Dr. Buttery's Public Health BLOG

Because the threat of genetic birth defects is still very real, says Dr. Neena Champaigne of UTMB's Division of Clinical Genetics, prospective parents who fall into several broad categories definitely should seek genetic counseling and screening before starting a family. Around two to three percent of all babies are born with birth defects notes Champagne. That number hasn't changed much over the years, despite advances in prenatal health care. Women who are over 35, or who have histories of multiple miscarriages should seek counseling, as should women and men who have family histories of genetic conditions such as birth defects and mental retardation. This advice also applies to members of specific ethnic groups. Caucasians, for example, should be screened for cystic fibrosis and African-Americans for sickle cell anemia. Cajuns and Ashkenazi Jews (Jews of eastern European descent) should be screened for Tay-Sachs disease.

Posted by at 10:44 AM | Permalink | Comments (0)

This article from the Mayo Clinic is a good primer on the confusion about Stem Cells, particularly with the latest newspaper story about who said what to whom when, and was a recent paper in Science fraud or just poor composition.

Posted by at 10:36 AM | Permalink | Comments (0)

The University of Vermont College of Medicine has been chosen as the single participating academic medical center in the nation to collaborate with the Navy Medical Research Center (NMRC) and Denmark-based ACE BioSciences in the development and evaluation of a new vaccine against one of the most common food-borne bacteria, Campylobacter. Campylobacter infections account for more than two million cases of food-borne illness and up to 100 deaths in the United States each year, as well as $1.5 to 1.8 billion in lost productivity.
Is there a point at which we give too many vaccines? Should we instead be looking for a better way to help the body reject inimical bacteria?

Posted by at 11:49 AM | Permalink | Comments (0)

From Bristol University(UK) academics have found, for the first time, smells from healthy faeces and people with infectious diarrhoea differ significantly in their chemical composition and could be used to diagnose quickly diseases such as Clostridium difficile (C. Diff.). It is hoped the discovery of these chemical profiles will lead to the development of a device capable of rapid diagnosis at the bedside, saving both time and money. Rather than trying to develop a "sniffometer" it would be simpler to train dogs to detect the difference. If dogs can smell drugs and explosive materials why not bugs?

Posted by at 11:40 AM | Permalink | Comments (0)

When it comes to lowering cholesterol levels, garlic stinks, according to a new study from the Stanford University School of Medicine. Despite decades of conflicting studies about the pungent herb’s ability to improve heart health, the researchers say their study provides the most rigorous evidence to date that consuming garlic on a daily basis—in the form of either raw garlic or two of the most popular garlic supplements—does not lower LDL cholesterol levels among adults with moderately high cholesterol levels. “It just doesn’t work,� said senior author Christopher Gardner, PhD, assistant professor of medicine at the Stanford Prevention Research Center. “There’s no shortcut. You achieve good health through eating healthy food. There isn’t a pill or an herb you can take to counteract an unhealthy diet.�

Posted by at 11:35 AM | Permalink | Comments (1)

Was this a study worth funding? Why would anyone be surprised by a Hopkins study that showed that patrons of bars that allow smoking are exposed to high levels of second hand smoke? This deserves Goldwater's Golden Finger award.

Posted by at 11:30 AM | Permalink | Comments (0)

A few days we read how useful the C-reactive protein test was going to be in advising about potential heart disease. Now, from Dartmouth Medical School researchers question the usefulness of the C-Reactive Protein (CRP) test for guiding decisions about the use of cholesterol-lowering medication, saying the test identifies too many at low risk. Has test got too many false positives? According to co-author Dr. Lisa Schwartz, also associate professor of medicine and community and family medicine, "A general population use of the test would identify millions of low-risk people, and we don't know if exposing them to cholesterol medications will do more good than harm. Plus, focusing on low-risk people seems misplaced since over half of high-risk people, who we know are helped by treatment, remain untreated."

Posted by at 11:22 AM | Permalink | Comments (0)

Researchers from Brigham and Women’s Hospital (BWH) have found that the three most commonly used drugs in the United States, acetaminophen, ibuprofen and aspirin, increase the risk of developing high blood pressure in middle-aged men. These findings are published in the February 26 issue of the Archives of Internal Medicine. Researchers analyzed questionnaires from 16,031 men with a mean age of 65 years old without a history of high blood pressure at baseline who are part of the Health Professionals Follow-up Study.
Men who took acetaminophen six to seven days per week had a 34% increased risk of hypertension
Men who took NSAIDs six to seven days per week had a 38% increased risk of hypertension
Men who took aspirin six to seven days per week had a 26% increased risk of hypertension

Posted by at 11:16 AM | Permalink | Comments (0)

From the London School of Hygiene & Tropical Medicine (UK) a new study finds that treating women who are infected with both the HSV-2 and HIV viruses with anti-herpes treatment can reduce the amount of HIV in the blood and genital secretions, according to the results of a trial published last week in the New England Journal of Medicine.

