Ever had pain so severe in your sides, flank, or your lower stomach that caused you to your knees or even unable to get out of bed. This pain can be sharp and/or burning. In addition, you may have noticed some blood in your urine. After a few days the pain may have seemed to “pass” and so did the blood.

You may have just been subject to a kidney stone. And it is exactly as it sounds; a stone forms in your kidney and either it remains in the kidney or it passes out in your urine.  Many Americans each year suffer from this condition. Some are required to go to the hospital for pain medications and others have kidney stones that are so large that specific procedures are done to break the stone into smaller pieces in order for them to pass.

Kidney stones have been described as equal or worse then pregnancy. If you have never had one it would be hard to believe. But if you have experienced a kidney stone then you know exactly what I am talking about.

Often the future prevention of kidney stones is at the top of the list for discussion by patients and their providers. Often individuals are encouraged to change their diet such as caffeine, sodas, chocolates, and others.

Often discussion about the benefit of fruit juices are in the mix. The hopes is that citrus juices may protect against the formation of calcium oxalate stones. These stones are one type of stones found in kidney stones and are the most common.

But are all juices equal?

It appears that the answer is no.

Often the juice recommended is Lemonade or diluted lemon juice along with dietary changes has been
found to be helpful.

But a study by the “National Institutes of Health” compared lemonade with Orange juice and it found that orange juice decrease levels of stones more efficiently then lemonade.

Other juices such as Apple and Cranberry did well with certain stones and bad for others. These two juices
actually raised the risk for calcium stones but helped with the less common brushite stones.

Grapefruit juice appeared to fail completely and raised the risk of all stones.

Finally

Therefore a couple essential things have been noted. First, dietary changes are essential. Second, knowing the type of stone can be helpful. Third, try to avoid grapefruit juice if you are at risk for kidney stones.

Lastly, some individuals will only have one stone and they will be done. Others, despite the attempts at modifying diet will always be at risk. Drinking fruit juices my help reduce that risk but it doesn’t mean that you won’t ever have kidney stones again.

Cholesterol is a waxy steroid metabolite that is useful in the body and could also be considered essential to human metabolism.  Cholesterol can be found as a transportation molecule within the body, within certain cell walls or “membranes”,  and it is essential in the synthesis of hormones and other necessary acids and vitamins within the body. 

The production or synthesis of cholesterol occurs in the body.  A large amount of cholesterol is produced within the liver.  Other sites for production include:  intestines, adrenal gland, and some reproductive organs. 

However, cholesterol can also be added to the body through dietary means especially animal products.  Animal fats are typical places to find cholesterol.  Plants and vegetables do not contain cholesterol unless it has been added through cooking process or other means. 

Sources of Cholesterol include:

   -  Cheese
   -  Beef
   -  Chicken
   -  Eggs
   -  Pork
   -  Shrimp

Another few players in cholesterol are Trans Fat and Saturated Fat

Saturated Fats can be seen in chocolate, some oils, animal fats, and some dairy products

Trans Fats can be seen in baked goods, fast food, snack foods, fried foods, margarine, and hydrogenated vegetable oil.    Trans fats are produced by partially hydrogenating unsaturated fats.  These are not found largely in nature.  It has been recommended to limit or eliminate trans fats to improve your health.

The health concerns of elevated cholesterol are intense and severe:

Hypercholesterolemia

Is when a high amount of circulating cholesterol can be found in the blood

It is not specifically a disease but may result from other issues such as diet, family genes, diabetes or thyroid problems.

Cholesterol can always be found in the blood – but when levels becomes quite elevated then the concern arises.

Elevated cholesterol can lead to serious medical concerns such as:  Atherosclerosis, Coronary Artery Disease, Worsening High Blood Pressure , Stroke, Peripheral Vascular Disease, Angina, and others

Atherosclerosis

Atherosclerosis is a response or result of damage to arterial blood vessels.

Is the result of hardening in the arteries and is typically caused by a build up of fatty molecules such as cholesterol.

It is more specific then the general term of arteriosclerosis.

Coronary Artery Disease

Plaque fills the inner pipes of arteries that supply oxygen to the heart.

