Archive for August, 2009

DOCTOR IS IN: Electronic Medical Records bring slow but substantial change

BY MARK WULKAN, M.D.

Surgical Director, Pediatric Intensive Care Unit and Director, Minimally Invasive Surgery Center, and Medical Director of Informatics, Children’s Healthcare of Atlanta; and Associate Professor of Surgery and Associate Professor of Pediatrics, Emory University School of Medicine

The electronic medical record (EMR) is slowly transforming the way doctors, nurses, and other health care providers deliver patient care. Patients financial records have been electronic for decades; however, clinical data (the information entered by doctors, nurses, and other health care professionals) has been lagging. Processes for capturing lab and radiology results, history and physical details, operative reports, discharge summaries and other critical data have been very basic; paper charts remain the primary means of documentation and communication among the health care team.

Today, some hospitals are creating comprehensive EMRs for their patients that include the …

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THINNER YOU: Snacking Healthy

BY LIZ NOELCKE of SPARKPEOPLE

While some dieters happily accept when someone suggests a snack, others feel pangs of guilt when a nibble is merely suggested. However, there is nothing inherently wrong with a bite between meals. In fact, snacking might be the missing ingredient that will help you reach your weight loss goals.

But how can this make sense, since snacking theoretically adds calories?

Snacking doesn’t serve to replace a meal. In fact, you should spread meals and snacks out by an hour or two, and snacks should total a couple hundred calories or less.

Munching between meals can actually reduce your overall caloric intake by curbing overeating at your next meal By controlling later binging, snacking can help you stay on track. You can actually use this to your advantage. If you know you are going out to a big dinner with friends later, for example, make sure you have a healthy snack before you head out so you’re less likely to order (and finish) a large entree.

How You …

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AGING & CARING: Ways to help ensure a ‘good death’

BY BARBARA KATE REPA OF CARING.COM

Poets, professors, priests, and plain folks all opine about what makes a “good death.” In truth, deaths are nearly as unique as the lives that came before them — shaped by the attitudes, physical conditions, medical treatments, and mix of people involved.

Still, many have pointed to a few common factors that can help a death seem good — and even inspiring — as opposed to frightening, sad, or tortuous. By most standards, a good death is one in which a person dies on his own terms, relatively free from pain, in a supported and dignified setting. Other things to consider:

Having affairs in order

Not everyone has the luxury of planning for death. But those who take the time and make the effort to think about their deaths during life and plan for some of the details of their final care and comfort are more apt to retain some control and say-so in their final months and days of life.

Legal specifics of such planning can include taking steps to get …

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HEALTHY EATING: Staying slim requires vigilance

BY CAROLYN O’NEIL

Losing weight is one thing. Keeping it off is another issue. Too many dieters end up back where they started: regaining the weight they worked so hard to shed.

So what are the savvy secrets for staying slim? Turns out it has more to do with what’s on your mind before you think about what’s on your plate.

Dr. John Foreyt, professor of psychiatry and director of the Behavioral Medicine Research Center at Baylor College of Medicine in Houston said, “The keys to long-term weight control are problem-solving on a daily basis, predicting challenges and then planning for them. People may say they want a detailed prescribed meal plan, but what they need is nutrition know-how and the problem-solving skills to use any day of their lives.”

He concludes that it’s the power of mind that keeps the trim people trim — and, boy, do they work at it.
“They are eternally vigilant with daily or weekly weighing, they monitor calorie intake and they’re highly …

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ASK DR. H: Guidelines changed for antibiotic usage

Q: For years, I’ve been getting a prescription of amoxicillin to take before seeing the dentist because of a history of a leaky mitral valve. However, my new doctor recently refused to give me a prescription, saying that it’s no longer necessary. I am concerned about the safety of this and am writing you for advice. Is he right? — S.K., Altamonte Springs, Fla.

A: Although it might make you uneasy to skip the antibiotic you’ve taken in the past to prevent an infection of your leaky heart valve, the latest guidelines from the American Heart Association and the American Dental Association support your new doctor.

The guidelines are based upon the lack of evidence that taking antibiotics before dental procedures for most heart valve conditions reduces the risk of developing infective endocarditis. Such heart conditions include mitral valve prolapse with orwithout heart murmur, rheumatic heart disease, calcified aortic valve stenosis, congenital heart conditions such as …

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PEOPLE’S PHARMACY: How should sunscreen, insect repellent be applied?

