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Tanning Salons Under the Spotlight

This morning a state House Committee will consider whether or not Pennsylvania should ban teens from tanning salons.

The proposal keeps anyone under 18 from using an indoor tanning bed. Sponsor RoseMarie Swanger, a Lebanon County Republican, is convinced the beds cause melanoma, which her younger sister is currently battling. “One of my colleagues did ask me – he said, ‘don’t people have the right to make stupid decisions?’ And my response to him was, yes, if you’re an adult,” she explained. “But if you’re a child, I think we owe children our protection from anything we could control that would prevent them from having to go through this later in life.”

The American Academy of Pediatrics recently called for a national ban on teens using tanning beds, warning, "The intensity of ultraviolet-A radiation produced by large, powerful tanning units may be 10 to 15 times higher than that of the midday sun."

A national trade group, the Indoor Tanning Association, insists the concern is unfounded, and the legislation is a government overreach. “I can just assure you that there’s absolutely no proof that using a tanning bed causes melanoma,” said its executive director, John Overstreet. He argued the beds’ ultraviolet lights aren’t any more dangerous than the sun. “Ultraviolet light is ultraviolet light, whether it comes from the sun or whether it comes from an indoor tanning bed,” he said. “And moderation is the key. And just like outdoor sunlight, you have risks and you have benefits. And you have to avoid overexposure. You definitely have to avoid…getting a sunburn.”

The bill would charge salons with a criminal offense, if they let teens in to tan. Swanger called the penalty an oversight, and promised to amend the legislation in committee. “I don’t agree with sending anyone to jail for violating this law,” she said. “But I would certainly advocate for a civil penalty of a substantial fine for a first offense. And then any other offense after that, just a loss of license.”

Emergency Physicians Want Protection from Liability

Emergency Medicine physicians are gathered in Washington this week calling on their representatives in Congress to approve medical liability reform.
53% of emergency room doctors who were surveyed said the main reason they conduct the number of test they do is fear of being sued. The survey by the American College of Emergency Physicians (ACEP) was released in time for the Washington meetings. ACEP President Sandra Schneider said medical liability reform is essential to meaningful health car reform and without the reform, health care costs will continue to rise. The organization estimates the cost of "defensive medicine" range from $60 billion to $151 billion per year.
Dr. Daniel Wehner, chair of Emergency Medicine for the Connemaugh Health System, says legislation in the House includes protection from liability for emergency physicians like public health providers have. Wehner says emergency doctors are required by federal law and emergency care is considered high risk for malpractice suits because patients are more seriously ill or injured and physicians often don't have access to their medical histories.
Wehner says it would also be more reasonable to hear malpractice suits in special panel courts..."instead of a jury of 12 lay people deciding upon whether medicine was practiced appropriately, to have some scientists aboard on that panel, physicians or other people with some experience in dealing with scientific logical reasoning to decide whether or not there was liability on the part of the physician."

Last week the Administrative Office of Pennsylvania Courts released data that shows in 2010 the number of medical malpractice lawsuits filed in the state dropped for a sixth straight year...down 45.4% since the base years of 2000-02. Those base years were just prior to 2 major rule changes made by the Pennsylvania Supreme Court: attorneys have to obtain from a medical professional a certificate that established the medical procedures in a case fell outside acceptable standards; and, medical lawsuits can only be brought in the county where the alleged malpractice occurred.

State Supreme Court Chief Justice Ronald Castille says progress has been made..."One of our fundamental priorities is to assure the Commonwealth's citizens that the legal process will not be abused in malpractice cases. We're very encouraged by these statistics. The crisis is over."

Race for the Cure

The 19th Susan G. Komen Race for the Cure will be held this Sunday, Mother's Day in Schenely Park in Oakland.

The race starts around 8am. Over 30,000 people participate and over two million dollars were raised last year.

