Watch Out this Memorial Day!

As we observe this Memorial Day and commemorate the men and women who died while serving in the American military let’s also remind ourselves to take care of the living. Holidays aren’t always fun and games. They also present ideal opportunities for our loved ones to get hurt. From burning themselves on the barbecue on Memorial Day to sticking themselves with carving knives on Halloween or ingesting sharp decorations on Christmas, holidays it seems are hazardous for health.

However, parents should be wary of both routine and out-of-the-ordinary activities on a holiday weekend.  According to a new study published in Pediatrics, children are more likely to suffer injuries from everyday activities, such as playing football, than they are to be victims of holiday-specific pitfalls.

Labor Day and Memorial Day are the top two holidays for injuries.  The study authors from the Center for Injury Research and Policy in Columbus, Ohio, and Ohio State University suggest this is because they are often celebrated outdoors and people are more likely to take part in physical activities.

The researchers collected childhood-related injury information from a nationally representative sample of 98 U.S. hospital emergency departments. They looked at records from 1997 through 2006 over eight holidays: New Year’s, Easter, Memorial Day, Fourth of July, Labor Day, Halloween, Thanksgiving and Christmas. They included injuries occurring in a five-day period around each holiday (two days before and two days after, as well as the holiday itself). The thinking was that people don’t always celebrate a holiday on the day itself, or they might hold festivities over multiple days.

An estimated 5,710,999 injuries related to holidays occurred over the nine-year period. After Labor Day and Memorial Day, the runners up for the most injuries were the Fourth of July and Halloween. Christmas had the least number of injuries.

Boys suffered from most of the injuries (62%), followed by children under 5 (29%). The most common injuries were lacerations (29.2%), and the most injured body parts were the face, fingers and hands.

Close to half of the injuries were sports or recreation related. Only a small portion of injuries were from activities that might be considered specific for the holiday. For instance, just 2.9% of injuries occurring around the Fourth of July were related to fireworks while 8.6% were related to riding bicycles!

SRxA’s Word on Health wishes all its readers a SAFE and HAPPY holiday.

An apple with your albuterol?

According to a study presented at the recent American Thoracic Society, people with asthma may be well-advised to avoid heavy, high-fat meals.

Individuals with asthma who consumed a high-fat meal showed increased airway inflammation just hours after the binge.  The high fat meal also appeared to inhibit the response to the asthma reliever medication albuterol.

“Subjects who had consumed the high-fat meal had an increase in airway neutrophils and TLR4 mRNA gene expression from sputum cells, that didn’t occur following the low fat meal,” said research fellow Dr. Lisa Wood, Ph.D. “The high fat meal impaired the asthmatic response to albuterol. In subjects who had consumed a high fat meal, the post-albuterol improvement in lung function at three and four hours was suppressed.”

Researchers recruited 40 asthmatic subjects who were randomized to receive either a high-fat, high-calorie “food challenge”, consisting of burgers and hash browns containing about 1,000 calories, 52% of which were from fat; or a low-fat, low-calorie meal consisting of reduced fat yogurt, containing about 200 calories, and 13% fat.

Sputum samples were collected before the meal and four hours afterward, and analyzed for inflammatory markers.

Subjects who had consumed the high-fat meal had a marked increase in airway neutrophils and TLR4 mRNA gene expression. TLR4 is a cell surface receptor that is activated by nutritional fatty acids: TLR4 ‘senses’ the presence of saturated fatty acids, and prompts the cell to respond to the fatty acids as if they were an invading pathogen, releasing inflammatory mediators. Subjects who had consumed the high fat meal also had reduced bronchodilator response.

The mechanism by which a high fat meal could change the bronchodilator response requires further investigation.  However if these results are confirmed by further research, strategies aimed at reducing dietary fat intake may be useful in the overall management of asthma.

Dying for a suntan this summer?

Half the battle in knowing how to properly protect yourself from skin cancer is being able to separate fact from fiction. Unfortunately, some myths about tanning and sun protection are deep rooted and could mislead people into thinking that tanning is safe – when, in reality, nothing could be further from the truth.

A new survey by the American Academy of Dermatology sets the record straight on some of the most common myths and what people believe to be true about tanning and sun protection.

The “Suntelligence: How Sun Smart is Your City?” online survey polled more than 7,000 adults nationwide to determine their knowledge, attitudes and behaviors toward tanning, sun protection and skin cancer detection.

“Our survey showed that despite our repeated warnings about the dangers of UV exposure and the importance of proper sun protection, many people could not correctly answer true/false statements on the subject,” said dermatologist Zoe D. Draelos, MD, FAAD, Duke University School of Medicine, Durham, N.C.

Examples of the myths included in the survey include:

• Some types of ultraviolet (UV) rays are safe for your skin?
  • The survey found that only about one-third of respondents correctly answered false to this question.

• Getting a base tan is a healthy way to protect skin from sun damage?
  • Less than half the respondents knew this statement was false.

• It is smarter to tan indoors using a tanning bed?
  • 63% of respondents knew that this statement was false.

