Friday, June 24, 2016

Health Care and Tetanus

One of the most painful medical conditions you can get is tetanus. Also known as lockjaw, tetanus is an infection characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. These spasms usually last a few minutes each time and occur frequently for three to four weeks.

According to the Mayo Clinic, tetanus is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and can threaten your life. Thanks to the tetanus vaccine, cases of tetanus are rare in the United States and other parts of the developed world. However, the disease remains a threat to those who aren't up to date on their vaccinations, and is more common in developing countries. There's no cure for tetanus. Treatment focuses on managing complications until the effects of the tetanus toxin resolve.

See your doctor for a tetanus booster shot if you have a deep or dirty wound and you haven't had a booster shot in five years. If you aren't sure of when your last booster was, get a booster. Or, see your family physician about a tetanus booster for any wound — especially if it might have been contaminated with dirt, animal feces or manure — if you haven't had a booster shot within the past ten years or aren't sure of when you were last vaccinated. Much more detailed info is available at this website: http://www.mayoclinic.org/diseases-conditions/tetanus/home/ovc-20200456 .

The Clostridium bacteria live in soil, saliva, dust, and manure. The bacteria can enter the body through a deep cut, like those you might get from stepping on a nail, or through a burn, according to the National Institutes for Health (NIH). In the US, where 50 or fewer cases of tetanus occur each year, deaths are more likely to occur in persons 60 years of age and older and in persons who are diabetic. More material on tetanus is available at these two websites: https://www.nlm.nih.gov/medlineplus/tetanus.html , and http://www.adultvaccination.org/tetanus_vaccine_vaccination_adult_immunizations.htm .

According to Nemours, Once the bacteria are in the body, they produce a neurotoxin (a protein that acts as a poison to the body's nervous system) that causes muscle spasms. The toxin can travel throughout the body via the bloodstream and lymph system. As it circulates more widely, the toxin interferes with the normal activity of nerves throughout the body, leading to generalized muscle spasms. Spasms can be so forceful that they tear muscles or even cause spine fractures. Without treatment, tetanus can be fatal.

In the United States, most cases of tetanus follow a contaminated cut or deep puncture injury, such as a wound caused by stepping on a nail. Sometimes the injury is so small the person never even sees a doctor. Injuries that involve dead skin (such as burns, frostbite, gangrene, or crush injuries) are more likely to cause tetanus. Wounds contaminated with soil, saliva, or feces — especially if not properly cleaned — and skin punctures from non-sterile needles (such as with drug use or self-performed tattooing or body piercing) are also at increased risk.

Another form of tetanus, neonatal tetanus, occurs in newborns who are delivered in unsanitary conditions, especially if the umbilical cord stump becomes contaminated. Prior to immunizations, neonatal tetanus was much more common in the United States. Now, routine immunizations for tetanus produce antibodies that mothers pass to their unborn babies. These maternal antibodies and sanitary cord-care techniques have made newborn tetanus very rare in developed countries. Much more information is available at this site: http://kidshealth.org/en/parents/tetanus.html .

Tetanus leads to death in about 1 in 10 cases. Several vaccines are used to prevent tetanus among children, adolescents, and adults including DTaP, Tdap, DT, and Td, according to the Centers for Disease Control (CDC). The Advisory Committee on Immunization Practices (ACIP) recommends 5 doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine for infants and children. One dose of DTaP vaccine is recommended at each of the following ages: 2 months, 4 months, 6 months, 15 through 18 months, 4 through 6 years old. DTaP vaccine may be given at the same time as other vaccines.

Some children should not get DTaP vaccine or should wait:
·         Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine.
·         Any child who had a life-threatening allergic reaction after a dose of DTaP should not get another dose.
·         Any child who suffered a brain or nervous system disease within 7 days after a dose of DTaP should not get another dose.

According to the CDC, you should talk with your doctor if your child:
·         Had a seizure or collapsed after a dose of DTaP
·         Cried non-stop for 3 hours or more after a dose of DTaP
·         Had a fever over 105 degrees Fahrenheit after a dose of DTaP.

Ask your health care provider for more information. Some of these children should not get another dose of pertussis vaccine, but may get a vaccine without pertussis, called DT. DTaP should not be given to anyone 7 years of age or older. Much more info is available at this website: http://www.cdc.gov/vaccines/vpd-vac/tetanus/ .

According to the National Vaccine Information Center, tetanus bacteria do not survive in the presence of oxygen, which is why puncture wounds, which do not bleed very much and are protected by tissue and skin from direct exposure to the air, are a perfect environment for tetanus bacteria to multiply and cause infection. The incubation period for tetanus infection, from time of exposure to appearance of the first symptoms, can be three days to three weeks.

