A Slippery Slope?

sledding 1As powerful blizzards hit the Midwest, leaving more than a foot of snow in parts of  Texas, Oklahoma, Illinois  and Missouri, many schools are closed leaving  kids to enjoy extended snow days, snowball fights, snowman building and maybe even some sledding.

But before heading to the hills, SRxA’s Word on Health wants to remind parents and children that although the adrenaline from speeding down an icy hill and feeling the snow spraying your face is hard to beat, serious injuries can also occur. While sledding has this connotation of innocence but you have to recognize that there is a potential for harm.

According to the CPSC (Consumer Products Safety Commission), each year there are more than 160,000 sledding, snow tubing and tobogganing-related injuries treated at hospital emergency rooms, doctors’ offices and clinics.

There are some hidden dangers to sledding. It’s a great winter pastime, but there are risks involved. Parents need to be aware of these risks to help prevent injuries,” says Terri Cappello, MD, pediatric orthopaedic surgeon at Loyola University Medical Center.

sledding 2In adults and older children extremity injuries such as broken fingers, wrists and ankles are the most common, while children aged 6 and under often suffer head and neck injuries. While some result in nothing more than minor concussion each year children suffer brain trauma, paralysis and even death as a result of sledding.

Over a 10 year period, the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio found an estimated 229,023 sledding injuries serious enough for ER treatment among children under 19. They also noted that:

  • 26% of the injuries were fractures
  • 25% were cuts and bruises
  • 51% of the injuries occurred during a collision
  • Collision injuries were most likely to result in traumatic brain injury
  • 34% of the injuries involved the head
  • 52% of the injuries occurred at a place of sports or recreation
  • 31% of injuries occurred on private property
  • 42.5% of injuries involved children aged 10 -14
  • 59.8% of all injuries were sustained by boys
  • 4.1% of all emergency department visits required hospitalization

sledding injuryParents don’t often think about putting a helmet on a child when they go sledding, but if the child is under the age of 6 it’s important. Also, never let your child sled head first. Injuries have been associated with the leading body part. If you lead with your head, you’re more likely to get a head injury,” warns Cappello.

Here’s a few more tips to keep kids safe while sledding:

  1. Adult supervision is critical. 41% of children injured while sledding are unsupervised. Ensure someone is there to assess the area and make sure it’s safe as well as to evaluate and respond should an injury occur.
  2. Make sure the hill is safe: that means a hill without obstacles in the sledding path, which doesn’t end near a street, parking lot, pond, or other danger
  3. Sledding should only be done in designated areas that are open, obstacle-free and groomed. Most injuries occur when a sled collides with a stationary object. Make sure there are no trees, poles, rocks, fences or cars in the sledding area.
  4. sled1Kids should be taught to be on the lookout for other sledders and to avoid collisions.
  5. Use helmets to avoid injuries and wear multiple layers of clothing for protection from injuries and cold
  6. Always sled feet first. Sledders should sit in a forward-facing position, steering with their feet.
  7. Use a sled that can steer—it’s safer than flat sheets, toboggans or snow discs

Stay safe in the snow!

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An Aspirin A Day…Takes Your Sight Away?

amdSRxA’s Word on Health has frequently reported on the health benefits of aspirin.  So we were more than a little shocked to read a new study in JAMA Internal Medicine which suggested that people who regularly use aspirin may be at increased risk of age-related macular degeneration [AMD].  This eye condition is common  among people age 50 and older and is a leading cause of vision loss in older adults.  AMD gradually destroys the macula, the part of the eye that provides the sharp, central vision needed for seeing objects clearly. 

age-related-macular-degeneration1In some people, AMD advances so slowly that vision loss does not occur for a long time. In others, the disorder progresses faster and may lead to a loss of vision in one or both eyes. The vision loss makes it difficult to recognize faces, drive a car, read, or do close work, such as sewing.

bayer low doseBut don’t go tossing out your Bayer’s just yet!

In this study, researchers at the University of Sydney looked at a large group of  people who took  daily low-dose aspirin as a preventive measure for cardiovascular disease.

Of nearly 2,400 elderly people studied over a 15-year period, 10% were regular aspirin users. Of that group, 25% developed  macular degeneration over that time frame, compared to 9% who developed it but were non-aspirin users.

While these results were statistically significant, more research needs to be done before  recommending that patients stop taking doctor recommended aspirin.   Despite their results, even the researchers admit that there’s just not enough evidence to support stopping aspirin therapy unless a person already has strong risk factors for age-related macular degeneration.

