Pages

Monday, August 20, 2012

Blood glucose monitoring in cats

Hoenig M, Pach N, Thomaseth K, DeVries F and Ferguson DC. Evaluation of long-term glucose homeostasis in lean and obese cats by use of continuous glucose monitoring. Am J Vet Res. 2012; 73: 1100-6.
Diabetes mellitus is of increasing concern in both humans and cats. Obese cats are found to be at higher risk of developing diabetes mellitus. Information has not been available on whether glucose concentrations in obese cats differ from those in lean cats throughout the course the course of a day during their regular activities, including consuming food. 

This study evaluated intra-day and inter-day variations in glucose concentrations in lean and long-term (>5 years) obese cats during a 156-hour period and tested the utility of a continuous glucose monitoring system (CGMS). A CGMS is used frequently in humans with diabetes. The investigators did not detect differences in glucose concentrations between lean and obese cats during the study periods. They also did not detect differences in daily variations in glucose concentrations between lean and obese cats. The results indicate that the CGMS can be useful in evaluating the long term effects of drugs or diet on glucose homeostasis in cats. [VT]

See also: Dietiker-Moretti S, Müller C, Sieber-Ruckstuhl N, et al. Comparison of a continuous glucose monitoring system with a portable blood glucose meter to determine insulin dose in cats with diabetes mellitus. J Vet Intern Med. 2011; 25: 1084-8.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

Hoenig M, Pach N, Thomaseth K, DeVries F and Ferguson DC. Evaluation of long-term glucose homeostasis in lean and obese cats by use of continuous glucose monitoring. Am J Vet Res. 2012; 73: 1100-6.
Diabetes mellitus is of increasing concern in both humans and cats. Obese cats are found to be at higher risk of developing diabetes mellitus. Information has not been available on whether glucose concentrations in obese cats differ from those in lean cats throughout the course the course of a day during their regular activities, including consuming food. 

This study evaluated intra-day and inter-day variations in glucose concentrations in lean and long-term (>5 years) obese cats during a 156-hour period and tested the utility of a continuous glucose monitoring system (CGMS). A CGMS is used frequently in humans with diabetes. The investigators did not detect differences in glucose concentrations between lean and obese cats during the study periods. They also did not detect differences in daily variations in glucose concentrations between lean and obese cats. The results indicate that the CGMS can be useful in evaluating the long term effects of drugs or diet on glucose homeostasis in cats. [VT]

See also: Dietiker-Moretti S, Müller C, Sieber-Ruckstuhl N, et al. Comparison of a continuous glucose monitoring system with a portable blood glucose meter to determine insulin dose in cats with diabetes mellitus. J Vet Intern Med. 2011; 25: 1084-8.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

Read More


Sunday, August 19, 2012

New tool allows analysis of nursing-home deficiencies across the country; Kentucky seems to rank high in serious problems

Reporters now have a tool at their fingertips that will allow them to find nursing home problems in facilities across Kentucky, which appears to ranks high in serious problems.(iStock photo)

The tool was launched this week by ProPublica, a nonprofit, investigative news group, and allows "anyone to easily search and analyze the details of recent nursing home inspections, most completed since January 2011," report Charles Ornstein and Lena Groeger.

The tool has features that the federal government's Nursing Home Compare doesn't have, including the ability to search using any keyword. Results can also be sorted according to the severity of the violation and by state.

About 1.5 million people still live in nursing homes nationwide, though more seniors are living at home or in assisted-living facilities. The reports show there were almost 118,000 deficiencies cited against 14,565 homes. According to the Centers for Medicare and Medicaid Services, the average number of deficiencies for a nursing home inspected in the U.S. is eight and the average in Kentucky is seven.

ProPublica's analysis shows Kentucky ranked fourth nationwide for the most "K" and "L" deficiencies, considered the most serious kind. The state had 45 in the analysis, as did South Carolina. Texas had the most in the country by far, however, with 183. 

While ProPublica does rank the states, nursing home industry officials say "inspectors in different regions of the country have different thresholds for issuing a citation, and that could unfairly make one state's homes appear worse than another's," Ornstein and Groeger report. (Read more)
Reporters now have a tool at their fingertips that will allow them to find nursing home problems in facilities across Kentucky, which appears to ranks high in serious problems.(iStock photo)

The tool was launched this week by ProPublica, a nonprofit, investigative news group, and allows "anyone to easily search and analyze the details of recent nursing home inspections, most completed since January 2011," report Charles Ornstein and Lena Groeger.