From 1972 to 2001, 52% of all tetanus cases reported in the U.S., and 76% of all deaths from tetanus were in persons over age 65. From 1987 to 2008, persons with diabetes accounted for 13% of all reported tetanus cases and 29% of all tetanus deaths. Intravenous drug abusers accounted for 15% of all cases during that time period. In 2009 there were 19 tetanus cases reported with two related deaths.

Vaccination is not completely foolproof and can cause some serious side effects in certain cases. The good news is that cases of tetanus have been vastly reduced over the last few decades. The bad news is that there have been some serious repercussions in a very small percentage of the overall population:

·         As of September 1, 2015, there had been 5,277 claims filed in the federal Vaccine Injury Compensation Program (VICP) for injuries and deaths following vaccination with tetanus or tetanus-containing vaccines combined with diphtheria vaccine, including 842 deaths and 4,344 serious injuries.

·         Using the MedAlerts search engine, as of September 30, 2015 there had been 22,686 serious adverse events reported to the Vaccine Adverse Events Reporting System (VAERS) in connection with tetanus and tetanus-containing vaccines combined with diphtheria vaccine since 1990.

·         Over 70%  of those serious tetanus vaccine-related adverse events occurring in children six years old and under. Of these tetanus-vaccine related adverse event reports to VAERS, 2,678 were deaths, with over 90% of the deaths occurring in children under six years of age.

Currently, there are 15 different tetanus-containing vaccines manufactured by various drug companies, which are licensed in the U.S.  More detailed material about tetanus is available at this website: http://www.nvic.org/Vaccines-and-Diseases/Tetanus.aspx .

Tetanus is a serious medical condition and should be treated as a deadly healthcare situation. Do not go without vaccination, but see your pediatrician or family medical practitioner to talk about all the available options and what they recommend as the best course of action for you and your family. Although all vaccinations carry some risk, the risk of going without preventive care is even greater. Talk with your doctor whenever you have any questions about tetanus.


Until next time.

Tuesday, May 31, 2016

Health Care and Inflammation

Do you ever suffer from joint pain or other maladies caused by inflammation? It’s more common than you may think. Inflammation is typically defined as a localized physical condition in which part of the body becomes reddened, swollen, hot, and often painful, especially as a reaction to injury or infection.

According to LiveScience, inflammation is a vital part of the body's immune response. It is the body's attempt to heal itself after an injury; defend itself against foreign invaders, such as viruses and bacteria; and repair damaged tissue. Without inflammation, wounds would fester and infections could become deadly. 

Inflammation can also be problematic, though, and it plays a role in some chronic diseases. Inflammation is often characterized by redness, swelling, warmth, and sometimes pain and some immobility. Much more detailed information is located at this website: http://www.livescience.com/52344-inflammation.html .

In a delicate balance of give-and-take, inflammation begins when pro-inflammatory hormones in your body call out for your white blood cells to come and clear out infection and damaged tissue, according to WomenToWomen. These agents are matched by equally powerful, closely related anti-inflammatory compounds, which move in once the threat is neutralized to begin the healing process.

Acute inflammation that ebbs and flows as needed signifies a well-balanced immune system. But symptoms of inflammation that don’t recede are telling you that the “on” switch to your immune system is stuck. It’s poised on high alert — even when you aren’t in imminent danger. In some cases, what started as a healthy mechanism, like building scar tissue or swelling, just won’t shut off. More material about inflammation is available at this website: https://www.womentowomen.com/inflammation/causes-of-inflammation/ .

According to Prevention Magazine, scientists refer to the immune response gone rogue as chronic inflammation and have identified it as a contributor to a wide range of conditions, including heart disease, asthma, and joint pain. Since studies started making these links in the early 2000s, the term inflammation has become somewhat of a buzzword, bandied about by health nuts and doctors alike.

Some physicians consider it such an important predictor of poor health that they monitor patients' blood for a marker of inflammation, called C-reactive protein, as part of a standard workup. This testing is still uncommon, and it's somewhat controversial, but more and more doctors are adjusting to the idea of quantifying how sick is their patient…really. One hundred million Americans suffer from chronic pain, and they deal with it day after day with no clear fix. Twenty-one million have depression, and for many of them, medication and therapy help only so much.

Meanwhile, scientists are still exploring what inflammation is and how it might be responsible for so many health problems like depression and depression symptoms. Much more detail on the connection between inflammation and depression is located at this site: http://www.prevention.com/health/health-concerns/ .