Smoking is the #1 preventable risk factor but so is elevated cholesterol

Coronary arteries supply the muscle of the heart with oxygen.

Plaque can fill or line the arteries of the heart

Rupture or tearing of the arteries can occur causing serious consequences.

Prevention and Exercise

Prevention is necessary for several reasons. Diabetes and Hypertension are serious diseases that can be made much worse with elevated cholesterol.  Diet and exercise are central to a good health in both improving cholesterol and additional symptoms associated with this disease. 

As in many other areas, preventing cholesterol build up before it changes your life can be difficult but critical.  HDL can be considered “the good cholesterol” and acts as a buffer to prevent a build up of unwanted cholesterol.  HDL is a lipoprotein that can be improved through exercise.   Other ways to improve HDL is stopping smoking, improving diet, weight loss, fish oil, flax seed and others.

The earthquake in Haiti has resulted in a medical crisis that has gone from bad to worse. Hundreds of thousands of the countries dead and thousands more are injured and sick. Diseases in Haiti are a serious concern and in some cases can be a preventable disaster. Increasingly and alarming are the concerns regarding water and sanitation problems of the region that are taking center stage.

Port-au-Prince the capital of Haiti is in a serious medical crisis. First, several refugee camps have been set up. These people are sleeping in the open and poor sanitation sites and low water rations are setting up a potential health bomb who’s explosion could lead to additional disease outbreaks such as cholera. Second, medical injuries are not being addressed due to the lack of availability of medical clinics and structural disasters following the earthquake. Third, mental challenges experienced by the survivors are being seen by those health care and aid workers at a high volume.

Injuries are currently a large concern and several plans are being put into place. Several hospitals and medical centres have been crushed and destroyed and little is available. Doctors Without Borders, are no longer able to uses several areas of the hospital. They only have 2 surgical rooms open in the entire city. There are hundreds of people waiting for care.

Portable or mobile operating rooms were en route but have been recently held up both on roads and in the air from the Dominican Republic. “Triage, stabilisation of the wounded and referrals for surgical needs are the medical priorities,” Dr. Mego Terzian said on the group’s Web site.

Dialysis

Many survivors are in danger of kidney failure. Due to debris, crushing injuries, loss of blood, and other causes of severe bleeding. kidney failure becomes an alarming concern.

Dialysis is a procedure that allows a solution of mannitol to be placed into the kidneys and it helps to flush them out. In addition dialysis helps to clean out the existing blood into cleaner and more usable blood for the body.

At this time it is believed that any dialysis treatment is not available anywhere in Port-au-Prince.

The Dead

In addition to the living tragedies it is also become an alarming concern about the corpses of the dead. This concern is both a mental and medical concern. Several mass graves have been created but still there are dead that can be found in hospitals, courtyards, and still some are found on the streets.

Many family members are still uncertain about the dead in their families. A closure of mental stability may be seen when a family member can identify a love one that is dead.

Though many believe that dead bodies can trigger an epidemic, the CDC and WHO are actively attempting to dispel
this myth.

The Bright Side

Amazing stories of courage and hope are coming out of Haiti daily from the survivors to the volunteers. Hope must remain of both a rebuilding process for each individual and the country as a whole. Aid, help, volunteers and stability are being infused into this region.

Rescuers continue to work diligently and Women’s health are giving out rice for vouchers. More specific plans are in place for those who are at a higher risk and concern especially children in Haiti.

The UN has begun a large-scale aid distribution in Haiti’s capital, aiming to feed two million people nearly three weeks after the deadly earthquake.

Serious medical problems are often seen following natural disasters because of lack of water and sanitation.  The earthquake in Haiti will be no different.  But in addition to lack of resources is the amount of deaths, injuries, and infections. 

12 major diseases that can be expected:

1.)   Measles
2.)   Viral Hepatitis
3.)   Typhoid fever
4.)   Gastroenteritis
5.)   Coccidiomycosis
6.)   Giardia
7.)   Cholera
8.)   MRSA skin infection
9.)   Malaria
10.)   Dengue Fever
11.)   Yellow fever
12.)   Others

“The disaster cut power, electricity and other utilities. This could leave people without clean drinking water and at greater risk of malnutrition and disease. The potential new mass of displaced persons could create crowded, unsanitary conditions that facilitate the spread of contagious respiratory infections,” said Dr. Peter Hotez, head of the department of microbiology at George Washington University.

