Monday, January 26, 2009

News Clipping Archives

 

Maryland / Regional

Board wants to make sure vets get their benefits (Annapolis Capital)

Don't share bed with infant, parents told (Baltimore Sun)

Hospitals not immune to the economic downturn (Baltimore Examiner)

State officials bring rabies alert into electronic age (Salisbury Daily Times)

Court officials push revision in handling of debt settlements (Baltimore Sun)

Two grocery chains label products with nutritional information (Baltimore Sun)

Carroll hospital offering new procedure (Carroll County Times)

National / International

Researchers find no risk of thimerosal in vaccines causing brain problems  (Baltimore Sun)

MRSA infections on the rise in kids (Baltimore Sun)

The reach of diabetes (Frederick News-Post)

FDA Conducts Safety Review of Plavix (Wall Street Journal)

Proposal: Sign a donor card, move up on transplant list (USA Today)

Opinion

Where's the urgency? (Baltimore Sun Editorial)

State still struggles with infant mortality (Baltimore Sun)

 

Maryland / Regional

 

Board wants to make sure vets get their benefits

Considers providing more services, faster

 

By Earl Kelly

Annapolis Capital

Monday, January 26, 2009

 

Seventy percent of the state's veterans returning from Iraq and Afghanistan are not enrolled with the Veterans Administration and therefore don't know what benefits and services are available to them, according to a state advisory board.

 

Lt. Gov. Anthony Brown, chairman of the newly created Veterans Behavioral Health Advisory Board, said during a meeting earlier this month that traditional veterans service centers often are not located where they are needed - in less-populated areas.

 

"We have a particular focus on rural Maryland," Mr. Brown said of the 12-member board. "That is where we believe the greatest need is."

 

Veterans in rural areas have limited access to mental health providers, especially psychiatrists who are licensed to prescribe medicines, Mr. Brown said.

 

The meeting addressed a range of topics, and Mr. Brown used the occasion to praise a memorandum of understanding reached in October between state and federal officials that allows veterans of Afghanistan and Iraq to receive mental health services faster.

 

Under the three-year agreement, the state Department of Health and Mental Hygiene will provide outreach to veterans in rural parts of the state, and will provide behavioral health services until the veterans can be linked to a VA facility.

 

Still, some current federal policies make it difficult for states to help veterans.

 

Sen. Douglas J. J. Peters, D-Prince George's, who is chairman of a task force within the state board, noted that a service member who leaves active duty must tell the Department of Defense if he wants his release papers, known as a DD-214, sent to a state veterans department. If the service member does not indicate a choice, the state never receives information about that veteran and, therefore, cannot contact him with offers of assistance.

 

Mr. Peters said the papers should be sent to the state automatically, unless the veteran indicates otherwise.

 

"There is a gap between state and federal communications. Period," he said.

 

The Department of Health and Mental Hygiene estimated that 15,000 veterans of Iraq and Afghanistan reside in the state. Of them, 5,000 are believed to have mental-health and substance-abuse problems.

 

Amy Fairweather, director of the Iraq Veteran Project at the California-based national group Swords to Plowshears, said that veterans across the country are facing unprecedented post-traumatic stress disorder.

 

"It can be attributable to the very harsh (combat) conditions; there is no rear area where you are safe," Ms. Fairweather said. "On top of that, there are the repeated deployments and exposure to trauma - the (powerful) explosions are off the charts."

 

Mental health problems and tough economic times are making the homeless one of the fastest-growing groups of veterans in the state, board members said.

 

The federal Veterans Administration runs three medical and rehabilitation centers in Baltimore and five outpatient clinics around the state, according to the department Web site.

 

The meeting, held at Anne Arundel Community College, was the second since Gov. Martin O'Malley and the General Assembly created the board in 2008.

 

David Boschert, a former delegate from Crownsville and now chairman of the county Veterans Affairs Commission, said he was encouraged by much of what he heard. The board, for example, appears to be leaning toward supporting additional veterans service centers throughout the state.

 

"I still want to take up Crownsville again," said Mr. Boschert, who has long advocated turning the abandoned state mental hospital into a veterans home and clinic. "The first goal is to get the clinic, or some kind of crisis center, established there."

 

Mr. Boschert said he has some contractors lined up to do much of the work for free.

 

"We already have the assets, the buildings," he said. "All we have to do is renovate them and get them going."

 

Mr. Boschert, who said he plans to run for the General Assembly again, said he and County Executive John R. Leopold are in the process of establishing a nonprofit account where the public may make donations to support veterans programs. Mr. Boschert said it was too soon for him to determine whether he'll run for the Senate or the House of Delegates.

 

A spokesman for the community college said the school has a number of programs designed to serve veterans, but sometimes there isn't enough money. For example, the children of Iraq and Afghanistan veterans often experience high levels of stress, but the college cannot afford an instructor to address these problems.

 

"Our Parenting Center offers courses for just what they talked about today," said Linda Schulte, a college spokesman. "We know there is the need, but we don't have the money right now."

 

The board's next meeting will be in Annapolis in March, but the date, time and place have yet to be determined. The board must file its preliminary report by Dec. 1 and its final report by Dec. 1, 2010.

 

Copyright 2009 Annapolis Capital.

 

Don't share bed with infant, parents told

Asphyxia study stirs worry over babies, parents sharing bed

 

By Kelly Brewington

Baltimore Sun

Monday, January 26, 2009

 

The rate of accidental suffocation deaths among babies increased fourfold over the past two decades, according to a new study, despite a national campaign to encourage safe infant sleeping.

 

Authors of the study, which appears today in the journal Pediatrics, say the nationwide increase probably is the result of more thorough investigations and changes in how deaths are classified. Nevertheless, the researchers and local medical experts said the figures reflect a continuing problem and highlight concerns about whether babies should sleep in the same beds as their parents or siblings.

 

"These deaths are likely preventable," said Carrie K. Shapiro-Mendoza, an epidemiologist at the federal Centers for Disease Control and Prevention and lead author of the study. "So this problem is ongoing, and we should not divert our attention. ... We need an infusion of more efforts to make them reduce further."