The tool has features that the federal government's Nursing Home Compare doesn't have, including the ability to search using any keyword. Results can also be sorted according to the severity of the violation and by state.

About 1.5 million people still live in nursing homes nationwide, though more seniors are living at home or in assisted-living facilities. The reports show there were almost 118,000 deficiencies cited against 14,565 homes. According to the Centers for Medicare and Medicaid Services, the average number of deficiencies for a nursing home inspected in the U.S. is eight and the average in Kentucky is seven.

ProPublica's analysis shows Kentucky ranked fourth nationwide for the most "K" and "L" deficiencies, considered the most serious kind. The state had 45 in the analysis, as did South Carolina. Texas had the most in the country by far, however, with 183. 

While ProPublica does rank the states, nursing home industry officials say "inspectors in different regions of the country have different thresholds for issuing a citation, and that could unfairly make one state's homes appear worse than another's," Ornstein and Groeger report. (Read more)
Read More


Friday, August 17, 2012

One of every 100 U.S. whites has celiac disease


One of every 100 U.S. whites has celiac disease


Tuesday, August 14, 2012
Related MedlinePlus Pages
By Kerry Grens
NEW YORK (Reuters Health) - One percent of non-Hispanic whites in the U.S. - close to two million Americans - have celiac disease, but most are not aware they suffer the gluten-intolerance problem, according to a new study.
The results back up earlier estimates of how common celiac disease is in the U.S. and Europe, the researchers say. They also support evidence that the condition is far more rare among Hispanics and blacks.
"This one...is pretty much in line with what was shown before," said Dr. Alessio Fasano, director of the Center for Celiac Research at the University of Maryland, who was not involved in the study.
Fasano said that despite how common the condition is in the U.S, he's not surprised that few people have been diagnosed with it.
"The symptoms are so vague and non-specific that it's very difficult to point to celiac disease when you have (for instance) chronic fatigue or anemia or joint pain," Fasano said.
Celiac disease is mainly a gastrointestinal disorder, and when people who have it eat gluten, they experience an immune reaction that damages the intestinal lining.
Most studies to determine how widespread the condition is have been done in Europe, so the researchers sought to get a sharper estimate of celiac disease in the U.S.
Dr. James Everhart, at the National Institute of Diabetes and Digestive and Kidney Diseases, along with colleagues at the Mayo Clinic and in Sweden, used data from a large, ongoing national study of health and nutrition.
About 7,800 people participated in the celiac survey, and gave a blood sample that was tested for signs of the immune response to gluten that characterizes celiac disease.
The researchers, who published their study in the American Journal of Gastroenterology, found evidence of celiac disease in 35 people, 29 of whom were not aware of their sensitivity to gluten.
Six of the 35 people with celiac disease were not white.
Everhart says that based on the number of non-whites in the study - 4,368 - having just six test positive illustrates that celiac disease is pretty rare among non-whites.
"I think we confirmed the clinical suspicion that this is largely a condition found among non-Hispanic whites in this country," he told Reuters Health.
Celiac disease is managed by following a gluten-free diet, which involves avoiding foods such as wheat, rye and barley.
In the study, 55 people reported that they followed a gluten-free diet, although only six of them tested positive for celiac disease.
Based on his clinical experience, Fasano said there are a number of people who choose to abstain from gluten not for medical reasons, but for other perceived health benefits.
"They believe, right or wrong, that gluten is not good for them," he said.
Although awareness of celiac disease has increased in the U.S., the study shows that few people are aware that they may have it themselves.
"This is a big issue," said Everhart, and the study does not lay out a clear path for trying to identify more people suffering with the disease.
"Screening everybody is not the way to go," said Fasano.
Celiac disease can develop at any age, making it difficult to know when to test people who don't have symptoms.
"If you don't have symptoms, it's hard to say categorically that identifying you as having this condition is going to do a lot of good at this point. That's for (other) studies to determine," said Everhart.
Everhart and his colleagues are continuing the survey to gather more numbers showing which groups of people appear to be most at risk of celiac disease, and whether the health of people with celiac disease is different from those without it.
SOURCE: bit.ly/OYbmxr American Journal of Gastroenterology, online July 31, 2012.
Reuters Health