• A sunscreen with a Sun Protection Factor (SPF) 30 provides twice the protection as an SPF 15?
  • Only 21% of respondents knew this statement was not true.  Contrary to popular belief, UVB protection from the sun’s burning rays does not actually increase proportionately with a designated SPF number. For example, an SPF of 30 screens 97 percent of UVB rays, whereas an SPF of 15 screens 93 percent of UVB rays, and an SPF of 2 screens 50 percent of UVB rays.

You can visit www.melanomamonday.org to take the Academy’s “Suntelligence” survey, as well as to find out how to perform a skin self-exam or find free skin cancer screenings in your area.

Parents want e-communications with their Kid’s Docs.

Health care reform legislation includes promoting electronic health records to improve the efficiency and quality of medical care. Yet, little attention has been paid to understanding whether parents have an interest in interacting with their children’s physicians in this way.

A new nationwide poll asked 1,612 parents about how they communicate with their children’s health care providers.  Results showed that less than 15% can currently access their physician on-line, although almost half would like to do so.

“Electronic communication between parents and their children’s health care providers offers a lot of potential benefits,” says Matthew Davis, M.D., associate professor of pediatrics and communicable diseases in the CHEAR Unit at the U-M Medical School. “For administrative tasks that almost all parents need to complete, electronic communication can reduce wasted time and minimize frustration for both parents and office staff. For clinical services, parents often have questions about whether minor injuries or illnesses require an office visit; electronic communication provides a way to obtain advice without waiting on hold for long periods of time.”

While having access to electronic methods of communicating with physicians may increase efficiency for parents, challenges exist for widespread adoption of online communication by physicians.

“Some health care providers have expressed concerns about reimbursement for electronic services that require staff time. Others worry about medical liability associated with offering clinical advice via e-mail or the Internet, without examining the patient,” says Davis.

What are your thoughts on this?  Word on Health is waiting to hear from you.

Working Too Much is Bad for Your Heart

According to a study just published in the European Heart Journal, working 3 to 4 extra hours a day is associated with increased risk for coronary heart disease (CHD).

More than 6,000 British government workers aged 39-61 with no evidence of heart disease at baseline were followed for an average of 11 years.  The outcome measures were fatal CHD, clinically verified non-fatal myocardial infarction or confirmed angina.

After adjustment for lifestyle, conventional cardiac risk factors, and other potential confounders, participants who worked 3 to 4 hours of overtime a day, beyond the standard 7–8 hours/day, faced a 60% increase in risk for CHD, compared with those who didn’t work any overtime.

Those who worked overtime for 1–2 hours/day did not show increased risk.

Word on Health would love to tell you more but our hearts are telling us it’s time to go!

New Way to Eliminate Source of Asthma?

U.S. researchers say they’ve found a way to eliminate the source of immune system molecules that cause asthma and other allergic diseases.

These soluble IgE moleclues are produced by immune cells called B cells. While targeting IgE in the blood is an effective treatment for moderate-to-severe allergic asthma, this approach doesn’t stop IgE production and patients require repeated treatments.

According to the May 10 edition of the Journal of Clinical Investigation, scientists from Genentech say they’ve developed a way to eliminate IgE-producing B cells.  This finding could potentially lead to new long-lasting treatments for asthma and other allergic diseases.  So far the method has only been tested in mice, where it proved highly effective.

Word on Health awaits the results of future studies in humans.

Barking your way to better health

Yes, we admit it!  We’ve watched the cute YouTube videos of cheetahs raising baboons and dogs feeding kittens. But so far we’ve resisted posting warm and fuzzy animal stories. However, when we heard that the world famous Mayo Clinic has just released its first children’s book featuring “Dr. Jack,” a miniature pinscher, we just had to share.

The 9 year old pooch is Mayo’s first facility-based service dog.  Escorted by his owner, Jack is part of the health care team that helps patients with physical activity, rehabilitation, and speech therapy. Mayo physicians place an order in a patient’s medical record when requesting a visit by Dr. Jack, who sees approximately eight to 10 patients per day. During his tenure at Mayo, Jack has helped more than 2,000 patients.

“In looking for ways to convey the Mayo Clinic model of care, we found a truly remarkable ambassador: a little dog named Jack,” says the book’s author Matt Dacy. “This book is the story of Mayo as told through the experience of Jack in a way that children can understand and adults and readers of all ages can appreciate.”

In the book, Dr. Jack wears an identification tag with the Mayo Clinics three shields -signifying clinical practice, education and research. When a young boy at Mayo Clinic meets Dr. Jack, he rubs his tag and the two go on an amazing tour of Mayo Clinic, including a helicopter ride on Mayo One.

“Why do we offer animal-assisted therapy? Because it works!” says Brent Bauer, M.D., Mayo Clinic Department of Complementary and Integrative Medicine. “Of course, almost every patient ‘feels’ better after a visit by a dog like Jack.  But scientific studies have shown this type of therapy can reduce pain in children, improve outcomes in adults hospitalized with heart failure, and reduce medication use in elderly patients.”

Your very own Word on Health blogger witnessed the miracle of pet power several years ago when visited by friends who brought along their mute, severely autistic 8 year old son. While the adults were enjoying dinner and adult beverages we suddenly heard a noise in the hallway. To his parents utter astonishment “Pedro” was lying on the floor telling elaborate stories to my 200lb Newfoundland dog. They were the first words they’d ever heard from him.