 

Researchers have long studied Sudden Infant Death Syndrome, a term that refers to infant deaths that cannot be explained after a medical investigation. Shapiro-Mendoza's study sought to find out if a newer, more specific category of infant death - by strangulation or suffocation - was increasing.

 

The National Institutes of Health launched a Back to Sleep campaign 13 years ago to reduce infant deaths, encouraging parents to place babies on their backs. Since then, deaths attributed to SIDS have decreased 50 percent, and pediatricians and child safety advocates cheered the campaign's success.

 

But taking a closer look at death certificates nationwide, Shapiro-Mendoza and others noticed a rise in infant deaths classified as suffocation or strangulation. These included babies becoming wedged between a wall and a mattress, another person rolling on top of an infant or suffocation on a pillow or soft mattress.

 

Dr. Scott D. Krugman, co-chairman of the Baltimore County Child Fatality Review Team, which reviews such deaths, said the study sends a clear signal that the Back to Sleep campaign is not enough.

 

"When the SIDS rates started plummeting, we all said to ourselves, 'Look, we're making such progress,'" said Krugman, who is chairman of pediatrics at Franklin Square Hospital Center. "But we were not looking at the fact that the total number of deaths has stayed the same. Sleep safety is the issue; we're just calling the deaths something else."

 

Researchers found that from 1984 to 2004, infant suffocation and strangulation deaths nationally rose from 2.8 per 100,000 live births to 12.5 per 100,000 live births. The largest increase took place after 1996, about the same time that SIDS rates leveled off.

 

Dr. Charles Shubin, director of pediatrics at Mercy Medical Center in Baltimore, said he thinks investigators have become more "honest" about classifying infant deaths. SIDS was often the catch-all for unexplained infant deaths, but closer investigation revealed that babies were suffocating accidentally.

 

The issue is serious in Baltimore, where the review team found 89 unexpected infant deaths between 2002 and 2006 and said that unsafe sleeping environments contributed to 91 percent of them.

 

"A decade ago, there were no real investigations," said Shubin, who helped organize Baltimore's child fatality review team to push for greater investigation of such deaths. "As we began to look at other ways that might be surrounding circumstances, the definition of SIDS became harder to meet, so we came up with a new diagnosis."

 

"This doesn't represent more children dying of asphyxia, it means we are recognizing it more accurately," Dr. David Fowler, Maryland's chief medical examiner, said of the new study. "Medical technology has improved. Training of death investigators and examiners has improved."

 

Even so, medical examiners differ widely in how they diagnose sudden infant deaths, Shapiro-Mendoza said.

 

"Some states might have a board-certified pediatric pathologist; other states may have a coroner who is an elected official and may have a [high school equivalency certificate] for their education," she said.

 

She said experts need uniform standards to analyze infant deaths and develop strategies to avoid them. The CDC wants to compile a database of infant deaths nationwide, with medical examiner and law enforcement reports and infant medical records.

 

For now, doctors such as Shubin and Krugman advise parents not to place a baby on soft bedding, to keep toys and pillows away from a baby's sleep area, and to adopt the ABC approach (Alone, on their Back and in a Crib). But not everyone agrees.

 

While the American Academy of Pediatrics discourages parents from sleeping with their infants, groups such as La Leche League and those that advocate "attachment parenting" say that babies can sleep with their parents safely and that the practice encourages lasting bonds.

 

And cultural and economic barriers sometimes prevent parents from using cribs or inventions considered safe, such as bassinets that attach to a bed.

 

Low-income parents might not be able to afford a crib, and immigrants, particularly from Asia or Latin America where sharing a bed is common, are reluctant to abandon doing so, Krugman said.

 

"I tell them, 'Your child is safest in a safe environment,'" he said. "'I want you to bond with your child, but I want them to be safe.'"

 

Copyright 2009 Baltimore Sun.

 

Hospitals not immune to the economic downturn

 

By Sara Michael

Baltimore Examiner

Monday, January 26, 2009

 

Maryland hospitals are beginning to feel the sting of the economic downturn as fewer people opt for elective procedures and more patients cannot pay for care.

 

And some hospital officials expect more belt-tightening.

 

"We are bracing ourselves for flat [patient] volume," said Chuck Orlando, chief financial officer for LifeBridge Health, which operates Sinai Hospital in Baltimore and Northwest Hospital in Randallstown, adding that usually patient admission grows 1 percent to 2 percent each year.

 

"We expect most of the impact of the recession will hit in 2009" as potentially more people get laid off.

 

At Greater Baltimore Medical Center in Towson, officials also expect to see a decline in patient volume in the coming months, as well as more uninsured or underinsured patients, said Eric Melchior, executive vice president and chief financial officer at GBMC.

 

The hardest hit have been the hospital's investments, which are used to offset operating expenses and support programs for which the hospital is not reimbursed, such as hospice care, he said.

 

The hospital's $10 million endowment, which pays for indigent care and other services, had grown to more than $15 million in previous years, but now has dropped below $8 million, Melchior said.

 

"We are not abandoning that commitment to providing those services, it's just going to have to come out of our bottom line," he said.

 

Hospitals statewide were beginning to see a drop in their profit margins as early as the end of fiscal 2008, according to the Maryland Hospital Association, which is now conducting a survey on the recession's effects.

 

Total margins, which include investment income, dropped to 2 percent in 2008 from 4.8 percent in 2007, said association spokeswoman Nancy Fiedler.

 

In the third quarter of 2008, the latest for which data is available, total margins decreased by nearly 5 percent, down to a negative 1.5 percent, Fiedler said. The fourth quarter is expected to bring more losses.

 

Fewer procedures and fewer patients with health insurance contributed to the dip, as well as drops in investment income, on which hospitals rely for capital programs and future services, Fiedler she said.

 

"I think they are all at a point where they are trying to determine what steps do they need to take," she said.

 

LifeBridge, like many area hospitals, hasn't had to lay off staff or cut programs. But officials across the state are looking for ways to save money.

 

Melchior said GBMC's patient demographics and its overall financial strength have shielded the hospital from too hard of a hit.

 

"We are going to evaluate the trends and not overreact to anything," he said.