"Seventy five 75 percent of that money stays in the Pitstburgh region to fund breast health and breast cancer awareness programs such as the Mammogram voucher program that helps women who are uninsured or underisnured to get a mammogram and then 25 percent of the money raised goes to the national organization to fund breast cancer research,' said Kathy Purcell, Executive Director of the Pittsburgh Chapter of the Susan G. Komen for the Cure Executive Director.

Those interested in donating but don't want to run or walk can do "Sleep in for the Cure" where they donate money but can stay in bed while the race occurs.

Allegheny: 42nd Healthiest County in PA

What's billed as the most comprehensive report of its kind ranks the overall health of nearly every county in all 50 states. The second annual "County Health Rankings" report from the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation is intended to give communities a roadmap to improve health.
The report looks at health outcomes: the rate of people dying before age 75; the percent of people who report being in fair or poor health; the number of days people report being in poor physical or mental health; and, the rate of low-birthweight babies.
The rankings also look at 4 categories of factors that impact health: health behavior (including smoking, drinking, teen birth rates), clinical care (including uninsured adults, primary care providers and diabetic screening) , social and economic factors (including unemployment, children in poverty, crime rate) and physical environment (air pollution and access to recreational facilities).

In Pennsylvania, Union County has the healthiest residents and Philadelphia is the least healthy county in the state. Allegheny County is 42nd among the 67 counties, an improvement from the 2010 report when it ranked 48th.
Bridget Booske is a senior scientist with the institute and deputy director of the County Health Rankings project...."When I look at Allegheny County, there's a high percentage of low-birthweight babies (8.6% compared to the national benchmark of 6%) than elsewhere. Other factors, like smoking and obesity, Allegheny is pretty much running about average, but average in Pennsylvania doesn't necessarily mean there's not a whole lot of improvement that can take place there."

Booske says that set a national benchmark of a 90th percentile where only 10% of the counties had healthier numbers in those categories because they believe improvement to reach that top 10% "is attainable."

Allegheny County exceeds the national benchmark in the category of health coverage with 11% of uninsured adults compared to the national figure of 13%.
Booske says it's not unusual to have neighboring counties with wide-ranging rankings. While Allegheny County is number 42, Fayette is 63rd, Greene-65th and Cambria is 64th; while Butler is number 11, Indiana is 17 and Westmoreland is 20th...
"Where we live, learn, work and play does really matter across the state."

Booske adds that improvements can be made through policy, through community programs and in individual homes..."Health is everyone's business. There is something we each can do. It's good for all of us to live in healthier economies. It's good for the economy to be healthy."

Determine Your Risk of Having Diabetes

As part of American Diabetes Association Alert Day, Allegheny County’s health department urges residents to take the Diabetes Risk Test on Tuesday, March 22.

According to Lorraine Starsky, a public health nurse with the Allegheny County Health Department, the risk test is a fairly simple questionnaire. She said in addition to identifying your age and ethnicity, the survey asks questions about “your weight, family history, [or] if you’re a female if you had a baby that weighed more than nine pounds at birth.”

According to the Center for Disease Control the number of people diagnosed with diabetes yearly continues to escalate. The center estimates 26 million people to be afflicted by diabetes, and a disturbing 27 percent don’t know they have it, contributing to the disease’s moniker “America’s Silent Killer.”

“The symptoms can be so easily overlooked and so we’re asking people look at your risk factors and if you see that you have two or more, if you’re scoring high on this test, then it’s important, it’s a wakeup call,” Starsky says.

Even more important, recently, is the increase of obesity leading to Type II diabetes in youth. Type II diabetes formerly affected mostly adults over the age of 45 but youth have continued to be diagnosed at younger ages.

Starsky says that untreated and unrecognized diabetes can be very detrimental to a person’s health.

“It’s doing a lot of damage to major body systems. It’s affecting your eyes, it’s affecting your kidneys, it’s affecting your cardiovascular system, your heart, and so a lot of times this damage goes on silently,” Starsky says.

To access the risk test, you can call 1-800-342-2383 to request a copy of the questionnaire or you can fill out the survey online.

