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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
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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.
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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)
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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)
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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)
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Thursday, August 16, 2012

Sodas losing fizz in schools, but exclusive deals remain

New research from the Robert Wood Johnson Foundation shows more than half of middle and high schools have purged the pop since the 2006-2007 school year. That year, 53.6 percent of high schools and 27.4 percent of middle schools gave students access to soda. In the 2010-2011 those numbers dropped to 25.3 in high schools and 12.5 percent in middle schools, reports Sarah Kliff for The Washington Post.

"You have policymakers at the state level, and also more local, moving policies into this directions," said researcher Yvonne Terry-McElrath. "You have policymakers at the state level, and also more local, moving policies into this direction. I also think you're seeing movement from parents and individuals who are becoming more aware of what is and isn't healthy."

That is the case in Kentucky. Under a state law passed a few years ago, students can only buy school-day-approved beverages — 100 percent fruit juice, lowfat milk and any beverage that contains no more than 10 grams of sugar per serving — during the school day. It may benefit reporters to ask school administrators though if there are vending machines at school that sell soda after the school day is finished, however. 

Though schools are getting rid of soda in high numbers across the country, a lot of them still have relationships with Coke or Pepsi, something reporters can find out by simply asking administrators.

Photo by Paul Robert Lloyd, via Flickr
A 2005 survey found nearly half of elementary schools and about 80 percent of public high schools nationwide had pouring rights contracts with one or the other of the soda companies, which gives them exclusive rights to supply all the beverages in school snack bars, vending machines, school stores and at sports events.

The upside for the schools can include funding for field trips, gym uniforms, SMART boards and other perks, reports blogger Tom Philpott for Mother Jones. Philpott cites one study that shows students living in states with laws that limit junk food sales gained less weight — an average of about 2.25 pounds for a 5-foot child — than those that didn't. A study in California showed students consumed 158 less calories each day in schools where sodas were banned and new nutritional regulations were implemented in cafeterias.

But one study of 20,000 students found no correlation between obesity rates and access to soda at school. "The research is pretty mixed," Terry-McElrath said.
New research from the Robert Wood Johnson Foundation shows more than half of middle and high schools have purged the pop since the 2006-2007 school year. That year, 53.6 percent of high schools and 27.4 percent of middle schools gave students access to soda. In the 2010-2011 those numbers dropped to 25.3 in high schools and 12.5 percent in middle schools, reports Sarah Kliff for The Washington Post.

"You have policymakers at the state level, and also more local, moving policies into this directions," said researcher Yvonne Terry-McElrath. "You have policymakers at the state level, and also more local, moving policies into this direction. I also think you're seeing movement from parents and individuals who are becoming more aware of what is and isn't healthy."

That is the case in Kentucky. Under a state law passed a few years ago, students can only buy school-day-approved beverages — 100 percent fruit juice, lowfat milk and any beverage that contains no more than 10 grams of sugar per serving — during the school day. It may benefit reporters to ask school administrators though if there are vending machines at school that sell soda after the school day is finished, however. 

Though schools are getting rid of soda in high numbers across the country, a lot of them still have relationships with Coke or Pepsi, something reporters can find out by simply asking administrators.

Photo by Paul Robert Lloyd, via Flickr
A 2005 survey found nearly half of elementary schools and about 80 percent of public high schools nationwide had pouring rights contracts with one or the other of the soda companies, which gives them exclusive rights to supply all the beverages in school snack bars, vending machines, school stores and at sports events.

The upside for the schools can include funding for field trips, gym uniforms, SMART boards and other perks, reports blogger Tom Philpott for Mother Jones. Philpott cites one study that shows students living in states with laws that limit junk food sales gained less weight — an average of about 2.25 pounds for a 5-foot child — than those that didn't. A study in California showed students consumed 158 less calories each day in schools where sodas were banned and new nutritional regulations were implemented in cafeterias.

