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- Maryland / Regional
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Roll Call: Senate OKs Children's Health Insurance
Program
(Annapolis Capital)
- National / International
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Women still 2nd-class citizens when it comes to
heart disease
(Baltimore Examiner)
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Spinach and Peanuts, With a Dash of Radiation
(New York Times)
- Opinion
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Developing a strategy on infant mortality
(Baltimore Sun
Editorial)
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- Maryland / Regional
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Roll Call: Senate OKs Children's Health Insurance
Program
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- Annapolis Capital
- Sunday, February 1, 2009
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- WASHINGTON - Here's how area members of Congress
voted in the week ending Jan. 30.
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- House
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- LILLY LEDBETTER ACT: Voting 250 for and 177
against, the House on Jan. 27 gave final congressional
approval to a bill (S 181) making it easier for
plaintiffs to file pay-discrimination suits. A yes vote
was to pass the bill.
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- Voting yes: Reps. Frank Kratovil Jr., D-Queen
Anne's, C.A. Dutch Ruppersberger, D-Baltimore, John
Sarbanes, D-Baltimore, Donna Edwards, D-Prince George's,
Steny Hoyer, D-St. Mary's, Elijah Cummings, D-Baltimore,
Chris Van Hollen, D-Montgomery. Voting no: Rep. Roscoe
Bartlett, R-Frederick.
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- DIGITAL TV DELAY: Voting 258 for and 168
against, the House on Jan. 28 failed to reach the
two-thirds majority needed to pass a bill (S 328) that
would delay from Feb. 17 to June 12 the national
deadline for converting over-the-air U.S. TV signals
from analog to digital. A yes vote was to pass the bill.
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- Voting yes: Mr. Kratovil, Mr. Ruppersberger,
Mr. Sarbanes, Ms. Edwards, Mr. Hoyer, Mr. Cummings, Mr.
Van Hollen. Voting no: Mr. Bartlett
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- Senate
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- CHILDREN'S HEALTH INSURANCE: Voting 66 for
and 32 against, the Senate on Jan. 29 sent to conference
with the House a bill (HR 2) expanding State Children's
Health Insurance Program (SCHIP) coverage. A yes vote
was to pass the bill.
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- Voting yes: Sen. Benjamin Cardin, D-Md. Sen.
Barbara Mikulski, D-Md.
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- ROE v. WADE: Senators on Jan. 29 rejected, 39
for and 59 against, an amendment to HR 2 (above) to
write into law a Bush administration regulation fthat
defines life as beginning at inception. Under Roe v.
Wade, a fetus does not gain viability until
approximately the third trimester of pregnancy. A yes
vote backed the amendment.
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- Voting no: Mr. Cardin, Ms. Mikulski.
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- Copyright 2009 Annapolis Capital.
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- National / International
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Women still 2nd-class citizens when it comes to heart
disease
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- By Leigh Vinocur
- Baltimore Examiner
- Sunday, February 1, 2009
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- Women may have “come a long way, baby” in voting and
politics, but not so when it comes to treating heart
disease.
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- There is still a huge gender gap for women with
respect to diagnosing and treating heart disease. Study
after study, even within the past three years, has shown
that women are not diagnosed as quickly as men, nor are
they treated with recommended medications and procedures
as often as men. And perhaps that’s why when women are
finally diagnosed and treated, they don’t fare as well.
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- Cardiovascular disease kills more women than men
every year — and almost 10 times more women than breast
cancer, according to the American Heart Association. So
where is the advocacy, the indignation, the walks for a
cure?
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- “Breast cancer, with its outward visible scars, is
still more jarring for women than heart disease — which
is 10 times more deadly,” according to Dr. Mandeep
Mehra, professor and division head of cardiology at the
University of Maryland School of Medicine.
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- Some of the blame lies with women who notoriously
put themselves last, especially when it comes to their
health.
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- Women are vigilant when it comes to heart health for
their spouses, Mehra said. However, he finds the reverse
is not true.
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- “I have yet to find a man who accompanies his wife
to an appointment with documented Internet research and
a list of questions.”
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- Dr. Erin Michos, a cardiologist at Johns Hopkins
School of Medicine who co-authored the American Heart
Association’s Cardiovascular Prevention Guidelines for
Women, agrees. “Women are the gatekeepers of health for
the whole family; when they take care of themselves the
whole family benefits.”
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- It isn’t that women blatantly ignore their symptoms;
many women don’t even realize they are having symptoms
of a heart attack. Unlike men who have easily
identifiable crushing chest pain and shortness of
breath, many women have vague complaints that could
easily be attributed to other problems. Mehra describes
“indigestion and fatigue, even something as ambiguous as
a change in sleep pattern.”
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- It’s these nondescript complaints that account for a
recent study published in January’s online issue of
Circulation: Cardiovascular Quality and Outcome.
Researchers found women with these types of cardiac
symptoms, when compared to men, were 50 percent more
likely to be delayed by 15 minutes in getting to the
hospital via ambulance.