Changes to PA Drug Abuse Programs

A new cabinet-level state department opens its doors July 1. A law passed last year separates the Pennsylvania Bureau of Drug and Alcohol Programs from the Health Department, creating a new entity.
Republican Representative Gene DiGirolamo of Bucks County authored the 2010 law. He says the new department will make substance abuse programs more accessible.

"I believe it's also a question about efficiency - government efficiency, fiscal efficiency. I think it's a big question of public safety. I think it's going to go a long way towards reducing crime in this state. "

DiGirolamo says the new agency won't cost extra tax dollars.

"It's about saving money, it's about public safety. But I think it's about saving lives. And it happens every day in every one of our communities across this great state."

The department's initial staff will only have around ten positions. This will be the first new state department formed since 1995.

Study: Radiation Works After Breast Cancer Surgery

Radiation and tamoxifen treatments reduce the risk of cancer recurrence in women who’ve had non-invasive breast lumps removed, according to a new study from Allegheny General Hospital.

Not only do radiation and tamoxifen reduce cancer recurrence, but the study also notes women who’ve had these treatments have a lower death rate than those who opt out – even when the cancer does come back.

Principal investigator Dr. Thomas Julian says adding radiation therapy following lumpectomy surgery reduced cancer recurrence in his study group by about 53%. He says most women with breast cancer could have the therapy, but many don’t take it due to bias against it in patients and physicians.

Julian says adding tamoxifen treatment to the patients’ therapy reduced cancer recurrence by an additional 32%; however, that treatment only works in 80- 85% of patients, depending on the type of cancer they have.

Julian says while many oncologists believe radiation therapy is overly diagnosed, the 15-year study shows a clear benefit to women who’ve had the treatment.

Valentine's Day Becomes National Organ Donor Day

The Center for Organ Recovery and Education (CORE) hopes that this Valentine’s Day, people considering becoming an organ donor and giving a true gift of affection.

Misty Enos, Associate Director of Community Outreach for CORE says that the number of organ donations needed remains high, but the list of providers is still very low.

“Last year we transplanted a little bit over 27,000 organs but over 110,000 people are waiting,” Enos says. “So the demand is very high, the need is very high, but the list of people who are actually registered as donors or who say yes is actually pretty low.”

Enos encourages those considering becoming an organ donor to do the research and educate themselves about the reality of donation. She asks the people on the fence to imagine if the person in need of a donation was a close relative and what you would want others to do.

“For me I look at my son, my husband, my mother, my brothers and sisters, and I think to myself if there was ever a time where their lives depended on a lifesaving organ transplant, what decision would I want my family to make?” Enos says.

Only 44 percent of people choose to be organ donors in the state of Pennsylvania and Enos says that anyone interested in becoming an organ donor should visit www.donatelife-pa.org and register using the PA State Donor Registry run through the DMV. Another method would be including your decision to be an organ donor in a living will.

Study Addresses Damaged Arteries

Researchers from the University of Pittsburgh have figured out how to grow arteries with highest level of elastin protein found in natural arteries, the most reported in vessels grown outside the body. The study was published in the Proceedings of the National Academy of Sciences, a weekly journal.

This could overcome a major barrier to creating living tissue replacements for damaged arteries.

The researchers used smooth muscle cells from adult baboons to make the elastin. The elastin allows the cells to expand and retract in response to blood flow. They cultured the baboon cells in a nutrient-rich solution to bear arteries with approximately 20 percent as much elastin as an inborn artery.

Elastin, unlike collagen, which is tougher and gives vessels their shape, has been dfficult to reproduce.

It took them three weeks to have functional arteries. They seeded muscle cells from baboons into degradable rubber tubes. Then they pumped the tubes into degradable rubber tubes chambered like honey combs. Those were then transferred to a bioreacter that pumped the nutrient solution through, mimicking the human circulatory system. This resembles how it would be used in a patient.