 

Some hospitals, such as Howard County General Hospital and Baltimore Washington Medical Center, which just celebrated a $117 million expansion, aren't yet feeling an impact from the recession, officials said.

 

But that hasn't stopped them from preparing for a downtown.

 

"We are taking a look at our expenditures and revenues and putting contingency plans in place," said Howard hospital spokeswoman Sharon Sopp.

 

Copyright 2009 Baltimore Examiner.

 

State officials bring rabies alert into electronic age

 

By Andrew Ostroski

Salisbury Daily Times

Monday, January 26, 2009

 

OCEAN VIEW -- State officials have chosen a new way to warn residents about potential dangers in their area, and residents couldn't be more satisfied.

 

Bill Winkler of Ocean View, along with several other residents along the Route 26 corridor, received an automated telephone message last week alerting them that a rabid cat was loose in their area. The tan and orange feline had scratched several people in the area of Deer Run, off Iron Branch Road in Dagsboro.

 

The message was part of a fairly new initiative by the Delaware Department of Health and Human Services' Division of Public Health to alert the public about potential health hazards.

 

"This is a fantastic idea," Winkler said. "It's about time the state stepped into the electronic age. The (DPH) is finally doing what they should be."

 

According to Heidi Truschel-Light of the DPH, the state's use of the program is not entirely new.

 

"We've been using this method for about a year," she said. "We developed the capability as part of our disaster preparedness program. Now it has an additional use."

 

Truschel-Light said the telephone method is used as a form of rabies education for the greater public.

 

"We don't just discuss rabies when there's a pretty prominent case," she said. "We educate throughout the year. (We also) encourage residents to get their pets vaccinated and adopt other practices that will reduce exposure to rabies."

 

Kim Engst, a technician with the Georgetown branch of the Society for the Prevention of Cruelty to Animals, said rabies is present in Sussex County, especially in the feral cat population. Any warning system that can be implemented, she said, will make a difference.

 

"You can't take rabies back," she said. "It's 100 percent fatal. If someone drops the ball on a rabies case and they don't follow through or aren't able to warn the public, someone or something is going to die. That's why warning systems are very big."

 

aostroski@dmg.gannett.com

 

302-537-1881, ext. 204

 

Additional Facts

For more info

 

Questions regarding rabies should be directed to the Division of Public Health's Rabies Program at 302-744-4545. Calls are answered 24 hours a day, seven days a week.

 

Copyright 2009 Salisbury Daily Times.

 

Court officials push revision in handling of debt settlements

Legal help proposed to lessen confusion in 'rocket dockets'

 

By James Drew

Baltimore Sun

Monday, January 26, 2009

 

Maryland district court officials want to give defendants in debt collection lawsuits new access to legal help and change the way that settlement conferences are handled, in response to criticism that hospitals, credit card companies and other creditors often have an unfair advantage.

 

The courts are responding to an investigation into hospital debt collection practices published last month by The Baltimore Sun. That report, as well as a University of Maryland law school study released in November, found that defendants are confused by the court process, do not understand that they sometimes have legitimate defenses and assume that they must accept whatever terms are dictated by hospital lawyers in settlement conferences. The Sun also found that hospitals almost always win cases that go before a judge, simply by presenting an affidavit that the person was treated there.

 

The district court system is considering setting up "self-help centers" so that people who cannot afford attorneys can get legal advice. It is also considering using computers to show simulated meetings between attorneys and unrepresented defendants in civil cases, said Ben C. Clyburn, the chief judge of Maryland's district courts.

 

The first change will take effect in two weeks, when defendants assigned to the so-called "rocket docket" in district courts in Baltimore and in Montgomery and Prince George's counties receive new notices about their rights - including that a judge will consider their case if they don't want to, or can't, reach a settlement with creditors' attorneys. That follows a recommendation in the University of Maryland study.

 

During the past few years, attorneys who file large numbers of debt collection lawsuits in those three jurisdictions have been given weekly access to courtrooms to try to work out agreements with defendants. These sessions are known as "rocket dockets" because they encourage rapid, on-the-spot settlements. Court officials have said the goal is to reduce the size of trial dockets.

 

"We will explain the process a lot better and put citizens in a better position to understand what they need to do, so they are prepared at these conferences," Clyburn said.

 

Nearly one-third of the 132,000 lawsuits that Maryland hospitals have filed against patients in the past five years over unpaid bills have been filed in Baltimore District Court, which serves many lower-income debtors. The Sun found that some hospitals have won judgments against patients covered by Medicaid, despite a Maryland law prohibiting that. Some hospitals have also sued patients three or more years after their stays ended, raising questions about whether the statute of limitations had expired.

 

Last year, 15 students in consumer law clinics at the University of Maryland School of Law observed rocket docket sessions in the three jurisdictions. They found that the process confuses many people because they are summoned for "trial." When the defendants arrive, they walk into a courtroom where a bailiff sits in the judge's chair and a clerk calls them to meet with creditor attorneys at a large table.

 

In Baltimore, defendants receive both a trial summons and a notice about the "007 docket" - a reference to the courtroom in which the rocket docket is held - that states: "This proceeding is not a hearing; a judge will not be present in the courtroom."

 

The University of Maryland study termed the two documents "confusing, misleading and contradictory."

 

The new notice written by the state district courts makes it clear that the rocket docket is a "resolution conference" and states: "Speaking with the plaintiff's attorney can help bring about the resolution of your case, but you are not required to speak with the plaintiff's attorney. It is your option and will not be held against you."

 

Many defendants are not aware of the legal consequences if they acknowledge that they owe a debt, that there are limitations on fees and interest rates that can be charged, or that collection can be barred by a statute of limitations, said Daniel L. Hatcher, an assistant professor of law at the University of Baltimore.

 

"Negotiation only works if there is a power balance," said Michael Millemann, a Maryland law professor who co-wrote the study. "Creditor attorneys have a real interest in resolving these cases promptly, even if they don't get 100 cents on the dollar. What is missing is the counterweight for the defendants."