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- Another study published in December 2008 in the
journal Circulation, found that women who had a more
severe type of heart attack called STEMI (ST Elevation
Myocardial Infarction) were twice as likely to die as
their male counterparts. Women also were less likely to
receive the standard treatments, a factor that may have
contributed to the higher mortality rate. The study
found women were 14 percent less likely to receive
aspirin therapy to prevent platelet and blood clots, and
10 percent less likely to receive beta-blocker
medications to lower heart rate and blood pressure. They
also were 25 percent less likely to receive reperfusion
therapy such as angioplasty and stents to restore blood
flow after arriving at the hospital.
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- Both of these studies, Michos said, “are very
frustrating. Gaps lie not only with treatment in the
hospitals but getting to the hospital, too.”
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- The key to closing this gap is education on all
levels because the bias is happening at all levels. An
American Heart Association survey found only 21 percent
of women realized heart disease as their greatest health
risk. Another survey among doctors found that fewer than
1 in 5 knew that more women died of heart disease each
year than men.
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- Women need to know their symptoms but more
importantly they need to know their risk factors:
smoking, a strong family history of heart disease or
diabetes, and numbers for blood pressure and
cholesterol. One or more risk factor can totally negate
any beneficial protection estrogen gives to younger
women with respect to heart disease, according to Michos.
And historically it’s that idea of the estrogen benefit
that might have initially created the bias we see today.
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- “Prevention is the best intervention,” said Michos,
who encourages women to empower themselves and take
action. The more they pay attention to their own heart
health, the more they will get their doctors to do the
same.
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- Mehra’s biggest piece of advice: “Don’t take no for
an answer. If you feel you’re still having a problem,
don’t stop until you find a doctor who finds the
problem.”
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- The ABCs of Heart Disease Prevention
- A — Aspirin and Anti-platelet therapy
- B — Beta Blockers and Blood pressure control
- C — Cholesterol and Cigarette cessation
- D — Diabetes prevention, and Diet and weight
management (Measure waist circumference.)
- E — Exercise
- F — Framingham Risk Assessment, which estimates
10-year risk for having a heart attack
- G — Goals for behavior change
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- Leigh Vinocur is a board-certified emergency
medicine physician at the University of Maryland School
of Medicine.
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- Copyright 2009 Baltimore Examiner.
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Spinach and Peanuts, With a Dash of Radiation
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- By Andrew Martin
- New York Times
- Monday, February 2, 2009
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- Before the recent revelation that peanut butter
could kill people, even before the spinach scare of
three summers ago, the nation’s food industry made a
proposal. It asked the government for permission to
destroy germs in many processed foods by zapping them
with radiation.
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- That was about nine years ago, in the twilight of
the Clinton administration. The government has taken
limited action since.
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- After spinach tainted with a strain of E. coli
killed three people and sickened more than 200 others in
2006, the Food and Drug Administration gave permission
for irradiation of spinach and iceberg lettuce. It has
yet to begin. Meat irradiation is permitted but rarely
used. Among common items on the grocery shelf, only
spices and some imported products, like mangoes from
India, are routinely treated with radiation.
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- The technology to irradiate food has been around for
the better part of a century. The federal government
says that it is safe, and many experts believe that it
could reduce or even eliminate the food scares that
periodically sweep through American society.
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- It might even have killed the salmonella that
reached grocery shelves in recent weeks after a factory
in Georgia shipped tainted peanut butter and peanut
paste, which wound up in products as diverse as cookies
and dog treats.
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- But irradiation has not been widely embraced in this
country.
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- Food manufacturers worry that the apparent benefits
do not justify the cost or the potential consumer
backlash. Some consumer groups complain that widespread
irradiation of food after processing would simply cover
up the food industry’s hygiene problems. And some
advocacy groups question the long-term safety of
irradiation.
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- Amid all these doubts, one thing is certain — food
poisoning continues. The cases that rise to public
attention are only the tip of the iceberg. The Centers
for Disease Control and Prevention estimates that there
are 76 million cases of food-borne illness each year in
the United States. The vast majority are mild, but the
agency estimates there are 5,000 deaths from food-borne
disease and 325,000 hospitalizations each year.
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- All of this drives advocates of irradiation crazy.
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- “Our society is running around with our head in the
sand because we have ways to prevent illness and death
that aren’t being used,” said Christine Bruhn, director
of the Center for Consumer Research at the University of
California, Davis. “The rules are so tight on
irradiation that you can’t pull it out and use it when a
new problem arises, and that’s to the detriment of the
American public.”
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- Suresh Pillai, director of the National Center for
Electron Beam Research at Texas A&M University, likened
fears of irradiation to early phobias about the
pasteurization of milk.
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- “It’s unnecessary for people to be getting sick
today with pathogens in spinach or pathogens in peanut
butter,” said Professor Pillai, who described the
potential for irradiation of food as “humongous.” “We
have the technologies to prevent this kind of illness.”