Lead researcher Yadong Wang said although this process took three years, they still are in the early phases. They will then test it out on animals and humans.

Water Quality Drops

The quality of the drinking water in the Pittsburgh area has dropped.

The good news is that while there are rising levels of contaminants, the water is drinkable. The bad news – officials aren’t exactly sure what is causing the increase in trihalomethanes or THM’s over the past couple months.

In high quantities and over long periods of time, THM’s can cause damage to the liver, kidney and central nervous system.

The Pittsburgh Water and Sewer Authority sampled The Allegheny River for bromides, which when combined with chlorine become a contaminant. Levels were unusually high.
Bromide is a naturally occurring substance in the soil. But it can come from other sources as well, says Ronald Schwartz of the Pennsylvania Department of Environmental Protection.

"There’s also industrial sources like coal fired power plants for example, we also find it in our mine drainage discharges, we also find it in the oil and gas wastewater, there’s a number of sources of bromide and we’re sort of finding where the higher sources may be in the region," he said.

The Allegheny County Health Department says the levels of THM’s don’t exceed health standards.

Nearly 1 in 8 Births in PA Is Premature

The percentage of premature births in Pennsylvania is declining but not enough to prevent the state from earning a "D" on the third annual report card from the March of Dimes. This latest report card studied births from 2008. In Pennsylvania, 11.6% of the births in 2008 occurred before 37 weeks gestation. That compares to 11.8% in 2007. Still, Dolores Smith, State Director of Program Services for the March of Dimes, says that in Pennsylvania more than 17,000 babies are born too soon each year before their lungs, brains and other organs are fully developed.

Pennsylvania's rate of women of childbearing age who smoke did fall to 23.4%. Smith says a leading cause of preterm birth is smoking while pregnant.

“If women smoke during their pregnancy they tend to have lower birth-weight babies even if their babies are full term. But there also is a risk of preterm birth related to maternal smoking while pregnant.”

Smith says preterm births bring serious health risks to the baby and can be prevented by being healthy and planning pregnancies while maintaining a relationship with one’s OB/GYN.

According to Smith, there are many problems that arise out of preterm births.

“Some have really very serious long-term issues, cerebral palsy, blindness, vision and hearing loss, difficulties in swallowing or breathing. There are some very serious complications simply because a baby is born too small and too soon.”

Smith also says that different health factors in different races can also affect pregnancy, and African-American women should be aware they face a higher possibility of having a child preterm.

“We look at all the disparities in health outcomes, you know heart health, diabetes, hypertension related to being African-American particularly. We also see that some of those same factors can negatively impact birth outcomes.”

The March of Dimes Report Card gave the nation a grade of "D" because the rate of premature births is still far from the Healthy People 2010 goal of 7.6%.

November is American Diabetes Month

Diabetes is an epidemic in the U.S., it's also on the rise around the world. That's according to Linda Siminerio, Director of the University of Pittsburgh Diabetes Institute.

Siminerio says that's especially true for certain at-risk groups, including overweight and obese people; those who aren't physically active; certain ethnic groups; and women who had diabetes during pregnancy, or who had a baby more than nine pounds.

Siminerio says while Type 1 diabetes is often unavoidable, Type 2 diabetes can be caused by an unhealthy lifestyle. She says that means a lack of physical activity and a poor diet.

Siminerio says diabetes is also occurring at younger ages. The Diabetes Institute Director says this is because children in the past were not exposed to as many unhealthy foods and activities. Siminerio says the rise of television, computers, and unhealthy food options in the past century has introduced a sedentary lifestyle that human genes weren't ready to adapt to.

Siminerio says parents can help their children and themselves avoid Type 2 diabetes by raising their children to live a healthy lifestyle. She says if these qualities are passed down through generations, rates of Type 2 diabetes should fall.

Pitt: Aspirin Can Kill Precancerous Colon Cells

Researchers at the University of Pittsburgh have discovered how drugs like aspirin and pain-killers can reduce the risk of colon cancer.