 

Tom McCray-Worrall, a Maryland law student who witnessed several rocket dockets, said he saw many instances in which attorneys for creditors said the defendant owed the debt, then asked if the person preferred a payment plan or a lump sum. No proof of the amount of the debt was presented, McCray-Worrall said.

 

The self-help centers envisioned for district court would be modeled after centers in circuit courts for family court cases. Those centers are staffed by lawyers hired under contract and legal services programs, including the Legal Aid Bureau and Maryland Volunteer Lawyers Service.

 

Other options include a program under which volunteer lawyers agree to staff a court for one day, lay advocates are trained to give legal information, and paralegals can represent clients.

 

An attorney who handles collection cases for the law firm of Peroutka and Peroutka said self-help centers could be helpful, but she said she was troubled by the implication that plaintiffs' attorneys do not help defendants.

 

"What I like about it is, you can work out what you can work out, and if there's a dispute, you can find out about it," said Michelle Gagnon, president of the Maryland-District of Columbia Creditors Bar Association.

 

Herbert A. Thaler, one of the state's most active hospital-debt collection lawyers, said the rocket docket should be reserved for "uncontested cases, where the person acknowledges they owe the money."

 

Thaler said he has declined to take part in the process, saying that he prefers to get a judgment or work out a payment plan that goes before a judge. But if a self-help center could be set up outside the courtroom where the rocket docket is held, he said, he would consider taking part.

 

Millemann said changes that could benefit alleged debtors in the rocket docket should also apply to those who decide to represent themselves in court.

 

"These trials are truncated, very abbreviated, very quick-moving. If you don't have a lawyer or some other source of legal advice, you are not much better off in the litigated process," he said.

 

Clyburn said court officials are examining The Sun's series as part of the work of the new Access to Justice Commission, which was formed by Robert M. Bell, chief judge of the Court of Appeals.

 

The commission, led by retired Court of Appeals Judge Irma S. Raker, is focusing on the civil docket in district courts and family court in circuit courts, Clyburn said. Millemann chairs the subcommittee that will focus on those who cannot afford to hire a lawyer.

 

"I think there will be some major changes to make it easier for citizens to understand and access the system," Clyburn said.

 

Copyright 2009 Baltimore Sun.

 

Two grocery chains label products with nutritional information

Giant, Shoppers join restaurants, food makers in attempt to help consumers

 

By Meredith Cohn

Baltimore Sun

Monday, January 26, 2009

 

William and Sarah Jenney need to limit the amount of sugar and salt they eat, so when they buy groceries for the week, they read all the labels. It's always time-consuming, and occasionally confusing.

 

"There's always something on the package that says, 'heart smart' or 'healthy' or 'light,'" said William Jenney, who was shopping at Giant Food in Glen Burnie one recent day with his wife, Sarah, as well as a fistful of coupons. "Who knows what it all means. We just read all the labels."

 

When Jenney heard that Giant had begun using its own labels on store shelves to steer shoppers to the healthy food - as determined by nutrition experts using government guidelines - he thought more information was better.

 

Giant officials hope so. And so do those at Supervalu, parent of Shoppers Food & Pharmacy, which launched a similar program. The two grocery chains said they started their programs because Americans don't eat right. Consumers are overwhelmed by nutritional information or too busy to consistently look at it.

 

The pair join the list of restaurants, food manufacturers and smaller markets that also have labeled their products with nutritional information or made easy-to-digest information available. Facing the costs of increasing obesity and health problems, some lawmakers also have required larger eateries in their cities to display calorie counts and other data so consumers can make healthier food choices.

 

Some critics are concerned that the new messages will be drowned out by the litany that already exists - to varying degrees of meaningfulness. But the grocers both say they believe they have found the best, unbiased systems to cut through the rest.

 

"I'm a mom of two little boys, and I don't have time when I shop to turn over every package to look at the nutritional facts," said Andrea Astrachan, a consumer adviser for Giant, which has 128 stores in the Mid-Atlantic. "We wanted to make it easier for the ones doing the shopping by having one simple symbol to denote the healthy foods."

 

Under Giant's program, called Healthy Ideas, a team of nutrition experts is using Food and Drug Administration nutrition guidelines and the Department of Agriculture food pyramid to identify items that could generically be labeled healthy. So far, 3,800 packaged foods have been tagged with a special icon, or almost 6,000 items if fruits and vegetables are counted. More will be added as they are examined. A typical store has tens of thousands of items.

 

At Supervalu, the program is called nutrition iQ and will be rolled out over the next six months at the 65 Shoppers in the Mid-Atlantic. The chain worked with nutrition experts at the Joslin Clinic, an affiliate of Harvard Medical School, to evaluate food for the healthiest choices based on FDA criteria.

 

Unlike Giant's single-tag system, Supervalu products will get one of seven color-coded tags. For example, those that are good sources of fiber will get an orange tag, those that are good sources of calcium will get blue tags, low-calorie items will get purple tags, and so on.

 

Supervalu will begin with such items as cereal and dairy products and move onto deli, bakery, produce and other foods. The company estimates that eventually about 10 percent of the 60,000 items in the store will carry a tag.

 

Company officials say most shoppers don't have time to read packages or are inundated by labels required by government and added by manufacturers. Still, they decided on multiple tags because shoppers may have different nutrition needs.

 

"When someone is in a rush, this draws attention to the bright colors," said Kim Kirchherr, a registered dietitian who works for Supervalu. "If you're looking for something with high fiber, you can compare a few products."

 

She said improved eating habits could help tackle some intractable problems facing the country: Two-thirds of adults are overweight, childhood obesity is at an all-time high and heart disease is the nation's No. 1 killer.

 

Others have already begun to address the problems: The Council of Better Business Bureaus launched the Children's Food and Beverage Advertising Initiative in 2006, and 15 food companies, including Kellogg Co. and General Mills Inc., have pledged to use half their youth advertising budgets to promote healthy eating.

 

The Center for Science in the Public Interest, or CSPI, reports that several state and local governments, including New York City, Philadelphia and California, have passed laws requiring some form of nutritional disclosure on chain restaurant menus such as calorie and fat content.