One of every 100 U.S. whites has celiac disease


Tuesday, August 14, 2012
Related MedlinePlus Pages
By Kerry Grens
NEW YORK (Reuters Health) - One percent of non-Hispanic whites in the U.S. - close to two million Americans - have celiac disease, but most are not aware they suffer the gluten-intolerance problem, according to a new study.
The results back up earlier estimates of how common celiac disease is in the U.S. and Europe, the researchers say. They also support evidence that the condition is far more rare among Hispanics and blacks.
"This one...is pretty much in line with what was shown before," said Dr. Alessio Fasano, director of the Center for Celiac Research at the University of Maryland, who was not involved in the study.
Fasano said that despite how common the condition is in the U.S, he's not surprised that few people have been diagnosed with it.
"The symptoms are so vague and non-specific that it's very difficult to point to celiac disease when you have (for instance) chronic fatigue or anemia or joint pain," Fasano said.
Celiac disease is mainly a gastrointestinal disorder, and when people who have it eat gluten, they experience an immune reaction that damages the intestinal lining.
Most studies to determine how widespread the condition is have been done in Europe, so the researchers sought to get a sharper estimate of celiac disease in the U.S.
Dr. James Everhart, at the National Institute of Diabetes and Digestive and Kidney Diseases, along with colleagues at the Mayo Clinic and in Sweden, used data from a large, ongoing national study of health and nutrition.
About 7,800 people participated in the celiac survey, and gave a blood sample that was tested for signs of the immune response to gluten that characterizes celiac disease.
The researchers, who published their study in the American Journal of Gastroenterology, found evidence of celiac disease in 35 people, 29 of whom were not aware of their sensitivity to gluten.
Six of the 35 people with celiac disease were not white.
Everhart says that based on the number of non-whites in the study - 4,368 - having just six test positive illustrates that celiac disease is pretty rare among non-whites.
"I think we confirmed the clinical suspicion that this is largely a condition found among non-Hispanic whites in this country," he told Reuters Health.
Celiac disease is managed by following a gluten-free diet, which involves avoiding foods such as wheat, rye and barley.
In the study, 55 people reported that they followed a gluten-free diet, although only six of them tested positive for celiac disease.
Based on his clinical experience, Fasano said there are a number of people who choose to abstain from gluten not for medical reasons, but for other perceived health benefits.
"They believe, right or wrong, that gluten is not good for them," he said.
Although awareness of celiac disease has increased in the U.S., the study shows that few people are aware that they may have it themselves.
"This is a big issue," said Everhart, and the study does not lay out a clear path for trying to identify more people suffering with the disease.
"Screening everybody is not the way to go," said Fasano.
Celiac disease can develop at any age, making it difficult to know when to test people who don't have symptoms.
"If you don't have symptoms, it's hard to say categorically that identifying you as having this condition is going to do a lot of good at this point. That's for (other) studies to determine," said Everhart.
Everhart and his colleagues are continuing the survey to gather more numbers showing which groups of people appear to be most at risk of celiac disease, and whether the health of people with celiac disease is different from those without it.
SOURCE: bit.ly/OYbmxr American Journal of Gastroenterology, online July 31, 2012.
Reuters Health
Read More


First cases of flu reported in Kentucky; not swine-related

By Tara Kaprowy
Kentucky Health News

Kentucky has its first confirmed cases of flu for the year, and officials are urging residents to get their vaccinations. (WYMT-TV photo)

The Department for Public Health reports six confirmed cases in Boyd County of the H3N2 strain, which is included in this year's flu vaccine. No cases of flu that contain genetic material from swine flu have been reported in Kentucky this year.

Kristy Bolen, senior epidemiologist at the Ashland-Boyd County Health Department, said both children and adults have been affected. "We do know that when kids go back to school, we tend to see more influenza," she said.

The reports of swine flu in Ohio and Indiana have prompted physicians to test for flu more than they normally would this time of year, Bolen told Kentucky Health News. "Being right on the border with Ohio, our local providers and local community members are more aware," she said. "It doesn't necessarily mean it will be a bad flu season."

The best way to protect against getting the flu is to get a vaccine, which should be done annually. The vaccine is recommended for anyone over 6 months of of age and is especially recommended for:
• Children age 6 months to 19 years
• Pregnant women
• People 50 years old or older
• People with any chronic health problems
• People who live in nursing homes or other long-term care facilities
• Health care workers
• Caregivers of people who have high risk for complications from the flu
• Out-of-home caregivers of people who live with children less than 6 months old.

