Pulse on Health by Jeff Hansel

Mayo Clinic: Don't switch HIV drugs that don't work...

Mayo Clinic researchers have announced an ironic finding in the search to find weapons against HIV/AIDS.

If no other treatments are available, it might be better to keep taking a drug that's not working than to stop taking the drug.

They also suggest a "novel protein" called "Casp8p41" might be a better measure of the illness than virus load.

"HIV causes disease by progressively killing CD4 T cells, whose function is to orchestrate the immune system. Loss of these cells renders patients susceptible to unusual infections and cancers. Over time, HIV mutates and can become resistant to the drugs used for treatment. Mayo researchers have discovered that viruses with certain mutations that render a component of the drug cocktail used to treat HIV infection ineffective also have an impaired ability to kill CD4 T cells. Even though mutated viruses replicate as well as normal HIV, they fail to cause the infected cells to die. Not all mutant viruses share this effect; only selected mutations cause the impairment in cell killing, without effecting virus replication," says an announcement from Mayo.

Dr. Andrew Badley is quoted by Mayo as saying that "changing treatments might not be needed in order to help the immune system."

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel

Medical loss of productivity...

Many years ago, in another state, I worked in a restaurant where we served a busy breakfast crowd.

One of the workers, by the name of Andy, was a skilled breakfast cook. But he became sluggish and his productivity lagged. He remained professional, but the meals he prepared began to seem to take forever to arrive, finally, in the warming window.

At times when other cooks might finish clearing the cooks' wheel of tickets, then run back to help the dish person get caught up or take the dirty dishes back for the bus person or offer to help the servers, Andy seemed to barely be able to simply get the food made.

If he ran low on eggs and had to step back to the cooler to get more, he didn't step up his pace and fit the extra duty in without delaying food preparation time. Instead, every instance he was away from the cooks' line seemed to result in twice as much delay in food preparation time.

I became frustrated, even though I wasn't a server. I wondered why this otherwise nice person didn't seem to care how fast the food went out.

But I got a wake-up call.

I asked one of the other cooks about Andy after a particularly difficult shift. Not in an unkind way, but just wondering why he had lost his motivation.

It turned out Andy was experiencing end-stage renal disease. His kidneys were failing. He was hoping for a kidney transplant.

And, despite the exhaustion and other symptoms that went along with his failing health, Andy kept working as hard as he could, taking each task in the order it came.

I gained a whole new respect for him as a person because I knew right then and there that he was a far more determined person than I -- I'm not sure, if the same were to happen to me, if I could keep right on working.

Andy was severely ill, but continued as a productive member of society. I'm sure medical costs were part of the reason. But it was also clear that he simply wanted to do his job, to the best of his ability.

So I learned that people who seem unproductive sometimes actually are, emotionally anyway, working harder than the rest of us. They must keep moving, even though they feel like sleeping. They must keep working, even though they are in pain. They must keep being productive, even when they feel sick.

I am thankful for that lesson.

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel

Mayo Clinic and a girl's body image...

Mayo Clinic advises talking to your daughter about body image, teaming with your doctor, and focusing on a "healthy" body instead of "fat" or "thin."

My friend Linda, long ago, would stay outside in the sun, baking her skin hour after hour. She barely ate,trying to get even skinier (even though she was very tall). She had an unobtainable hope for a future body image.

I can think of her eating but a few times, always just tidbits. I guessed, and she confirmed, that she had anorexia, or a similar condition. Linda moved away, and we lost contact with her. I have always wondered if she is O.K.

MayoClinic.com offers advice for parents about how to talk with their daughters about healthy body image, including:

• Team up with your family doctor. Your family doctor can help your daughter set realistic goals for body mass index and weight based on her personal weight history and overall health. The doctor can also help identify early indicators of an eating disorder by asking questions about your daughter's eating habits and satisfaction with her appearance during routine medical appointments.
• Help establish healthy-eating habits. Offer healthy meals and snacks, but be careful to let your daughter make choices about the food she eats.
• Counter negative media messages. You may not be able to shield your daughter from media images that promote an idealized image of women's bodies. You can, however, show her books, articles and movies about women who are famous for their achievements — not their appearance. For example, consider giving your daughter a subscription to a news magazine instead of a fashion magazine.
• Encourage a positive school environment. Support school policies that aim to stop size and sexual discrimination, harassment, teasing and name-calling.
• Praise achievements. Help your daughter value what she does, rather than what she looks like. Look for opportunities to praise her efforts, skills and achievements.
• Encourage physical activity. Participating in sports and other physical activities can help promote good self-esteem and a positive body image. Consider encouraging activities that don't emphasize the importance of weight or value leanness.
• Set a good example. Explain to your daughter that you eat a healthy diet and exercise for your health — not just to look a certain way. Also, think about what you read and watch as well as the products you buy and the lessons your choices send.