Ophthalmologist Justis Ehlers, MD, agrees, “Aspirin has clearly been shown to have good secondary prevention for different cardiovascular diseasesWe need to sort this out over time to see what it means.

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A Ray of Sunshine?

sunshineIt’s already 15 months overdue and it will be another year still before the information is public, but last week  the government  set out  the final rule for the Physician Payment Sunshine Act (Sunshine Act) in a 287 page document!

The Sunshine Act (passed in 2010 as part of the Affordable Care Act) requires manufacturers of drugs, devices, biologicals, and medical supplies to report all payments and other transfers of value to physicians and teaching hospitals. The rule was supposed to be published in October 2011, but has suffered continuous delays amongst intense lobbying both by groups keen to get the data in the public hands, such as the AARP, and those most affected by it, such as the American Medical Association (AMA).

The final rule announced February 1st, officially puts the Industry on notice. They have until March 2014 to get their payments reporting act together. The U.S. Centers for Medicare and Medicaid Services (CMS), will then input the data, including payment information from August through December of this year, into a publicly available database which, they say, will be online by September 2014.

doctor_bribes_0318And its not only payments to doctors of medicine that have to be reported. Under the definitions of the Act, “physicians” include doctors of osteopathy, dentists, podiatrists, optometrists and chiropractors.

The rule also requires reporting on both the form and nature of payment or transfer of value made by a manufacturer to a physician.

Forms of payment included under the final rule :

  • Cash or a cash equivalent
  • In-kind items or services
  • Stock, a stock option, or any other ownership interest, dividend, profit or other return on investment
  • Any other form of payment or transfer of value

While, nature of payments include:

  • Consulting fees
  • Compensation for services other than Consulting
  • Honoraria
  • Gifts
  • Entertainment
  • Food
  • Travel
  • Education
  • Research
  • Charitable contributions
  • Royalty or license
  • Current or prospective ownership or investment interest
  • Direct compensation for serving as faculty or as a Speaker for a medical education program
  • Grants
  • Any other payment

doctor + moneyAdvocates of the Sunshine Act have long argued that the public needs to know when doctors are getting paid and by who. “You should know when your doctor has a financial relationship with the companies that manufacture or supply the medicines or medical devices you may need,” said Peter Budetti, M.D. CMS deputy administrator for Program Integrity. “Disclosure of these relationships allows patients to have more informed discussions with their doctors.”

This increased transparency is also intended to help reduce the potential for conflicts of interest that physicians or teaching hospitals could face as a result of their relationships with manufacturers.

Relationships between doctors and drugmakers have been brought up in a number of cases when FDA advisory panels have ruled for or against drugs in which doctors had some interest. For example, last year an advisory panel voted 15-11 to support the approval of Bayer‘s Yaz birth control pills, but allegations later surfaced that four committee members had ties to the manufacturer.

Once the bill is introduced, doctors will get 45 days after information is submitted to vet it for accuracy.

physicians_relationship_with_pharma_companThe American Medical Association (AMA) is not happy.  The doctors’ group wants physicians to have more than 45 days to challenge information in the government’s database and add commentary to explain the payments. It also wants some corporate contributions to physicians excluded from disclosure, including sponsorships for educational activities and “indirect” payments, such as unsolicited contributions a company might make to a nonprofit group affiliated with doctors or to physicians’ employers or practices.

AMA president Jeremy Lazarus wants to ensure “the registries will provide a meaningful and accurate picture of physician-industry interactions. It is critical that the final rule provide physicians with a clear way to correct any inaccurate information and not place any substantial administrative burden on physician practices.”

And the AMA is not alone. Unsurprisingly, the Pharmaceutical Research and Manufacturers of America (PhRMA), the primary lobbying group for drugmakers, said that while it supports more disclosure, the new regulations should take into account the importance of context in the publication of physician payment information.

Ethical interactions between biopharmaceutical companies and health-care professionals are essential to maintaining patient trust,” said Matthew Bennett, a spokesman for PhRMA. The principle behind the so-called sunshine provision “is complementary to this belief and it has great potential for helping patients understand the ways in which such collaboration benefits their health and medical innovation,”

What’s your take on this new rule? Is the government helping to let the sun shine in or is this a dark, dark day for doctors and pharma?  Let us know your thoughts.