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- Food is irradiated by brief exposure to X-rays,
gamma rays or an electron beam. The process is intended
to reduce or eliminate harmful bacteria, insects and
parasites, and it also can also extend the life of some
products.
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- Advocates say it is particularly effective at
killing pathogens in items like ground beef and lettuce,
where they might be mixed into the middle of the product
or hiding in a crevice that is hard to clean by
traditional means.
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- The United States is dotted with irradiation
centers, but they are generally used to sterilize
medical supplies like bandages and implants, not food.
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- Food and Water Watch, an advocacy group, has long
maintained that irradiation would be too expensive,
impractical and sometimes ineffective because it might
hide filthy conditions at food processing plants. Patty
Lovera, the group’s assistant director, said irradiation
not only kills bacteria but can also destroy nutrients
in food.
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- “There’s a whole impact on the food product, which
we think is an unacceptable cost,” Ms. Lovera said.
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- She pointed out that irradiated beef was offered at
many grocery stores nationwide at the beginning of the
decade but it did not last long. Customers were turned
off by the higher price and by the extended shelf life
of irradiated beef.
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- “People that did the shopping, they would look at
the date and be freaked out at how long it would be good
for,” she said.
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- Food industry officials, meanwhile, remain wary of
irradiation because of the upfront costs and the
potential public reaction to any technique with the word
“radiation” in it. (Irradiation leaves no traces of
radioactive material in food.)
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- One potential test of public acceptance could come
with the marketing of irradiated spinach and lettuce.
After the E. coli outbreak in 2006, the spinach industry
lost 30 percent of its business. The F.D.A. approved
irradiation for spinach and iceberg lettuce in August.
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- “There’s no shortage of people who are looking at
it,” said Hank Giclas, vice president for strategic
planning, science and technology for the Western Growers
Association. “I don’t know of anyone who is moving
forward with it at this time.”
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- Officials at two irradiation companies said business
for food was growing slightly.
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- “It’s changed a little bit, but not a whole lot,”
said Harlan Clemmons, president and chief operating
officer of Sadex, which operates an irradiation plant in
Iowa. He said he does twice as much business irradiating
pet treats and livestock feed as human food.
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- “It’s very amazing,” he said. “There are so many
products that could be made safe by using irradiation.”
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- It remains an open question if peanut butter or
products with peanut paste would be likely candidates
for the technique.
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- Irradiation typically does not work so well on
products with high amounts of fat or oil like peanut
butter because they can turn rancid during the process.
A spokesman for the American Peanut Council said
irradiation was tested but found unacceptable because it
degraded the taste of the nut.
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- Nonetheless, Professor Pillai said a low dose of
radiation might be effective in killing traces of
salmonella in peanut butter — or manufactured products
with peanut paste — without ruining the taste. He said
it would not work as a substitute for basic hygiene and
food safety measures.
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- “You customize the amount of dose with the product
that you are using,” he said.
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- Similarly, a spokesman for the Grocery Manufacturers
Association said food companies should make sure plants
are clean and follow good manufacturing and food safety
practices. If problems remain afterwards, then
irradiation could be an option, provided it is permitted
by the federal government.
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- The association, then called Grocery Manufacturers
of America, was among the sponsors of the application
that was filed with the F.D.A. nine years ago, which
sought approval to irradiate ready-to-eat meat and
poultry products and fruit and vegetable products.
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- Now that spinach and iceberg lettuce have been
approved, it is focusing on persuading the F.D.A. to
permit irradiation of hot dogs and deli meats. An F.D.A.
spokesman declined to comment, saying the agency does
not comment on open petitions.
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- Copyright 2009 The New York Times Company.
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- Opinion
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Developing a strategy on infant mortality
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- Baltimore Sun Editorial
- Sunday, February 1, 2009
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- The Baltimore Sun's call for action to improve birth
outcomes in the city is on the mark ("Where's the
urgency?" editorial, Jan. 26).
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- Today, those who feel the urgency work on the front
lines - including community health nurses, outreach
workers from Healthy Start and other agencies, and
obstetric and pediatric caregivers. But improving birth
outcomes requires the attention of a much broader group
of partners - indeed, of our whole community.
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- And as important as urgency is strategy. With the
support of Mayor Sheila Dixon, the state health
department and many private organizations, Baltimore
will soon release a birth outcomes strategy.
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- Our goal is to put into place a structure for
substantial improvements in a range of birth outcomes
over time. It will not be a quick fix; there is no such
thing for infant mortality, one of the health indicators
most tied to social inequality and most resistant to
change.
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- The strategy will need resources, and as we begin to
succeed, we will seek to capture the savings accruing to
systems that no longer have to care for as many low-birthweight
and pre-term babies as they do now.
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- It will also need the assistance of many different
organizations, systems and community groups who may not
yet realize that their commitment is critical to saving
the lives of babies.Dr. Joshua M. SharfsteinBaltimore
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- The writer is Baltimore health commissioner.
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- Copyright 2009 Baltimore Sun.
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