Posted by at 9:24 AM | Permalink | Comments (0)

By now many of you have heard about, or read editorials or opinion pieces about, the new bill just introduced into congress. This bill has 155 pages and is not easy reading. I wonder how extensive the hearings will be and whether the tobacco companies will use the bill to print on each pack, FDA Approved? We know little about the hundreds of other chemicals also found in tobacco products, beside nicotine.

Posted by at 1:04 PM | Permalink | Comments (0)

QFLU is a new daily collection and analysis service specifically established to support pandemic flu planning. It has been set up by the University of Nottingham and EMIS (the main supplier of general practice computer systems within the UK) in collaboration with the Health Protection Agency. Currently, QFLU is a not-for-profit network of over 3,300 general practices spread throughout the UK covering a total population of almost 22 million patients (> 25% of the UK population).

Posted by at 12:07 PM | Permalink | Comments (1880)

New research from Carnegie Mellon shows a patient-centered case management program designed to improve health care quality and reduce medical expenses for those with complex or clinically advanced illnesses resulted in a 38 percent decrease in hospital admissions, reduced costs by more than $18,000 per patient and garnered high patient-satisfaction scores. Patient-centered management (PCM) assigns highly trained nurses to provide extensive patient education and care coordination, as well as pain and end-of-life management. PCM helps patients select services, consider different treatment options and avoid unnecessary hospitalization and emergency room visits — in essence changing some patient behaviors and environments that impair their care or yield unnecessary health-care expense.

Posted by at 11:14 AM | Permalink | Comments (0)

A good link for local health department websites is the American Dental Association for Child Health month (February) "Preventive dental care has greatly improved the oral health of American children," states Kimberly Harms, D.D.S., American Dental Association consumer advisor and general dentist from Farmington, Minn. "It is now possible for many children to reach adulthood without ever experiencing tooth decay and that is why good oral health practices should begin in infancy and continue throughout adult life."

Posted by at 10:59 AM | Permalink | Comments (0)

The human brain is set up to simultaneously process two kinds of information: the emotional and the empirical. But in most people, emotional responses are much stronger than the rational response and usually take over, according to Michigan State University environmental science and policy researcher Joseph Arvai. Decision making isn't always as rational as you think (or hope.) "People tend to have a hard time evaluating numbers, even when the numbers are clear and right in front of them," Arvai said. "In contrast, the emotional responses that are conjured up by problems like terrorism and crime are so strong that most people don't factor in the empirical evidence when making decisions."

Posted by at 10:50 AM | Permalink | Comments (0)

A study on female navy recruits by faculty at Creighton University for an eight week training period women, ages 17 to 35, were divided into two groups with one group receiving daily pill supplements of 2,000 Mg of calcium and 800 IU of vitamin D, and the other group receiving placebo pills. The recruits in the placebo group experienced stress fractures, about 25 percent more than in the group taking the calcium/vitamin D supplements. A history of regular exercising decreased the risk of stress fractures, while cigarette smoking increased the risk.
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Posted by at 10:35 AM | Permalink | Comments (0)

An excellent presentation on heart disease, on PBS last night, to be repeated twice, is worth watching and should be placed as a link on all public health web pages. The resources identified and the discussion of "One Step at a Time" are worth reviewing.

Posted by at 10:23 AM | Permalink | Comments (0)

According to a new study from the Stanford University School of Medicine, the incidence of heart disease and associated fatalities are higher for people who live in poor neighborhoods vs. those who live in more affluent areas. They found that new cases of heart attacks and stroke were 1.9 times higher for women and 1.5 times higher for men who lived in high-deprivation vs. low-deprivation neighborhoods. Census data was used to determine the level of neighborhood “deprivation,� which was measured by an index of education, income, unemployment and welfare assistance levels. I am not sure why this research would be thought to find anything new. Those of us who have managed public health programs have known this for years.

Posted by at 10:14 AM | Permalink | Comments (0)

From the University of Bristol. UK. breastfed kids climb higher up the social ladder than bottle-fed children, reveals a large, long term study by Dr Richard Martin. Over 3,000 children from 16 rural and urban areas across England and Scotland were monitored from birth. The prevalence of breastfeeding varied from 45 per cent to 85 per cent, but was not dependent on household income, expenditure on food, number of siblings, birth order, or social class in childhood. But those who had been breastfed as babies were 41 per cent more likely to move up the social ladder as adults than those who had been bottle fed. The longer a child was breastfed, the greater were their chances of upward mobility, the results showed.