 

And YUM! Brands, parent of KFC, Pizza Hut and Taco Bell, has added calorie counts to its menus nationwide. Others, including Dunkin' Donuts and Au Bon Pain, have introduced menus with healthier items and smaller portion sizes and eliminated trans fats.

 

Michael F. Jacobson, executive director of the CSPI, said moves such as calorie counts on menus have been well received by consumers. Congress is expected to consider legislation this year that would take that nationwide.

 

As for the grocery labels, he said they, too, could offer help to some consumers. But, he said, a consistent nationwide program sponsored by the government would garner more trust from the public overwhelmed with labels that make various, sometimes dubious, health claims. His group is advocating a study to determine the best system of labels and then a mandate for manufacturers to boldly display an icon on the front of their packages, rather than on store shelves.

 

"There is the issue of label fatigue," he said. "Who knows if people are listening anymore. A certain percentage of the population will listen, but with the government behind one system, it would have greater support."

 

Consumers, for their part, do seem befuddled. A survey conducted last year by the American Dietetic Association showed that 67 percent of consumers thought diet and nutrition were "very important," but about half said they "weren't doing more" to improve their diet because they needed tips to eat better. More than 40 percent said they didn't know or understand nutritional guidelines. These were increases from a similar survey conducted in 2000.

 

At the grocery store, some consumers said government data on the back panel are more trustworthy than manufacturer labels on the front.

 

"I just turn every package around and take a look at the nutritional information," said Alisa Chappell of Westminster, who was shopping recently at the Glen Burnie Giant for cereal with her 7-year-old son, Ian. "But you do have to know what you're looking for or it can be confusing. I pay attention to sugar and fat and salt."

 

Chappell said she hadn't noticed Giant's new tags, which began showing up about a month ago and were small - some shoppers said too small - and tucked next to the price on the shelf. But after learning about them, she said they would be helpful if she was in a hurry and didn't have time to read every label on unfamiliar products. The Golden Grahams chosen by Ian and approved by Chappell did have a Healthy Ideas tag.

 

Eric Coles of Severna Park said he isn't always a label reader and also thought claims made by manufacturers on their packages were suspect. But he said Giant's new tag, from independent analysts, may be enough to sway him when differences aren't obvious.

 

Indeed, he and his 2-year-old daughter, Emilia, walked off with Hunts crushed tomatoes, which had a tag, instead of the store brand that did not after a quick look at the nutritional data showed similar values. (Closer inspection revealed that the store brand based its data on a smaller serving size, so the same amount of Hunts had less salt and calories.)

 

It's those pitfalls, and that level of investigation, that the grocers are hoping to eliminate.

 

"We realize there is a lot of information out there for consumers to digest and understand," said Haley Meyer, a spokeswoman for Supervalu. "As a national grocery company, we felt we had an opportunity, even an obligation, to serve as a conduit for information."

 

In the end, the stores will not likely know how many shoppers continue to buy food based on cost or taste and how many will factor in another label.

 

William Jenney said he will read the grocers' labels. But he won't stop reading the others, either.

 

healthful labels

 

Giant Food's Healthy Ideas

•Products that meet government guidelines for nutrition will get a tag labeling them healthy.

 

•So far, 3,800 packaged foods have been given a label, or almost 6,000 items if fruits and vegetables are counted. More will be added as they are examined.

 

•The labels will be applied to national and store brands and to all price levels in the stores.

 

•Giant has 128 stores in the Mid-Atlantic region.

 

Supervalu's nutrition iQ

•Products will get one of seven color-coded tags for: good sources of fiber (orange), calcium (blue), protein (yellow), low calorie (purple), low sodium (dark green), low saturated fat (red) and whole grains (dark orange).

 

•Eventually, an estimated 10 percent of the store's approximately 60,000 items will get a label.

 

•Candy, cookies, coffee, bottled water and other items that are too high in fat, sugar or salt or lack nutritional value will be excluded.

 

•Supervalu has 65 Shoppers Food & Pharmacy stores in the Mid-Atlantic region.

 

Copyright 2009 Baltimore Sun.

 

Carroll hospital offering new procedure

 

By Mary Scott, Landmark News Service

Carroll County Times

Monday, January 26, 2009

 

When Mount Airy resident Michael Vlahos felt the stabbing sensation of a heart attack shortly after New Year’s Day, he knew he had to get treatment quickly.

 

Thanks to an advanced procedure now being offered at Carroll Hospital Center, Vlahos was able to receive emergency care and be resting comfortably within 67 minutes of arriving.

 

Beginning in October, CHC teamed up with the University of Maryland Medical Center to offer a percutaneous coronary intervention, better known as an emergency angioplasty, to patients experiencing a certain kind of heart attack.

 

“It’s actually amazing. They come in writhing in pain having a heart attack and within an hour they’re feeling fine,” said Dr. David Zimrin, medical director of the Cardiac Catheterization Lab at UMMC and one of the interventional cardiologists performing the procedure at CHC.

 

According to Leslie Simmons, chief operating officer at Carroll Hospital Center, emergency angioplasties will save valuable time for heart attack patients arriving at CHC. Prior to October, patients requiring the treatment had to be transferred to another hospital, which could take hours.

 

“Time is probably the most significant issue when somebody is having a heart attack. The quicker we can get the artery open and the blood restored to the heart, the less damage there will be,” Simmons said.

 

Zimrin said that while the state requires 80 percent of patients undergoing the procedure to be treated in less than 120 minutes, Carroll’s goal is 90 minutes. So far, he said, all but one of the patients has been treated in less than 90 minutes, but that patient still came in under the required two-hour mark.

 

Doctors perform the procedure by threading a small tube with a tiny balloon at the end through a large vessel in the patient’s groin. Once the tube reaches the blockage area in the heart, the balloon is inflated, pushing the artery open and restoring blood flow. To be effective, it must be performed soon after heart attack symptoms appear.

 

Vlahos, who on Jan. 2 became the 27th patient at Carroll to receive an emergency angioplasty, said he was told by doctors that if he had waited much longer to call for an ambulance, he might have been killed by the heart attack.

 

“I’ve always been macho my entire life and just assumed there was nothing a shower couldn’t make better,” Vlahos said. “If I were to do that in this case, I would’ve been dead.”