Inflammation has become a medical hot topic, according to Women’s Health Magazine. More and more research shows that chronic inflammation is involved in heavy-hitting illnesses like the following:
·         Cancer
·         Heart disease
·         Diabetes
·         Depression
·         Allergies

It all starts with the immune system, the body's first line of defense against any kind of harm. When you're injured or sick, your bone marrow dispatches veritable SWAT teams of white blood cells to root out infection and jump-start the healing process. Sometimes, however, the immune system gets a faulty distress signal and deploys an unnecessary first-aid squad. Those misguided white blood cells still mobilize just like they would if you were actually under the weather, but because there's no infection for them to attack, they end up just hanging around, often for a long, long time.

However, the problem is that your body isn't made to accommodate this kind of unfocused immune activity, and eventually those white blood cells can start damaging your internal organs. They can also needlessly assault other cells the body routinely uses to push off disease, leaving the door cracked open for illnesses such as cancer. More information on inflammation is located at this website: http://www.womenshealthmag.com/health/chronic-inflammation .

For centuries, scientists have debated whether inflammation is good or bad for you, according to New Yorker Magazine. Now they believe that it’s both: too little, and microbes fester and spread in the body, or wounds fail to heal; too much, and nearby healthy tissue can be degraded or destroyed. The fire of inflammation must be tightly controlled—turned on at the right moment and, just as critically, turned off.

Understanding and controlling inflammation has become a central goal of modern medical investigation. The internal research arm of the National Institutes of Health recently designated inflammation a priority, mobilizing several hundred scientists and hundreds of millions of dollars to better define its role in health and disease. More detailed material about this topic is available at this site: http://www.newyorker.com/magazine/2015/11/30/inflamed .

According to BodyEcology, there are many reasons why you may suffer from inflammation:
·         Chronic low-grade food allergies or food sensitivities that may cause a few symptoms.
·         An imbalance of bacteria and fungi in your gastrointestinal tract, also known as dysbiosis. This causes your immune system to overreact to bacteria in your gut and can be without notable symptoms.
·         Stress! Constant psychological, emotional or physical stress raises the level of cortisol, creating inflammation.
·         Environmental toxicity from air, water, food pollutants and toxic metals like mercury and lead all contribute to inflammation and have been linked to diseases as varied as endometriosis and cancer.
·         Diet and lifestyle: too much fat, sugar, and protein in your diet, constant dehydration, consumption of too many sodas or caffeine, inactivity, and lack of sleep can all increase inflammation in your body.

If you reduce inflammation in your body, you'll not only look and feel younger, but you'll significantly lower your risk for chronic disease. More info on this subject is located at this site: http://bodyecology.com/articles/inflammation_cause_of_disease_how_to_prevent.php .

According to Mercola, the presence of inflammation is what makes most disease perceptible to an individual. It can and often does occur for years before it exists at levels sufficient to be apparent or clinically significant. How long it has been smoldering really determines the degree of severity of a disease and often the prognosis assuming the inflammation can be controlled.

Inflammation is rampant. In fact 1 in 12 women and 1 in 24 men are dealing with full blown autoimmune mediated inflammation. The number of undiagnosed people is going to be much higher. People with inflammation in the early phases of autoimmunity will often claim no dietary involvement. This is an inaccurate assumption however because the autoimmunity is often triggered by factors not strictly related to diet and the diet can become a secondary trigger later in the development of the condition.

If you are dealing with inflammation, then get a comprehensive professional medical evaluation to look at what is perpetuating your personal situation. More information is located at this website: http://articles.mercola.com/sites/articles/archive/2013/03/07/inflammation-triggers-disease-symptoms.aspx .

Inflammation can be good for you when it’s controlled. When it is out of control, then your natural healing process needs help. See your doctor in cases of acute or ongoing inflammation, and recognize the symptoms of how your personal situation have developed. Diagnosis and treatment in a timely manner are worth the time and effort to discover the cause and possible options for your own healthcare when you suffer from inflammation.


Until next time.

Thursday, May 26, 2016

Health Care and Lithotripsy

When a kidney stone gets too big to pass in the urinary tract system, trying to migrate from the kidney to the bladder, your doctor or urologist may suggest a procedure known as a lithotripsy. Surgery was the only method to remove stones too large to pass until lithotripsy was developed and replaced it as the most frequent treatment beginning in the 1980s.