Posted by at 10:24 AM | Permalink | Comments (0)

From Ohio State University & Johns Hopkins we find a nursing infant's exposure to VOCs from indoor air was 25- to 135-fold higher than what that infant ingested through breast milk. In fact, levels found in milk were far below the U.S. EPA's maximum contaminant levels for drinking water. The researchers stress that despite human milk's vulnerability to chemical contamination, the health benefits of nursing far outweigh the risks, and that breast milk is the best source of nutrition for a growing infant.

Posted by at 10:19 AM | Permalink | Comments (0)

From ProMed today a note about neurocysticercosis, a brain infection caused by a pork tapeworm, which is a "growing public health problem in the United States," especially in states bordering Mexico, where the disease is endemic. Cysticercosis, an infection which can also harm eyes and muscles. "Recent data indicate cysticercosis is an important cause of death in California,"

Posted by at 4:33 PM | Permalink | Comments (0)

Just announced from the Fred Hutchinson Cancer Research Center in Seattle; The launch of the first large-scale study to evaluate a candidate HIV vaccine on the African continent was announced today by study collaborators in the United States and South Africa. The trial will involve up to 3,000 participants at five sites throughout South Africa and is expected to continue for four years.

Posted by at 11:01 AM | Permalink | Comments (0)

From Stanford School of Medicine never-smokers get lung cancer more often than thought, with women even more at risk than men. For women, the lung cancer incidence rate in never-smokers ranged from 14.4 to 20.8 cases per 100,000 person-years. In men, it ranged from 4.8 to 13.7 incidents. The authors infer that around 8 percent of lung cancer cases in males and close to 20 percent of cases in females are among never-smokers.

Posted by at 10:35 AM | Permalink | Comments (0)

From the Feb 9 MMWR In 2004, poisoning was second only to motor-vehicle crashes as a cause of death from unintentional injury in the United States. Nearly all poisoning deaths in the United States are attributed to drugs, and most drug poisonings result from the abuse of prescription and illegal drugs

Posted by at 12:40 PM | Permalink | Comments (11)

From the NIH we learn that newly analyzed data shows that the number of women who die from heart disease has shifted from 1 in 3 women to 1 in 4 — a decrease of nearly 17,000 deaths from 2003 to 2004. Elizabeth G. Nabel, M.D., director of NHLBI said that “To see such a significant reduction in deaths underscores that the efforts of many individuals and organizations to raise awareness, improve treatment and access, and inspire women to take action are truly saving lives.�

Posted by at 11:45 AM | Permalink | Comments (0)

George Washington University School of Public Health now provides access to Public Health Grand Rounds on the Intenet. The current grand round is on Cardiovascular DIsease in Women. It is excellent and recommended to all. Now we have two sources, UNC & GW. The GW grand rounds are broght to us via the Kaiser Family Foundation.

Posted by at 6:34 PM | Permalink | Comments (0)

While Rabies has been almost eliminated in the west it cotinues to be a significant problem elsewhere. The first human death from Rabies in 2007 in Beijing has just been reported. While in the US the major domestic animal carrier is the cat, elsewhere the dog is still a major vector.

Posted by at 10:56 AM | Permalink | Comments (0)

From the Mayo Clinic today comes a call for a reimbursement system based on value rather than the current "pay-for-performance" system used by many insurers, including Medicare. Unfortunately this is one more plan for institutional benefit rather than population benefit.

Posted by at 11:33 AM | Permalink | Comments (0)

CDC has released its newest interim planning guidance, including commnity strategies for intervention on its Pandemic Flu website. The PDF document Community Strategy for Pandemic Influenza Mitigation (PDF - 2.51 MB) should be read by all public health agencies/educators.

Posted by at 10:54 AM | Permalink | Comments (0)

Posted by at 1:52 PM | Permalink | Comments (0)

From Queen's University, Toronto ,Canada a study shows that giving nitroglycerin to women who enter labour early results in significant improvement to their babies’ health. The improvement is most marked in babies who are born very prematurely (at 24 to 28 weeks). A five-year, randomized controlled trial involved 153 women who were recruited at the time they went into pre-term labour. The study shows that using nitroglycerin patches for pregnant women helps to prolong pregnancy and – most importantly – improves babies’ outcome, with fewer side effects than experienced through the use of other drugs.

Posted by at 11:18 AM | Permalink | Comments (0)