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DNA in a Twist?

dna structureWhat does DNA look like? Ask anybody who’s studied biology over the last 50 years and they’ll instantly tell you about its double helix structure.  A few might also remember that it consists of a twisting ladder of base pairs constructed of adenine coupled with thymine and cytosine with guanine . (A, T, C, G)

The now-ubiquitous double-helix structure was first published in the journal Nature in 1953 by scientists James Watson and Francis Crick from the University of Cambridge. In 1962, the pair were awarded The Nobel Prize in Physiology or Medicine “for their discoveries concerning the molecular structure of nucleic acids and its significance for information transfer in living material”.

Now, nearly 60 years later, scientists from the same institution have published a paper in the same journal, but their results suggest that there may be more to the structure of DNA than their predecessors thought.

quadruple-helixThe new study  presents evidence that some human DNA may actually have four strands instead of two. There is also evidence that the quadruple helix may be linked to cancer.

Researchers have been searching for quadruple-helix DNA for the better part of a decade. They knew such structures existed in microscopic ciliates, but had never observed them in humans. However, by building antibodies that bind to the four-stranded structure, the Cambridge team was finally able to pin down the existence of the quadruple helix in human DNA and pinpoint its location on individual chromosomes.

The quadruple helix forms in the presence of unusually high levels of guanine.  They also found that it forms during the phase of DNA replication when the genetic material is being copied, and that the number of quadruple-helices increased with each replication. The growth is somewhat similar to that of cancer, which alters the genetic code to increase DNA replication and cause tumor growth.

Understanding the helix’s structure and function may well be key to solidifying its association with cancer. If proven true, researchers may one day treat the disease by making structure-specific antibodies to block the replication response that causes tumors.

Now that’s worth getting ourselves in a twist about!

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Super-Sized Super-Bowl!

Superbowl-2013If you’re going to be in America this weekend, chances are you will be glued to the Super Bowl on Sunday night. Whether you’re tuning in as a fan of the 49ers, to rave for the Ravens, or even just to catch the commercials, this television and sporting extravaganza will probably be accompanied by food.  Lots and lots of food.

That’s right!  The “Big Game” has become much more than football. Aside from the multi-million dollar ads, it’s also the second biggest day for food consumption in the United States after Thanksgiving.

But before you dive into the dip or start piling on the pizza, you may want to take note of the following exercise equivalents you’d have to do to burn off your favorite football foods. nachos

According to Charles Platkin, PhD, MPH, editor of DietDetective.com and Distinguished Lecturer at the CUNY School of Public Health:

A handful of pita chips accompanied by artichoke dip = running the length of 141 football fields

Each chip is 13 calories, and each tablespoon of dip adds another 80 or more calories. 

Two slices of Dominos Bacon Cheeseburger Pizza = 209 minutes of performing in a marching band

Each slice weighs in at a staggering 490 calories

Four Dominos stuffed cheesy bacon and jalapeno breadsticks = 193 Touchdown Dances in the end zone

At 160 calories a piece, those four little breadsticks add up to a whopping 640 calories

One Sloppy Joe = 59 minutes of stadium stair climbing

This is a Tex-Mex creation that includes fatty ground beef, sugar, ketchup, flour and bread runs at over 500 . Sloppy Joes have more than 500 calories a time.

buffalo wingsSix Buffalo Wild Wings with ranch dressing = doing “the wave” 6,480 times

Six wings from Buffalo Wild Wings have 990 calories. Adding a small dip of dressing per wing adds on another 340 calories – taking this game day favorite to 1,330 calories.

Two handfuls of Cheetos Jumbo Puffs = 30 minutes of playing professional football

Each 2 ounce handful is equivalent to about 320 calories. To burn this off you’d actually have to be playing the game for 30 minutes rather than watching it. The only problem with this, according to The Wall Street Journal, is there are only about 11 minutes of actual ball playing in a football game. That means you would need to play almost three games of professional football to burn off the two handfuls


Outback Baby Back Ribs = 123 minutes of team practice and conditioning

A full order of Outback Baby Back ribs is 1,156 calories, thanks to the fatty meat and sugary sauce.

Three 12oz Pepsi’s = 57 minutes of dancing to Beyonce’s half-time performance

Each 12-ounce can equals 100 calories. When’s the last time you danced for an hour straight?

So, to make sure your next game isn’t an appearance on The Biggest Loser, snack smart and think before you super-size your super-bowl.

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