The introduction of lithotripsy in the early 1980s revolutionized the treatment of patients with kidney stone disease, according to Johns Hopkins Medicine. Patients who once required major surgery to remove their stones could be treated with lithotripsy, and not even require an incision. As such, lithotripsy is the only non-invasive treatment for kidney stones, meaning no incision or internal telescopic device is required. More information is available at this website: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/urology/lithotripsy_92,p07720/ .

Kidney stones occur when minerals and other substances in the blood crystallize in the kidneys, forming solid masses (stones). Stones may consist of small, sharp-edged crystals, or smoother, heavier formations that resemble polished river rocks. They usually exit the body naturally during urination, according to Healthline.

However, sometimes the body can’t pass larger formations through urination. This can lead to kidney damage. People with kidney stones may experience bleeding, severe pain, or urinary tract infections. When stones begin to cause these types of problems, your doctor may suggest lithotripsy. More info about lithotripsy is located at this site: http://www.healthline.com/health/lithotripsy#Overview1 .

According to the National Kidney Foundation, extracorporeal shock wave lithotripsy (ESWL) is a technique for treating stones in the kidney and ureter that does not require surgery. Instead, high energy shock waves are passed through the body and used to break stones into pieces as small as grains of sand. Because of their small size, these pieces can pass more easily from the body along with the urine.

There are two ways to remove stones using shock wave treatment. In one method, the patient is placed in a tub of lukewarm water. Using x-rays or ultrasound to pinpoint the location of the stones, the body is positioned so that the stones are targeted precisely. In the second, more common method, the patient lies on top of a soft cushion or membrane through which the waves pass. About 1-2 thousand shock waves are needed to crush the stones. The complete treatment takes about 45 to 60 minutes. Much more detail about this process is located at this website: https://www.kidney.org/atoz/content/lithotripsy .

ESWL is usually an outpatient procedure, according to Healthwise. You go home after the treatment and do not have to spend a night in the hospital. After ESWL, stone fragments usually pass in the urine for a few days and cause mild pain. If you have a larger stone, you may need more ESWL or other treatments. ESWL may be used on a person who has a kidney stone that is causing pain or blocking the flow of urine.

Stones that are between 4 mm (0.16 in.) and 2 cm (0.8 in.) in diameter are most likely to be treated with ESWL. ESWL may work best for kidney stones in the kidney or in the part of the ureter close to the kidney. Your surgeon may try to push the stone back into the kidney with a small instrument (ureteroscope) and then use ESWL. More info is available at this site: http://www.webmd.com/kidney-stones/extracorporeal-shock-wave-lithotripsy-eswl-for-kidney-stones .

As with any medical procedure, there are always inherent risks to patients. According to the American Urological Association, although manifestations of chronic injury have been identified, it seems likely that the full spectrum of long-term injury—the form and severity of chronic adverse effects—has yet to be determined. It is intuitive that chronic effects derive from acute tissue damage, but very little is known about the progression of tissue changes that link the two.

There is also limited information about treatment dose and the development of chronic effects and whether specific risk factors exist that predispose an individual to long-term effects. Much more clinical data and research is available at this site: https://www.auanet.org/education/guidelines/shock-wave-lithotripsy.cfm .

According to the University of Florida Medical Center, here are some post surgery symptoms you may experience after going through lithotripsy:

·         Flank Pain: Most patients experience some degree of discomfort for a day or two after ESWL. The pain is usually described as a dull ache or soreness over the kidney or flank area, and is typically at its worst the evening following surgery. The pain lessens over the following days.

·         Blood in Urine: It is normal to see visible blood in the urine for days to several weeks after surgery. It is important during this time of bleeding that you avoid strenuous activity, blood thinning medications, and drink plenty of fluid.

·         Fevers: Low grade fevers are not uncommon following any surgical procedure and anesthesia. If you have fevers >101o F, please notify your surgeon and ask to be connected to the urologist on call.

There are some patients who are not suited to undergo lithotripsy. Patients who are pregnant, have active urinary infection, obstruction of the kidney or are on blood thinning medications that cannot be discontinued are not ideal candidates for ESWL treatment. Patients with particular known stone composition including cystine and certain types of calcium phosphate stones are not ideal candidates as these stone types may not fragment well with ESWL due to their dense nature. Much more detailed material is available at this website: http://urology.ufl.edu/patient-care/stone-disease/procedures/extracorporeal-shock-wave-lithotripsy-eswl/ .

If your child needs this procedure, follow the directions of your child’s doctor and nurse for caring for your child at home after the treatment. According to AboutKidsHealth, they will usually instruct that your child:
·         Drink plenty of fluids, especially water.
·         Change their diet, if needed.
·         Take medication to manage pain and nausea.
·         Get plenty of rest.