For those who’d like to learn more, there are numerous books on pet therapy.  In the meantime we’d love to hear your stories on how an animal has helped you, or someone you know, with illness.

FDA launches BadAd campaign

Stethoscope? Check. White Coat? Check. Whistle? Pardon!!!

Citing a limited ability to identify violative pharmaceutical advertising and promotional activities, the FDA has announced the launch of its “Bad Ad” Program.  The Program encourages health care prescribers to directly report false and / or misleading drug advertising, marketing materials and promotional activities to the FDA – specifically activities that:

• omit or downplay the risks of a drug
• overstate the effectiveness of a drug
• promote off-label uses
• compare drugs in a misleading manner

In addition  to asking doctors to whistle-blow on violations that occur during speaker programs, sales presentations, TV, radio & print advertisements, websites and print materials the FDA wants doctors to “monitor promotional activities that occur in private.”

FDA is particularly interested in what pharma reps say during sales calls, presentations, discussions at medical conferences, and in other face-to-face interactions.

Health care professionals who encounter suspect claims or activities are asked to notify the FDA’s Division of Drug Marketing, Advertising and Communications (DDMAC). As part of the program, the FDA will offer physicians training at medical conferences on how to identify misleading sales aides. In addition, the agency has simplified the reporting process which now includes a hotline and email address.  Submissions may be anonymous.

DDMAC enforcement activity has  risen dramatically over the past year, and the “Bad Ad” Program suggests that FDA hopes to take even more enforcement action in the future.  The issue of concern here is whether by directly engaging the help of doctors as informal enforcement agents, the FDA is creating an “us against them” culture – where “us” is FDA and doctors, and “them” is the pharmaceutical industry.

While Word on Health is all for marketing compliance we wonder if doctors will  answer the call.   Do they have the time to be on the  look-out for bad ads?  Will they want to engage in time consuming activities for which there is no reimbursement? And do they want to be seen as the “enforcers?”

But assuming they will, SRxA can help guide you through the complex world of marketing compliance. We can help you deliver non-violative information to physicians. Contact us today for more information.

The Doctor Won’t See You Now

Obtaining access to busy physicians grew more difficult for pharmaceutical representatives in 2009.

• The number of physicians willing to see most reps fell nearly 20%
• The number of prescribers refusing to see most reps increased by half
• The number of management-planned sales calls that were nearly impossible to complete topped 8 million.

These are among the findings of a report from global consulting firm ZS Associates that examined how often physicians and other prescribers will meet with sales representatives from pharmaceutical manufacturers.

The study monitored the sales rep-related interactions of more than 500,000 physicians, nurse practitioners and other pharmaceutical prescribers and tracked both the planned and completed sales calls of more than 41,000 pharmaceutical representatives — about half of all representatives in the United States.

According to the spring 2010 report only 58% of prescribers in 2009 were “rep-accessible”. This is down 18% from the previous year.  At the same time, the number of “rep-inaccessible” prescribers — those who saw fewer than 30 percent of the reps who called on them — increased from 6 to 9%.

The report noted that this trend reflects both the physician’s busier schedule and the pharmaceutical industry’s lack of new blockbuster drugs.  As a result, physicians are loath to see any but the most valuable pharmaceutical sales representatives.  Even those physicians classified as “rep-accessible” became more discriminating.  In this category, 94% of primary care providers and 83% of specialists did not see even the best representatives more than twice each month.

Based on these findings, the authors concluded that more than 8 million sales calls are nearly impossible.

“Pharmaceutical representatives are operating today in an increasingly unwelcome physician-office environment,” said principal author Chris Wright. “Certain prescribers simply won’t see pharmaceutical representatives and they won’t do it under any circumstances”.

This report clearly shows that pharmaceutical companies need to find an alternate way to get their messages to prescribers.  Contact SRxA to learn how we can help you achieve this.

Allergy Aid is just a click away

For many people the arrival of spring is a time for celebration marking, as it does, the end of winter and the coming of summer. But for the 50 million Americans with allergies, spring heralds the arrival of pollen and a long season of misery.  However, this year, there is hope.  The American Academy of Allergy, Asthma and Immunology (AAAAI) has teamed up with Rite Aid to bring help to allergy sufferers.

Visitors to www5.riteaid.com/health/allergies can:

• learn about allergens
• download a free allergy relief guide
• sign up for email, iTunes or cell phone alerts on daily pollen levels
• take advantage of rewards programs and savings on allergy products
• create a personal, customized guide for managing allergies

Rite Aid’s focus on allergy awareness is part of its yearlong commitment to health and wellness.

Additional resources for allergy sufferers can be found on the AAAAI website including an allergist locator, a pollen monitoring database and The Virtual Allergist, an interactive tool to help patients better understand their symptoms before consulting with a board-certified allergist.

Whether you suffer from allergies, treat allergy sufferers, or manufacture allergy relief products, SRxA’s Word on Health would love to hear your tips for coping with spring allergy season.