“What you have is the perfect storm of infection,” Hotez said. “What you have is a breakdown. It is already a fragile infrastructure with high rates of infectious and neglected tropical disease. Now there are potential breakdowns in sanitation, clean water, housing and subsequent crowding. That’s a terrible mix.”

For more information on the Haiti earthquake check out the following blog article on Water and Sanitation

Athlete’s deaths over the last several years and especially recently with Gaines Adams’ death last week have triggered talks by the NFL on the evaluation process for its professional football players. The National Football League has creasted their own Cardiovascular committee and are considering putting into play a heart scan called an echocardiogram.

The heart is one of the more concerning aspects of sudden death leading to cardiac arrest.  Deaths can be seen from high school students up to professional athletes.

The first group affected may be those who will be invited to the NFL combine in February.  The largest concern is the fear of legal liability. In addition the concern is where will, if any, cut off line and will it be the cardiologists that stop the career of a player.

Many questions still linger regarding the evaluation process. An echocardiogram is only the beginning of evaluation.

Other more sensitive tests subh as a Cardio Catheter Procedure, EKG, and other tests may follow. But at what point would they be required.

The current guideline is when a player had a family history of heart problems or an abnormal EKG then a echocardiogram may be ordered.

Gaines Adams had an autopsy that showed he had an enlarged heart which can be referred to as Cardiomyopathy that can often lead to cardiac arrest.

Further investigation showed that Adams had a normal EKG and no family history of cardiac abnormalities.

He went into Cardiac arrest two weeks ago at his family’s home in South Carolina.

Another blog article dealing with the sudden death of an athlete is found at the following address  http://www.iahealth.net/unexpected-sudden-death-of-an-athlete

The Haitian earthquake is an unexpected and devastating natural disaster that has hit and is affecting a large number of people.  Travelers, locals, businesses, health care, government, and many others have been affected.

Our focus, for good reason, is on the event itself and the resolution and help for victims, survivors, clean-up, and the rebuilding process. The focal point is often on villages for reconstruction, temporary shelters, food, water and supplies.  This focus is essential to the region affected. 

Outside help is equally necessary.  Without the efforts of many the consequences of the earthquake would be many fold worse.

The military, rescue personnel, and volunteers from many countries have arrived and U.N officials are setting up camps and passing out rations of aid that has been flowing into the country for the past few days.  But the work of the government, health workers, volunteers and others are at risk.  The infrastructure has fallen in the country and looters are trying to find food, water and shelter.  In addition, a local prison in the capital of Port-au-Prince had 4,000 inmates escape and are roaming around the town.

Often overlooked is the health and mental health conditions that remain one week, one month, and even one year after the disaster.   This earthquake in Haiti will remind us quickly of the large concerns that are present following an earthquake.  With hours turning into days without proper shelter, food and water the local people will become desperate and increasing looting and problems can be expected to continue.

Lets take a look at the earthquake back in September on the Indonesian island of Sumatra.  Doctors Without Boarders/Medecins Sans Frontieres (MSF) were still in full force 1 month after the earthquake.

Mental Health

The destruction so absolute of the world you once knew can be devastating for anyone.  The expectation to pick up where you were remains.  The difficulty is the loss of life, home, water, food and “normality” of life.

“I worried a lot and had difficulty sleeping during the first two weeks after the earthquake, but I am getting better after a psychological consultation with MSF,” says Novaldi, 29, from Lubuk Laweh near Pariaman.  He lost six family members in the earthquake.

This help may need to be provided for months after an earthquake and is a remarkable and necessary aspect of progression and rebuilding an village or neighborhood.

Health Issues:

Following an earthquake two serious concerns need to be addressed;
Water and Sanitation

Without a good plan for bringing in drinkable water into an area can have wide spread consequences.   Most individuals start to begin to suffer side effects from dehydration after 30-36 hours without water.  A city or village is very vulnerable to the water system being contaminated.  