If your child is toilet trained, your child’s doctor or nurse may also instruct you to strain your child’s urine for several days and will explain how to do this. Straining the urine will enable you to collect any stone particles so that they can be analyzed in a laboratory. Your child’s doctor will use the information about the make-up of the stone to monitor your child and make recommendations (such as changes in diet) to prevent the kidney stones from recurring. A lot of additional material on this healthcare subject is located at this site: http://www.aboutkidshealth.ca/En/HealthAZ/TestsAndTreatments/Procedures/Pages/shock-wave-lithotripsy.aspx .

Kidney stones are very painful, and those that don’t pass easily are even worse. As one option for treatment, lithotripsy has its merits in spite of the associated risks. However, if your family has a history of kidney stones, you may possibly encounter this situation at some point. Educate yourself on how to deal with the medical options, the procedure, and its outcome.


Until next time.

Monday, May 16, 2016

Health Care and Dehydration

When your body doesn’t have enough fluid to maintain its equilibrium to sustain itself, you may be suffering from dehydration. According to osteopathic physician, Dr. Joseph Mercola, your body requires water to work well. In fact, up to 60 percent of your entire body is made of water, 83 percent of your lungs is water and 73 percent of your brain and heart are composed of water. Water is very important to your ability to function, think, breathe and live. More information is found at this website: http://articles.mercola.com/sites/articles/archive/2016/05/14/urine-dehydration.aspx#_edn1

Summertime means outdoor activities, prolonged exposure to the sun, and excessive sweating—all of which can lead to dehydration, according to Medicine in Motion. Although dehydration can happen any time of the year, the summer months are of particular concern because of the higher temperatures. When a person has lost more than two percent of their body weight during activity, they are considered to be dehydrated.

The best way to battle dehydration, of course, is to drink lots of water or sports drinks before, during and after any intense physical activity or prolonged exposure to hot temperatures. If ignored, dehydration can lead to other problems such as heat exhaustion, muscle cramps, fatigue or even heat stroke. More information is located at this site: http://www.newson6.com/story/31979569/austin-sports-medicine-practice-provides-warning-signs-and-life-saving-tips-for-dehydration .

Fluid concentration does not have to experience a major change before dehydration can occur. Dehydration is mostly caused by fever, serious sweating (after an intense workout, especially in summers), and diarrhea. Dehydration can occur in any age group, but it is most common in young children and older adults. The signs and symptoms of dehydration can be mild or severe. The good news is that your body will notify you if you are getting dehydrated. More details are available at this website: http://fatalsymptoms.com/10-symptoms-of-dehydration/?gclid=CL621JfU3swCFZCIaQod4NEBbg .

According to the Mayo Clinic, mild to moderate dehydration is likely to cause the following symptoms:
·         Dry, sticky mouth
·         Sleepiness or tiredness — children are likely to be less active than usual
·         Thirst
·         Decreased urine output
·         No wet diapers for three hours for infants
·         Few or no tears when crying
·         Dry skin
·         Headache
·         Constipation
·         Dizziness or lightheadedness

The Mayo Clinic also reports that severe dehydration, a medical emergency, can cause these symptoms:
·         Extreme thirst
·         Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults
·         Very dry mouth, skin and mucous membranes
·         Little or no urination — any urine that is produced will be darker than normal
·         Sunken eyes
·         Shriveled and dry skin that lacks elasticity and doesn't "bounce back" when pinched into a fold
·         In infants, sunken fontanels — the soft spots on the top of a baby's head
·         Low blood pressure
·         Rapid heartbeat
·         Rapid breathing
·         No tears when crying
·         Fever
·         In the most serious cases, delirium or unconsciousness

Unfortunately, thirst isn't always a reliable gauge of the body's need for water, especially in children and older adults. A better indicator is the color of your urine: Clear or light-colored urine means you're well hydrated, whereas a dark yellow or amber color usually signals dehydration. More details about this health care issue are located at this site: http://www.mayoclinic.org/diseases-conditions/dehydration/basics/symptoms/con-20030056 .

According to the New York Times, there are some ways to help prevent dehydration:
·         Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising.
·         If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults.
·         Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration.
·         If you think you or someone in your family may become dehydrated, call your health care provider. Do this before the person becomes dehydrated.

For more severe dehydration or heat emergency, you may need to stay in a hospital and receive fluid through a vein (IV). Your health care provider will also treat the cause of the dehydration. Dehydration caused by a stomach virus should get better on its own after a few days. More information is available at this website: http://www.nytimes.com/health/guides/disease/dehydration/overview.html .