 

In an effort to save time, treatment plans for heart attack patients are begun before the patient even arrives at the hospital now, according to Simmons. She said every ambulance in the county is equipped with an Internet-based system that allows the paramedics to take a cardiogram and send it to the hospital while the patient is still at home.

 

“The most amazing thing about this is the [cardiac] team is waiting for the person to be brought off the ambulance when they get there,” Simmons said.

 

Through Carroll’s partnership with UMMC, doctors from UMMC are on-staff or on-call at Carroll 24 hours a day, seven days a week to perform the procedure, according to Zimrin. He estimated between 80 and 100 patients at CHC will require one each year.

 

Simmons said that only about half of the hospitals in Maryland are authorized to perform emergency angioplasties.

 

“There was a clear-cut need for it here in Carroll,” Zimrin said.

 

Mary Scott can be reached at 410-857-3316 or mary.scott@westminsteradvocate.com.

 

Symptoms

The five major symptoms of a heart attack are:

 

# Pain or discomfort in the jaw, neck or back

 

# Feeling weak, light-headed or faint

 

# Chest pain or discomfort

 

# Pain or discomfort in the arms or shoulder

 

# Shortness of breath

 

Source: Centers for Disease Control and Prevention

 

Copyright 2009 Carroll County Times.

 

National / International

 

Researchers find no risk of thimerosal in vaccines causing brain problems

 

Associated Press

By Carla K. Johnson

Baltimore Sun

Monday, January 26, 2009

 

CHICAGO (AP) — A new study from Italy adds to a mountain of evidence that a mercury-based preservative once used in many vaccines doesn't hurt children, offering more reassurance to parents.

 

In the early 1990s, thousands of healthy Italian babies in a study of whooping cough vaccines got two different amounts of the preservative thimerosal (pronounced thih-MEHR'-uh-sawl) from all their routine shots.

 

Ten years later, 1,403 of those children took a battery of brain function tests. Researchers found small differences in only two of 24 measurements and those "might be attributable to chance," they wrote in the February issue of the journal Pediatrics, which was released Monday.

 

Only one case of autism was found, and that was in the group that got the lower level of thimerosal.

 

Autism is a complex disorder featuring repetitive behaviors and poor social interaction and communication skills. Scientists generally believe genetics plays a role in causing the disorder; a theory that thimerosal is to blame has been repeatedly discounted in scientific studies.

 

"Put together with the evidence of all the other studies, this tells us there is no reason to worry about the effect of thimerosal in vaccines," said the new study's lead author, Dr. Alberto Tozzi of Bambino Gesu Hospital in Rome.

 

The debate over thimerosal and autism has been much stronger in the United States than in Italy, Tozzi said. But the researchers recognized a chance to examine the issue by going back to the children who had taken part in the 1990s whooping cough research.

 

Randomization sets the new study apart. The random assignment of children rules out the chance that factors other than thimerosal, such as education or poverty, caused the results.

 

Thimerosal, used in some vaccines to prevent the growth of bacteria and fungus, hasn't been in U.S. childhood vaccines since 2001, except for certain flu shots. Italy and other European nations began removing it in 1999. U.S. health officials recommended the removal of thimerosal as a precaution and to reduce the overall exposure of children to mercury.

 

Safety regulations still require multi-dose vials of vaccines to contain some type of preservative to prevent the spread of infection from contaminated vials.

 

The study, funded by the U.S. Centers for Disease Control and Prevention, drew praise from outside experts.

 

"It's yet another well done, peer-reviewed research study that has demonstrated there is no risk of any neurodevelopmental outcomes associated with thimerosal in vaccines," said epidemiologist Jennifer Pinto-Martin of the University of Pennsylvania.

 

"This becomes the fourth study to look for subtle signs of mercury toxicity and show the answer was 'no,'" said Dr. Paul Offit, chief of infectious diseases at the Children's Hospital of Philadelphia, the author of a book on autism research and the co-inventor of a rotavirus vaccine.

 

Tozzi said comparing children with no exposure to thimerosal could have improved the study. "However, if thimerosal were a cause of harm, it is likely that this effect would increase with the administered dose," he said.

 

The children received either 62.5 micrograms or 137.5 micrograms of ethyl mercury from all their shots during their first year of life. Thimerosal breaks down as ethyl mercury in the body. Before the reduction of thimerosal in the United States, the maximum exposure for infants was 187.5 micrograms of ethyl mercury.

 

The researchers found the children in both groups scored, on average, in the normal range on 11 tests of memory, attention, motor skills and other brain functions.

 

Those 11 tests included 24 measured outcomes. Small, but statistical differences were found for only two of those areas, and only for girls. The girls with higher exposure scored worse on a finger-tapping test with their dominant hands, and on a vocabulary test in which they were asked to name common objects.

 

There was no difference in boys on those outcomes or others. Researchers also found no difference in tic disorders. And the one autism case found in the lower-intake group was likely a chance finding, Tozzi said.

 

On the Net:

Pediatrics: http://www.aap.org/

 

Copyright 2009 Baltimore Sun.

 

MRSA infections on the rise in kids

 

Associated Press

Baltimore Sun

Monday, January 26, 2009

 

Researchers say they found an "alarming" increase in children's ear, nose and throat infections nationwide caused by dangerous drug-resistant staph germs. Other studies have shown rising numbers of skin infections in adults and children caused by these germs, nicknamed MRSA, but this is the first nationwide report on how common they are in deeper tissue infections in the head and neck. The study found the percentage caused by hard-to-treat MRSA bacteria more than doubled from 2001 to 2006.

 

The study is in January's Archives of Otolaryngology.

 

Copyright 2009 Baltimore Sun.

 

The reach of diabetes

Health Notes

 

By Ashley Andyshak

Frederick News-Post

Monday, January 26, 2009

 

Nearly 13 percent of adults age 20 and older have diabetes, but 40 percent of them have not been diagnosed, according to sobering new data from the National Institutes of Health and the Centers for Disease Control and Prevention.

