Monthly Archives: May 2016

Bacteria Also Spreads Outside Hospitals

The dangerous bacteria Clostridium difficile spreads not only in hospitals but also in other health-care settings, causing infections and death rates to hit “historic highs,” U.S. health officials reported Tuesday.

C. difficile is a deadly diarrheal infection that poses a significant threat to U.S. health care patients,” Ileana Arias, principal deputy director at the U.S. Centers for Disease Control and Prevention, said during a morning news conference. “C. difficile is causing many Americans to suffer and die.”

The germ is linked to about 14,000 deaths in the United States every year. People most at risk from C. difficile are those who take antibiotics and also receive care in any medical facility.

“This failure is more difficult to accept because these are treatable, often preventable deaths,” Arias said. “We know what can be done to do a better job of protecting our patients.”

Much of the growth of this bacterial epidemic has been due to the overuse of antibiotics, the CDC noted in its March 6 report. Unlike healthy people, people in poor health are at high risk for C. difficile infection.

Almost 50 percent of infections are among people under 65, but more than 90 percent of deaths are among those aged 65 and older, according to the report.

Previous estimates found that about 337,000 people are hospitalized each year because of C. difficile infections. Those are historically high levels and add at least $1 billion in extra costs to the health care system, the CDC said.

However, these estimates might not completely reflect C. difficile’s overall impact.

According to the new report, 94 percent of C. difficile infections are related to medical care, with 25 percent among hospital patients and 75 percent among nursing home patients or people recently seen in doctors’ offices and clinics.

Although the proportion of infection is lowest in hospitals, they are at the core of prevention because many infected patients are transferred to hospitals for care, raising the risk of spreading the infection there, the CDC said.

Half of those with C. difficile infections were already infected when they were admitted to the hospital, often after getting care at another facility, the agency noted.

The other 50 percent of infections were related to care at the hospital where the infection was diagnosed.

The CDC said that these infections could be reduced if health care workers follow simple infection control precautions, such as prescribing fewer antibiotics, washing their hands more often and isolating infected patients.

These and other measures have reduced C. difficile infections by 20 percent in hospitals in Illinois, Massachusetts and New York, the CDC said.

In England, infections have been cut 50 percent in three years, the agency said.

Patients get C. difficile infections mostly after taking antibiotics, which can diminish the body’s “good” bacteria for several months.

That’s when patients can get sick from C. difficile, which can be picked up from contaminated surfaces or spread by health care providers.

The predominant sign of C. difficile infection is diarrhea, which can cause dehydration. If serious, the infection can become deadly. Other symptoms include fever, nausea and loss of appetite.

The CDC advises that if diarrhea occurs after a patient starts antibiotics, C. difficile should be suspected and treatment continued with another antibiotic.

Commenting on the report, infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University, said, “All these recommendations are fine; the problem is they are not going to work, you can’t stop these practices. This bug exists in a climate of overuse of antibiotics.”

Food Swaps to Lower Cholesterol

  • Making an effort to lower your cholesterol numbers can require some serious life changes, most drastically when it comes to your diet. For many people, the “bad for you” list looks a lot like a list of favorite foods — and that’s the biggest challenge.

    But smart food choices are essential for lowering cholesterol and lowering your risk of heart attack. Watching your diet can reduce your cholesterol levels without medication, or enhance the effects of the cholesterol-lowering drug you take. “Your genetics play a big role in your cholesterol level, but so do other factors — including diet — and the foods you eat can help to lower it,” says Harvey Kramer, MD, a cardiologist at Danbury Hospital in Danbury, Connecticut.

    If your new diet rules seem daunting, here are some simple food swaps for an easier transition.

    Scallops Instead of Red Meat

    Swapping out red meat for fish — especially fattier varieties, like salmon — may contribute to lower cholesterol numbers overall, says Sue Gebo, RD, MPH, a nutrition expert and assistant professor of family medicine at the University of Connecticut Medical School in Hartford.

    Scallops are a particularly healthy substitute because they’re among the lowest in fat of all fish choices, so you’ll save on calories, too. Plus, Gebo adds, “they have a rich texture and a very satisfying flavor, especially when they’re grilled.”

    Crushed Walnuts Instead of Croutons on Salad

    High-fiber vegetables are great for lowering cholesterol, so salads are a go — that is, until you top them off with high-carb croutons, which may also be high in unhealthy fats. Enter heart-healthy nuts; walnuts in particular are a great healthy food swap for garnishing a salad. A study published in March 2014 in the journal Metabolism showed that when people added 43 grams (g) of walnuts (about 6 tablespoons) to their diet every day for two months, their bad cholesterol levels went down significantly — by about 7 milligrams per deciliter (mg/dL) more than a control diet. And when it comes to nuts, walnuts are a particularly heart-healthy food for low cholesterol because they’re rich in polyunsaturated fatty acids, a healthier type of fat.

    Canadian Bacon Instead of Regular Bacon

    Bacon lovers, rejoice! While 1 ounce (about 3 slices) of regular bacon contain a whopping 12 g of fat, 3 ounces of Canadian bacon have less than half of that amount — 5 g of fat. “I don’t know why they call it bacon, because Canadian bacon is really just round slices of really lean ham,” says Gebo. No matter what you call it, it’s by far a better, healthier option.

    An English Muffin Instead of a Croissant

    Those flaky, perfectly shaped croissants look delicate and delicious at the bakery, but the layers of flour and butter equal a big mistake if you’re watching your cholesterol. Butter is high in cholesterol-raising saturated fat, while a whole grain English muffin not only has less saturated fat, but also adds around 4 g of heart-healthy fiber. Making this swap will put you well on your way to the American Heart Association’s recommended 25 g of fiber a day to help lower your cholesterol.