But one study of 20,000 students found no correlation between obesity rates and access to soda at school. "The research is pretty mixed," Terry-McElrath said.
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Anesthesia safety for cats with heart disease

Final report, Winn/Miller Trust grant MT10-001
Does treatment of anesthetic-induced hypotension with dopamine or phenylephrine cause myocardial damage in cats with hypertrophic cardiomyopathy?
Investigators: Bruno Pypendop, Ashley Wiese, Linda Barter, Jan Ilkiw
University of California, Davis

Hypertrophic cardiomyopathy (HCM) is the most common heart disease of cats. The development and complications of hypotension (low blood pressure) in anesthetized cats is a concern for both healthy cats and cats with HCM. Persistent hypotension in healthy anesthetized cats is treated with the administration of drugs such as dopamine. Blood pressure can also be increased by administration of another type of drug, phenylephrine. The effects of these drugs on cardiac output (CO) and blood pressure have not been investigated in anesthetized cats with HCM. 

The investigators studied the cardiopulmonary effects of dopamine and phenylephrine during isoflurane-induced hypotension in 6 cats with severe naturally occurring HCM. The results indicated that both dopamine and phenylephrine induced dose-dependent increases in systemic and pulmonary blood pressure, yet only dopamine resulted in increased cardiac output. Anesthesia-induced hypotension and the infusions of dopamine and phenylephrine caused a significant increase in cardiac troponin I, a sensitive and specific biochemical marker for myocardial damage. The authors suggest that based on the study results, dopamine is superior to phenylephrine if the goal of treatment of inhalation anesthetic-induced hypotension in cats with non-obstructive HCM is to restore blood pressure through an increase in cardiac output. [VT]

Wiese AJ, Barter LS, Ilkiw JE, Kittleson MD and Pypendop BH. Cardiovascular and respiratory effects of incremental doses of dopamine and phenylephrine in the management of isoflurane-induced hypotension in cats with hypertrophic cardiomyopathy. Am J Vet Res. 2012; 73: 908-16.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
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Read the Cat Health News Weekly
Join us on Google+
Final report, Winn/Miller Trust grant MT10-001
Does treatment of anesthetic-induced hypotension with dopamine or phenylephrine cause myocardial damage in cats with hypertrophic cardiomyopathy?
Investigators: Bruno Pypendop, Ashley Wiese, Linda Barter, Jan Ilkiw
University of California, Davis

Hypertrophic cardiomyopathy (HCM) is the most common heart disease of cats. The development and complications of hypotension (low blood pressure) in anesthetized cats is a concern for both healthy cats and cats with HCM. Persistent hypotension in healthy anesthetized cats is treated with the administration of drugs such as dopamine. Blood pressure can also be increased by administration of another type of drug, phenylephrine. The effects of these drugs on cardiac output (CO) and blood pressure have not been investigated in anesthetized cats with HCM. 

The investigators studied the cardiopulmonary effects of dopamine and phenylephrine during isoflurane-induced hypotension in 6 cats with severe naturally occurring HCM. The results indicated that both dopamine and phenylephrine induced dose-dependent increases in systemic and pulmonary blood pressure, yet only dopamine resulted in increased cardiac output. Anesthesia-induced hypotension and the infusions of dopamine and phenylephrine caused a significant increase in cardiac troponin I, a sensitive and specific biochemical marker for myocardial damage. The authors suggest that based on the study results, dopamine is superior to phenylephrine if the goal of treatment of inhalation anesthetic-induced hypotension in cats with non-obstructive HCM is to restore blood pressure through an increase in cardiac output. [VT]

Wiese AJ, Barter LS, Ilkiw JE, Kittleson MD and Pypendop BH. Cardiovascular and respiratory effects of incremental doses of dopamine and phenylephrine in the management of isoflurane-induced hypotension in cats with hypertrophic cardiomyopathy. Am J Vet Res. 2012; 73: 908-16.

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