Lead researcher Lin Zhang says doctors have known for a while that non-steroidal anti-inflammatory drugs, or NSAIDs, can help in preventing tumors of the colon. But Zhang says until now, scientists didn’t know how they did it.

“Some of these anti-inflammatory drugs prevent colon cancer by killing so-called stem cells that accumulate genetic changes that predispose one to cancer,” says Zhang. “So, [this is a] major finding.”

Zhang says this information will be especially useful to people with a hereditary genetic defect called FAP. The defect causes patients to develop cysts on their colons, which can easily become cancerous.

While NSAIDs can reduce one’s risk of colon cancer by as much as 80%, they are not risk-free. Zhang says they’re also known for risks involving the heart. Zhang also notes at this point, NSAIDs can be used for prevention of cancer, but not treatment of tumors.

Marijuana Discussed

A panel debated the pros and cons of marijuana legalization in Pittsburgh on Friday. The debate, entitled Medical and Recreational Marijuana: Scientific, Legal and Societal Considerations featured several local panelists with opposing views.

The panel was held after California voters Tuesday rejected a proposal to legalize marijuana for recreational use and there is a bill in the Pennsylvania legislature to legalize marijuana for medical purposes. Among the speakers was Lisa Freeland, a federal public defender for the Western District of Pennsylvania. She said the money spent on law enforcement and incarceration for non-violent drug offenders would be better spent on education and drug treatment.

"One of the things we know particularly with non-violent drug offenders is that the majority of offenders that are incarcerated today suffer from drug addiction. So, putting some money into treatment and alternatives to incarceration would not only shift the focus of our policy but also yield substantial savings I believe."

Another speaker Frederick Thieman, former US Attorney for the Western District of Pennsylvania is opposed to the legalization of marijuana. He said there is not enough research done on marijuana to consider legalizing the drug.

"The subject has not been researched well enough and breaking the status quo so to say of non-legality right now is a dangerous step in terms of the overall costs to society unless the topic is researched to a much greater degree."

SIDS Education Bill Passes House and Senate

A bill that requires hospitals and nurse midwives to educate new parents on SIDS (Sudden Infant Death Syndrome) has been approved by the Pennsylvania House and Senate. The bill, which is expected to be signed by Governor Ed Rendell this week, will force hospitals not currently providing new parents with SIDS education to do so.

Introduced by State Representative Lawrence Curry (D)- Montgomery/Philadelphia the bill only needs to be signed by the Governor before taking effect.

Nilima Karamchandani, Chief of the Division of Neonatalogy at West Penn Hospital, says that most hospitals already offer SIDS education but without a law there is no way of making sure that every hospital does..... "I think the nurses are being educated and the hospital personnel are already aware, they just need it formalized so it is done consistently." She also said that education varies from hospital to hospital and more requirements on what parents are told could save more lives.

Karamchandani says that some of the most frequent mistakes by parents that may contribute to SIDS death are laying infants on their stomachs, letting them sleep in a crib with a thick comforter or stuffed animals, and parents sleeping in the same bed with the child. She also said that parents can sleep in the same room as infants but not in the same bed. According to the Department of Public Health, in 2008, 85 infants in Pennsylvania died of SIDS or accidental suffocation compared to 93 in 2007. 51% of those deaths deemed "sleep related" involved the infant sleeping with others.

Symposium on Aging

A symposium exploring social justice and health care options for the elderly is being held in Pittsburgh.

Aging issues in this country aren’t new- but as the baby boomer generation gets older they are taking on a new urgency.

There are health care issues. There is policy that must be tailored for this growing population. And there is the question of housing. People want to live in communities - not institutionalized nursing homes.

A symposium addressing those issues is being held this week at Duquesne University.
Eileen Sullivan-Marx, a Dean at The University of Pennsylvania’s School of Nursing was among the speakers. She spoke about community based long-term care facilities.