Often a recommendation is the melting of ice cubes when no other water source is available

Sanitation Standards

Human excreta contains a large amount of germs.   The possibility of increase infections and disease rises dramatically in times of natural disaster.

Often water lines and such become non functioning.  This results in a buildup or concern for sanitation.  Contamination of drinking water, rivers and lakes can occur during rains and other times.

Proper disposal of solid waste and other sanitation materials is essential. In addition hand washing becomes an increase concern as well when locals do not have enough clean running water.  Build-up of sanitation will increase flies and other infectious diseases.

Flies will often then land on nearby food transferring the infection to many others.

Infectious diseases

Often after a severe natural disasters epidemics due to infectious diseases emerges. 

This is a potential for a disaster and a high mortality during this period. 

Often it depends on type of disaster, location, time of year, and associated rainfall or other weather changes.

Previous natural disasters have seen large increases in the following:

1.)    Measles
2.)    Viral Hepatitis
3.)    Typhoid fever
4.)    Gastroenteritis
5.)    Coccidiomycosis
6.)    Giardia
7.)    Cholera
8.)    MRSA skin infection
9.)    Malaria
10.)    Dengue Fever
11.)    Yellow fever
12.)    Others

We should have hope
 
Currently it is hoped that the earthquake in Haiti will not lead to large problems with infectious diseases, if fact the Associated Press wrote the following:   “Medical experts say disasters such as an earthquake generally do not lead to new outbreaks of infectious diseases, but they do tend to worsen existing health problems.”

But also reported was a concern by the associate director of the UCLA Center of Public Health and Disasters in the same report.   “Haiti’s quake refugees likely will face an increased risk of dengue fever, malaria and measles — problems that plagued the impoverished country before,” said Kimberley Shoaf.

Our hopes and prayers go out to all those who have suffered severe losses and those who have the means to provide care and hope for those affected.   Let us hope for the best outcome possible

President Barack Obama has promised an “all-out rescue and humanitarian effort”,  he also added that the hope and expected a large U.S. commitment for those in need.

“We have to be there for them in their hour of need,” Obama said.

References:

Indonesia: One Month After Earthquake, Focus is on Mental Health   -   http://doctorswithoutborders.org/news/article.cfm?id=4041&cat=field-news

Water Sanitation and Health (WSH)  recommendations by the WHO: http://www.who.int/water_sanitation_health/hygiene/emergencies/javaearthquake/en/index.html

Infectious Complications after Mass Disasters: The Marmara Earthquake Experience   http://www.informaworld.com/smpp/content~db=all~content=a714026034

Bodies piled on streets after powerful Haiti quake   -  http://news.yahoo.com/s/ap/20100113/ap_on_re_la_am_ca/cb_haiti_earthquake

Tougher smog restrictions may be on the horizon but will it really help you if you suffer from asthma, COPD, or other breathing or respiratory conditions?  Many who are truly affected by the increase in pollution, smog, inversion are asking the question.

Activists that are reportedly protecting the environment want tougher standards on pollutants, ozone levels, and air quality.   However, if you suffer from a severe respiratory condition extreme changes in temperature, pollutants, and smog can be quite devastating to your breathing.

Asthma is a condition that is affected by air control, inflammation, and oxygen intake.  Each can easily be affected by sevaral risk factors .  Asthma is a chronic condition that affects the lungs.

“EPA is stepping up to protect Americans from one of the most persistent and widespread pollutants we face,” said Lisa Jackson, the EPA administrator.

“EPA’s proposed standards promise clean air protections that reach from the nation’s urban neighbourhoods and communities to our rural forests and croplands,” said Cal BaierAnderson, a toxicologist with the Environmental Defense Fund.

Health officals agree that smog, pollutants and other things like smoking, allergens, and weather can be detrimental to some health conditions, but it is unknown what actual benefit will be seen because what true chances are actually going to occur.  There are many who voice a concern on the controls countries will have on the companies or agencies that do not follow the new recommendations [if they are approved].  What sort of accountability will be enforced.

Others do no agree with the recommendations set by the EPA, including the oil industry and others.  “There is absolutely
no basis for EPA to propose changing the ozone standards promulgated by the EPA administrator in 2008,” the American Petroleum Institute said.