"Getting the flu can be debilitating and sometimes life-threatening, so it's extremely important to take simple preventive steps to avoid i," said Dr. Steve Davis, acting commissioner for the DPH. "You should also follow the advice your mother gave you to prevent flu and other illnesses that tend to circulate at this time of year — wash your hands frequently, cover your mouth when you cough or sneeze, and stay home when you're sick." (Read more)

For more information about the flu, click here.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the University of Kentucky School of Journalism and Telecommunications, with support from the Foundation for a Healthy Kentucky.
By Tara Kaprowy
Kentucky Health News

Kentucky has its first confirmed cases of flu for the year, and officials are urging residents to get their vaccinations. (WYMT-TV photo)

The Department for Public Health reports six confirmed cases in Boyd County of the H3N2 strain, which is included in this year's flu vaccine. No cases of flu that contain genetic material from swine flu have been reported in Kentucky this year.

Kristy Bolen, senior epidemiologist at the Ashland-Boyd County Health Department, said both children and adults have been affected. "We do know that when kids go back to school, we tend to see more influenza," she said.

The reports of swine flu in Ohio and Indiana have prompted physicians to test for flu more than they normally would this time of year, Bolen told Kentucky Health News. "Being right on the border with Ohio, our local providers and local community members are more aware," she said. "It doesn't necessarily mean it will be a bad flu season."

The best way to protect against getting the flu is to get a vaccine, which should be done annually. The vaccine is recommended for anyone over 6 months of of age and is especially recommended for:
• Children age 6 months to 19 years
• Pregnant women
• People 50 years old or older
• People with any chronic health problems
• People who live in nursing homes or other long-term care facilities
• Health care workers
• Caregivers of people who have high risk for complications from the flu
• Out-of-home caregivers of people who live with children less than 6 months old.

"Getting the flu can be debilitating and sometimes life-threatening, so it's extremely important to take simple preventive steps to avoid i," said Dr. Steve Davis, acting commissioner for the DPH. "You should also follow the advice your mother gave you to prevent flu and other illnesses that tend to circulate at this time of year — wash your hands frequently, cover your mouth when you cough or sneeze, and stay home when you're sick." (Read more)

For more information about the flu, click here.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the University of Kentucky School of Journalism and Telecommunications, with support from the Foundation for a Healthy Kentucky.
Read More


Students with tooth problems don't do as well in school



More evidence shows students who have dental problems struggle more in school. A new study of almost 1,500 disadvantaged students in Los Angeles public schools found those who had had recent tooth pain were four times more likely to have a low grade-point average (below 2.8) than those who didn't have problems.

Another recent survey found that one in nine American children ages 9 to 11 have untreated tooth decay in their permanent, adult teeth. A 2011 study in North Carolina concluded students with poor oral health were three times more likely to miss school because of dental pain.

Parents and policy makers should be concerned with the findings, says Matt Jacob for the Pew Center on the States. In California, about 504,000 children missed at least one school day in 2007 because of a toothache or another oral health-related problem. (Read more)


More evidence shows students who have dental problems struggle more in school. A new study of almost 1,500 disadvantaged students in Los Angeles public schools found those who had had recent tooth pain were four times more likely to have a low grade-point average (below 2.8) than those who didn't have problems.

Another recent survey found that one in nine American children ages 9 to 11 have untreated tooth decay in their permanent, adult teeth. A 2011 study in North Carolina concluded students with poor oral health were three times more likely to miss school because of dental pain.

Parents and policy makers should be concerned with the findings, says Matt Jacob for the Pew Center on the States. In California, about 504,000 children missed at least one school day in 2007 because of a toothache or another oral health-related problem. (Read more)
Read More


State's largest health care system says it will end contract with Coventry Cares

KentuckyOne Health, the state's largest health-care system with almost 200 hospitals, physician groups, primary care centers and other agencies, is canceling its contracts with Coventry Cares, one of the state's four Medicaid managed-care organizations. Terminations will be effective Nov. 1 for Jewish Hospital & St. Mary's HealthCare and Saint Joseph Health System.

The decision came after Coventry sent a letter announcing it would terminate its contract July 18 with Our Lady of Peace hospital in Louisville. Coventry also terminated its contract with Taylor Regional Hospital in Campbellsville, another KentuckyOne facility, reports Valarie Honeycutt Spears for the Lexington Herald-Leader. She notes that Our Lady of Peace serves high-risk patients with intellectual disabilities. It is one of the largest private, non-profit psychiatric hospitals in the country.

"We feel Coventry Care's actions will ultimately hinder and prevent the care our communities need and deserve," said Barbara Mackovic, a KentuckyOne spokeswoman. "That is especially true when a plan would put our most vulnerable patient populations at Our Lady of Peace at risk."

Issues with Coventry Cares have been mounting ever since it started administering Medicaid Nov. 1. The company, the state and Appalachian Regional Healthcare fought in court after Coventry threatened to terminate its contract. TCoventry temporarily extended its contract, but in in May the firm announced it would also end contracts with Baptist Healthcare System.

