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The Healthy Flap: January 25, 2013

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These are my links for January 20th through January 25th:

  • Penalty could keep smokers out of health overhaul -Millions of smokers could be priced out of health insurance because of tobacco penalties in President Barack Obama’s health care law, according to experts who are just now teasing out the potential impact of a little-noted provision in the massive legislation.The Affordable Care Act — “Obamacare” to its detractors — allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums starting next Jan. 1.For a 55-year-old smoker, the penalty could reach nearly $4,250 a year. A 60-year-old could wind up paying nearly $5,100 on top of premiums.

    Younger smokers could be charged lower penalties under rules proposed last fall by the Obama administration. But older smokers could face a heavy hit on their household budgets at a time in life when smoking-related illnesses tend to emerge.

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  • Lawmakers seek to repeal ‘fiscal-cliff’ provision aiding Amgen -A bipartisan group of U.S. lawmakers is seeking to repeal a Medicare-pricing provision in the recent “fiscal-cliff” deal in Congress that benefits Thousand Oaks biotech giant Amgen Inc.Legislation to eliminate the exemption for a class of drugs, including Amgen’s Sensipar, that are used by kidney dialysis patients, was filed this week by U.S. Rep. Peter Welch (D-Vt.). The fiscal cliff legislation approved this month excluded these oral medications from Medicare price controls for an additional two years.”Amgen managed to get a $500-million paragraph in the fiscal cliff bill, and virtually no one in Congress was aware of it,” Welch said. “It’s a taxpayer rip-off and comes at a really bad time when we’re trying to control healthcare costs. Amgen should not be allowed to turn Medicare into a profit center.”

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  • Gap widens between actual weight and people’s imagined weight -Men and women, particularly those categorized as obese, have grown increasingly likely over the years to underestimate their true weight, according to a recent study.In a paper published Wednesday in the journal PLoS ONE, researchers at University College of Cork examined height and weight data for Irish adults over a nine-year period. In three separate health surveys, men and women were asked to estimate their height and weight, and those figures were used to calculate body mass index, or BMI. Afterward, they were weighed and measured for accuracy.What researchers discovered was that while people routinely misjudged their true dimensions, their weight estimates had grown increasingly inaccurate over time. Their height estimates however remained more or less constant.

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  • U.S. researchers tracking flu through Twitter -Researchers and computer scientists at Johns Hopkins University have devised a way to track cases of influenza across the United States using the microblogging site Twitter.Twitter is full of tweets about the flu, which has been severe and reached epidemic proportions this year, but it has been difficult to separate tweets about the flu from actual cases.”We wanted to separate hype about the flu from messages from people who truly become ill,” said Mark Dredze, an assistant research professor in Johns Hopkins’ department of computer science, who monitors public health trends by looking at tweets.

    To solve the problem, Dredze and his colleagues developed a screening method based on human language-processing technologies that only delivers real-time information on actual flu cases and filters out the rest of the chatter on the public tweets in the United States.

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  • Quitting smoking prolongs life at any age -t’s never too late to quit smoking, and researchers have new data to prove it. Even at the age of 64, kicking the habit can add four years to a person’s life, while quitting by age 34 can increase life expectancy by a decade, according to a study published online Wednesday by the New England Journal of Medicine.After analyzing health data from more than 200,000 Americans, researchers calculated that current smokers were three times more likely to die during the course of the study compared with people who had never smoked. For the most part, their deaths were caused by smoking-related ailments, including heart and lung disease. Overall, their odds of surviving to age 80 were half as good as for never-smokers.But the study, one of two large-scale surveys in the journal providing updated information on smoking and mortality, saw significant benefits for those who quit. Giving up smoking between the ages of 35 and 44 was associated with a gain of nine years of life, and those who quit between 45 and 54 lived an extra six years.

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  • Quitting smoking by age 40 erases most of the risk of an early death -Smokers who quit by around age 40 can stave off an early death, according to a landmark study that fills key gaps in knowledge of smoking-related health ills.While smokers who never stop lose about a decade of life expectancy, those who quit between ages 35 and 44 gained back nine of those years, the study found.Moreover, the benefits of dropping the habit extend deep into middle age. Smokers who quit between 45 and 54 gained back six otherwise lost years, and those who quit between 55 and 64 gained four years.

    Quitting young, before age 35, erased the entire decade of lost life expectancy.

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  • Antibiotic-resistant diseases pose ‘apocalyptic’ threat, top expert says -Britain’s most senior medical adviser has warned MPs that the rise in drug-resistant diseases could trigger a national emergency comparable to a catastrophic terrorist attack, pandemic flu or major coastal flooding.Dame Sally Davies, the chief medical officer, said the threat from infections that are resistant to frontline antibiotics was so serious that the issue should be added to the government’s national risk register of civil emergencies.She described what she called an “apocalyptic scenario” where people going for simple operations in 20 years’ time die of routine infections “because we have run out of antibiotics”.