Q: I have to use insect repellent every time I go outside. When I also need sunscreen, which goes on first?

A: This straightforward question has no simple answer. The Centers for Disease Control and Prevention recommend that “Sunscreens should be applied to the skin before insect repellents.”

In the next sentence, however, the CDC advises travelers not to use combination products containing both repellents and sunscreens. It points out that “DEET-containing insect repellents may decrease the effectiveness of sunscreens and sunscreens may increase absorption of DEET through the skin.”

We also discovered research demonstrating that DEET and the sunscreen ingredient oxybenzone (benzophenone-3) mutually increased skin absorption (Toxicology and Applied Pharmacology, Sept. 1, 2007). Since oxybenzone has estrogenic activity, increased absorption is not desirable. If you use a sunscreen that relies on zinc oxide or titanium dioxide, this should not be a concern.

For more …

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DOCTOR IS IN: The Stress Sandwich

BY CHARLES RAISON, MD

Assistant professor of psychiatry, clinical director of the Mind-Body Program, and director of the Behavioral Immunology Program in the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine.

Stress is everywhere today, both in our private and public lives, but also relentlessly in print, with discussion after discussion regarding what it is and what can be done to ease it. At the risk of adding to the din let me touch upon one aspect of stress here that has implications for ways we can reduce its bad effects in our lives.

Think of stress like a sandwich. There’s a piece of bread on the top, a piece of bread on the bottom and usually something tastier in the middle (except for a poor college student friend of mine who put two pieces of white bread together and called it a wish sandwich!). Think of bad stress as the bread on the top and bottom and let’s call the good stuff in the middle something like …

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THINNER YOU: Alcohol and weight loss

BY LIZ NOELCKE of SPARKPEOPLE

Alcohol and weight loss are enemies, but an occasional drink can have a place in a healthy lifestyle. In fact, many experts note the health benefits of consuming a single drink per day, including a reduced risk for high blood pressure. If, however, you are exceeding one drink daily, you might be sabotaging your weight loss plans.

Alcohol is metabolized differently than other foods and beverages. Under normal conditions, your body gets its energy from the calories in carbohydrates, fats and proteins that need to be slowly digested in the stomach—but not when alcohol is present. When alcohol is consumed, it gets special privileges and needs no digestion. The alcohol molecules diffuse through the stomach wall as soon as they arrive and can reach the brain and liver in minutes. This reaction is slightly slowed when there is also food in your system, but as soon as the mixed contents enter the small intestine, the alcohol grabs first place and …

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AGING & CARING: 5 legal documents you need for your parents

BY SUSAN KOSTAL OF CARING.COM

These documents will ensure that you can assist your parents in a medical or financial emergency and, at their deaths, ease the distribution of their estate:

A medical directive

Also known as a living will or advance health care directive, this document sets out what kind of care your parents want to receive if and when they become ill or incapacitated.

A durable power of attorney for healthcare and HIPAA release

A durable power of attorney for healthcare allows you to make healthcare decisions for your parents. A HIPAA release gives you access to your parents’ health records and physicians.

A durable power of attorney for finances

A durable power of attorney for finances allows you to manage your parents’ financial affairs, pay bills, sell property, and so on.

A revocable living trust

It allows your parents to retain control over their estate while making transfers of assets to beneficiaries. Your parents designate what property (home, …

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HEALTHY EATING: Study finds kids are trying to eat well

BY CAROLYN O’NEIL

How about some good news about kids and what they’re eating?

Turns out all that encouragement to “eat your vegetables” might be sinking in because a new survey found that children are making more of an effort to do just that when dining out.

The Kids and Moms Consumer Trend Report conducted by Technomic asked 1,200 kids ages 6 to 12 about their dining habits.

Results might surprise parents who assume their kids will say no to substituting fruit for fries. About 80 percent of the children surveyed said they have tried to eat more fruit in the past six months, and 77 percent said they tried to eat more vegetables. One-third said they consider health information when dining out. Salads are leading the pack in popularity on kids menus, and older children are skipping the chicken fingers and pizza and opting for healthier items from the adult side of the menu.

Once upon a time it was a special occasion to eat out with your parents, but now it’s part of …

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