Managed care has saved the state money but has caused major headaches, including delayed provider payments and overly-burdensome preauthorizations. Coventry alleges "that it has too many high-risk patients and that the state needs to adjust the risk model so Coventry can receive more money for sicker patients," Spears reported in May. (Read more)
KentuckyOne Health, the state's largest health-care system with almost 200 hospitals, physician groups, primary care centers and other agencies, is canceling its contracts with Coventry Cares, one of the state's four Medicaid managed-care organizations. Terminations will be effective Nov. 1 for Jewish Hospital & St. Mary's HealthCare and Saint Joseph Health System.

The decision came after Coventry sent a letter announcing it would terminate its contract July 18 with Our Lady of Peace hospital in Louisville. Coventry also terminated its contract with Taylor Regional Hospital in Campbellsville, another KentuckyOne facility, reports Valarie Honeycutt Spears for the Lexington Herald-Leader. She notes that Our Lady of Peace serves high-risk patients with intellectual disabilities. It is one of the largest private, non-profit psychiatric hospitals in the country.

"We feel Coventry Care's actions will ultimately hinder and prevent the care our communities need and deserve," said Barbara Mackovic, a KentuckyOne spokeswoman. "That is especially true when a plan would put our most vulnerable patient populations at Our Lady of Peace at risk."

Issues with Coventry Cares have been mounting ever since it started administering Medicaid Nov. 1. The company, the state and Appalachian Regional Healthcare fought in court after Coventry threatened to terminate its contract. TCoventry temporarily extended its contract, but in in May the firm announced it would also end contracts with Baptist Healthcare System.

Managed care has saved the state money but has caused major headaches, including delayed provider payments and overly-burdensome preauthorizations. Coventry alleges "that it has too many high-risk patients and that the state needs to adjust the risk model so Coventry can receive more money for sicker patients," Spears reported in May. (Read more)
Read More


Legislative committee delays vote on state insurance exchange, though the move is only symbolic

Kentucky legislators have made another symbolic move against creating a health insurance exchange, with the Interim Joint Committee on Health and Welfare delaying a vote on its creation until next month's meeting. The exchange is one of the cornerstones of the Patient Protection and Affordable Care Act and would allow individuals earning up to to 133 percent of the federal poverty level to buy health insurance through a state-run marketplace.

Rep. Addia Wuchner, R-Florence, made the motion to table the vote on the order Wednesday, saying she does not have enough information about the cost of the exchange and how it will operate. "All we have is the executive order" from Gov. Steve Beshear creating the exchange, Wuchner said. The exchange must be in operation by Jan. 1, 2014. The first year, it will be paid for by the federal government. The second year, it will cost $67 million, but the state will use grant money to pay that sum, reports Beth Musgrave for the Lexington Herald-Leader. In the long term, fees from insurance companies are supposed to pay the costs.

If the committee opts to reject the order, Beshear can override it, Musgrave reports. It's the second time the legislative has acted against the creation of an exchange. Earlier this summer the Capital Projects and Bond Oversight Committee voted along party lines against a lease that would have housed employees of the exchange. Finance Secretary Lori Flanery has the power to overturn the vote and rent the space. (Read more)
Kentucky legislators have made another symbolic move against creating a health insurance exchange, with the Interim Joint Committee on Health and Welfare delaying a vote on its creation until next month's meeting. The exchange is one of the cornerstones of the Patient Protection and Affordable Care Act and would allow individuals earning up to to 133 percent of the federal poverty level to buy health insurance through a state-run marketplace.

Rep. Addia Wuchner, R-Florence, made the motion to table the vote on the order Wednesday, saying she does not have enough information about the cost of the exchange and how it will operate. "All we have is the executive order" from Gov. Steve Beshear creating the exchange, Wuchner said. The exchange must be in operation by Jan. 1, 2014. The first year, it will be paid for by the federal government. The second year, it will cost $67 million, but the state will use grant money to pay that sum, reports Beth Musgrave for the Lexington Herald-Leader. In the long term, fees from insurance companies are supposed to pay the costs.

If the committee opts to reject the order, Beshear can override it, Musgrave reports. It's the second time the legislative has acted against the creation of an exchange. Earlier this summer the Capital Projects and Bond Oversight Committee voted along party lines against a lease that would have housed employees of the exchange. Finance Secretary Lori Flanery has the power to overturn the vote and rent the space. (Read more)
Read More