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  • Marijuana still a drug with no accepted medical use, court says -Marijuana will continue to be considered a highly dangerous drug under federal law with no accepted medical uses, after a U.S. appeals court Tuesday refused to order a change in the government’s 40-year-old drug classification schedule.The decision keeps in place an odd legal split over marijuana, a drug deemed to be as dangerous as heroin and worse than methamphetamine by federal authorities, but one that has been legalized for medical use by voters or legislators in 20 states and the District of Columbia.A marijuana advocacy group went to court, arguing that federal officials had a duty to reexamine the medical evidence and reclassify marijuana as a drug that has clear benefits for those who are suffering and in pain. Joe Elford, counsel for Americans for Safe Access, said federal drug officials had a bias against marijuana that caused them to ignore its benefits and to exaggerate its dangers.

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  • Big Xylitol Trial Finds Scant Benefits in Adult Caries -The first big randomized controlled trial of xylitol for caries has found no statistically significant benefits in a population of adults at high risk for the disease.Published in the January issue of the Journal of the American Dental Association, the Xylitol for Adult Caries Trial (X-ACT) showed a 10% reduction in caries in a high-risk population who sucked xylitol lozenges compared with a matched population who sucked sucralose lozenges.This effect fell below statistical significance (P = .06). “What this says is xylitol is not going to be a frontline defense for those at high risk,” lead author James Bader, DDS, MPH, a research professor at the University of North Carolina at Chapel Hill, told Medscape Medical News. “Use it, but don’t rely on it.”

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  • A Check on Physicals -Even if there is no direct medical benefit, many doctors say that having their patients visit once a year helps to maintain a meaningful relationship and alert doctors to changes in patients’ lives that could affect health. It is also an opportunity to give patients needed immunizations and to remind them to get their eyes, teeth and skin checked.But the long-sacrosanct recommendation that everyone should have an annual physical was challenged yet again recently by researchers at the Nordic Cochrane Center in Copenhagen.Tags:

  • Snowboarding linked to injury rate rise on slopes: study -Allowing snowboarders to hit the slopes at one U.S. ski resort led to a small rise in the number of overall injuries, a trend in line with findings at ski areas elsewhere, according to a U.S. report.Injuries rose by 13 percent in the two years after snowboarders were permitted at the Taos Ski Valley in New Mexico, compared to the two years before, according to the report in The American Journal of Sports Medicine.”We recognize that a small but statistically significant increase in injury rate was observed after the addition of snowboarding to this mountain but that factors other than type of sport may play a role in the differences that were identified,” said study leader David Rust from the University of new Mexico in Albuquerque.

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  • Getting a flu shot can be sticking point with healthcare workers -As a nurse at a Downey hospital, Darlene Andres spends her days caring for postpartum mothers and their newborn babies. Andres urges new moms to get the flu vaccine before leaving.But Andres, 36, decided not to get the flu shot herself. Andres — a self-proclaimed “germ freak” — said she just washes her hands instead.”I heard from a lot of co-workers on the floors that they were getting a lot of symptoms after getting the flu vaccine,” she said. “I kind of got scared.”

    On Friday, public health officials warned that the flu wreaking havoc elsewhere has finally arrived in California and is now causing widespread hospitalizations across the state. The increase in illnesses so early could signal a worse flu season than in years past.

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  • Graphic warnings on cigarettes effective across demographic groups -Quitting smoking is a common New Year’s resolution for Americans each year, but research has repeatedly shown it is not an easy task. Some groups, such as racial/ethnic minorities, have an even harder time quitting. New research suggests hard-hitting graphic tobacco warnings may help smokers of diverse backgrounds who are struggling to quit. A new study by researchers at Legacy® and Harvard School of Public Health provides further evidence that bold pictorial cigarette warning labels that visually depict the health consequences of smoking — such as those required under the 2009 Family Smoking and Prevention Tobacco Control Act — play a life-saving role in highlighting the dangers of smoking and encouraging smokers to quit.Tags:

  • Flu season fuels debate over paid sick time laws -Sniffling, groggy and afraid she had caught the flu, Diana Zavala dragged herself in to work anyway for a day she felt she couldn’t afford to miss.A school speech therapist who works as an independent contractor, she doesn’t have paid sick days. So the mother of two reported to work and hoped for the best — and was aching, shivering and coughing by the end of the day. She stayed home the next day, then loaded up on medicine and returned to work.”It’s a balancing act” between physical health and financial well-being, she said.

    An unusually early and vigorous flu season is drawing attention to a cause that has scored victories but also hit roadblocks in recent years: mandatory paid sick leave for a third of civilian workers — more than 40 million people — who don’t have it.

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Dentistry

Oral Health America Slogan Contest Targets Youth Baseball and Smokeless Tobacco

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Photo courtesy of Matt McGee on Flickr

From the press release:

Attention all 2012 Little League baseball and softball players! Oral Health America’s (OHA) NSTEP® program (National Spit Tobacco Education Program) is teaming with Little League International to launch its eleventh annual slogan contest where players have a chance to win a trip to the Little League World Series! To enter, Little Leaguers ages 8-14 create a ten-word phrase that describes why spit tobacco is dangerous and deadly.