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel

Goodhue County flu shot sites...

Goodhue County Public Health reminds you it's not too late to get vaccinated against flu this year "and this year everyone 6 months of age and older is recommended to get vaccinated."

Flu vaccination clinics in Goodhue County will be held:

• Thursday, December 2 from 2 to 5 p.m. in Red Wing at the First Lutheran Church, 615 W. 5th Street.

• Sunday, December 4 from 10 a.m. to 1 p.m. in Zumbrota at the Goodhue County Fairgrounds 4-H building.

"Flu shots or FluMist cost $25 for adults and $14 for children and uninsured adults, but no one will be turned away for inability to pay," says an announcement.

Another option is going to the Public Health building in Red Wing, 512 W. 6th Street every Tuesday from 2 to 4 p.m. (Public Health no longer bills Medicare.)

Questions? Call 651-385-6100.

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel

Minnesota roads getting safer...

The Emergency Nurses Association says a "new report shows Minnesota, Arkansas, Louisiana and Wisconsin (are) making (the) greatest gains in laws to promote roadway safety."

The association advocates on behalf of laws that regulate things like texting and cell phone use, seat belt use and teen driving.

The Association says Minnesota has the following things that its members like:
• An organized state trauma system.
• A primary seat belt law.
• Booster seat requirements.
• Youth passenger safety rules.
• Texting laws.

What's Minnesota missing? Apparently requirements for "interlock devices" that prevent intoxicated individuals from driving, as well as universal motorcycle helmet laws. 

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel

Pill decreases gay male HIV infection risk...

The New England Journal of Medicine has reported that a pill already used to fight HIV — along with comprehensive preventive services — decreases the risk of getting HIV in the first place.

Prevention services included things such as HIV testing, counseling about how to reduce risk, condoms and treatment for sexually transmitted infections.

The two-and-a-half-year global, placebo-controlled study of nearly 2,500 individuals included people at high risk of HIV infection.

Included were gay and bisexual men, and transgender women born male who have sex with men.

"In this multinational study, called the Preexposure Prophylaxis Initiative (iPrEx) trial, we aimed to evaluate the safety and efficacy of once-daily oral FTC–TDF as compared with placebo for the prevention of HIV acquisition among men and transgender women who have sex with men," the journal says.

A statistically significant difference in new infections occurred among study participants who took the drug.

"Once-daily oral FTC–TDF provided 44% additional protection from HIV among men or transgender women who have sex with men who also received a comprehensive package of prevention services," the researchers funded by the National Institutes of Health and the Bill and Melinda Gates Foundation write.

The results are promising, especially since the drug (widely reported as Travuda) is already on the market.

"Among the 100 subjects with emergent HIV infection, 36 occurred in the FTC–TDF group, and 64 occurred in the placebo group, representing a relative reduction of 44% in incidence in the modified intention-to-treat population (95% confidence interval [CI], 15 to 63; P=0.005)," the New England Journal of Medicine article says.

Some people responding to the news have suggested worry that, if the drug eventually gets prescribed as preventive, it might not have the intended effect because people who believe there's protection will often behave in more-risky ways than they would have otherwise.

Also, the drug might not be affordable for many individuals.

The trial does not tell us, either, whether the same benefit will hold true for heterosexual males and/or females.

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel

Mayo + Intel = smart football helmets....

Intel and Mayo Clinic are working together to develop "intelligent football helmets" and faster medical scans, says EE Times Asia (Electrical Engineering).

"Using supercomputers and workstations based on present and future Intel processor technology, researchers are simulating collisions to study the impact on the brain, and use that information to design new football helmets that reduce the risk of short- and long-term injuries," says a Market Watch article.

Concussions among athletes from peewee through professional have begun to get more attention in recent years as the concept of repetitive concussive injury gains more acceptance among football officials.

Concussions are also a problem in mens and womens hockey and soccer, and sometimes basketball, baseball and other sports.

"While no equipment can prevent 100 percent of injuries, Intel is also working with Mayo Clinic to accelerate the ability to process medical scans. In this application, cranial scans running on Intel(R) Many Integrated Core (MIC) architecture co-processors were accelerated by up to 18 times," Market Watch reports. "… Intel also discussed future technologies, based on its Intel(R) Atom(TM) processors, which could be embedded in helmets and wirelessly feed data into servers and cloud networks that measure injury risk and impact in real-time."