 

Nearly one-third of people age 65 and older are diabetic, and an additional 30 percent of all American adults are pre-diabetic, with elevated blood sugar levels not yet in the diabetic range. Diabetes also disproportionately affects blacks and Hispanics; prevalence is up to 80 percent higher in these groups than among whites.

 

The new stats include information gleaned from Oral Glucose Tolerance Tests, which researchers say more accurately detect diabetes and pre-diabetes.

 

Diabetes can cause a myriad of health problems, including blindness, kidney failure, and amputations, and is a leading cause of heart disease and stroke. Researchers recommend that people over age 45, as well as younger people who are overweight, get tested for pre-diabetes or diabetes. If pre-diabetes is detected, losing a moderate amount of weight and increasing physical activity can significantly lower the risk of developing diabetes, experts say.

 

For more information, visit www.cdc.gov/diabetes, or www.diabetes.org.

 

Copyright 2009 Frederick News-Post.

 

FDA Conducts Safety Review of Plavix

 

By Jennifer Corbett Dooren and Jared A. Favole

Wall Street Journal

Monday, January 26, 2009

 

WASHINGTON -- The Food and Drug Administration said it was conducting a safety review of the anticlotting drug Plavix, focusing on whether the drug is less effective in certain patients.

 

The review was announced Monday in a so-called early communication posted on the FDA's Web site involving Plavix, marketed by Bristol-Myers Squibb Co. and Sanofi-Aventis SA. Plavix is one of the world's top-selling drugs, with nearly 25 million prescriptions written for the drug in the U.S. in 2007, according to IMS Health.

 

The FDA said it was looking at genetic factors in some patients as well as the use of proton pump inhibitors, or drugs designed to reduce stomach acid that could make the drug less effective. The agency said patients currently on Plavix should keep taking the medication as directed but should talk to their doctors if they are now taking a PPI.

 

"The FDA is aware of published reports that clopidogrel [marketed as Plavix] is less effective in some patients than it is in others," the agency said.

 

In a statement, Bristol-Myers and Sanofi-Aventis said they were working with the FDA to conduct additional studies that "will allow us to understand and characterize the factors that may influence this complex issue."

 

Plavix is used to prevent blood clots that could lead to heart attacks or strokes in patients at risk of such problems.

 

The agency said proton pump inhibitors are often used with Plavix because it can irritate the stomach lining. The FDA said some studies have suggested that use of certain PPIs may make Plavix less effective by inhibiting the same enzyme involved with making the drug effective, while other studies haven't shown the same effect. PPIs include Prilosec, Zegerid, Prevacid, Protonix, Aciphex and Nexium.

 

The FDA said it has no evidence that other drugs, known as H2 blockers that also treat heartburn, interfere with Plavix. H2 blockers include Zantac, Pepcid, Tagamet and Axid.

 

One such study involved 16,690 people and was conducted by pharmacy-benefits company Medco Health Solutions Inc. It suggested that people who combine a heartburn pill like Nexium or Prilosec with Plavix at their doctors' direction have a 50% higher risk of a heart attack or other cardiac event compared with those taking Plavix by itself. In December, three articles in prominent medical journals showed that Plavix might not be effective for 30% of cardiac patients because of a genetic abnormality in some heart patients that could interfere with their liver's ability to completely process the drug in the bloodstream.

 

Larry Lesko, director of the FDA's office of clinical pharmacology, told Dow Jones Newswires previously that the agency was in discussions with Bristol-Myers about updating Plavix's label.

 

Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@dowjones.com and Jared A. Favole at jared.favole@dowjones.com

 

Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved.

 

Proposal: Sign a donor card, move up on transplant list

 

By Chris Joyner

USA Today

Monday, January 26, 2009

 

JACKSON, Miss. - Amanda Hayes of Yazoo City, Miss., has been waiting for a kidney since 1994, so she has some pretty strong opinions about organ donation.

 

She favors giving preference on the national organ donation list to recipients who have taken good care of their health, despite their disease, and would take care of the new organ. Hayes goes to dialysis three times a week, doesn't drink and keeps her weight at the right level.

 

"I'm keeping myself healthy. If I was able to give a kidney, I would be on a donor list," she says. "They should look at that closely."

 

For people like Hayes, 39, the waiting is one of the most frustrating parts of needing a new organ. And more people are waiting in the USA than ever before.

 

Last fall, for the first time in its history, the national organ transplant waiting list topped 100,000 people, according to the United Network for Organ Sharing (UNOS), the non-profit assigned by the federal government to maintain the list. The list is up to 100,457, and three out of every four are waiting for a kidney.

 

Waiting is their reality

Alan Hawxby, transplant surgeon at the University of Mississippi Medical Center in Jackson, says the growing list is evidence of a dire need for more organs.

 

"We do tell people what to expect," he says. "Waiting for them is kind of a way of life. It's just the reality of their lives."

 

For some patients, a kidney can take six months to find, but that's only for those with Type A blood. It can take two or three years or more to find a match for O and B types, Hawxby says.

 

UNOS says 45% of patients on the list have been waiting two or more years for a kidney, heart, liver or some other organ.

 

The growing list of Americans waiting for organs prompted David Undis, president of the non-profit organ donation network LifeSharers, to propose last fall that UNOS reorder the list to give preference to patients who had agreed to become organ donors before their illness. The waiting list is now calculated to give the sickest patients the highest priority.

 

Undis says only half of the people eligible to become organ donors actually sign up, meaning millions of viable organs are buried with their original owners every year.

 

Creating "A" and "B" priority lists favoring those committed to becoming organ donors would greatly increase the number of people who sign up to be donors themselves, he says. No one would want to take the chance of ending up on the "B" list, Undis says.

 

"Altruism, which is a wonderful thing, just is not a sound basis for public policy," Undis says. "There are nice people out there, but there aren't enough out there to fix this problem."

 

Creating a new system

Six-year-old LifeSharers, based in Nashville, is itself an attempt to create a preferential system in miniature. LifeSharers' 10,000 members all have agreed to donate their organs upon their death, with the stipulation that first priority goes to any LifeSharers member in need.