According to Everyday Health, when it comes to total water intake, which includes water gained from foods and other beverages like tea and milk, the  Institute of Medicine recommends that most women get about 2.7 liters of water a day (or about 12 cups), and most men get about 3.7 liters a day (or about 15 cups). Much more detailed information is available at this site: http://www.everydayhealth.com/news/unusual-signs-of-dehydration/ .

According to Merck Manuals, seniors are more susceptible to dehydration.  In older people, common causes of dehydration include the following:
·         Confusion
·         Disorders that make obtaining fluids difficult (usually because of restricted mobility)

Additionally, older people sense thirst more slowly and less intensely than younger people do, so even those who are otherwise well may not drink enough fluids. Seniors usually have a higher percentage of body fat. Because fat tissue contains less water than lean tissue, the total amount of water in the body tends to decrease with age. More detailed material is available at this website: http://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/water-balance/dehydration .

Children are especially prone to dehydration. Be alert for the warning signs of dehydration in children, and notify the pediatrician immediately if any of them develop. More info is located at this site: https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/dehydration.aspx .

Should you be concerned about dehydration during pregnancy? According to the American Pregnancy Association, the answer is YES. Dehydration is the result of your body losing water faster than you are taking it in. It is a serious issue for the health and wellness of anyone, but for pregnant women, it is especially important to stay well-hydrated.

Pregnant women need more water than the average person, since water plays an important role in the healthy development of your baby. Water helps to form the placenta, which is what a baby relies on to receive nutrients during pregnancy. Water is also used to form the amniotic sac later in pregnancy. Therefore, it is important to avoid dehydration during pregnancy. More information on this topic is located at this site: http://americanpregnancy.org/pregnancy-complications/dehydration-pregnancy/ .

Dehydration can be prevented if common sense safety precautions are observed. Don’t let yourself or someone you know lose too much fluid without replacing it right away. Dehydration can happen quickly and unexpectedly. It pays to know the symptoms and how to react when you suffer the symptoms.


Until next time.

Tuesday, April 26, 2016

Health Care and Endocrinology

You may have heard the word Endocrinology used in a sentence by a health care professional, like your family physician or someone that has had to visit an endocrinologist, but not really know what it is or what part of your body is the primary focus for this type of medical need. is a specialty of medicine; some would say a sub-specialty of internal medicine, which deals with the diagnosis and treatment of diseases related to hormones.

Endocrinology also focuses on the endocrine glands and tissues that secrete hormones, and it is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental events proliferation, growth, and differentiation, and the psychological or behavioral activities of metabolism, growth and development, tissue function, sleep, digestion, respiration, excretion, mood, stress, lactation, movement, reproduction, and sensory perception caused by hormones.

From a clinical and research perspective, the Endocrine Society (100 years old this year) does a significant amount of scientific study about this particular field of medicine. The Society offers scientific statements to educate basic scientists, clinical scientists, and clinicians on the scientific basis of disease and its application to the practice of medicine with regard to both prevention and management.

Scientific statements provide an overview of basic and clinical science content on topics of emerging importance. Content is evidence-based to the extent possible but also identifies areas of basic or clinical knowledge that require additional research. Topics are selected on the basis of their emerging scientific impact on disease and broad clinical relevance to the general population. Much more detailed material is located at this website: http://www.endocrine.org/about-us .

According to the Society for Endocrinology, at its simplest, a hormone is a chemical messenger from one cell (or group of cells) to another. Hormones are released in the body and have an effect on other parts of the body. The effect is to communicate with other distant parts of the body. So for example, the adrenal glands may secrete adrenalin, which has an effect on several different organs. An endocrine gland is a gland which secretes hormones. Not all glands are classified as endocrine glands. For example, sweat glands or lymph glands are not endocrine glands).

Hormones are found in all organisms with more than one cell, and so they are found in plants and animals. They influence or control a wide range of physiological activities, such as growth, development, puberty, level of alertness, sugar regulation and appetite, bone growth and other bodily functions. You also find that problems with hormones and the way they work contribute to some of the major diseases of mankind; for example, diabetes, thyroid conditions, pituitary conditions, some sexual problems, some neurological problems, appetite and obesity, bone problems, cancer, and more. Additional info is found at this site: http://www.endocrinology.org/ .