According to the Centers for Disease Control and Prevention, since 2003 there has been a 36 percent increase in the rate of smokeless tobacco use among high school boys. This alarming statistic is what led parents of the 2011 slogan contest winner, John and Julie Lafakis, to participate with their son Lou. “In addition to being thrilled and proud of Lou’s slogan,” said John Lafakis, “we are equally delighted that the NSTEP contest provided an opportunity for our family to discuss the harms of tobacco use.”

NSTEP works with Little League International to educate families about the risks of spit tobacco use, including oral cancer, gum disease, tooth decay, and nicotine addiction. “The health and well-being of children has been one of Little League’s guiding principles since its founding in 1939. We are proud to partner with NSTEP to educate young people about the dangers of smokeless tobacco,” said Stephen D. Keener, President and Chief Executive Officer of Little League Baseball and Softball.

NSTEP is also part of a coalition of organizations that influenced the limit on use of smokeless tobacco in Major League ballparks. For the first time in history, players are unable to use smokeless tobacco products on field and in front of fans and cameras. “The new limits are a positive step toward reducing the damaging influences of smokeless tobacco,” said Beth Truett, President and CEO of Oral Health America. “NSTEP is proud to have helped influence the ban and will continue to help educate Americans about the dangers of tobacco use.”

To enter the slogan contest, visit www.oralhealthamerica.org. The most creative slogan participant will win an all-expenses paid trip to Little League World Series in Williamsport, PA plus a $500 cash prize. Oral Health America will also make a $500 donation to the player’s Little League organization.

There is no reason for baseball, America’s past time, to be any longer associated with spit or smokeless tobacco.

Programs like this that increase awareness of the dangers of tobacco use should be encouraged.

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Cancer

Beastie Boy’s Singer Adam Yauch Dies of Rare Salivary Gland Cancer

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 Quite a shame, but this cancer is rare.

Beastie Boys member Adam Yauch, also known as MCA, died Friday after a long battle with salivary gland cancer, according to multiple reports.  He was 47 years old.

Yauch announced in 2009 that he had been diagnosed and was being treated for cancer of the parotid glands and lymph nodes.  There are three major pairs of salivary glands – sublingual, submandibular and parotid, the biggest of the glands.

According to the American Society of Clinical Oncology, salivary gland cancer is very rare, only affecting two out of 100,000 adults each year in the U.S.

But, recognizing some warning signs is important.

Genden said that while Yauch’s case is tragic, it is still very uncommon.  However, he hopes for people to be aware of potential symptoms of salivary gland cancer, which include trouble swallowing, pain or numbness in the face, and most notably, a large lump in the neck.

“It’s not that it’s preventable, but this is the kind of thing that with careful screening and good examinations, you should be fine. The sooner you seek medical attention, the better chance for survival.”

So, if there are any doubts, discuss it with your dentist or physician.

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Dentistry

Medicaid Does Not Improve Access to Dental Services for Poor Children

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According to a new study.

Abstract –  Background:  Data are lacking to support the contention that Medicaid services improve utilization of healthcare services and result in better health.

Objective:  To compare sociodemographic, utilization of healthcare services and health status characteristics among Medicaid-eligible children.

Methods:  The third National Health and Nutrition Examination Survey included 2821 children 2–16 years of age eligible for Medicaid. The main outcome measures are annual physician visit, annual dentist visit, general health status, oral health status, asthma (second most common childhood disease), dental caries (most common childhood disease), asthma treatment needs, and dental treatment needs. We quantified the association of these outcome measures with Medicaid insurance status and sociodemographic status using multiple logistic regression modeling, taking into account the complex survey design and sample weights.

Results:  Among Medicaid-eligible children, 27% were uninsured. Among uninsured Medicaid-eligible children, 62% had an annual physician visit, 32% had an annual dentist visit, 10% needed asthma treatment, and 57% needed dental treatment. Among insured Medicaid-eligible children, 81% had an annual physician visit, 39% had an annual dentist visit, 13% needed asthma treatment, and 42% needed dental treatment. After simultaneously taking into account other characteristics, uninsured Medicaid-eligible children were more likely to not have an annual physician visit (ORNoMDvisit = 2.21; 1.26–3.90), and to need dental treatment (ORDentalNeed = 1.57; 1.13–2.18).

Conclusions:  This USA population-based study found disparities exist within Medicaid’s services between utilization of dental and medical services. Medicaid insurance improved utilization of medical services, but did not improve the utilization of dental services. This suggests that Medicaid insurance does not improve access to dental services for poor children.

Once upon a time, when I treated California Denti-Cal (Medicaid) patients, the no show or broken appointment rate was astounding. These folks were getting “FREE” dental treatment and they continued to not show up.

I have to agree with the conclusions of this study.

If the patient or the parents of the child patient do not have any “skin” in the game, it doesn’t matter that much to them.

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Dentistry

Shopping for Dentistry on the Internet?

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View more videos at: http://nbcdfw.com.

Patients can use online resources to shop around for the best price for dental services, but dentists say people shouldn’t pick a provider solely based on price.

Watch the video above and be very cautious.

I prefer patients obtain recommendations from their friends and family members. Be especially weary of corporate dentistry offices that want you to take large lines of credit to pay for “comprehensive” treatment.

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