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel

Secondhand smoke killing 600,000 yearly...?

An article in the scientific journal "The Lancet" suggests secondhand smoke kills more than hal a million people around the world each year, many of them children, says a CNN blog post on "The Chart" by Dr. Sanjay Gupta.

"Based on 2004 data gathered from 192 countries, researchers estimate 'as many as 40 percent of children, 35 percent of women, and 33 percent of men are regularly exposed to secondhand smoke indoors,'" the post says.

According to Blue Cross and Blue Shield of Minnesota, "each year smoking is responsible for 5,135 deaths in Minnesota and $2.87 billion in excess health care costs - that's $554 for every man, woman and child in the state."

Readers of the Gupta post suspect foul play, one saying, "this is nothing but a campaign against people who smoke. Why don't these organsizations look at the real killer in the world. ALCOHOL"

Will the evidence become irrefutable, as it has with the knowledge that smoking causes cancer? Or, will we eventually learn that kids who sit in a car while Mom or Dad smokes don't get sick any faster than other kids?

"According to the World Health Organization:
Smokers are not only putting themselves at risk, but also 1.8 billion non-smokers. In 2004, 40% of children, 33% of male non-smokers and 35% of female non-smokers were exposed to SHS worldwide. This exposure led to:
379,000 deaths from ischaemic heart disease
165,000 deaths from lower respiratory infections
36,900 deaths from asthma
21,400 deaths from lung cancer"

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel

$6 million for Mayo Clinic's Native outreach....

The National Cancer Institute has awarded Mayo Clinic $6 million, over five years, for expanded health-disparities outreach to American Indian and Alaska Native patients.

"Specifically, this funding will enable clinical research studies to be conducted in Alaska and Wisconsin, as well as help formalize the Hampton Faculty Fellows Program to mentor the next generation of Native American cancer control researchers," says an announcement from Mayo.

Mayo's Native American Programs director Dr. Judith Kaur will lead the new Spirit of E.A.G.L.E.S. Community Network Program, which will focus on "comprehensive cancer control, including translational research, clinical trials and continued community-based participatory research."

I have followed Dr. Kaur's work to raise breast cancer awareness and meet the needs of Indian and Alaska Native populations for many years, even before coming to Rochester. Kaur is one of only two American Indian medical oncologists in the United States, according to Mayo.

So bolstering the Fellows Program will be especially welcomed by her, I am certain, as she has previously told me of her desire to encourage Indian youth to become interested in oncology.

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel

August opening for Elk Run...

The planned Elk Run biobusiness park in Pine Island is on schedule for opening the first building to its "major tenant" in August of 2011, the project manager says.

Geoff Griffin of G-Cubed Realty in Chatfield, Minnesota (contract manager for developer Tower Investments) said an extension on the building permit was approved by the city of Pine Island recently through December 31 of 2011.

That's an administrative action, which doesn't require city council approval. An extension was needed because builders wouldn't make a December 31, 2010 construction deadline.

The Minnesota Department of Transportation wrote to Pine Island and Tower, noting that state officials aren't worried about the building permit. Instead, the state is focused on job creation.

The initial "cooperative agreement" between Pine Island and MnDOT called for the city to, "at a minimum to construct, or cause to be constructed, one 40,000 sq. ft. building to be substantially completed by 12/31/2010 … substantial completion means receipt of a Certificate of Occupancy…."

MnDOT's Elk Run project manager, Terry Ward, wrote to Pine Island and Tower, saying, "this language was written to commence the Job Creation Goals on 12/31/10, or earlier if the first bioscience building was occupied sooner. There is no 'penalty' in the agreement for the City not having the first building occupied by 12/31/10 nor is the City of Pine Island in default of our signed agreement."

The first building planned is actually scheduled to be 50,400 square feet, rather than the 40,000 called for in the initial agreement. 

Ward was clear that the state expects job creation to remain the top priority.

"As per the Agreement … the Job Creation Goals will commence on 12/31/10 and Mn/DOT does not intend to modify that starting date of the job creation goals," Ward wrote.

Griffin, for his part, said in an interview, "we feel very confident that we're going to meet all the job goals."

Griffin has said the project is now moving on the tenants' timetable, rather than on Tower's. The "major tenant" wants the building ready for occupancy in August, and that's what will happen, Griffin said.

"Nothing has changed," he said. 

Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904 
Twitter Hansel's Pulse: @Jeff Hansel