The Journal of Endocrinology is a leading global journal, available through the Society of Endocrinology, that publishes original research articles, reviews and science guidelines. Its focus is on endocrine physiology and metabolism, including hormone secretion; hormone action; biological effects. The journal publishes basic and translational studies at the organ, tissue and whole organism level. You can find more information at this site: http://joe.endocrinology-journals.org/  

The American Association of Clinical Endocrinologists (AACE), founded in 1991, now has over 7,000 members who work together as a professional community of physicians specializing in endocrinology, diabetes, and metabolism committed to enhancing the ability of its members to provide the highest quality of patient care. Their website has significant information on the study of endocrinology and provides a detailed list of definitions for anyone seeking to know more about this type of medicine. More info can be found at this website: https://www.aace.com/about/mission .

On a more detailed basis, according to the American College of Physicians, endocrinologists are frequently involved with the diagnosis and management of these health care problems:
·         Hypothalamic disorders (abnormal sodium and water balance)
·         Pituitary diseases (tumors, over- or underproduction of pituitary hormones)
·         Parathyroid abnormalities (hypercalcemia, hypocalcemia)
·         Thyroid diseases (hyperthyroidism, hypothyroidism, goiter, nodules)
·         Adrenal cortex dysfunction (mineralcorticoid, glucocorticoid, sex hormone abnormalities)
·         Gonadal disease (hypogonadism and reproductive disorders)
·         Pancreatic endocrine disease (diabetes mellitus)
·         Bone metabolism (osteoporosis)
·         Lipid metabolism
·         Iatrogenic effect of glucocorticoids

Training in endocrinology includes two years of additional training following successful completion of a basic internal medicine residency training program. More details are found at this website: https://www.acponline.org/about-acp/about-internal-medicine/internal-medicine-subspecialties/endocrinology-diabetes-and-metabolism .

An additional materials resource is this site: http://www.nature.com/nrendo/index.html , where you can find detailed scholarly journals and research information about endocrinology. And, Healio online has some very good materials about this type of medicine: http://www.healio.com/endocrinology .

There are many good hospitals and health care organizations in the US that have special sections and staff allocated to the study of endocrinology. One of them is Children’s Hospital of Dallas, and you can find more details about their treatment options at this site: https://www.childrens.com/specialties-services/specialty-centers-and-programs/endocrinology .

Another great location for treatment, especially for adults who need specialty care, is located at the University of Chicago Department of Medicine. Their 3-fold mission: (1) to provide excellence in patient care; (2) to perform cutting-edge basic, clinical and translational research in endocrine diseases, diabetes, obesity and hypertension; and (3) to provide outstanding educational opportunities for medical students, house staff and fellows. More information is located at this site: http://medicine.uchicago.edu/endo/index.html .

Hormones are a huge part of what makes your body tick. Endocrinologists are medical specialists that can help determine what may be out of whack if you are experiencing symptoms or medical issues that need more detailed study and care. Talk with your doctor or a medical professional who can assist you in getting the quality of care you need for any problems dealing with hormonal imbalances. It’s worth your time.


Until next time. 

Friday, April 8, 2016

Health Care and Data Breaches

This blog post is my 500th article!!! 

One of the most critical issues in the healthcare field today, for medical providers and facilities and for consumers, is the breach of personal health care information. The theft of personal medical records is big money on the black market, and ID theft due to that crime is rampant.

According to Modern Healthcare magazine, 2016 is being deemed the “year of data security” in healthcare—if only because 2015 was a substantial wake-up call for the industry. Nearly 90 percent of healthcare providers have been hit by data breaches in the last two years, according to security research firm Ponemon Institute, with many large-scale and criminally driven attacks publicized in 2015. More details are located at this website: http://www.modernhealthcare.com/article/20160227/SPONSORED/160229900/2016-the-year-of-data-security

HIT Consultant reports that one in three Americans were victims of healthcare data breaches in 2015, attributed to a series of large-scale attacks that each affected more than 10 million individuals. These and other statistics are contained in Bitglass’ 2016 Healthcare Breach Report.

Among the most significant findings of the report was that in 2015, 98 percent of record leaks were due to large-scale breaches targeting the healthcare industry. These high-profile attacks were the largest source of healthcare data loss and indicate that cyber attackers are increasingly targeting medical data.

Such breaches include the widely publicized Premera Blue Cross hack involving 11 million customers, and the Anthem hack which resulted in 78.8 million leaked customer records. More info is located at this website: http://hitconsultant.net/2016/01/28/hackers-caused-98-of-healthcare-data-breaches/ .

According to Health IT Security, 80 percent of organizations handling sensitive information report concern for large-scale data breaches, based on a survey conducted by Advisen. This survey included organizations from several different industries, but the most highly represented industry was healthcare, comprising 22 percent of the respondent sample.

