 Nov 2010 09:11 AM PST

Weight Watchers Overhauls Points System

Not all calories are created equal. Indeed, a 100-calorie apple is a better choice than 100 calories worth of chips or cookies—a lesson Weight Watchers wants to instill with its new PointsPlus System, unveiled on Monday. The system assigns points to foods based on their macronutrients like protein, carbohydrates, fiber, and fat, rather than emphasizing only their calories. Under the old plan, for example, a buttered croissant would have had the same points value as a healthier breakfast of toast, ham, and eggs, provided both contained an equal number of calories. Now, the croissant would be assigned more points to reflect its higher fat and carbohydrate content, while the toast, ham, and eggs—a richer source of fiber and protein— would be assigned fewer points. The new formula takes into account that protein and fiber ward off hunger, and also factors in that the body has to work harder to process some foods than it does others, which burns more calories. Fresh fruits and vegetables will now carry zero points, an effort to make them more appealing.

For Help With Medical Bills, Cut a Deal With the Doctor

Getting a diagnosis isn't the only nerve-racking aspect of a medical visit, Meryl Davids Landau writes for U.S. News. The bill you're handed can be even scarier, especially when you lack health insurance or face an intimidating deductible or copay. But just as big employers and insurance companies negotiate prices down as a matter of course, individuals can bargain with doctors and hospitals, too, says Erin Moaratty, chief of external communications at the nonprofit Patient Advocate Foundation.

Ideally, the time to make your case for a discount is before you go in for a procedure. Call the medical facility and ask for the projected fees; if you have insurance, contact the company next to find out how much it will pay. Then talk over your situation with the billing department, requesting a break. You might win as much as 50 percent off full price if you offer to pay quickly by cash or check, says Cindy Holtzman, a medical billing advocate in Marietta, Ga., who's part of a growing industry of professionals dedicated to aiding patients with billing disputes. Providers accustomed to accepting less than they'd like from insurers often realize that getting payment without hassle or delay is preferable to waiting for the full amount or having to hire a collection agency.

If you can't pay even a discounted amount promptly, you'll likely still be able to get a good deal if you promise regular payments of an agreed-upon size, Holtzman says. Patients with severe financial problems (especially those brought on by illness) may find their physician is compassionate enough to accept the insurer's portion as full payment. And uninsured low-income individuals who make too much to qualify for Medicaid may be eligible for free or reduced charity care. [Read more: For Help With Medical Bills, Cut a Deal With the Doctor.]

Four Loko May Be Gone, but Dangerous Alcohol Drinks Remain

Caffeine and alcohol don't mix well, which is why the Food and Drug Administration has ordered the manufacturers of Four Loko, Core High Gravity, Moonshot, Joose, and Max to stop selling the amped-up drinks. According to the FDA, caffeine is an "unsafe food additive"—at least when it's mixed with a potent slug of alcohol.

The FDA's ban on caffeinated alcohol has been a long time brewing, but an incident in October, when nine students at Central Washington University ended up at the hospital after drinking Four Loko, might have pushed the FDA to act. The drink had 12 percent alcohol in each 23.5-ounce can; by the ounce, that's three times the amount as in a typical beer, and the alcohol equivalent of four glasses of wine. The drink comes in flavors like lemonade and watermelon. So it's no wonder that someone could down several and find himself in serious trouble, writes U.S. News contributor Nancy Shute.

"We're seeing a disturbing trend, in which marketers are targeting these younger drinkers," says Daniel Z. Lieberman, professor of psychiatry and behavioral sciences at George Washington University, in Washington, D.C. "They're doing it with high sugar content. They're doing it with flavors that appeal to young drinkers—fruit punch, raspberry, peach—and they're doing it by making [the drinks] inexpensive." [Read more: Four Loko May Be Gone, but Dangerous Alcohol Drinks Remain.]

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Prescriptions for Stimulants, Painkillers Soaring Among Youth

Posted: 30 Nov 2010 06:00 AM PST

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