"Pennsylvania has grown the best range of community based long term care facilities. They are called living independently for elders program and Pennsylvania has more of these programs than any other state in the country and they are very effective. It’s like turning a nursing home inside out. So we’re providing all of the services that would be available in a nursing home but providing them in their homes and in their communities," she said.

Pennsylvania has the second largest elderly population in the country –and that population is only expected to grow.

Bacteria Alters Genetic Make-up in Real Time

Researchers at Allegheny General Hospital have made a key discovery in the evolutionary nature of bacteria in chronic infectious disease. Dr. Garth Ehrlich, scientific director of the Center for Genomic Sciences at AGH, says the research team found that a group of highly-related bacterial strains change genetically so fast that it is likely nearly impossible for the host's immune system to effective track and eradicate the infection.
Dr. Ehrlich says the team documented the first evidence that bacteria alter their genetic makeup in real-time to circumvent the immune system...
"Much like we see with other successful pathogens, such as viruses and certain parasitic organisms, which are designed to mutate and confuse the immune system, bacteria--which cause the vast majority of chronic infectious disease in the United States--appear to be using a similar tactic. And they are doing so through a dynamic, real-time process of altering their genetic code that until now has not been understood and which is counter to conventional wisdom about the typical pace of species evolution."
Bacterial infections have traditionally been studied under the assumption that a single genetic organism is at the heart of any single case of infection. But this new research shows that many chronic infections are the result of multiple strains or species of bacteria.
"It is essentially a genomic chess match where bacteria through horizontal gene transfer are always staying one step ahead."
Ehrlich says once they verify the gene transfer is common in chronic bacterial infections, he hopes it will lead to promising directions in treatment.

Searching for A Cure

As the population ages and is increasingly at risk for developing Alzheimer’s Disease, researchers continue searching for a cause and a cure.

Curcumin, commonly known as the spice Turmeric has been shown to have beneficial effects in patients with Alzheimer’s disease. The catch? A person would have to consume pounds and pounds of it a day or take 400 tablets of a supplement daily.
But with the help of a new foundation’s money researchers at The University of Pittsburgh and Harvard University are working together to create new drugs that will slow or cure the disease. And their focus is on the spice.

"Ninety nine point nine nine nine percent gets broken down – its thrown out by the body. So what they’re trying to do is find that 000.1 percent of curcumin that would get to the brain from pounds gets to the brain from taking one little pill. So that’s the whole idea here to make a curcumin derivative that’s stabile in the body but still does the same thing that curcumin does," said Bill Klunk, a professor of psychiatry and neurology at the University of Pittsburgh and Co-Director of the Alzheimer Disease Research Center.

This week they received $400,000 from The Cure Alzheimer’s Fund, a local foundation.
Alzheimer’s Disease is an irreversible, progressive brain disorder that destroys memory and thinking skills. Five million Americans have it. By 2050, 16 million Americans are expected to have the disease.

Study Reveals Increased Use of Antibiotics by Seniors

A University of Pittsburgh study of spending on antibiotics under Medicare Part D shows an increase in antibiotics use by seniors with pneumonia, which is an improvement, but also an increase in broad-spectrum antibiotics, which could mean an overuse of inappropriate drugs.
The study’s lead author, Yuting Zhang, of the Graduate School of Public Health says there’s been a major improvement for those with pneumonia who did not have drug coverage before the implementation of Medicare Part D. “It’s important that they use antibiotics to control their condition.”
However, she says there is also a misuse of prescription antibiotics, and this could lead to excessive government spending and overdose.
Zhang says there are a few things that can be done to prevent the misuse of these antibiotics without changing Medicare Part D. “There could be different education programs or reimbursement policy changes.” For example, she says policymakers could consider using a different pricing strategy that may involve charging higher for certain drugs that may not be appropriate for certain patients.
The assistant professor of health economics says they maintain one goal: to find another type of reimbursement policy program to reduce the inappropriate use of antibiotics… “Which always has been a very important thing and we have made a lot of progress and probably still have some room to improve on that.”