Despite the growing concern for large-scale data breaches, the study’s authors report that organizations may not be doing enough. While three quarters of respondents report having some sort of data breach response plan, these plans may not go through rigorous enough testing. You can find more material on this subject at this site: http://healthitsecurity.com/news/large-data-breaches-top-worry-for-health-pros-survey-shows .

Forbes Magazine reported that 2015 was the worst year yet for data breaches. The online mechanism for the Office of Civil Rights (OCR) under Health and Human Services publishes data breaches as reported to them and required by HIPAA. The numbers last year are just staggering:

·         According to OCR, there were 253 healthcare breaches that affected 500 individuals or more with a combined loss of over 112 million records.
·         The top 10 data breaches alone accounted for just over 111 million records that were lost, stolen or inappropriately disclosed.
·         The top six breaches affected at least 1 million individuals–and four of the six were Blue Cross Blue Shield organizations.

While HIPAA is the legislation (passed in 1996) designed to protect patients against loss, theft or disclosure of their sensitive medical information, the fines and penalties don’t appear to be having a discernible effect on either patient privacy or data security.

A recent data breach study estimates that breaches cost the healthcare industry about $5.6 billion annually. As healthcare moves toward connected care, the amount of data exchanged between organizations is only going to grow. So what does this mean? It means that in 2016, the healthcare industry is going to see a huge movement towards encryption in hospitals and other healthcare facilities in order to protect EHRs (electronic health records) and other vulnerable PHI (Personal Health Information). More detailed material is located at this website: http://www.forbes.com/sites/danmunro/2015/12/31/data-breaches-in-healthcare-total-over-112-million-records-in-2015/#3f9cb33b7fd5 .

Oddly enough, however, according to Health IT Security, the first few months into 2016 are showing a slightly different trend, with results from the Department of Health and Human Services (HHS) indicating that stolen devices and improper disposal are the top threats currently facing the industry. Patient names, addresses, phone numbers, Social Security numbers, dates of birth, health insurance numbers, other medical status and assessment information as well as some financial information have been exposed with these incidents.

The top five healthcare data breaches of this year so far do not involve hacking or an IT incident, according to the HHS Office for Civil Rights (OCR) data breach reporting tool. Instead, theft, loss, improper disposal, and unauthorized email access or disclosure have caused the largest incidents in 2016. More info is located at this website: http://healthitsecurity.com/news/top-5-healthcare-data-breaches-in-2016-not-from-hacking .

According to IT Business Edge, a big part of the problem is that security organizations are still focused on preventative security — looking for a silver bullet that will keep an attacker out of their networks in the first place. Despite a Gartner recommendation that organizations shift security efforts toward the detection of network intruders and the emergence of promising new behavioral analytic tools and security strategies, well under 1 percent of enterprises have the ability to find a post-intrusion network attacker. Cyber criminals continue to have the potential for unimpeded, long-term success. More info is located at this site: http://www.itbusinessedge.com/slideshows/2016-security-trends-whats-next-for-data-breaches-06.html .

Hospitals, health systems, payers and any organization with stewardship of healthcare data are prime targets for cyberattacks, according to Becker’s Hospital Review (BHR). And there are plenty of cautionary tales showing just how much damage hackers can do. While no healthcare organization will ever be completely invulnerable to such attacks, they can learn from others' mistakes.

Here are four lessons, according to BHR, healthcare providers can consider when thinking about data breach prevention and preparedness:
1.    Don't fall prey to known vulnerabilities.
2.    Utilize experience-based training.
3.    Consider a third party for security audits.
4.    Create a contingency plan.


Businesses, especially in the healthcare field, must always make every effort to protect patient information. That is their responsibility, and they can be held civilly responsible, and criminally responsible if there is a proven negligent act. As a consumer, you may receive a letter or an email informing you that your personal information may have gotten into the wrong hands as a result of a data breach.  Perhaps a media report alerted you to a security breach at a company where you do business.

Regardless of the type of data breach, medical information is more difficult to recover, manage, and restore, especially for consumers. According to Privacy Rights Clearinghouse, there are helpful tips on what to do if a breach has occurred. Much more detail is located at this website: https://www.privacyrights.org/how-to-deal-security-breach .

Always be diligent to monitor your healthcare information. Take steps to protect your personal data, and never provide your information to businesses that have no protection or privacy capabilities in place. Always ask who will see your information, and request a copy of their privacy policies. If you discover that a breach has occurred, take quick action to reduce the exposure and limit the damage that can be done. It’s your life. Keep it secret. Keep it safe.

Until next time.