    Dark Chocolate Instead of Milk Chocolate

    If you’re a chocoholic trying to stick to a heart-healthy diet, opt for the dark stuff. While milk chocolate contains saturated fat that can raise your LDL (“bad”) cholesterol, you can choose dark chocolate and skip most of the fat. Studies have shown that dark chocolate may actually boost your HDL (“good”) cholesterol, too. Cocoa butter contains oleic acid, a healthier monounsaturated fat like that in olive oil. Additionally, cocoa may lower LDL cholesterol in people at risk for heart disease. Just make sure the dark chocolate you choose has 70 to 80 percent cacao, suggests Chauncey Crandall, MD, cardiologist at the Palm Beach Gardens Medical Center and the Good Samaritan Medical Center in West Palm Beach, Florida.

     

    Hummus Instead of French Onion Dip

    You probably already know to skip potato chips in favor of vegetables such as celery and carrot sticks, but what’s the best choice for dipping? Hint: It’s not the favorite high-calorie French onion dip. Hummus, made from mashed chickpeas and heart-healthy olive oil, is just as tasty and has both fiber and protein, unlike saturated fat-rich cream-based dips. You can also pair it with whole grain pita chips, which aren’t fried like potato chips.

     

    Ground Turkey Chili Instead of Beef Chili

    If you’re a purist, you may not favor ground turkey itself; even in burgers, it can taste like, well, turkey. But lean ground turkey, which usually contains 7 percent fat compared with the 20 percent fat content of that “80 percent lean” ground beef at the market, is a cinch to disguise. The lower the saturated fat, the less detrimental it is to your cholesterol level. Even better, “no one can tell the difference,” says Gebo, who uses ground turkey all the time to make chili. One more diet tip for lower cholesterol: Ground turkey makes a great substitute for ground beef in dishes like meatballs or meatloaf.

     

    Roasted Potatoes Instead of French Fries

    French fries are, well, fried and usually doused in fat, so they’re a good food to skip when you’re watching your cholesterol levels. Avoid ordering fries at restaurants whenever possible. Instead, make them at home, where you can control the preparation (it’s easy to roast them rather than fry them). Gebo’s recipe: Cut a potato into sections, brush with olive oil, and bake in the oven — 20 minutes at 450 degrees should be enough to render them nice and crispy. Sprinkle them with pepper for more flavor.

    Swapping out red meat for fish — especially fattier varieties, like salmon — may contribute to lower cholesterol numbers overall, says Sue Gebo, RD, MPH, a nutrition expert and assistant professor of family medicine at the University of Connecticut Medical School in Hartford.

    Scallops are a particularly healthy substitute because they’re among the lowest in fat of all fish choices, so you’ll save on calories, too. Plus, Gebo adds, “they have a rich texture and a very satisfying flavor, especially when they’re grilled.”

Why Checkups Are Vital

When you were little, your parents probably made sure you had an annual checkup with your doctor. But as you’ve grown older, you may have gotten out of this habit.

Health professionals stress that these regular exams are important to help identify risk factors and problems before they become serious. If diseases are caught early, treatments are usually much more effective. Ultimately, having a regular doctor’s visit will help you live a long and healthy life.

Doctor’s Visit: The Prevention Checkup

Depending on your age, sex, and family medical history, a checkup with your doctor may include:

  • Blood, urine, vision, and hearing tests to evaluate your overall health
  • Assessments of your blood pressure, cholesterol level, and weight
  • A discussion about your diet and exercise habits and any tobacco, drug, and alcohol use
  • Immunizations and booster shots
  • Screenings to assess your risk of developing certain diseases, including diabetes (if you already have high blood pressure or high cholesterol) and cancer
  • Depending on your age and sexual lifestyle, testing for STDs and possibly HIV
  • Starting at age 50, or younger if you have a family history, a screening test for colorectal cancer
  • A discussion about depression and stress to evaluate your mental health

Doctor’s Visit: Concerns for Men

For men, in addition to checking weight, high blood pressure, and other basics, your doctor’s visit may specifically include:

  • Starting at age 50, or younger if you have a family history, a rectal exam to check for abnormal bumps in the prostate and a prostate specific antigen (PSA) blood test to screen for prostate cancer
  • Between the ages of 65 and 75 if you have ever smoked cigarettes, an abdominal exam to check for an enlargement in your aorta; an abdominal aortic aneurysm, a weakness in the lining of the aorta (a large blood vessel in your chest and abdomen), can develop with age and become a life-threatening problem.

Doctor’s Visit: Concerns for Women

For women, in addition to checking weight, high blood pressure, and other basics, your doctor’s visit may specifically include:

  • A test for cervical cancer, called a Pap smear, every one to three years
  • A clinical breast exam to check for any unusual lumps or bumps in your breasts
  • Starting at age 40 (or younger if you have a strong family history for breast cancer), a breast cancer screening with a mammogram every one to two years
  • Starting at age 65, a referral for a bone density test to screen for osteoporosis, the disease that causes brittle, fragile bones and typically affects older women; women with more than one risk factor for osteoporosis may start earlier

Doctor’s Visit: Preparation

It’s important for you to play an active role to get the most out of your doctor’s visit. Before your exam, review and update your family health history, be prepared to ask if you’re due for any general screenings or vaccinations, and come up with a list of questions if you have particular health concerns.