Honestly, this could be another smoke and screen on issues related to the community with several stories and recommendations but the accountability and actions could leave us far from secure or satisfied.  We will all need to wait to see the outcome of this story.

The battle continues on the reccomendations for the guidelines for breast cancer screening.  Recently two groups placed importance for the age 40 for breast cancer screenings for those who are high-risk patients.  Also recommended are imaging evaluation of mammography, MRI and ultrasound.

Both the Society of Breast Imaging (SBI) and the American College of Radiology (ACR)
gave the recommendations for the Journal of the American College of Radiology (JACR) in the
January issue.

“The significant decrease in breast cancer mortality, which amounts to nearly 30 percent since 1990, is a
major medical success and is due largely to earlier detection of breast cancer through mammography screening,” said Carol H. Lee, MD. “For women with the highest risk of developing breast cancer, screening technologies in addition to mammography have been adopted,” said Lee.

Recommendations:

1.)     Average age for screening should be age 40
2.)    Higher risk patients should begin at age 30
3.)    Screening should not begin before age 25 unless otherwise indicated

For more information about JACR, please visit www.jacr.org.

Tylenol Arthritis, a medication designed to treat arthritis has expanded its recall.  Tylenol is a top medication used in several forms and areas.  The FDA has been recommending this recall as well.

The recall began in November because of a smell that has been described as “moldy” or “musty“.  It is believed that this smell is caused from a chemical called “2,4,6 tribromoanisole“.   The overall health concern remains unknown and studies have not been performed to see if any health problems may result.  

It can therefore be assumed that, at this time, the large majority of the reason for this recall is smell alone. 

Though many describe symptoms including: 

   -   Nausea
   -   Vomiting
   -   Abdominal pain
   -   Abdominal discomfort
   -   Diarrhea 

***   -   These symptoms appear to only last for a short period of time. 

The bottle for this medication is unique to this brand.  Johnson & Johnson has produced a E-Z bottle top that is bright red.  The top is larger than a typical top and Caplets of 100 per bottle are seen.

It is recommended that you stop taking this medication immediately and contact the company for the return and refund policy.

For more information the following is a link to the Tylenol website -  link

Recalls are seen with Automobiles, toys, furniture and other material items but should we be concerned with a recall of a vaccine?

Especially at this time with the concern for the Swine Flu .

Today, hundreds of thousand Swine Flu Vaccines intended for young children have been recalled. 

Sanofi Pasteur, a France based manufacture, is voluntarily recalling 800,000 doses intended for children between ages of 6 months to 35 months.

The vaccine where this dosing was manufactured was in Swiftwater, Pennsylvania

The reason for the recall is that post shipment testing has shown some lack of effectiveness and a decrease quantity of vaccine.  Hope still remains for many health officials that those who have been vaccinated will still become immunized. The positive note is that this recall was not caused by a concern for patient safety.

The cause appears to remain unknown

Is the recall a concern?

Truthfully, recalls are important and necessary.  This appears to be a important way for companies to correct problems.  In this case, it would do no one any good to be vaccinated by this “batch” of vaccines because the end result wouldn’t be the expected or intended result.

The CDC strongly communicates that their is no children that have been or will be in any danger.  This recall is for effectiveness only.

However, this recall may be problematic to the appearance of the importance of the vaccine as a whole.  Concerns for safety, side effects, danger, and deaths will be on the forefront of the minds of those who read the headlines at a distance. 

What should parents do?

The answer is nothing.  No harm or foul has been seen and many Health officials believe that no additional vaccinations will be required.

Testing by the company are done on each “batch” of vaccines sent out and the findings were that the “vaccine containing as little as half of the recommended dosage” reported a spokesman of Sanofi Pasteur Len Lavenda.

The doses in question were shipped in November but findings of the failure of these vaccinations were found on December 7th.

CDC and the Food and Drug Administration were quickly informed and the recall was initiated.

Recommendations for Children under than the age of 9 but older than 3

  -  2 flu shots are required to be protected – usually a full doses in each syringe

Recommendations for Children under than the age of 3

  -  0.25 milliliter pre-fill syringes get two shots several weeks apart but they are only getting half the dose each time.