 

Undis says the idea has not yet been put into practice because no members have died. Incorporating the LifeSharers model into the national waiting list has not gained much traction with UNOS, which has committees tasked with tweaking the waiting list protocols.

 

UNOS president Robert Higgins, a heart surgeon, concedes that there are problems with the list, starting with the fact that minorities are disproportionately represented. "Certain populations wait a long time. We need more organs."

 

UNOS processes 7,000 to 8,000 organ donations each year. And while organ transplantation, once a chancy procedure, has become more routine, Higgins says the demand has increased as the U.S. population has aged and people have become less healthy.

 

Higgins contends the LifeSharers' proposal raises some complicated questions.

 

"If you had a child who had liver failure who wasn't a donor, that child deserves to have a transplant even if they weren't a donor," Higgins says.

 

Likewise, some people - those without driver's licenses, for instance - might never have been presented with the option of becoming a donor, he says. Higgins acknowledges that the problem will get worse as Baby Boomers age and chronic illnesses become even more common.

 

Logical, but will it work?

Mark Fox, associate director of the Oklahoma Bioethics Center at the University of Oklahoma-Tulsa, says fixes such as the LifeSharers plan have "inherent logic" to them.

 

Perhaps prior willingness to donate could factor in as a "tiebreaker" in awarding organs, but he says there is no evidence such a plan would increase donation.

 

"We are an age- and death-defying society," he says. Most people do not sign up to donate because they do not think about their own medical frailties, he says.

 

Fox says a benefit of the current system is that is it based on science and has been developed in a thoughtful and open matter.

 

Billions of dollars have been poured into refining organ transplant procedures and the medical machinery needed to keep patients alive while they wait, he says, but less effort has been put into healthy living strategies.

 

"We haven't managed the demand side of the demand-supply equation," he says.

 

Joyner reports for the Clarion-Ledger in Jackson, Miss.

 

READERS: Are you an organ donor? Should being an organ donor affect a person's wait to receive an organ if they need one? Share your opinions below:

 

Find this article at:

http://www.usatoday.com/news/health/2009-01-25-transplant-debate_N.htm

 

 

Copyright 2008 USA TODAY, a division of Gannett Co. Inc.

 

Opinion

 

Where's the urgency?

Our view: Despite efforts, Baltimore made little progress in reducing infant mortality last year and nothing suggests that this grim statistic will change this year

 

Baltimore Sun Editorial

Monday, January 26, 2009

 

Rickeya Robinson left home one day last April to pick up her older kids and bring them back to the house. But when they returned, an ambulance was sitting out front: Ms. Robinson's 2-month-old infant son Zy'key, whom she had left in the house with her brother, had suddenly stopped breathing. Paramedics were unable to revive the child.

 

Sudden infant death syndrome is the second-biggest killer of children under 1 year old in Baltimore. Only disorders related to short gestation and low birth weight take a greater toll. In 2007, the last year for which statistics are available, 19 of the 112 infant deaths in Baltimore were attributed to SIDS, whose only symptom is the sudden and unexplained death of an apparently healthy infant.

 

Ms. Robinson, her children and brother and the child's father were devastated by the loss, as were members of both their extended families. Nearly a year later, they are still grieving.

 

Yet the tragedy that shattered their lives will likely touch just as many Baltimore families this year as it did last. Despite the efforts health officials are making to reduce infant deaths in the city, little progress has been made. The state health department expects no significant change in Baltimore's infant mortality rate this year. Maryland's infant mortality rate of eight deaths per 1,000 births exceeds that of Singapore and Cuba. Baltimore's rate is even higher -11.3 deaths per 1,000 births. It's an appalling loss of life in a state that boasts some of the best medical care in the country.

 

Baltimore's health commissioner, Dr. Joshua M. Sharfstein, is drafting a comprehensive plan to improve birth outcomes in the city. It focuses on services before, during and after pregnancy that have been shown to have a positive impact, including better primary health care for young women, substance abuse and smoking cessation programs for both men and women and support for victims of domestic violence. Health officials also want to mobilize community support groups in high-risk neighborhoods.

 

But the plan is still on paper. Meanwhile, current programs remain scattered and underfunded, and officials realize they may not have the resources to cover the whole city. Dr. Sharfstein estimates his agency would need several million dollars in additional funding to fully implement the plan.

 

Every infant death is a terrible tragedy for families. And the enormous costs of caring for low-birthweight babies ultimately are shared by everyone. Reducing infant mortality and low-birthweight deliveries is a question of humanity, but it's also common sense. All babies born in Maryland, one of the wealthiest states in the nation, deserve the same chance at a healthy life.

 

Copyright 2009 Baltimore Sun.

 

State still struggles with infant mortality

 

Baltimore Sun Letter to the Editor

Monday, January 26, 2009

 

Frank D. Roylance's article "CDC reports a sudden uptick in births, along with some troubling medical details" (Jan. 18) does point out "some worrisome changes in recent childbirth patterns across the nation." However, the idea that "Maryland women generally scored as well as or better than the national average" may give Maryland health care providers and state legislators an ill-founded sense of complacency.

 

In 2007, 112 babies in Baltimore died before their first birthday. And, as Mr. Roylance's article suggests, there are still sharp contrasts in birth outcomes for whites and minorities; infant mortality in Baltimore still disproportionately affects African-Americans.

 

Nearly as tragic is the number of babies born pre-term, those with low birth weights and those who live with chronic health problems throughout their lives.

 

And in Baltimore, African-American babies are twice as likely to have low birth weights as other infants.

 

Many factors can contribute to poor birth outcomes. However, one thing is certain: Healthier women have a better chance of having healthier babies.

 

And since 50 percent of pregnancies are still unplanned, it's important for women to have reliable health care throughout their child-bearing years.

 

That is why Planned Parenthood of Maryland is joining with the statewide Babies Born Healthy initiative to emphasize the importance of health care before a pregnancy occurs.

 

We believe that the Babies Born Healthy initiative can significantly impact future generations and hope that the General Assembly will support sustained funding for this crucial program. John W. Nugent Baltimore

 

The writer is president and CEO of Planned Parenthood of Maryland.

 

Copyright © 2009, The Baltimore Sun.

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